4 months to CA1 for me...thank God!

[DreamLover]

I have been marking off the days on my calendar one by one since July 1st.

I have 4 more months before I leave this place and head off to my Advance Anesthesiology position.

All I can say is that as this year has gone by and I am currently 17 days into my 3rd unit month...I don't like critical care medicine. That's probably the most helpful thing I've learned thus far in this excrutiating year of IM.

Other things I have learned:

1. No matter if the DAU is positive for cocaine...they have "not used in atleast 3 weeks"

2. No matter how many times they have been discharged with their beta blocker...they still aren't taking it.

3. No matter how many times you tell them that you don't treat diabetic peripheral neuropathy with morphine, they still say it's the only thing that helps.

4. No matter how early you get to the hospital to pre round, it's never enough time

5. I hate rounding

6. I HATE my pager

This list could go on and on and on....I'm really not as bitter as this post sounds...but if you couldn't tell, I'm on call today and that makes me transiently bitter

Please feel free to add to the list what you've learned thus far from your year of IM!!

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[Coastie]

I have been marking off the days on my calendar one by one since July 1st.

I have 4 more months before I leave this place and head off to my Advance Anesthesiology position.

All I can say is that as this year has gone by and I am currently 17 days into my 3rd unit month...I don't like critical care medicine. That's probably the most helpful thing I've learned thus far in this excrutiating year of IM.

Other things I have learned:

1. No matter if the DAU is positive for cocaine...they have "not used in atleast 3 weeks"

2. No matter how many times they have been discharged with their beta blocker...they still aren't taking it.

3. No matter how many times you tell them that you don't treat diabetic peripheral neuropathy with morphine, they still say it's the only thing that helps.

4. No matter how early you get to the hospital to pre round, it's never enough time

5. I hate rounding

6. I HATE my pager

This list could go on and on and on....I'm really not as bitter as this post sounds...but if you couldn't tell, I'm on call today and that makes me transiently bitter

Please feel free to add to the list what you've learned thus far from your year of IM!!

I gotta say, intern year has gotten better. Efficiency has shot up through the roof, and I actually discovered that I love critical care medicine: something I was fairly neutral about in medical school. I've got so many internship stories, but here is one from today:

Somewhere on the medicine wards...

Nurse: Doctor, help help, this patient is coding!
Me: What's going on? (sees patient laying against the wall)
Nurse: Call a code blue, call rapid response!
Me: Uh, no, wait. He's breathing, and....yeah, he has solid pulses. Somebody get his chart.
Nurse: He is a hospitalist patient.
Me: Page them...*flips through chart*. Looks like he has atypical seizures versus pseudoseizures. He is shaking a bit. Get a bite block so he doesn't break one of his gold teeth (he is also wearing HUGE bling).
Nurse: How can we tell if he is having a pseudoseizure?
Me: *removing huge gold bling from the guys neck* Quick guys, take his gold chain, and sell it off while we can.


Patient woke up in a second. One of the best clinical calls I've made in all of intern year.

 

[cchoukal]

that's consultant-level medicine. Solid.

 

[Gimlet]

Me: *removing huge gold bling from the guys neck* Quick guys, take his gold chain, and sell it off while we can.


Patient woke up in a second. One of the best clinical calls I've made in all of intern year.

LOL!

 

[Coastie]

Before I get any haters, obviously I assessed the patient and realized that he was "having" a pseudoseizure.

Alright, let's hear some more fun intern stories.

 

[nociceptor]

I !

I have no idea what you wrote I can't stop staring at your avatar. They just don't make actresses like that anymore.

/dirty old man

 

[nutmegs]

I have been marking off the days on my calendar one by one since July 1st.

I have 4 more months before I leave this place and head off to my Advance Anesthesiology position.

All I can say is that as this year has gone by and I am currently 17 days into my 3rd unit month...I don't like critical care medicine. That's probably the most helpful thing I've learned thus far in this excrutiating year of IM.

Other things I have learned:

1. No matter if the DAU is positive for cocaine...they have "not used in atleast 3 weeks"

2. No matter how many times they have been discharged with their beta blocker...they still aren't taking it.

3. No matter how many times you tell them that you don't treat diabetic peripheral neuropathy with morphine, they still say it's the only thing that helps.

4. No matter how early you get to the hospital to pre round, it's never enough time

5. I hate rounding

6. I HATE my pager

This list could go on and on and on....I'm really not as bitter as this post sounds...but if you couldn't tell, I'm on call today and that makes me transiently bitter

Please feel free to add to the list what you've learned thus far from your year of IM!!

seriously, if I had to do an entire year of internal medicine, I would have quit or killed myself. no joke.

gotta love the peds-surg-IM mixitup of the categorical internship. at least it's a different kind of hurt throughout the year.

NICU nurses are definitely the bitchiest though, holy hell.

 

[Dr Serenity]

I have been marking off the days on my calendar one by one since July 1st.

I have 4 more months before I leave this place and head off to my Advance Anesthesiology position.

All I can say is that as this year has gone by and I am currently 17 days into my 3rd unit month...I don't like critical care medicine. That's probably the most helpful thing I've learned thus far in this excrutiating year of IM.

Other things I have learned:

1. No matter if the DAU is positive for cocaine...they have "not used in atleast 3 weeks"

2. No matter how many times they have been discharged with their beta blocker...they still aren't taking it.

3. No matter how many times you tell them that you don't treat diabetic peripheral neuropathy with morphine, they still say it's the only thing that helps.

