2 weeks

Today marks the two week mark until the end of my clinical rotations.  After that, I have two more weeks until I graduate.  Thus, I am four weeks from graduating after 2 1/2 years of work that has changed the way I think, changed the way I function, and changed the landscape of my home and family.  This is perhaps cheesy, but examining myself before PA school and comparing that individual to the present is an interesting mental exercise.

2 1/2 years ago I could not have told you what BUN, Creatinine, or GFR are.  But this past week I spent a good amount of time managing a patient with wild abnormals for all of these and, essentially, turning kidney failure around.  Now, granted, I have not repaired any kidneys and I have certainly not changed the course of kidney disease significantly.  But I helped a patient stay out of the hospital, which was her biggest wish.  And the idea that I could ever have the skills, the resources, or the will and daring to attempt to manage something like kidney failure in the outpatient setting would never have even crossed my mind.  I had oversight - my preceptors were there the entire time and ready to keep me from killing the patient.  But I put the knowledge that my instructors instilled in me to work and made the right choices so that they didn't have to jump in and take over and instead they stood by and watched as the patient's condition improved, much to my surprise.  Despite knowing the right information and making good decisions, I still wasn't sure the treatments I prescribed would have the effects necessary to achieve the desired result - thus I was pleasantly surprised and gratified that things are looking up.

Even comparing myself now to a year ago - I had just finished my didactic year, my brain full of facts and protocols and ready to begin my real training.  But when I set foot in my first rotation, my eyes were big as saucers and I had no idea what I had gotten myself into.  My first consult in the ER was more a rote memory of how to perform an H&P than it was the application of learned skills.  That I happened upon the right diagnosis at the time was more luck than knowledge, and even now I always say, "it's better to be lucky than good," when I have a success.  The point is that I marvel at the change.  It is cliche to say that I've progressed by leaps and bounds, but it describes the situation well. 

I am grateful to God for my successes and give Him the credit.  And I still pray that, even though I helped turn kidney failure around, my hands will be blessed and the patient will have a good weekend and be waiting to greet me at the door to the clinic on Monday morning rather than lying in a hospital bed having been admitted while I wasn't watching.

What have I gotten myself into?