Any other interns feeling overwhelmed?

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All the other co-interns seem very happy and enthusiastic running around busily doing all their paperwork and admitting new patients. But I feel so tormented inside by the amount of work and lack of satisfaction I am on the verge of tears at times. Only for a year, I tell myself. Only for a year.
 
Hang in there. It's a steep learning curve. You may have problems, or you may just be acutely aware of how much you need to figure out. August was my worse month of intern year. I made a rule for myself that the only place I could cry was in my car on my way home from work. It was a 10 minute drive, I got it out and then moved on. It was crazy; I switched services, something clicked, and the rest of the year was fine. It'll get better, intern year was actually pretty fun once I got the hang of it.
 
At least some of those "happy and enthusiastic" interns feel the same as you, or worse. Take a cue from them, and put on your own cheerful face for the duration. It's only while you are at work, and only for a year, so fake it till you make it.

Make a mental note of every success and thing you get right, and give yourself a pat on the back for it.

Turn every negative experience into a learning opportunity - "It took me too many tries to get that right, but now I know how not to do it", "I didn't notice that, but I will next time", "Now I know who to call about that", and so on.

Talk to your fellow interns, and try to make friends with them. People who have good relationships with their colleagues are more likely to be successful long term than those who are more isolated.

Good luck.
 
urdnot said:
All the other co-interns seem very happy and enthusiastic running around busily doing all their paperwork and admitting new patients. But I feel so tormented inside by the amount of work and lack of satisfaction I am on the verge of tears at times. Only for a year, I tell myself. Only for a year.
Click to expand...

95% of interns feel lost, stupid, and completely overwhelmened right now

5% feel like they've got it all under control. Most of them are really, really dangerous.
 
I felt the same way! I was also on crutches the first week (I was that guy who played sand volleyball 2 days before intern year started and hurt my ankle). Imagine doing those 30-hour calls on a severely sprained ankle!

after walkin on it for 30 hours, it was twice the size when I got home. bad memories!
 
You're only one week into this. Nobody is "running around, happily getting their work accomplished in a timely fashion" at this point. Some of them just manage to smile as they get overwhelmed.
 
Hour30 said:
I felt the same way! I was also on crutches the first week (I was that guy who played sand volleyball 2 days before intern year started and hurt my ankle). Imagine doing those 30-hour calls on a severely sprained ankle!

after walkin on it for 30 hours, it was twice the size when I got home. bad memories!
Click to expand...

Haha! At least it was only a week. We had one who injured his Achilles, and had to ride a skateboard looking scooter thing around the hospital for like 2 months. Youd be rounding and something would flash by, your hair blown back...oh dont worry, thats just Dr Scooter!
 
Just starting to get used to the day-to-day and now I'm expected to manage a med student!

It's only a matter of time before I'm exposed for the fraud I am...:scared:
 
urdnot said:
What's the risk of not being promoted/passing your internship?
Click to expand...

Not sure what you're asking here.

What (numerically) is the chance of this happening? A small but non-zero number.

Or...

What happens if you don't get promoted? You may/should get a chance to remediate but you should assume you're fu**ed.
 
h7809AB1F



I feel like my notes suck, presentations suck, differentials suck, plans suck, pretty much I'm bad at everything. Just 11 months and 2 more weeks then off to greener pastures. I really hope I don't get fired.
 
I have absolutely zero clue what I'm doing. My notes and presentations are terrible. I often go to sleep thinking I've mismanaged multiple patients throughout the day.

However, now I'm getting paid for it? And free lunches? Whats not to be happy about 😀

shopsteward said:
so fake it till you make it.
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I am so sick of hearing this. Heard it all during undergrad when completing medical school required classes and volunteering. Heard it throughout MS1-2, and all throughout the wards M3-4. Heard "fake it till you make it" on the interview trail and now intern year.

Enough about faking being a successful well adjusted individual! Just be happy with the journey. Holy **** SDN.
 
