Who knew this would be harder than school?

Am I the only one that feels like this?











I'm about 3 weeks in to working in Urgent Care and feel like I'm on a trampoline. Some days I come home feeling like I had the best day ever - I like seeing patients, I like fixing their small problems or ordering tests, I feel like I'm making people feel better or understand their diseases better and am good at doing it. And other days, like yesterday, I feel like I am utterly unprepared for this and/or I have nothing to offer patients (I'd like to take back pain outside and beat it silly) or I just don't have a clue what the right answer is and every other provider in the office is in another room seeing patients and my second patient was roomed 40 minutes ago after waiting outside for over an hour. Rrrr. Those are not my best days.

And while I'm on this rant (which feels pretty great!) does anyone ever feel like if this was an OSCE you'd have just failed miserably? I saw a guy yesterday for LLQ pain x 8 hours and sent him out the door, thinking he was a bit hypersomatic and probably in need of some reassurance and a good bowel movement. But I didn't exactly like the way it felt, just sending him out (even though ordering a CT seemed like intense overkill) and I talked with one of the docs in our office after sending the guy home (in retrospect, completely silly) who pointed out that that's in fact a classic presentation for diverticulitis, no fever or diarrhea needed, and that if it were him he would just slap the guy with a couple of antibiotics. Which I did, after the fact. Felt kind of sheepish, though, and very thankful for cell phones.

After all this, I think some optimism is needed. So I should include some of the highlights that I've also had so far. I love when patients ask if I could be their PCP, even though I still have to say no (although I'm slotted to switch into family med starting in April or May). I also love positive rapid Strep tests - they always give me this little sense of accomplishment and pride, like making a 3-pointer in a high school basketball game. I love the answers that I get from one of the physicians I work with - he's a faster talker than I am but lays out the thinking behind his answer is such great detail that I'm always happy to have interrupted him to ask the question. And I really like some of the MAs and other providers I work with and the brief moments we get of joking around in between patients.

I'm sure there are other things I find completely enjoyable - but since yesterday was such a downer they've temporarily escaped. Maybe I'll find them again tomorrow.