First Time as a General Medicine Attending

 Yesterday I worked my first ever shift as a medicine attending. My hospital was looking for extra weekend help, so I volunteered to cover one of the gen med teams on Sunday. It was really a lot of fun.

When I was an intern I occassionaly had to cover the whole list (up to 12 patients) solo with an attending on the weekend. I remember those days being very stressful and busy. I felt like it was a lot to round on 12 patients, write 12 notes, update families, manage discharges, and be sure that all orders were placed. Plus, I had to make time to "round" with my attending and see the patients together. That usually took about an hour. 

Yesterday I was providing care for 10 pretty complex patients. I arrived at 7 am to "pre-round" and chart review. Then around 9 am, I walked the hospital to meet each of the patients, examine them, and update them on the plan for the day. Around 10:30 am I took a pause to call into the multi-disciplinary rounds to update the case managers, pharamacists, and charge nurses about my plans for the day and to hear their needs/concerns for my patients. After multi-d rounds, I finished seeing my patients. I was back at my desk around 11:20 am to place orders, write notes, and follow-up on tests.

By 3 pm yesterday I had wrapped up my care on my patients. I had written 10 notes, discharged one person, placed many orders, and updated sign-out for today. It was a low key day and I enjoyed the work and caring for my patients. As I was preparing to leave, I felt pretty accomplished. I thought back to my days as an intern when this volume of work was particularly stressful. I was amazed that I had done it all in less than 8 hours. More than that, I am so thankful to now have the knowledge and experience to do this kind of work independently. I am grateful for my excellent residency programs (Cleveland Clinic and UC San Diego) that prepared me to be a great internist. I am also thankful for the health system, patients, and families that entrust me with their care.

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