Medical practice self-identification

Part 1: Self-identification of medical practice

The 6-month internship period is about to end. The time is really fast. Internship is the first step in turning my theory into ability and progressing to the clinic. I benefited a lot during the internship and will be used for my whole life. Self-identification in the face of the performance during this internship.
In July, I went to Hunan Fukang Hospital of Integrated Traditional Chinese and Western Medicine for internship. According to the requirements of the hospital and the school, I went to the Department of Surgery, Acupuncture and Moxibustion, ENT, Traditional Chinese Medicine, Western Medicine, Emergency Department, etc. During the internship, I strictly abide by the various rules and regulations of the hospitals and hospitals, obey the law, respect the teachers, unite the students, and strictly demand that they do not be late, do not leave early, do not work, etc., take care of the patients, and be kind to them. , strive to combine theoretical knowledge with practical experience.
During the clinical internship, I actively studied with clinicians. After nearly one year of internship practice, I have mastered the writing of all medical records such as medical records, discharge records, laboratory tests, and mastering the operations of debridement and suturing. Method, I have been working hard on the study of internal medicine, surgery, integrated Chinese and Western medicine, pediatrics, etc., focusing on the diagnosis and treatment of diseases, focusing on the characteristics of some common diseases, frequently-occurring diseases, diagnosis, identification and treatment principles. , laid a solid foundation for future clinical practice. During the internship process, I continued to summarize the learning methods and clinical experience, and strive to cultivate my own independent thinking, independent problem solving, independent work ability, and internship life also cultivated me wholeheartedly for the people. The lofty thoughts of service and the professional ethics that medical workers must possess. But we also know that there are still many diseases that we can't overcome on humans. I don't know him yet, so I know more about my shoulder responsibility and work in the future. Work hard, pay attention to the combination of theory and practice, and make outstanding contributions to the medical cause of the motherland.
After 4 years of medicine, I have created a healthy, confident self, self-confidence comes from strength, but at the same time, I must also recognize that the society is changing rapidly, the requirements for talents are getting higher and higher, the society is constantly changing, developing, and development is needed. Looking at the problem, I still have a lot of shortcomings and deficiencies. I have to adapt to the development of society and constantly improve my thinking and understanding, improve myself, and correct my shortcomings. As a medical professional, the social pressure will be heavier than other industries. Learn to learn, learn to innovate, and learn to adapt to the development requirements of society.

Part 2: Self-identification of internal medicine practice

During the two months of internal medicine, I learned a lot of things that I didn't understand in class, with the careful and patient teaching of the teacher. In the days of internship, I learned the general process of treating patients: such as measuring vital signs; asking patients about medical history, history of allergies, etc., carefully writing the nursing records, observing the patient's illness, and cooperating with the teacher's guidance to understand the antibiotics for various digestions. The basic application of the system.
During the internship process, I strictly abide by the rules and regulations of the hospital and various departments, conscientiously fulfill the duties of nurses, strictly demand myself, respect the teachers, unite the students, work hard, and wholeheartedly consider the patients. At the same time, I sat down to understand family members, correctly handle the relationship between nurses and patients, do a good job of explanation and comfort, and say "sorry". It is the family members who understand the work of nurses and reduce unnecessary misunderstandings or excessive behaviors.
Cardiology is more common in hypertension, arrhythmia, coronary heart disease and heart failure. Under the teacher's teaching, I have mastered some common diseases and basic exercises; smiling to meet new patients and do hospital admission assessment; close monitoring Vital signs and standardized records; correct collection of blood and urine specimens; active cooperation with doctors; strict implementation of three investigations and seven pairs; conscientious implementation of intravenous infusions... While working, I also constantly study and sum up experience, can be diligent and good at Observe the patient's condition, so as to grasp the changes in the condition in time and make an accurate judgment. During this time, although the time was not long, I was exposed to a lot of specialist knowledge and skills that I didn't know before, and I picked up a lot of operating techniques, such as the principle of sterility, the application of oxygen, and the five fixed vehicles.
In short, I feel that I have learned a lot during this internship. Although I am still a student, maybe my ability is limited, but I use my efforts to enrich my knowledge and skills, hoping to send my patients away with my smile. Healthy departure, eager to learn. This is just the beginning of the internship, it is a challenge and an opportunity. I must apply the knowledge I have learned to the next internship department, and keep in mind the teacher's teachings and keep learning and progressing. At the same time, I would like to thank the patients in the department, they are very cooperative to let me do treatment, as the saying goes, the patient is the teacher. I hope that the next stop will be all right.

