Advice for Pediatric Residents starting residency in June 2009

TexasRose

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    Please any advice how to cope with the new environment, the fatigue and new colleagues during the the beginning of residency.

    Any suggestions will be appreciated.
    1. Rest and relax now.

    2. Start residency rested and relaxed and with a positive attitude.

    :)

    The first few calls will be painful, but the adjustment is quicker than you might think!
     

    Stitch

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      1. Rest and relax now.

      2. Start residency rested and relaxed and with a positive attitude.

      :)

      The first few calls will be painful, but the adjustment is quicker than you might think!

      Agreed. Enjoy 4th year and drink. :)

      That said, go into residency knowing that it's not medical school. Your coworkers are not competition, they are collegues. Treat them as such. Look out for one another and make sure you do your work without dumping on others, even when it gets tempting to 'just sign out' after a tough night. If you take care of one another, you'll get paid back.

      Remember that your seniors are there to help you out. You're not expected to have all the answers (and remember that you don't have all the answers).

      Make nice with the nurses. They can break you on call, like it or not. Plus some of the good ones really know the ropes and can help you through things. Yes, they can be quite irritating at times too, but don't let it get to you. Pick your battles. Most things don't matter that much.

      And finally, go out once in a while. Have some fun when you can. Commiserate with your friends. There IS time if you make it, despite all the hard work.
       
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      arasheed

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        Thank You "Texas Rose" and "Stitch". I appreciate your advice.

        Its only that i am quite anxious about residency, as i had read some frightening posts on this forum regarding issues encountered during residency.

        Anyways thanks!!!! will also appreciate further input from anybody on the forum.
         

        Sweet Tea

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          Stitch pretty much said what I was going to say. I've been through 2 internships now, and he's pretty much hit all the high points. Your intern year is like nothing you've ever experienced before, and you're going to feel over your head. But your seniors are there to support you, and your fellow interns are there all going through the same thing. You'll be okay.

          And make sure you enjoy your fourth year!!!
           

          kristing

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            Sleep when you can.
            Ask for help when you need it.
            I will second and third this idea because it is SO IMPORTANT: make nice with the nurses. If they like you, you will do well. If they don't your life can be very very bad.
             

            Sweet Tea

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              Sleep when you can.
              Ask for help when you need it.
              I will second and third this idea because it is SO IMPORTANT: make nice with the nurses. If they like you, you will do well. If they don't your life can be very very bad.

              And if you make nice with the nurses (for real nice, not bull sh!t nice, they can smell a fake), they will a) go above and beyond to help and b) help you sleep when you can. A good nurse is worth their weight in gold.

              When I'm on call in my favorite unit in my hospital I do a lap or 2 before going to bed to check up on things/ see if any one needs a tylenol or heparin order signed/whatever. The nurses appreciate you making an effort to tie up loose ends, and they'll usually help you sleep if you do this and they'll stack their calls. Would you rather get paged once at 3:45am and deal with 4-5 things, or get paged 4-5 times between 3:30am-3:55am?
               

              Peds2ER

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                when you get those calls in the middle of the night that wake you up, if there's any doubt... resist the temptation to phone it in. Get your booty up and go assess the patient. I've seen a few people burned because they didn't follow this simple rule. GO SEE THE PATIENT!!!
                 

                BigNavyPedsGuy

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                  A couple of things:

                  -An attending taught me a good thing to go by: if you're on the fence about doing something (treating a patient, changing fluids, etc) and you're going to worry about after you go home - just do it.
                  -I ALWAYS try to go around to the nurses late at night when/if things calm down and just say "hey, I wanted to touch base about this patient. Any questions or concerns. My plan is . . . . . The thing I'm worried might happen is . . . .

                  This will go a long way toward building favor with the nurses it will also make patient care better and help you learn what's going on with the patient. Oh, and it will make them less likely to nickel and dime you with petty calls.
                   

                  oldbearprofessor

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                    One thing not mentioned is that I would be extremely careful to not "guess" when talking with attendings. If the attending asks "Does the baby have a murmur?" and you didn't get a chance to listen yet, just say "I haven't had the chance to do a full exam yet". This may get them a bit annoyed, but nothing like what will happen when the attending picks up the stethoscope and hears the murmur across the room.:cool:

                    More common is being asked "Is the baby on X medication?" or "What labs were ordered today?". The tendency for the resident to just guess is real - sometimes you think you know, other times, it's just a guess. Often it's wrong. This happens to everyone on occasion, but with some residents, it's a pattern and an obvious one.

                    I know folks reading this may think this doesn't happen, but it does all the time. Having residents "make things up" repeatedly is one of my first clues that I have a resident that I won't be able to trust.

                    A resident that says "I'm not sure about the labs" or "I didn't get to that yet" is a keeper.
                     

                    Sweet Tea

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                      One thing not mentioned is that I would be extremely careful to not "guess" when talking with attendings. If the attending asks "Does the baby have a murmur?" and you didn't get a chance to listen yet, just say "I haven't had the chance to do a full exam yet". This may get them a bit annoyed, but nothing like what will happen when the attending picks up the stethoscope and hears the murmur across the room.:cool:

                      More common is being asked "Is the baby on X medication?" or "What labs were ordered today?". The tendency for the resident to just guess is real - sometimes you think you know, other times, it's just a guess. Often it's wrong. This happens to everyone on occasion, but with some residents, it's a pattern and an obvious one.

                      I know folks reading this may think this doesn't happen, but it does all the time. Having residents "make things up" repeatedly is one of my first clues that I have a resident that I won't be able to trust.

                      A resident that says "I'm not sure about the labs" or "I didn't get to that yet" is a keeper.

                      I have a couple of attendings who are very helpful on the phone, but will ask oddball questions like "What was the potassium and BUN last Tuesday at 3am?" This is why when I'm going to have to call an attending with a question I really don't know the answer to, I call from the bedside, after examining the patient, with the chart open, the computer open and labs/radiology pulled up, and the nursing chart. I've found that most attendings are okay if you say "hold on, let me pull up the xray...hey there's a new consolidation in the left lower lobe and that's where he's got decreased breath sounds." This technique is especially helpful when you're crosscovering and seeing the patient for the first time.

                      Other things to help intern year: don't screw over your fellow residents. You can be the smartest person in the world and the number-one umbilical line placer, but if you consistently show up late, ask people to switch calls, and sign out stupid things to the on-call person and don't do your own work, you won't win friends. It also means helping out when you can; say the post-call person on your team got a late admit and is now behind on pre-rounding. Volunteer to gather labs and vitals for them or hell just run to the caf and grab them the caffienated beverage of their choice and you'll be repaid in spades.

                      I love my residency class. Most of us really go out of our way to help each other out, and it's made for a tight-knit group who actually enjoy working together. It makes it easier to work together, and we hang out together a lot, too. All but 3 of the guys in my residency are shaving their heads for St. Baldrick's day together on Saturday, and several of us girls are running a half-marathon together the following Sunday. Being friends makes residency so much easier.
                       
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                        All but 3 of the guys in my residency are shaving their heads for St. Baldrick's day together on Saturday, and several of us girls are running a half-marathon together the following Sunday. Being friends makes residency so much easier.

                        What is this with guys shaving their heads in peds residencies? I had this happening at three of the programs I interviewed at. I like my hair! ;)
                         
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