Gynecology Clinical, Week Four

The following is the email I sent to "check in" with my midwifery/women's health friends at school last week. It's kind of funny, but also shows what it's like to be a student learning it all for the first time!

Today my preceptor did an "observation" of me where she just stood in the back of the room and watched everything I did for the first annual exam of the morning (after the first day we pretty much did the exams on our own and she only came in if we asked her to). I sweat *SO* bad she had to go get me some new non-wet-with-sweat gloves...seriously my hands were so sweaty I couldn't get the gloves on right. Then I almost did a bimanual with HAND SANITIZER instead of lube. Can you imagine? I caught myself but my preceptor was like "I should move this for you!" Then I said "I'm going to put the 'stethoscope' in now." LOL Then I had a patient with a yeast infection, but what was my diagnosis? "String" Yeah, when I looked in the microscope, I said "I don't see anything but *string*" It was yeast! Then I couldn't think of the treatment for yeast infection...I said "Bactrim" and my preceptor said "NO!" (but not in a mean way) and I said "ok, let me look in my black book"...but when I looked, I didn't have the the damn CDC guidelines for tx of yeast infection in my BB. *sigh* What is it? Friggin MONISTAT *duh.* Then I had to do a full exam on a woman who happened to be a doctor. She came in for DUB (dysfunctional uterine bleeding), and it took me a *while* to find the cervix because she had had a baby and so it didn't just "pop" into the speculum like the other cervices usually do. And she was from India* and very concerned about the draping of the sheet and not being exposed (she brought safety pins for the top part of the gown to keep it closed) so I was trying to hold the sheet down so it covered as much of her legs as possible AND do the exam. I was *SO* freaked out you guys *sigh.*

*I don't know if this cultural, but I wanted to make sure people pay attention so that they are conscious and respectful.

Even though this email might not sound like it, I am usually very comfortable in clinical (besides the everyday learning pains required to grow ;o) and I usually do just fine. Even though I was so nervous because my preceptor was watching, it all still went well. I'm glad she wasn't in there for the exam of the physician though because that was so unnerving without her in there. That exam went well and the woman said that physicians weren't as "gentle" or "patient" (regarding all of the draping, explanations of procedure, and "introduction of touch") in India because there are so few physicians and so many patients that they just don't have the time. It was nice to be able to remind her that I am a student midwife (I say it when I introduce myself) and feel so proud of the fact. Also, kudos to my school and preceptor and for teaching me how to do a pelvic exam that is kind, respectful, and gentle enough.

The midwifery students do a semi-weekly "check in" over the lunch hour at school. We talk about how everything is going, plan stuff if we need to, and talk about what we want relayed at the faculty meetings (2 students act as faculty liaisons and attend the faculty meetings to relay the students' concerns) But I am not so good with sharing at this "check in" because I don't feel like I know the women in my class very well yet, and I don't completely trust them yet. So I/we, my smaller group of classmates that I do know well and trust enough, are trying to also check in through email while we build some relationships in the larger group.

So that's gynecology clinical, week four. Next week I will try to post what the typical day of clinical was like (as far as what kinds of patients, what exams, tests, medications, etc) so that people can see what they might be doing on a typical day, and what information they might need to brush up on. If I don't remember, someone please remind me! (Someone did this for me and it was so nice to feel confident on the first day because I was able to at least look up some of the meds and procedures that I might encounter)

Anyway, off to study genetics for patho. Ugh.