Self-appraisal during the internship of Ultrasound Department 1 After completing the internship task of radiation diagnosis, I entered the internship stage of my major-ultrasound. I am determined to be an excellent ultrasonic diagnostic doctor. Internship has made me take a step towards this goal. Although there is still a long way to go, I believe that as long as I work hard and put my heart into it, this distance will be narrowed step by step. After entering the internship, I found that ultrasound is far from as easy as I thought. My theoretical knowledge at school is mainly diagnostics. However, what I see in clinic is not all standard sonograms. Different patients have their own advantages in normal structure and morphology. It was really difficult at first, and I didn't know many images. My teaching teacher asked me to know the normal images first, and then remember the abnormal sonograms. Only in this way can I accurately diagnose abnormal images.
Another key of ultrasound is manipulation, and in-depth manipulation must rely on clinical practice to make continuous progress. The importance of manipulation is that sometimes even if it can be diagnosed, if the manipulation is not in place, the key ideal section can not be reached, and the lesion can not be clearly displayed, there is no way to diagnose it. This lies in the characteristics of ultrasound, especially the real-time imaging of heart ultrasound. The patent ductus arteriosus in infants is often very subtle, which requires a slight rotation of the probe and careful observation, and the operation is not in place. Manipulation is indeed a difficult learning process, which requires both hand strength and arm strength. Especially for patients with thick fat layer, sometimes it is necessary to press with both hands to get an ideal image, otherwise it is impossible to diagnose. At the beginning of the operation, my hands began to tremble, so I think maybe I should practice my hand strength and finger strength like an acupuncture and massage doctor. I will definitely strengthen the manipulation practice in the future.
Teacher Xie, director of the Department of Ultrasound, said: "The technique should be alive, and books should not be forcibly moved. For example, if you look at the fetal lips, you will say, first find the fetal chin and punch the lips. In fact, when you can't hit your chin but your eyes and nose are good, you can choose to hit your lips, but it's easier. " It can be seen that skills need a certain comprehension ability, and only by doing more and summing up can they be improved. It's really urgent to start an internship. In the process of practice, the theory is constantly hindered by the gap, but as long as it persists, such a process will always become a thing of the past and gradually become familiar: when you see hydronephrosis, you will start looking for stones in the next step; The high echo in the gallbladder makes the patient turn over. If it moves, it is a stone, and if it doesn't move, it is a polyp. Seeing that the acoustic halo sign on the ultrasound image of the liver is a space-occupying lesion of the liver, and seeing that the intestine is obviously dilated and considering intestinal obstruction, theory and practice are gradually linked, and I have gradually made progress. I remember Teacher Xie told me about an intussusception patient in his fifties. Because the diagnosis took a long time, because he had never seen an intussusception patient except a child, but ultrasound was like this. Since we have seen the sonogram of intussusception, there is nothing to doubt, so we should dare to diagnose it.
The infinite possibilities in medicine, we should dare to believe what we see: congenital stenosis of individual arteries, patients with congenital monocular kidney and so on. At that time, I met a patient who had never seen the echo of gallbladder. If she shrinks, she will also see the echo of the gallbladder fossa. Teacher Zhao was firmly diagnosed as congenital absence of gallbladder, which was confirmed by surgery. Teacher Zhao said that the basis of diagnosis is the anatomical relationship between gallbladder, common bile duct and adjacent structures. In the teachers, I deeply realized the spirit of self-confidence but not conceit, which also showed the importance of anatomy to ultrasound. Ultrasonic diagnosis doctors also need to have rich clinical knowledge, and we also need to look at and ask the patient's medical history, so as to have a clear mind, and certain clinical experience will in turn help our ultrasonic diagnosis. Usually, we should pay more attention to clinical communication and gradually improve the diagnostic level.
The hospital regularly arranges professors from China Medical University to give lectures. I remember Professor Wang from the First Affiliated Hospital talked about gallbladder. There is a lot of knowledge about a small gallbladder. The most impressive thing is that the gallbladder of chronic cholecystitis is full after fat meal test, while the gallbladder of adenomyosis is strongly contracted after fat meal. The fatty tissue in the neck of gallbladder is not limited to thickening; Gallbladder disease is not limited to gallbladder tenderness and the like, which has benefited me a lot. I like to do three-dimensional color Doppler ultrasound, because many pregnant women do prenatal diagnosis. I like to feel the happiness of those expectant mothers, and I will be happy when I see their happy expressions. But we will also meet sad mothers, such as fetal malformation, and sometimes we will be sad to see their sad tears. In particular, some pregnant women don't do three-dimensional color Doppler ultrasound until the expected date of delivery, and it is cruel to find deformity, so the propaganda of prenatal diagnosis needs to be strengthened, and our responsibilities are getting heavier and heavier.
