Remember the small things

A reflection on my internship year by Dr Megan Bleeze

It is easy to think of internship in terms of big concepts—being able to call yourself a doctor, having more financial freedom, and experiencing different rotations.

This year is a big step to take—the move from playing the, “I’m just a medical student” card, to owning the responsibility of making and acting on your decisions.

For me, looking back on my intern year, the most important lessons learnt came from the small moments.

Small moments to yourself

Long shifts, missed lunches, stressful days—all aspects that we associate with the life of a junior doctor.

It is not like that every day but, at times, it seems unavoidable.

I remember that one of the greatest feelings was coming home in my first week, sitting down on the couch and realising I had nothing to do—absolutely nothing.

Cherish the feeling of not having to hit the books.

Take a break from the lingering, nagging and guilty feeling when you are not studying.

You have worked hard for that feeling, so enjoy yourself and unwind.

Small moments with patients

People will say internship is mostly acting as a glorified paper-pusher. Unfortunately, there is some truth in it (although slightly exaggerated).

However, there are moments where you can practise medicine and have meaningful interactions with patients.

If you find yourself blessed with a quiet evening on ward cover, use the time to bless others.

Pop in to see the patient recovering from a Whipple procedure, not yet on full diet, in a bleak environment, who would rather be home watching the footy with his mates.

Ask the mum of the 13-year-old girl admitted with an eating disorder how she is coping.

Take the time to read through a patient’s discharge summary with them.

While these actions might appear small in isolation, they will give you the opportunity to keep your patients at the centre of your work.

If you are getting bogged down in paperwork remember that it is an integral part of the bigger picture—there is a patient behind the paperwork.

The small details

There is a lot of work recharting medications, charting fluids and the request is quite often preceded by the simple word, ‘just’—“Can you just sign this? Just rechart this? Just chart some analgesia?”

Those four letters can place false assurance in your mind.

We are junior and inexperienced, we place trust in others, and—more often than not—we are run off our feet, which makes it easy to “just” complete the task.

I am not suggesting you second guess everything anyone tells you, but do not be afraid to take the time for the small tasks.

Ask yourself—what if a patient needed the pain relief because of a post-op complication? Take the time to review the charts, see the patient, and pause before “just” doing anything.

The small examples

As junior doctors we are privileged to work with and observe many senior colleagues with different expertise and experience—from RMOs to registrars to consultants.

I encourage you to take on board the small things they do that you admire—an RMO with a knack for communicating with patients; the surgical registrar who fostered self-confidence by supporting well-reasoned decisions; a cardiology consultant who endeavours to find a point of commonality with every patient.

The learning curve in your internship can be steep as you desperately try to learn the essentials to get by each day.

I promise that your internship is rewarding, enjoyable and inspiring—just be sure to take the time to look at the small things.

Dr Bleeze was the 2018 GPSN National Chair. She attended the University of Notre Dame, Fremantle, graduating in 2018. Completing her internship at Fiona Stanley Hospital in Perth, she also spent a term at the Albany Health Campus in southern Western Australia. Dr Bleeze is passionate about a career in general practice and is excited by the opportunity to work closely and collaboratively with patients and develop a continuity of care. She loves everything from paediatrics to geriatrics—being a GP is the perfect fit.

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