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1/12(金)

◆今日の気持ち
(外科 4ヶ月目)
・大失敗。DMを勉強しなおさねば…。数字、忘れてた、忘れてた…。忘れたことは忘れたと自覚できさえすれば調べられるのだが、そこを自覚するのは難しい。きっと今後もそんなミスはする。頻度を減らすために、まず、自分を自分で締めるべきタイミングを掴みなおさないと。
・失敗。指導医が仕事くれる隙を見せてくれたのに、手を出し損ねる。余裕、持たないと。自信がないのは、乗り越えないと。
・GF。無駄が多く、時間かかりすぎ。ねじれが強い。近づきすぎやすい。全体像を意識し続けろ。困ったときに最初から仕切りなおす癖は、患者を余計に苦しめる。口への差し込み方が、だめだから右に行く。重力を意識すべし。流れを身につけろ。イメトレ、イメトレ、イメトレ。せっかく今日は人数少なかったのに、上級医のたくさんの時間をもらってしまった。
・体が動き始め、耐久力も出てきた気がする。慣れもあるが、やっぱり、数ヶ月鬱に入っていたようだ。しかし、外科ももうすぐ終ってしまう…。効率が落ちていたうちに過ぎてしまった数ヶ月は仕方がない。後をきっちり、身につけていかねば。
・悔しさに向けて行動する活力が、重要なポイント。そこなくなっていたら休むべし。
・鬱に繋がるダメージには、カルチャーショックがもっとも大きいものなのかもしれない。
・鑑別疾患、検査前確率意識しないで並べ立てるのは好きでないけれど、見落としなくす能力を身につけるためには重要な過程。その上で、あえて検査をしない理由を論じれるようにならないと。
・基本的に、何事にも時間かけすぎ。並列で仕事できない。経験不足。

●目指す医師像
総合内科医 治療前から治療後まで、とらえきりたい

●今日の新患・診断
・風邪症候群? …かと思ったら髄膜炎。疑いはしたけれどそうだとは…。髄膜刺激症状のない髄膜炎をルンバールに踏み切れるようにならないと!
・高齢者の呼吸不全、脱水。原因は? 発熱はなかったが…
・腹痛、理由がわからなかった…

●今日の病院滞在時間
当直〜20時半

●今日行ったこと・見たこと・知ったこと
・GF
・A/C Ca OPE

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