Good doctor-patient relationship is also an important part of a doctor's life. Patients are vulnerable groups. As voluntary workers, we should not only treat their physical diseases, but also pay attention to their mental pain. We should care about them and respect them. For example, you should make it clear to the patient when you collect the bill. We need to fill the bladder when we make kidneys, ureters and bladders, but we can't eat before we make liver, gallbladder, spleen and pancreas. We should answer the patient's questions patiently and gently. Once, it was the first time that I met the misunderstanding of the patient's family, saying that we were unfair, and the patient who queued late did it first. In fact, the patient just entered the clinic to pay the ticket in line, and did not do it first. I was puzzled by the noise of that family member, but I calmly and patiently explained it and solved the misunderstanding of the family member. I think I can get along well with patients as long as I treat them sincerely. With the rapid development of ultrasound, the application of ultrasound is more and more extensive, occupying an irreplaceable position in auxiliary examination. With the rapid development of ultrasonic diagnosis knowledge, every ultrasonic diagnostic doctor will not relax his study. I will work harder to charge myself and become a qualified ultrasonic diagnostician as soon as possible to serve more patients.
Self-evaluation in the probation period of Ultrasonography 2. Looking back on the dribs and drabs during this period, although it can't be said that it is passionate, it is paid after all. Although the harvest is not great, it far exceeds expectations. Nowadays, it is really sad to leave the teachers who led us into the ranks of ultrasound, but everything must be settled. This time, we plan to get together better next time.
When I first entered the department of ultrasound, I had a lot of maladjustment. The combination of theory and practice is still so strange to me. Everything I learned at school was refined bit by bit, and then I realized that what I learned at school was so rare.
In less than two months, I understand that ultrasound is not as easy as I thought. My theoretical knowledge at school is mainly diagnostics. But in clinic, what I see are not all standard sonograms. Different patients have their own advantages even if their structures are normal. I still remember the day when I first came to the ultrasound department. I didn't even know that the pictures and teachers were strange. At that time, I hardly knew where to start, but the teacher soon took me in. A week later, when the environment became familiar, the teacher began to arrange for us to learn to type a report. Don't be mistaken for a report-it's nothing more than typing on the keyboard to record the teacher's description, but it's not that simple! Because there will be hundreds of patients in the department every day, the average time for each patient is about five minutes, and that for 100 patients is 500 minutes, while the working time per day is actually only 450 minutes. From this, we can imagine the importance of accuracy and speed of typing reports. In addition to learning to make reports, every Thursday afternoon, department teachers will arrange time to explain some basic knowledge about ultrasound and some typical lesions, so as to consolidate and enrich our knowledge.
In addition, I have mastered the inspection techniques of abdominal, urine, gynecology and body surface diseases, mastered the diagnosis of these diseases, further understood the two-dimensional and three-dimensional inspection methods of heart, peripheral blood vessels and fetus, and further understood the contrast-enhanced ultrasound technology and a series of ultrasound-guided puncture biopsy techniques.
Through this internship, I have a more detailed and profound understanding of my major, more understanding of the actual operation, enhanced my sensibility and cognition of professional knowledge, and gained a new understanding of my major. From this internship, I realized that there is a certain distance between the actual work and the knowledge in books, and I need to study further. As the saying goes, a journey of a thousand miles begins with a single step, and these basic skills cannot be learned thoroughly in books. The short internship opened my eyes, and I learned a lot, which also made me think about the industry I want to engage in in in the future. This one-and-a-half-month internship seems to sublimate my thoughts once again and give me a new understanding of life.
This internship made me deeply realize that reading is a way to increase my knowledge and broaden my horizons, but it is also an excellent choice to improve my comprehensive quality by practicing more, enjoying the practical work in practice, touching the pulse of society and setting myself a position.