2010-2011 "OMG I'm an intern!" thread

[Deferoxamine]

Let's bump this. I (and many others) start on Friday. God help us all.

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[jdh71]

Let's bump this. I (and many others) start on Friday. God help us all.

haha

owned

lawl

 

[theneh]

I start on thursday and am really not looking forward to it. I basically am doing IM to attain a cards fellowship. That said, I start with a cardiology rotation and will be working with the program director...He knows I want cards and sure expects something from me, but I haven't touched a book in a long time. I am going over EKG's, ACLS/ ACS protocol at the moment. Any suggestions? I'm feeling incredibly anxious, my guess is I am being ridiculous considering the PD will be more concerned about the new fellows...

 

[jdh71]

I start on thursday and am really not looking forward to it. I basically am doing IM to attain a cards fellowship. That said, I start with a cardiology rotation and will be working with the program director...He knows I want cards and sure expects something from me, but I haven't touched a book in a long time. I am going over EKG's, ACLS/ ACS protocol at the moment. Any suggestions? I'm feeling incredibly anxious, my guess is I am being ridiculous considering the PD will be more concerned about the new fellows...

heh . . . well, I would tell you to not be all worked up about it, but it's too late

you won't be applying for fellowship for two years now, so there's really no need to do much else except for show up on time, get your work done and be present

 

[gutonc]

I start on thursday and am really not looking forward to it. I basically am doing IM to attain a cards fellowship. That said, I start with a cardiology rotation and will be working with the program director...He knows I want cards and sure expects something from me, but I haven't touched a book in a long time. I am going over EKG's, ACLS/ ACS protocol at the moment. Any suggestions? I'm feeling incredibly anxious, my guess is I am being ridiculous considering the PD will be more concerned about the new fellows...

True story. This morning I ran into the PCCM PD here who is a friend of mine (he wrote me an awesome LOR for my non-PCCM specialty a few yrs ago).

Me: You headed over to the unit to check out the new meat?
Him: they don't start until Friday.
Me: But the new interns start today.
Him: Oh...I don't give a s**t about them. As long as they're not actively killing patients, I'm happy.

 

[theneh]

Thanks to both jdh71 and gutonc. Somehow I feel slightly better now. I just hope my seniors will be patient with me. haha

 

[Deferoxamine]

I did minor reading a few weeks ago. I was tempted to pull the book out again before Friday, but now I just don't feel like it anymore.

Right now I know nothing. NOTHING.

In a perjorative sense, I am quite f*cked... amirite?

 

[jdh71]

I did minor reading a few weeks ago. I was tempted to pull the book out again before Friday, but now I just don't feel like it anymore.

Right now I know nothing. NOTHING.

In a perjorative sense, I am quite f*cked... amirite?

proper f*cked

good luck

 

[Deferoxamine]

Yeah well that's kinda my point.

Have I already dropped the ball?

 

[Gastrapathy]

Yeah well that's kinda my point.

Have I already dropped the ball?

There is no ball.

 

[jdh71]

Yeah well that's kinda my point.

Have I already dropped the ball?

There is no ball.

the cake is a lie

 

[DrVanNostran]

I start my acting internship on Tuesday. I look forward to being an interns secretary for a month.

 

[theneh]

Had my first day and it was a bit terrifying. Mostly cause I am on a super busy cardio service with a first year fellow and fast-paced attending and I kept getting lost, and had trouble with the computer system. It was a long day full of fear and uncertainty. luckily nothing horrific happened. I take 3 things from today:
I had a special k bar and coffee in the morning, that's it...i will have stones if this persists
I need to start reading again
I think i can survive residency...maybe...yea...hm, no...sure...eh

 

[jdh71]

Had my first day and it was a bit terrifying. Mostly cause I am on a super busy cardio service with a first year fellow and fast-paced attending and I kept getting lost, and had trouble with the computer system. It was a long day full of fear and uncertainty. luckily nothing horrific happened. I take 3 things from today:
I had a special k bar and coffee in the morning, that's it...i will have stones if this persists
I need to start reading again
I think i can survive residency...maybe...yea...hm, no...sure...eh

Sounds like strong work to me.

No sarcasm intended or implied. Surviving first day is a big deal.

 

[Yakko]

I did minor reading a few weeks ago. I was tempted to pull the book out again before Friday, but now I just don't feel like it anymore.

Right now I know nothing. NOTHING.

In a perjorative sense, I am quite f*cked... amirite?

It's been nearly 8 months since I was on a Medicine floor. I start tomorrow and I think I know less than I did before starting 3rd year.

I'm a bit tense.

 

[AZhopeful]

It's been nearly 8 months since I was on a Medicine floor. I start tomorrow and I think I know less than I did before starting 3rd year.

I'm a bit tense.

It's been about 8 months for me, too. Good thing my program seems to have thought, "hey, AZ is interested in Pulm/CC! Let's put him in the MICU on his first month!".

After the first 3 rotations or so, it feels like M4 year may have been the worst thing to happen to my medical education... We'll see how much I remember when I report for duty on Friday night

 

[Deferoxamine]

Survived. I guess that's the important part.

