California

Can I just say I LOVE where I live?!  I'm SUPER glad I ended up in Redlands and not one of the other many ghetto cities around the area, such as San Bernardino (one of the highest murder rates in the nation and most poverty-stricken, only after Detroit).  There is a super cute downtown area complete with shopping and restaurants.  Every Thursday night they have a street market, which runs year long.  I went to it a few weeks ago and couldn't help but think of Portland - vendors and street performers.  The grocery store is just down the street.  The temple is 5 minutes from my house.  The mountains are 25 minutes.  The beach is 60 minutes, give or take.  And there's all kinds of fields filled with orange trees.  You must come for a visit.  

So I actually really like my YSA ward.  The Bishop's wife is a PA who actually used to work in my same ER for 6 years so she knows a lot of the same people.  I have a good group of friends in the ward who are older and involved in medical school, dental school, doctorate of anatomy, nursing, etc. (thank goodness for Loma Linda University nearby!).  I feel fortunate to have already made some good friends to do things with.  I've only been to church every other week due to trips to AZ and San Diego, so I have yet to get a calling, but I'm hoping that happens soon since I haven't had a calling in almost 2 years (life of a nomad and moving every 6 weeks).

As far as work goes, I'm working like a dog, about 55 hours per week.  Which doesn't sound like a lot, but I barely have time to grocery shop or pay the bills, let alone go to the gym (signing up this week!).  Night shifts include four 12 hour shifts plus 8 hours of lecture and Day shifts include five 10 hour shifts plus 4-6 hours of lecture.  There are 6 different pods in the ER (plus the trauma bay), based on level of acuity, or severity.  I've been rotating through them, working in a different pod each day.  I usually also work with a medical resident or PA, then have to present each patient I see to my attending physician.   It's been a little challenging trying to get used to the work flow and figure out how things work.  Some attending physicians and medical residents are better to work with than others.  I can't believe I've already put in 2 months and I've already seen HUGE strides in my patient management.  This was a smart move on my part.  Yes, it's exhausting and stressful, but it will be worth it.  I want to be a competent and confident provider for my future patients.  I'm liking it more and more as I feel more comfortable, just wish I was getting paid more.  But at least I'm getting to do lots of procedures (suturing, lumbar puncture, paracentesis, etc.).  There's no freaking way (excuse my language) I could have worked as the SOLE provider in Burley, Idaho.  This extra year of guidance is going to be invaluable for me.  

Plus, I got to do a ride-along with Mercy Air flying on the helicopter one day. :)  We were going to transfer a patient from Barstow to Loma Linda, which has pretty large mountains between.  The pilot flies by visual only and there was a huge cloud cover over the mountains, so you couldn't actually see them.  So the pilot was flying around for like 10 minutes trying to find an opening in the clouds, all the while verbally calculating how much fuel we had left.  So he finally found an opening and said MAYBE we could make it through.  WHAT DO YOU MEAN, MAYBE??  So the other flight nurse said there's was NO WAY we were going to attempt it.  Had the pilot not said maybe, she'd be all for it.  So we diverted to Palm Springs instead.  That whole conversation made me so nervous!  Helicopters also do not handle turbulence very well.  They shake quite a bit, but good thing I like turbenlence!

One more thing about work... I did not actually realize that the hospital was a county hospital so I would say 75-80% (or higher) are uninsured.  Thus, they do not have primary care doctors and do not take their medication as prescribed.  What do you mean you haven't taken your blood pressure medication for THREE YEARS??  Thus, I see quite a bit of end stage disease processes and organ failure.  Everything from amputated legs due to diabetic ulcers, kidney failure, hepatitis, HIV, and the list goes on.  It's definitely NOT typical of a regular community hospital and it's SUPER challenging sometimes, but at least I'm getting lots of great experience.  We also see the behavioral health and jail patients, so my education is very well-rounded.  Hope I survive another year!