INTERNSHIP ASSESSMENT

INTERNSHIP ASSESSMENT:

Neha Pradeep

Roll number: 110

My medicine posting during my internship year extended from 12th of April 2023 to the 12th of June 2023. 

My time in medicine was divided into 4 parts, with 2 weeks each. 

June 12th- June 28th : (UNIT) 

I was placed in second unit. In this unit, Dr. Abhinaya, Dr. Narsimha, Dr. Prachethan and Dr. Harika were my SR and PGs. In duty, my main learnings came from time spent in OP, casualty and monitoring of admitted patients in unit. 

Since we didn't have any admissions in unit for my first two weeks, most of my experience came from OP.  Here, we took history, examined the patient with respect to their presenting complaints. Here we learnt how to localize the problem without requiring excessive investigations and medicating without over treating. 

On our first OP day, a case was brought to casualty in an unresponsive state, with seizure like activity. 

Handling this case taught us a few basics of first line of treatment in emergency cases. Unfortunately this case crashed at 4:30am, and was unrevivable even after 2 rounds of CPR. 

On my second OP day, several acute gastritis cases were brought to casualty, with similar complaints of epigastric pain. 

On an average OP day we saw between 50-70 cases. 

Discussion of cases in OP helped improve my understanding of disease symptomology and treatment. 

June 29th - May 13th: (ICU, NEPHRO, WARD)

I started my peripheral rotation in Nephrology. I monitored several dialysis patient's vitals, have taken multiple ABG samples. 

In nephrology, I received the opportunity to do 2 ascitic taps on patients with several ascites. 

Nephrology patients tend to have extremely high blood pressures, hence making monitoring vital. Unlike any other in patient part of our hospital, the dialysis center has just day care patients, which introduced me to a new aspect of patient care in the hospital.  

After my 5 days in Nephrology, I then moved to ICU rotation. I spent 5 days monitoring the ICU and AMC patients. 

Here my job entailed, monitoring the AMC and ICU patients. These patients tend to be in critical condition and require very close monitoring. There were 3 patients who required CPR assistance during my time in the ICU. I assisted in one intubation. 

On night shifts, we had to send many blood samples, I practiced sample taking and sending of vials in the ICU. Also had to make sure the treatment was given to the respective patients at the right time. 

During Day shifts in the ICU, I followed rounds whenever possible, whether it be SR rounds or HoD rounds. It gave us more input on the status of the patient and what further investigations should be conducted to help our patients improve. 

Finally, my last 5 days in peripherals consisted of ward duty. This entails making sure the units have updated their respective elogs and PaJr groups with the current days findings. Ward vitals and any investigations or referrals were sent. Most of the cases in the ward are stable and were discharged quickly. 

May 14th - May 28th: (PSYCHIATRY) 

The next 15 days were spent in psychiatry department. There we observed case history taking of various patients. This included schizophrenia, alcohol dependency, and depression. 

We saw first hand how detailed the history taking in psychiatry is and how patients need to be patiently explained the treatment and the condition. Mental health holds a lot of stigma and should be explained with care. 

Some conditions were explained along with treatment in those cases. 

We also went to the DAC (deaddiction center) and witnessed patients being weaned off of their dependency and the precautions taken to protect even the health care workers aiding them. 

May 29th - June 12th: (UNIT) 

After Psychiatry, I returned to the unit. In second unit, we had Dr. Nikitha, Dr. Pavan, and Dr. Lohith. 

We had a couple of admitted cases, which required us to update SOAP notes, create Elogs and update the patient's findings on their respective PaJR groups. 

During these two weeks, I took several patients around the hospital for various referrals, and observed various cross consultations. 

My patients required updating of fever charts, and sending various samples. 

On our casualty night duties, we had several cases come with gastritis, SOB, and chest pain. They were given conservative treatment after reviewing their investigation reports. 

Overall, unit taught me the effect of focus on individual patients and following the patient's responsive to the treatment given. 

Given below are the E-logs I created in internship Medicine posting: 

https://nehapradeep99.blogspot.com/2023/06/45f-systemic-lupus-erythematosis.html?m=1

https://nehapradeep99.blogspot.com/2023/06/40f-hypovolemic-shock-2-to-acute-ge.html?m=1 

https://nehapradeep99.blogspot.com/2023/06/45f-with-paraparesis-since-4-days.html

https://nehapradeep99.blogspot.com/2023/05/67f-with-ckd-on-mhd-since-2-years.html?m=1

https://nehapradeep99.blogspot.com/2023/05/45m-with-ckd-on-mhd-since-2-years.html

https://nehapradeep99.blogspot.com/2023/04/57m-with-altered-sensorium-2.html