Advice for First Attending Call?

[OBGirlie]

Just wonder if any of the veterans out there (which means everyone who has at least taken one attending call!) had any advice as I get ready to take my first call supervising residents in a few weeks.

I guess that residents at my institution sometimes discharge triage patients without informing the attending until later! I don't want to be the new graduate who is all paranoid, but I feel like i need updates on matters that involve myself and my medical license! Oh well, tips are welcomed!

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[MeowMix]

Bottom line is that your medical license and your professional reputation are on the line. Residents expect that new attendings will be more cautious and more hands-on, and it's OK. Especially if you did not train in this program, you do not know yet how the group works best. You do not know yet how you will function best. Talk to other attendings about how they manage. i did my fellowship on a deck with more than 40 OB attendings, and even the experienced docs who were new to the facility had many questions for each other about how the system worked.

Best piece of advice i got at the beginning of fellowship was to remember that everyone is your friend until something goes wrong, and then they will throw you under the bus to protect themselves. This does not mean that we approach everyone with suspicion and distrust, or that we do full-on CYA tactics all the time. We can respect residents' autonomy while staying engaged and available, and maintaining a high standard of care.

As a newer attending, i tended to be more involved. I wanted to hear about strip issues immediately, i wanted to know about new patients, and i did not want anyone doing "practice" pushes without me knowing about it. You do not want an over- confident intern "accidentally" catching a baby without you in the room. The residents knew my preferences and were completely ok with it. Also, everyone was treated the same way, so if i had a less experienced or skilled resident, they did not feel they were being babysat.

 

[JulianCrane]

Just wonder if any of the veterans out there (which means everyone who has at least taken one attending call!) had any advice as I get ready to take my first call supervising residents in a few weeks.

I guess that residents at my institution sometimes discharge triage patients without informing the attending until later! I don't want to be the new graduate who is all paranoid, but I feel like i need updates on matters that involve myself and my medical license! Oh well, tips are welcomed!

Hey,
Having done a few attending night calls, I affirm what has been said. I am definitely cautious about patient care and am the attending that needs to know EVERYTHING. But, I do things by letting the residents give me a plan first. If it is a good plan, then I let them execute it. With deliveries, I do stand there until the placenta is out, just my thing, I'm not too much of a hawk about tracings, otherwise, I would go insane. I do think it will take a little time to develop my style, but at this point with every clinical decision I make, I do take a some time to think about just what consequences my decisions may harbor. Good luck to us all. If we just focus on the fact that we are there to help women, we will have our priorities in line.