I cannot hardly keep open my eyes

(sleep-plumb)

I decided Monday night that despite the registration link not working I’d try just showing up and watching the live cast of the event in the hallway because the topic sounded like one I should know about—USP standards. That morphed into deciding to get there in time to see if I could actually get in. Unfortunately, my ability to estimate time is somewhat nonexistent and I looked at my phone at 4:30 and then not again until 5:20, so I had about ten minutes to get ready and actually show up on time. So that didn’t happen, but luckily they started so late that I still got there, found they were accepting walk ins, and had a place to sit long before it started. The breakfast was great even though not much food was left by the time I got there. There were square hash browns which is my favorite kind. The square ones, in my opinion, are far superior to the shreddy ones or the round ones. Also, there was bacon and amazing apple juice. The talk itself was pretty good too. Although I do wonder how my friends at the FDA write up 8.3 things at each visit…lol… Then I almost forgot about the next session I was headed to and so I was a couple minutes late again, and this time I legit was late since they seemed to have started on time. It was pretty interesting, because it was structured as a debate session. I appreciated that it was a topic that I actually could keep up with and have my own opinion, although I don’t think the presenters did a great job sharing their opinion as they debated, rather they spent most of their allotted talking time bashing the other person without including data to support that bashing.

 

I went from there to the showcase. I was actually at the showcase for almost an hour…but a lot of that was because I went to chat with a few people. Also, I saw someone on my way out who told me I really needed to go see a particular program. Being the obedient girl that I am, I did go see that program. I knew pretty quickly I wasn’t interested. It was an adult hospital and while the person talking did tell me that they have a children’s hospital on site, when I asked how much I could focus my time at the pediatric hospital the response was that “for the benefit of the resident” they don’t think it is a good idea for PGY1 residents to be exposed to pediatrics. At that point my ability to be open minded completely disappeared. I had already stated that I was interested in pediatric critical care by this point, so obviously we could have cut this conversation short if you knew you couldn’t offer that. I pretended to actually care about her rant about her stupid program, but if you aren’t interested in letting me even see the ONLY population I have any intention of focusing my service career on in the future then I am not interested in anything else about your program. I know some adult hospitals with onsite children’s hospitals will allow a PGY1 to spend all their time on the pediatric side, so I really was willing to give this program a chance, but seriously? No exposure? Why even bother? That is a huge disservice even to a resident interested in adult medicine, because even in a dedicated adult hospital there will be a little triaging of pediatric concerns as well as the teens and tweens who don’t quite fit in a pediatric or an adult setting.

 

I went back to my room to calm down and try to study, but there were already all my roommates there so what really happened was that I walked in, tried to get ready to study, then walked back out. I tried the exhibit hall again because I figured that was one way to get homework done. The goal for this rotation that I chose to focus on since for AmCare we have to select one of the rotation goals to work the most on, was communication skills. The exhibit hall gave me lots of social opportunities. Sure, I had to feign interest in certain products in order to glean opportunities to practice social skills, but I did it. I actually had some pretty good conversations. I talked with one EnFit rep who clearly was so full of himself that he couldn’t take any criticism and just wanted me to be proud of him for his crappy product, but then I found another EnFit rep who actually was very personable. I brought up to her again about the major problems with their products. My goal was to either keep the biggest issues on their radar or to find out what they had figured out since the last time I talked to them towards the end of my HSM rotation. As it turns out, the rep told me she wished people asked the questions I was asking sooner, because they had had to go back to the drawing board to figure it out. She did show me some of their solutions to the problem. I don’t think the solutions are great—the old syringes are still far superior to the new syringes plus the solution they figured out—but it is certainly a step in the right direction…and I totally understand that most people forget about pediatrics and see a syringe as a way to access an enteral feeding tube and kind forget the reason the smaller syringes exist is because in pediatrics we use syringes for oral administration. I see a few years down the line when the EnFit syringes are all people are familiar with someone coming up with this great idea for a much better pediatric syringe…just like the ones we have now. For feeding tubes I think the new syringes are a great idea so that they lock on to the tubing, but for oral use they are awful. The fix is a step in the right direction, but still isn’t anything close to ideal.

 

I also talked to the First compounding kit people. I let them know about one (of the many) reasons their products are annoying. The rep seemed to actually care about that and I hope they take it into consideration and potentially redesigning the product. Since their goal in being there is to get their name out there I didn’t want to be a negative Nancy, but chances are I’ll have to come here at least one or two more years to be shown off as a resident, so perhaps in future years I can address other issues with the product. I also talked with a children’s hospital that has a PGY-1 program. It wasn’t one I had on my list, and I wasn’t sure why I eliminated them, so I listened to their spiel, and while it sounded like a great program, not knowing what had kept it from my list before, I opted not to add them to my list. If I fail to match and have to apply again they might come back into consideration if they also don’t match, but we’ll see.

 

From there I dropped some stuff off in my room and then to the showcase again. I discovered that there was at least one other internal candidate at my hospital…which was a little scary because I was kind of counting on being the only internal candidate as being a motivating factor in selecting me. I stopped by the FDA booth a few times. When it was manned there were no signs and only one person, but most of the time it wasn’t even manned…lol…I guess they aren’t worried about attracting anyone…

 

I also went to a session on critical illness in pregnancy. It wasn’t what I was expecting—focused on DVT and hypertension management in pregnancy whereas I was more interested in balancing the needs of mom and baby and exploring how various treatments may affect the fetus—but it was a good session. Then I tried really hard to do homework while my roommates kept doing all sorts of other things to keep me distracted. I tried to go to student’s night, but it started at eight and by the time my roommates finally managed to get a shoe on BOTH feet, it was already 9 o’clock. I figured I’d go for a few minutes even though we were late, but whoever planned that event clearly had very few brain cells and if I hadn’t been with other people I wouldn’t have made it all the way in before I left. I love loud music, but that music was too loud even for me. I guess electricity must be expensive, because they had people stationed around the room holding flashlights. There weren’t any snacks or drinks—not even the kind I wouldn’t be interested in anyway. Unless we were just too late and missed it, it appeared there wasn’t any programming except stand around and talk—except you couldn’t do that because the music was too loud. The music wasn’t even good either. I lasted about 3 minutes.

 

Then of course a few hours later my roommates had to come back into the room LOUDLY and chat loudly about all the stuff they got at the exhibit hall. They did that for approximately an hour or so…not sure since I wasn’t staring at my phone the whole time. So yeah, I am super exhausted, but I’m determined that if I paid this much to be here that I am going to get everything out of it that I can.

I also was scared because my roommate started talking about being sick but didn’t seem sick, which might mean the real kind of sick. Lol…when I don’t have much sleep it is really easy for fear to sneak in. I’m fine now anyway though.

 

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