Starting at the VA / Winning the game!

I'm about three weeks into my rotation at the VA, and at first, it felt like I was starting internship all over again.

Being in a different hospital means many things are different. As an intern, it's my job to get stuff done--tests, labs, consults, etc. If they don't get done, I see it as me failing at my job. Patients staying extra days in the hospital means higher risk for hospital-acquired infections and complications, so all around it's frustrating for me and somewhat dangerous for my patient when there are delays in diagnosis and therapy.

The VA computer system is regarded as one of the best if not the best in the country. However, if you don't know how to fully utilize it, it can be a complete disaster! Although I did a rotation at this hospital as a medical student, I wasn't familiar with all the steps it takes to get things done. It was taking me 30 minutes to figure out how to order regular finger sticks to test blood sugar levels on a diabetic! There's also cultural things about each hospital--which antibiotics they tend to use, availability of certain imaging, consults, and pharmacy rules. If you don't know these things, you'll definitely be less efficient.

However, I'm on another great team, and we all helped each other out as best we could. My first week was plagued with late nights cursing the separate menus on the computer system, and I would come home every night wondering why I could not get myself out of the hospital earlier. I have slowly picked up tips in my weeks there, and today, I won the game!

"Winning the game" in the medical training sense means discharging all your patients the day before a routine day (a day when you are not admitting patients to the hospital). It's a big deal because it means that you don't have to go into the hospital on your routine day--an extra day off! I didn't even realize I had won the game until my last patient left the hospital and my list said "no patients found". There were lots of high fives all around, but it felt that the stars aligned for this to happen. I don't know about other programs, but I see it as pretty unlikely that I'll repeat this feat again.