Part 3: Self-identification of clinical medical practice

This time, under the organization of the school, I came to the ** People's Hospital for a one-month internship. The enriched and tense internship ended in an instant, and this experience was a great harvest, which made a qualitative leap in the understanding of medicine. The following is a personal identification of the internship.
Before entering icu, I took the teacher to explain the management system and disinfection system in ICU, and introduced the icu environment, which made me understand the intensive care unit and work very well. Special arrangements for special disease knowledge lectures, that is, the introduction of common diseases in thoracic surgery, have made me have a certain understanding of chest and heart surgery diseases, which is conducive to postoperative monitoring. It gives me an idea of ​​the significance and importance of central venous manometry. It is an objective criterion for direct response to left heart function and measurement of blood volume, guiding rehydration rate and assessing blood volume.
After entering the clinical internship, I tend to focus on the operation, the internship report network and the relaxation of theoretical study and clinical thinking training, especially in thoracic surgery. Chest and heart surgery has many diseases and many operations. I can easily focus on the operation. Therefore, I have more surgery and more hands as the main purpose of internship. The pathophysiology after surgery will change a lot. I must comprehensively and accurately comprehensively analyze the medical history, physical signs, condition, and surgical methods to be able to accurately grasp. The key point is to see the essence, understand the impact of surgery on patients, and develop correct treatment measures.
After one month of internship, I have an understanding of the postoperative monitoring of thoracic surgery, and basically master the clinical application and precautions of monitors, ventilators, defibrillators, micro pumps, etc., and can independently complete the detection of central venous pressure. , intubation in the tracheal intubation, the writing of nursing records, the summary of the amount of access and other monitoring skills.
This valuable internship is very lacking in clinical experience. In the process of internship, I maintain a modest and serious attitude towards learning and take the initiative to learn.

Part 4: Self-identification of clinical practice

After the clinical medical internship, I felt a lot, and the internship activity has been over for a long time, but until today, the thinking left to me by the internship is still in my mind. I don't know how long those feelings are going to stay in my heart, and I don't know if these ideas are good or bad in my heart. After having such experiences, the whole person has changed, and it seems to be changing now. For me, the internship experience seems to be more difficult than any previous assignment, hesitating for a long time can not write. The things in the brain have never been as much as they are now, but it is difficult to position them. If the following is too messy, I hope you will forgive me.
What impressed me the most was Professor Wang's "combination of clinical scales to treat patients with obsessive-compulsive disorder". In that class, I was fully exposed to how to write patient medical records for the first time.
The medical record should reflect the following parts:
1 The general condition of the patient. Name, age, occupation, place of origin, residence, etc.
2 the main complaint situation. That is, the patient's family provides information about the patient.
3 The patient's current medical history. The patient's current illness status.
4 The patient's past history. The patient or family member provided information about the patient's previous illness. Special attention should be made to determine whether the patient has organic brain trauma, and especially consider whether the patient has alcohol dependence.
5 patient personal history. Contains whether or not the child is born or not, parental personality, living environment, work situation, learning situation, tobacco and alcohol history, marriage and love history, family history, etc.
6 psychiatric examination. Consciousness examination, perceptual disorder examination, thinking activity disorder examination, attention disorder examination, memory impairment examination, intellectual activity disorder examination, presence or absence of self-control examination, emotional and emotional activity disorder examination, will behavioral activity disorder examination, etc. Wait.
7 scale evaluation, B-ultrasound report, X-ray inspection report, etc.
According to Mr. Wang Jian, all the reports should be completed within 72 hours. If any one of them is not completed, they must be called back and can not be diagnosed.
This part of the medical record writing requirements, only a small part of the entire internship content, probably took less than 30 minutes, but I feel it is especially important for our doctors. It is the main idea of ​​the doctor's diagnosis In other words, it is the step in which your doctor's thinking is implemented, in order to give a qualitative question to the case. The rigor of the medical record can reflect the level of a doctor's medical skill. It is also related to the accuracy of the diagnosis. Involved in the patient's treatment and treatment, the relationship is significant.
In the past textbooks, I simply talked about the general situation of the help-seekers, physical symptoms, psychological symptoms, family support system structure, and auxiliary scale assessment. However, the introduction of the book did not have a comprehensive introduction by Professor Wang. The professor clearly emphasized the following points in the class.
1 to highlight the past history. Pay special attention to the exclusion of organic brain disease on neurosis, such as pulmonary encephalopathy, hepatic encephalopathy and mumps. Also don't forget to consider alcohol dependence.
2 In the personal history section, from the small to the university's study and life part of the question is to be fine, almost as long as the patient has setbacks to ask why. In the family history, ask the parents of the two-line three-generation members near-marriage.
3 mental examination part should pay full attention to check the patient's self-control ability.
There is also a B-ultrasound report and an X-ray test report on the medical record report.
The above points are not part of the textbook or are not emphasized, and those parts are very important in clinical practice. According to the medical history introduced by the teacher, the thoughts are given, giving people a serious, serious, scientific and rigorous feeling. The scientific spirit, a responsible attitude worthy of patient trust.
When Professor Wang invited patients to clinical teaching in combination with medical records, the points described in the medical records basically covered the patient's situation, even more than the patient knew. This obviously surprised the patient.
According to the patient's statement, "I feel that my condition is controlled during the time of admission. It is... I have taken the right medicine..."
This is a small "medical report" that makes me feel deeply.
I am very concerned about the highlights that can reflect the "responsibility". "The medical record report" has a feeling, it is so experienced, if there is no such emotional, I will probably write the impression that the patient gave me in the first class. The impression is absolutely fresh. Two months later, I can still imagine that he is in his fifties, and he respects us for the first team. But the teaching example does not fully reflect the rigor of not wanting to leak a drop of water. I always feel that only this rigor can infiltrate the responsibility of science to people. This kind of responsibility has an indescribable charm.
Through the internship, I feel that as a medical worker, I should pay attention to the following points in my daily work.
First, we must pay attention to the personal image. This problem seems to have never been mentioned in the entrance education. However, I believe that many outsiders, including doctors in medical students’ impressions, should be like Yusuke Jiangkou’s Yushu, although the actual situation May make you stunned. From the day you step into the ward, you become a prospective doctor. Although the doctor's position in China is not high, even though everyone in the entire ward wants to support you, you can't look at yourself by yourself. What's more, no patient will fully trust a unshaven, white coat and crumpled at the beginning. The doctor, there is no MM will be at the first sight on your "wolf with white coat".
So, please pay attention to your image, from head to toe, from the outside to the inside, clean and tidy, refreshing spirit. The most important thing is that it is white. In the same year, the clothes that were extremely envious of the doctor were very shaggy and white enough to change twice a week. However, whether I take Omo, Tide or White Cat, I have always been unsatisfactory. Because, in the hospital, it was sent out and washed. So, how can we get our own white coat into it? We tried to write a number on the white coat with a pen and succeeded several times.
But then I was lazy. Boys often do not wash once a few weeks.
Second, please don't be late. This is a common problem. Many people are rushing into the ward, whether they are internships or in the hospital. In the internship of the cardiology department, Professor Shi once asked the intern students to enter the ward at 7:00, the resident doctor arrived at 7:30, and the attending at 8:00.
But after a few days, it will be gone. Although it is not required to arrive early, the bottom line is not to be late. Of course, there is no church at all for you, and there are many models that are late for teaching. However, it is advisable to learn from foreign doctors, develop a good habit of getting up early, and put a good amount of blood pressure on this amount. Give greetings to the patients on the bed, "Is it good to sleep last night? What to eat for breakfast?" Help me to buy breakfast. In this way, I am very grateful to the church for your decision to ask you to drink pearl milk tea at noon. The patient will also treat you as a bed doctor and leave your teaching aside.
Third, something in the pocket. In the white coat pocket, you must first put a small book. The top is full of things, there are weird doctor's orders, syndromes, drug names and usages, there are stages of the test notes to be opened today, and there are various phone numbers, QQ numbers, emails and MSN. This is the testimony of your internship, which is filled with your happiness, sadness, admiration and doubt. Remember not to take notes from the paper in the hospital, it is not good-looking, it is easy to lose, and more importantly, it is seen by some old professors, such as Professor Zhang of the surgery. Followed by a stethoscope and a pen. Most of the time there are mobile phones, it is recommended to put vibration or shutdown when checking the room. Otherwise, when the professor checks the room and is struck by your ringtone, it’s still a good idea! If you look at it, you will call the high school to give you a serious internship! It’s better to put a solid in your pocket. Glue, this can avoid the unfortunate encounter of popo in orthopedics. It is true that glue is often not found in the ward.