4. No matter how early you get to the hospital to pre round, it's never enough time

5. I hate rounding

6. I HATE my pager

This list could go on and on and on....I'm really not as bitter as this post sounds...but if you couldn't tell, I'm on call today and that makes me transiently bitter

Please feel free to add to the list what you've learned thus far from your year of IM!!

What you REALLY need to know as an intern:

1. GOMERs don't die.
2. GOMERs go to ground.
3. At a cardiac arrest, the first procedure is to take your own pulse.
4. The patient is the one with the disease.
5. PLACEMENT comes first.
6. THEY CAN ALWAYS HURT YOU MORE.
7. If you don't take a temperature, you can't find a fever.

I'm sure by now you know the rest; if you don't, ya know where to look it up...

 

[OB1🤙]

What you REALLY need to know as an intern:

1. GOMERs don't die.
2. GOMERs go to ground.
3. At a cardiac arrest, the first procedure is to take your own pulse.
4. The patient is the one with the disease.
5. PLACEMENT comes first.
6. THEY CAN ALWAYS HURT YOU MORE.
7. If you don't take a temperature, you can't find a fever.

I'm sure by now you know the rest; if you don't, ya know where to look it up...

I just recently reread this book, and it was even more amazing than I remember it being as an MS1, which is obviously no surprise.

 

[badgas]

These last 4 months can't move fast enough. 2 more months IM, 1 anesth and 1 rads. Unfortunately, one of those IM months is at the VA. Here is an honest to god standard call at the VA.

7:00 arrive to round on 8-10 patients
9:00 admit first patient... 35 y/o M with STREP THROAT!
9:00-10:00 fight with ED about admitting a pt with STREP THROAT
10:00 admit 85 y/o M myelodysplasic FULL CODE for the 15th time of year for simple blood transfusion
12:00 admit ANOTHER blood transfusion pt
14:00 admit end stage liver dz pt from NH for his asymptomatic ascites... only purpose for admission is a paracentesis
15:00-23:00 attempt to get a paracentesis kit from nursing staff. "we can't find any. we are out" paracentesis never gets done.

Then we move on to crosscover issues. On average, get paged once every 10 minutes. Here are the common issues.

#1 - nurse "hello dr, i wanted to report mr. veterans bp is 107/70"
me "please don't call me at 3 am with normal BPs again"

#2 - nurse "hey, we just can't not get an IV on mr. HIV despite multiple attempts. you need to do it or put in a central line"
me - go to see the patient. ZERO attempts were made. apparently nursing didn't want to deal with IVs and HIV. drop an IV in on first attempt

#3-6 - nurse "hello dr, mr veteran is very combative. we need haldol and restraints"
me - go to see patient. resting comfortably in bed. no prior episodes of aggitation at all.

REPEAT #1-6 q10 minutes ALL DAMN NIGHT.

So in short, the VA is a waste of my time, taxpayers money and more importantly, veterans health. I leave that building every day with 1 less month on my life expectancy. Ok, that is my rant on the VA.

 

[Dr Serenity]

These last 4 months can't move fast enough. 2 more months IM, 1 anesth and 1 rads. Unfortunately, one of those IM months is at the VA. Here is an honest to god standard call at the VA.

7:00 arrive to round on 8-10 patients
9:00 admit first patient... 35 y/o M with STREP THROAT!
9:00-10:00 fight with ED about admitting a pt with STREP THROAT
10:00 admit 85 y/o M myelodysplasic FULL CODE for the 15th time of year for simple blood transfusion
12:00 admit ANOTHER blood transfusion pt
14:00 admit end stage liver dz pt from NH for his asymptomatic ascites... only purpose for admission is a paracentesis
15:00-23:00 attempt to get a paracentesis kit from nursing staff. "we can't find any. we are out" paracentesis never gets done.

Then we move on to crosscover issues. On average, get paged once every 10 minutes. Here are the common issues.

#1 - nurse "hello dr, i wanted to report mr. veterans bp is 107/70"
me "please don't call me at 3 am with normal BPs again"

#2 - nurse "hey, we just can't not get an IV on mr. HIV despite multiple attempts. you need to do it or put in a central line"
me - go to see the patient. ZERO attempts were made. apparently nursing didn't want to deal with IVs and HIV. drop an IV in on first attempt

#3-6 - nurse "hello dr, mr veteran is very combative. we need haldol and restraints"
me - go to see patient. resting comfortably in bed. no prior episodes of aggitation at all.

REPEAT #1-6 q10 minutes ALL DAMN NIGHT.

So in short, the VA is a waste of my time, taxpayers money and more importantly, veterans health. I leave that building every day with 1 less month on my life expectancy. Ok, that is my rant on the VA.

I think you forgot to insert the pages you get for patients that are on services that you are NOT cross-covering for...

I got just a smidge of what VA life is like during my medicine sub-I there a few months back...I'm sure it's 100X worse as a true intern...

 

[OB1🤙]

Try doing 10/12 months at the VA. LIFE IS AWESOME.

And by awesome, I mean it's awesome I haven't killed myself and everyone around me yet.

I feel so sorry for the poor vets who get subjected to such pisspoor care.

 

[Dr Serenity]

Try doing 10/12 months at the VA.

 

[DendriticCell]

All i know is that i dont have to stick my finger into ppl's rear end after this year....

 

[nutmegs]

I stopped doing butts. One day I just said "this isn't what I do. I do mouths, not butts" and I'd placed enough clutch foot IVs, EJs, and a-lines for my IM coterns that it actually worked.