Friday, June 30, 2006

La Mascota

The official name of the hospital where I work is “Hospital Infantil Manuel de Jesus Riveras.” But that’s a mouthful to say, and so it is instead referred to as “La Mascota” which means The Pet. There must be a story behind this name, so I’ll have to do some investigation to figure it out.

“La Mascota” is one of the best public children’s hospitals in Nicaragua, and children from all over the country come here for treatment. The doctors are knowledgeable and well-trained. It is a teaching hospital, and serves as a major training center for the medical students who attend the public university in Managua. On the infectious disease ward there are two senior residents, four interns, and six medical students who work under the supervision of the attending physicians who are infectious disease specialists. Each morning the entire medical team visits each of the patients on the ward. They call it “La Visita.” Each patient is presented to the group by a medical student or resident who gives a summary of the patient’s history and physical exam. Then the attending physician questions the child or parent to fill in any gaps in the history and afterwards briefly examines the patient. The final step before leaving each patient is to come up with a plan of what needs to be done for the patient. The entire Visita usually lasts about an hour, and writing up the orders for tests, external consults, discharge summaries, etc. usually keeps the interns and residents busy until 3pm or so.

Everyone arrives by 7:30am. The medical students leave by 11am. The attending physician leaves around 1pm. The interns leave at 3pm. And the residents stay until evening. Night call starts at 6pm and involves one resident and one intern. They call it doing a “Turno” and it comes every four nights.

I’ve been going on the Visita each morning, and then afterwards I work on the ultrasound data analysis project on my computer. Sometimes before the visita I’ll take a history and physical of one of the patients but thus far I haven’t worked up the courage to present any patients to the team. Once I get more comfortable with how things work then I’ll present a patient.

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