This past weekend marked a year since my last day at work! I miss the people I used to work with, but glad to be moving forward professionally.
On Sunday the kids and I met my husband in Charlotte to celebrate my oldest child turning 8. It was hard when we were hugging goodbye to let go of my husband. He'll be coming to Durham this weekend so we can celebrate his birthday, but it is getting harder and harder to live apart. I don't know if it is the fact it has been a year or if it is because we were able to spend so much time together in July and I got used to living with him again... or the fact we were apart on our ten year wedding anniversary. That part of this whole going to graduate school experience has been the most difficult.
But hating it doesn't change that it is my reality so I should suck it up and keep going, which is how we've traditionally dealt with unpleasant things we can't change.
There was a strange moment when we were eating dinner together on Sunday when we were figuring out if we'd make Carowinds theme park the oldest child's birthday tradition (this is the second year in a row he's gone since it took him to age 7 to be tall enough to ride the fun rides)... It hit us that next year I'd have a job somewhere and we may have picked up and moved across the country by the time my son was 9. Exciting but scary!
Tuesday, July 31, 2012
Monday, July 30, 2012
Different mindset
I started my first surg path rotation today (it went well!) but... I got in early this morning and looked over what was there before my classmate arrived. I figured I'd knock out the small stuff really quickly so we could concentrate on the bigger stuff. Which is what I would have done at work... but this is not work and getting the smalls out of the way would mean stealing educational experience from my classmate...
And then later when we were going over the larger specimens there was one type I'd done before at my old job so I said I would take it since I was comfortable with it. Except... that would have been less helpful when it comes to learning new things so my classmate took that specimen and I took something I'd never done before.
The goal of these rotations is not the same as working. We still need everything grossed and on the processors but so that everyone's had a chance to do their share and that we've all gotten to do specimens that we haven't done before. I need to remember that. I'm just used to where I used to work where we also wanted to get everything done as fast as possible since we had sort of a set schedule for when processors needed to be loaded (and also because we couldn't leave at the end of the night until everything was done). To that end, everyone grabbed what they were good with and did them.
And then later when we were going over the larger specimens there was one type I'd done before at my old job so I said I would take it since I was comfortable with it. Except... that would have been less helpful when it comes to learning new things so my classmate took that specimen and I took something I'd never done before.
The goal of these rotations is not the same as working. We still need everything grossed and on the processors but so that everyone's had a chance to do their share and that we've all gotten to do specimens that we haven't done before. I need to remember that. I'm just used to where I used to work where we also wanted to get everything done as fast as possible since we had sort of a set schedule for when processors needed to be loaded (and also because we couldn't leave at the end of the night until everything was done). To that end, everyone grabbed what they were good with and did them.
Wednesday, July 25, 2012
Evisceration and adventures in histology
This morning we had a conference with some of the autopsy staff where we had a presentation on evisceration. One of the PAs made us cinnamon rolls. As we all sat around munching on breakfast and watching slides on how to properly remove the chest plate (and hearing about how to deal with a heart that is adhesed to it if the patient has had bypass surgery), I realized that the level of squeamishness of the people in the room was ridiculously low. This is probably a good thing given the profession we are training for.
The autopsy staff PAs are also pretty accommodating about student guided learning. If we want to practice a given skill, then we can (I want to see if I can get the brain out by myself, for instance. I feel like I can do that so I'd like to try it and see how it goes). If we want to focus on a particular organ block then we can or if we need someone to walk us through removing the bowel one more time, then they're there. Not that I've removed a bowel yet. That was more of a resident thing since they were getting ready to be on their own for weekend call. But the next time I'm there I should be able to do the evisceration with assistance (for the summer rotations I started out in the middle of the two weeks of autopsy, so I'll have my second week after I go through the VA and Duke surg path).
Moving on to today's rotation, I practiced frozen sections which I haven't done in ages and didn't feel very secure about. However, using the microtome on Monday made it easier to use the cryostat. The tissue was also well frozen and not very fatty, which I'm sure helped immensely. The histology lab manager mounted one block for me and showed me how to use the machine. Then he left and I practiced a bit before mounting a second specimen on my own and making my slides. They turned out much better than I thought they would, so that is a relief!
