MY JOURNEY IN GENERAL MEDICINE POSTINGS AS AN INTERNEE

 Name: K. Thanmai 

Roll no: 76

Batch: 2017

   I'm K. Thanmai working as Intern and I'm here today to share few experiences of my journey in General medicine postings which was for 2months,from 12-02-2023 to 13-04-2023 

My duties went as follows:

Psychiatry postings for 15days

Unit duties for 1month and followed by peripherals including ward,nephrology and ICU duties for 15days

PSYCHIATRY POSTINGS:

In those 15days I was exposed to different types of patients and their scenarios.

I observed how PG's approach the patient. Their methods of approaching the patients main concern and the way they counsel the patients.

I have seen cases like schizophrenia, depression,anxiety disorders,alcohol dependence syndrome.

I even monitored a patient who was diagnosed as alcohol withdrawal and was having hallucinations and was irritable. 

Majority of cases that I came across in these 15days was mostly related to the ALCOHOL where patients get addicted to it in order to escape from their reality.

Many patients were also counselled and some were willing to get admitted in our de-adiction center in order to rectify their mistakes.

UNIT DUTIES:

I was in the UNIT IV which was under DR.RAKESH BISWAS(HOD) DR.SUSMITHA(SR) DR.RAVEEN (PG 3RD YR) DR.HARIPRIYA(PG 2ND YR) AND DR.GOVARDHINI (PG 1ST YR)

The first thing that I did as I started my unit duties is to know about my patients who were under our care,their history,diagnosis and the treatment that we were providing.

In that time period I have learnt many things like approach to patient,taking history,examining the patient and ruling out differential diagnosis based on our examination and as well as the investigations.

In our OP day we use to check the vitals of the patient,taking the history,writing the investigation requisitions that are related to the patients problem.

I also examined patients for rhombergs sign,postural hypotension and also reflexes

What I observed in op days is that majority of the patients use to come with problem of neck pain,headaches,tingling and numbness in limbs. Also maximum people suffer from Hypertension and Diabetes mellitus.

Our PG's also helped me in understanding the importance of  taking negative history, their daily routine,their food habits.

I have seen different type of cases in given time period. Following are the links related to the cases that I followed:

https://65thanmaireddy.blogspot.com/2023/03/20year-old-lady-with-co-difficulty-in.html

https://65thanmaireddy.blogspot.com/2023/03/50-yr-old-m-with-co-sob-since-10days.html

https://65thanmaireddy.blogspot.com/2023/03/50-yr-old-m-with-co-sob-since-10days.html

https://65thanmaireddy.blogspot.com/2023/03/50yr-old-m-with-co-sob-and-cough-since.html

https://65thanmaireddy.blogspot.com/2023/03/60yr-old-f-with-low-back-pain-since.html

https://65thanmaireddy.blogspot.com/2023/03/60year-old-lady-with-complaints-of.html

https://65thanmaireddy.blogspot.com/2023/02/65year-old-woman-denovo-diabetes-type-2.html

If I summarise my blogs maximum number of patients complaints were shortness of breath,cough and chest pain.

In my cases..2 patients were TB patients where I have learnt about the symptoms, investigations to confirm the diagnosis,course of treatment.

We have counselled the patients regarding the importance of TB,their spread, importance of ATT and followed the case after discharge.

I also examined a case of 50year old male with complaints of sob and diagnosed as heart failure with reduced ejection fraction. We can clinically assess this case as we have positive signs of raised JVP , cardiomegaly. He is a known case of heart failure for which he got treated 2months back but later on due to his binge drinking he again started having the symptoms and got admitted. He also diagnosed with B/l pleural effusion. We have warned the patient regarding his drinking habit and counselled him to stop drinking which may wosen his condition.

There were also cases like lumbar spondylosis,migraine and denovo Diabetes. I have counselled the patients regarding the diet that has to be followed in order to control the sugars and  high blood pressure and I also learnt that how diet can play important role in our day to day lives.

I used to upload daily fever charts,SOAP notes,and I even created PaJR group where patients and their attenders can actively participate and pose questions regarding condition of the patient.

PERIPHERALS:

NEPHROLOGY:

My nephrology duty was under the care of DR.BHARATH (PG 2ND YR)

In these 5 days I have known the process and importance of hemodialysis.Monitored vitals during the hemodialysis. Understood about the mechanism of the hemodialysis. 

 I understood about the condition of the patient and their sufferings. Took histories and compared between the patients regarding their lifestyle,family history.

In my duty hours I also came across emergency condition of dialysis patient where he went into cardiac arrest during the dialysis where his BP was non recordable.

We performed CPR, used Defibrillator to induce shock, took ABG sample and revived patient and shifted him to ICU. Where again he went into arrest and again performed CPR . This was my first exposure to an emergency condition and observed steps that we took to revive the patient.

I also assisted in performing central line.

Ward :

My ward duty was under care of DR.PAVAN KUMAR(PG 2ND YR) DR.HIMAJA(PG 1ST YR)

In these 5days of ward duties I have make sure that SOAP notes and fever charts were uploaded on time.

Known about the cases that were present,attended the rounds and discussed about the scenario of the case.

ICU DUTIES:

My ICU duties were under the care of DR.NARSIMHA(PG 2ND YR) DR.VIVEK(1ST YR PG)

These 5days I came across multiple tasks where I monitored patients without fail,their status of health day by day.

Put Ryles tube, foleys catheter and giving food and medication via ryles tube,sending ABG samples 

Performing CPR,helping in bedsore dressings for chronically ill patients. Bedsore are the worst condition that can ever happen to patient who is chronically ill,because they already suffer from their present condition and these are kind of adding extra pain to the patients. Learnt about stages of bedsores and their prevention.

Took care that patients get treatment on time,followed up the insulin dosages based on their GRBS.

At the end of postings our SR mam have conducted the test regarding my learning in these 2months.

Thus this is my experience and journey in 2months of General Medicine posting. I have learnt many valuable things,counselled many patients, understood the condition of patient,did follow up of patient after their discharge .

Understood about treatment,their dosages,their course and multiple procedures like ascitic tap,pleural tap,hemodialysis.

I would like to thank all my PG's and HOD sir who guided me and helped me in understanding the condition of the patients and made my journey valuable.