Part 5: Self-identification of medical students

It took a month in the acupuncture department to pass, and I feel that the time has passed is really fast. I will report to China in the next week.
I still remember that when I went to the acupuncture department and followed the teacher, I didn’t understand anything. I didn’t know what I was supposed to do. I stood there stupidly. I slowly got used to it and could help me on the side. Do something that you can do, although sometimes it will be a bit hard, but it feels good. I think it is skillful and stressful to take the needle out of the patient. It is not always easy to look at it easily. The needle is pulled fast, so that the patient does not feel pain; but it seems that my speed is not fast enough, sometimes it hurts the patient. Sometimes I have a better patient, although it hurts, but he will also talk to me and teach me how to pull it. Occasionally, I will encounter patients who are difficult to get along with. I remember that I once pulled the needle out of the patient. I pulled a needle and called her. I also tried to hide and hide. Then I tried to hide from her.
A month of trainee, although I can't say what I learned, there are still many gains. The trainee allows us to go to the clinic, not only to stick to the theoretical knowledge in the book, but also to improve our practical ability, theory and practice. Sometimes the teacher will let me tie the common acupuncture points on my hands and feet. I just started to give the patient a needle. It is quite melancholy. I can’t get my hands, I’m afraid that I’m going to break someone else. The back is a little bit better, but the movements and techniques. There is still room for improvement. I used to think that the head was a very dangerous part. I was shocked by the scalp needle. I felt very dangerous. But the teacher said that it is safest to scalp because of the skull. Also taught me how to fight, I also tried to beat the patient.
Today is the last day of the acupuncture department. It is also the first day of the last summer of the summer disease. There are quite a lot of people who have posted plasters. The whole morning has been busy, and it will end at 12:30. But looking at the patient who was plastered by himself, my heart is still quite fulfilling.
I am going to another department tomorrow, I hope I will continue to cheer!