Also I went through my now stained and cover-slipped slides from Monday to pick out the ones for grading and see which ones needed recuts. I had a couple that I redid and will stain in the morning after conference. The histology manager looked over my special stains and said they were all just fine so that's good! I just have to finish up the written portion of the rotation (which is not going as quickly as I would like) and I should be all set to turn everything in on Friday.
So far, so good with regards to rotation. Next week is the VA though, which is more surg path and a grab bag of specimens so we will see how that goes!
The autopsy staff PAs are also pretty accommodating about student guided learning. If we want to practice a given skill, then we can (I want to see if I can get the brain out by myself, for instance. I feel like I can do that so I'd like to try it and see how it goes). If we want to focus on a particular organ block then we can or if we need someone to walk us through removing the bowel one more time, then they're there. Not that I've removed a bowel yet. That was more of a resident thing since they were getting ready to be on their own for weekend call. But the next time I'm there I should be able to do the evisceration with assistance (for the summer rotations I started out in the middle of the two weeks of autopsy, so I'll have my second week after I go through the VA and Duke surg path).
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| Random internet picture of a cryostat |
Also I went through my now stained and cover-slipped slides from Monday to pick out the ones for grading and see which ones needed recuts. I had a couple that I redid and will stain in the morning after conference. The histology manager looked over my special stains and said they were all just fine so that's good! I just have to finish up the written portion of the rotation (which is not going as quickly as I would like) and I should be all set to turn everything in on Friday.
So far, so good with regards to rotation. Next week is the VA though, which is more surg path and a grab bag of specimens so we will see how that goes!
Monday, July 23, 2012
Autopsy, special cuttings, and histology
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| Paraffin tissue blocks (not mine though!) |
Duke's autopsy service is pretty busy, some cases come from outside hospitals and some from Duke itself. Autopsies happen and I will be present for some of them (some as the person eviscerating, some assisting a resident or staff PA, and some as the lead prosector). We have three diener's (known collectively as "The guys") who do most of the eviscerations, prep work, lung inflation, and clean up. It is very helpful to have such experienced techs, especially considering how much time the autopsy services spends training residents, med students, and PA students.
I like autopsy, in general (although the smell can be very noticeable at times)...the schedule can be irregular though. In addition to the actual autopsies, which can start any time between 8 am and 1:30 pm, there are the slide sign outs (going over the slides with the attendings). Some sign outs have more of a set schedule, but other times it is when the residents have had a chance to look over their slides and can grab an attending. There are also the special cuttings (brain, eyes, and sometimes heart if there is a reason for it) which may or may not have a regular schedule (brain definitely does) and may or may not be mandatory (eyes aren't). It just makes me worry that I'm going to miss something. But the autopsy PAs are fantastic and the residents I was with last week were so great to work with, so it was a really amazing first rotation.
This week is histology! They set aside sample tissue during preceptor week and I took my blocks down for processing on Friday. I embedded them this morning (with a break to go to a special cutting) and spent the afternoon cutting slides. I've embedded before, but this was my first time making slides. Oh my goodness, I would be the worst histotech ever! Or at least the slowest. And paraffin shavings get everywhere! The rest of the week will be spent doing special stains and studying the histology textbook.
Friday, July 20, 2012
Congratulations to the class of 2012
Yesterday the members of the class of 2012 presented their senior seminar cases. I learned some things and enjoyed seeing everyone looking very professional and prepared. Public speaking is never fun but they all did a good job with it.
Folks are getting ready to move, start new jobs, and maybe even start thinking about taking the certification exam. It is an exciting time for them and I really do wish them well!
It has been an interesting two weeks watching them get ready to leave while still trying to pass on helpful information to our class as we start rotations. It was great to get to go on rotations with them, especially the ones who have gone out of their way this year to advise and encourage our class.
It doesn't seem real that they're done and my class is definitely the second years, but the PA room is half empty and awaiting the incoming class so it must be!
Folks are getting ready to move, start new jobs, and maybe even start thinking about taking the certification exam. It is an exciting time for them and I really do wish them well!
It has been an interesting two weeks watching them get ready to leave while still trying to pass on helpful information to our class as we start rotations. It was great to get to go on rotations with them, especially the ones who have gone out of their way this year to advise and encourage our class.
It doesn't seem real that they're done and my class is definitely the second years, but the PA room is half empty and awaiting the incoming class so it must be!
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