 

[obiwan]

time to hijack the thread so sorry

any words of advice from the sages for us newly minted JARs... i'm in the ER for my first month so I have some time before i'm brought to the front lines

 

[Instatewaiter]

Since I'm also a JAR I dont have much advice but for the ED here it goes:
If the patient has lungs, they probably need a CT of them. Include contrast almost all of the time without checking the renal function.

If a patient is hypotensive and has a history of cardiomyopathy, please give fluids before doing a physical exam. It's never caused by volume overload.

If a patient looks septic, give antibiotics prior to getting blood cultures. It really helps with management decisions later on.

 

[jdh71]

Since I'm also a JAR I dont have much advice but for the ED here it goes:
If the patient has lungs, they probably need a CT of them. Include contrast almost all of the time without checking the renal function.

If a patient is hypotensive and has a history of cardiomyopathy, please give fluids before doing a physical exam. It's never caused by volume overload.

If a patient looks septic, give antibiotics prior to getting blood cultures. It really helps with management decisions later on.

I don't think I've ever seen you try and be funny. I'm glad to see you're starting to lighten up.

 

[Deferoxamine]

Yeah it's an interesting transition to go from 8 lazy months to full-blown workday and then some, with real responsibilities again, people asking you to make decisions on the fly, in (often) an entirely foreign hospital system.

People skills and organization used to be my strong points, and it's weird to suddenly be at a place where EVERYONE is on top of their ****.

 

[theneh]

I was on call yesterday. We have both phones and pagers, but the nurses always call us. Damn phones only invite more ridiculous nurse inquiries late at night! BTW, I had no idea i would have to cross-cover around 40 or so patients...My 4th admit was interrupted by 3 calls, and when i got back to the ED to finish the admit, my patient had been transferred up, within 5 minutes I heard an RRT... guess who's pt that was? yup, this guy! pt is okay, but i was definitely sh#*ting my pants...

 

[AZhopeful]

Got owned on my third night in the MICU. Experienced my first crashing patient who went from "barely looks sick enough to be in MICU" to "thoracic surgery, cards, and MICU teams all trying to figure out what to do to save his life". As he's circling the drain, a transfer from the bone marrow transplant unit comes in with likely sepsis, and the standard cadre of train-wreck BMT problems.

At least I handled the cross-cover ok.

 

[Instatewaiter]

I don't think I've ever seen you try and be funny. I'm glad to see you're starting to lighten up.

Since intern year is over, I think it was about time. Time to move onto my next stage: being a sarcastic Jar with a whole bunch of snarky posts

Got owned on my third night in the MICU. Experienced my first crashing patient who went from "barely looks sick enough to be in MICU" to "thoracic surgery, cards, and MICU teams all trying to figure out what to do to save his life". As he's circling the drain, a transfer from the bone marrow transplant unit comes in with likely sepsis, and the standard cadre of train-wreck BMT problems.

At least I handled the cross-cover ok.

Nicely done. Getting through that first tough night is always a good feeling. Makes you realize that you have help and that you can get through intern year.

 

[Yakko]

Just checking back in. Last Friday was an absolute **** show in that I had no idea how to do anything, and could barely get my notes and work done.

Yesterday, (day 5), I was post-shortcall, and the team leader because my 2nd year was post call. (Third years are mostly on electives and basically MIA on the floors)

10 patients, 1 intern, two third year students, and a sub-I, and a cross-covering (not really) 2nd year who had her own patients to deal with. Oh, and I had my first clinic from 4-8PM.

I ended up leaving the hospital at about 930, but we somehow managed to do rounds, d/c 3 patients, schedule follow ups, handle an admit, and get all the miscellany done.

It was nice to see that I could make it from a day like that, but I'd like to avoid repeating it for at least a coupla weeks.

 

[theneh]

Just checking back in. Last Friday was an absolute **** show in that I had no idea how to do anything, and could barely get my notes and work done.

Yesterday, (day 5), I was post-shortcall, and the team leader because my 2nd year was post call. (Third years are mostly on electives and basically MIA on the floors)

10 patients, 1 intern, two third year students, and a sub-I, and a cross-covering (not really) 2nd year who had her own patients to deal with. Oh, and I had my first clinic from 4-8PM.

I ended up leaving the hospital at about 930, but we somehow managed to do rounds, d/c 3 patients, schedule follow ups, handle an admit, and get all the miscellany done.

It was nice to see that I could make it from a day like that, but I'd like to avoid repeating it for at least a coupla weeks.

wow. that really sucks. having a senior to show you the ropes a bit and be a safety net, not only ensures things get done, but accelerates the learning process. my first week i feel like I've learned so much, mostly hospital dependent protocol and paperwork, but i could not have done so without help. I'd be extremely pissed in your position, but i gotta say it seems you handled it way better than most would have.

 

[Foodie]

Since I'm also a JAR I dont have much advice but for the ED here it goes:
If the patient has lungs, they probably need a CT of them. Include contrast almost all of the time without checking the renal function.

If a patient is hypotensive and has a history of cardiomyopathy, please give fluids before doing a physical exam. It's never caused by volume overload.

If a patient looks septic, give antibiotics prior to getting blood cultures. It really helps with management decisions later on.

Also, get EKGs on chest pain pts and don't check them afterwards. Same goes for trops.

 

[morbo]

If you are in an academic setting, utilize your medical students! You'd be surprised how much heavy lifting they can do once you mold them into your own style.