Finished up another emergency medicine rotation

Everyday I work in the emergency department I feel like at the end of the shift I have added more to my data base knowledge of disease and pathology. For example, the other day I show up on my shift and I had to perform a couple knee taps from traumatic knee injuries where the patients had bled into the joint space of their knee due to an injury from falling onto their knee. You have to drain the fluid and the blood if enough pressure builds up in the knee the you the patient will have their nerves and blood vessels pinched to the point of infarction. They can experience permanent damage if you do not remove the fluid.

You palpate the knee to find the fluid build up and then use a needle and syringe to evacuate the fluid. It can be hard to find the fluid filled space but once you get it and drain the fluid the patient immediately feels relief and is happy with your work. It is a great procedure.

So now I am comfortable with knee taps. I feel the whole education and training process is all about getting exposure to all the many different illnesses and procedures needed to be a good physician. Each time you perform a given procedure your skills improve and you knowledge advances. This part of the reason that the training requires so many years. It just takes a long time to get all of the procedures down. Some days I show up to work a shift with know real clinical knowledge of a given procedure other than reading about it and the by the time I leave I have performed the procedure and added it to my skill set.

It is amazing when you look back over a few months of many long shifts and realize how much learning has occurred and it keeps you going on the days when you feel like you are no where near the level that you need to be at to be a excellent physician. It is a day by day, hour by hour process and eventually you get there. I love it and enjoy the whole process. Even a bad day is great compared to some of my past jobs / careers.