I had my 90 day review this week. When I first started my job in January the clinical services coordinator when over everything that would comprise my review of the first 90 days.
They would send our Head Honcho NP out to observe me for a few hours, they would do a chart review of a selected number of my charts, and they would review input from all my clinical preceptors that had worked with me in those 90 days. We would talk about my strengths, weaknesses, and talk about goals moving forward. It sounded daunting, and extremely terrifying to go through all that. It was like a site visit from midwifery school on steroids.
In midwifery school we had clinical preceptors that oversaw our every day interactions with patients and guided our clinical learning, but our professors would come out once or twice a quarter for site visits. At these visits they would do much of the same that I have already listed above. So, although I was no stranger to someone evaluating my clinical performance, when it’s your first job, it’s a slightly more high-stress situation.
Needless to say, they didn’t fire me. It went fine, as nervous as I was. In addition to providing me feedback of my performance for the last 90 days, it also provided the space for me to think about how far I’ve come, how far I have yet to go, and my goals for the next 90 days, next six months, and next year. What do I want my practice to look like? What skills do I want to develop? What do I want to learn?
This weekend I had to refer (yet another) patient to the ER. Usually I usually talk to the charge nurse on the phone when I call, but this time, when I explained my situation the nurse went to get the Doc. Fear of inadequacy/sounding like an idiot ensued while I was put on hold. I’m familiar with giving report to other nurses. I’m usually giving report to another woman, when I mention details that are not quite so significant they understand why I included them, because they are also nurses and think the same way I do. They generally ask a few pointed questions and then hang up. I’d never given report to an ER doc before. I’m not sure what I was so scared of, and some of my friends have told me I probably suffer from impostor syndrome, but all I knew is that I didn’t want to sound like an idiot. And you know what? I didn’t. Because I’m not an idiot. I explained what was going on. He asked some pointed questions and then hung up. And then called me back a few minutes later because he forgot to ask me some questions. Because you know what else? Not everyone knows everything, and we all have learning to do.
While I have definitely learned about a million things (or at least it seems like it) since I started, I got to think about what I wanted to learn next. On my list of skills I want to learn are:
1) Paracervical blocks (When an anesthetic is injected into the cervix for difficult IUD insertions and for surgical or aspiration abortions)
2) Medication abortion (I’m already slated for Med AB training later this month! So excited!)
3) Endometrial biopsy (When a sample of tissue from the uterine lining is taken to rule out pathology/cancer)
4) More about primary care and initial screening and management
Those are some pretty big skills, so I’ll leave it there for now. Something that I love about the work I do is that every time I walk into a room, for the most part, I have a problem to solve. I am an investigator. I am a scientist. And based on how I feel after 90 days, even after 90,000 days I’m sure I’ll still be learning.