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Smurf Account said:
I have absolutely zero clue what I'm doing. My notes and presentations are terrible. I often go to sleep thinking I've mismanaged multiple patients throughout the day.
However, now I'm getting paid for it? And free lunches? Whats not to be happy about 😀
Click to expand...

THIS. The key is to admit that you have no idea what you are doing and accept the ridiculousness that they are letting you manage people and also understand it falls on them. I got chewed out for stuff, simple things. Forgetting to do something nobody told me how to do. And they're gonna chew me out for that? Fine, yeah buddy, I'm here to learn. I'll take it and say yes sir, I'll get it right next time. Won't forget to go to that conference again, order that lab again, get that note in, whatever. But let it bother me? Hell no.

There will be the obnoxious interns who behave as though they are a PGY-3 or even an attending on the first day. They are likely very insecure and fund of knowledge isn't any better than yours. They will get their kicks by criticizing your decisions in front of superiors. Screw em. Especially if you're a prelim. Get through it, try to enjoy and use your days off to stay rested, healthy and happy.
 
Remember, the scariest intern in the hospital is the one who is way too cocky and thinks they already know it all. Also, noone gives a **** how good you did in med school, what your Step scores were, etc. That ALL goes out the window. Residency is where you work your butt off and train to be a competent physician. In the beginning, everyone feels lost and has trouble with "simple" stuff. That's the whole point. To learn and gain knowledge so that you can master those things. Your notes and presentation may suck at first, but that's the point. With time, practice and experience, it'll get better!
 
45408 said:
You're only one week into this. Nobody is "running around, happily getting their work accomplished in a timely fashion" at this point. Some of them just manage to smile as they get overwhelmed.
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I'm too busy to mope around while getting my work done. 15-16 hours later, once I've had a chance to sign out, is when I have a chance to mope about... and that's just eating into what precious little sleep time I have.

Perfect example? Responding to a 2 year old thread.

/up late because I'm on my 1.5 days off where I switch from days to night float.
 
atomi said:
... I got chewed out for stuff, simple things. Forgetting to do something nobody told me how to do. And they're gonna chew me out for that? Fine, yeah buddy, I'm here to learn. I'll take it and say yes sir, I'll get it right next time. Won't forget to go to that conference again, order that lab again, get that note in, whatever. But let it bother me? Hell no...
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If they (I'm assuming residents) are chewing an intern out, it's likely because this is going to be the conduct that's going to get THEM chewed out if YOU (the intern) don't straighten up. Residency is a rigid hierarchy and %#^* flows down stream. Guess what -- you (the intern) are at the bottom of the stream this year. The residents are the sergeants and you are Gomer Pyle ( only more clueless and less likable). The good chiefs and seniors ideally will protect you from the wrath of their superiors and scold you themselves, in a way that will get the point across won't have longterm career impact. Better to be yelled at by your senior and not have something put into your file than by an attending or administrator. You will act the same way in a year.


To the OP, residency is 3-7 years long for a reason. If you knew what you were doing by the second week it wouldn't need to be.
 
On night float, most times I have no idea what I'm doing. Combine that with the new interns giving subpar sign out leads to multiple "I have no idea what's going on with this patient" moments when a nurse pages me.
 
secants said:
On night float, most times I have no idea what I'm doing. Combine that with the new interns giving subpar sign out leads to multiple "I have no idea what's going on with this patient" moments when a nurse pages me.
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Most (essentially all) of the services at my hospital lives and dies by patient lists on Excel, which includes why they're there, PMH, and what has left to be done. My experience so far is that most of the time sign out consists of talking about the long term plan. I don't care what the the discharge criteria for ___ lab is, or the placement issues. Let me know what lab tests I need to follow up on that are currently in process if I need to take action on and any likely calls that I'm going to get overnight about. Telling me the patient needs PT isn't useful.
 
During the day, I feel fine. I feel like I've adjusted to the workload and I can manage the usual things like writing notes and putting in orders. I mean my notes could definitely be better, hoping I can improve on that as time goes by. But taking call is very stressful for me...Managing 40 patients on the floor WHILE taking admissions makes me so freakin stressed out. First off, I'm pretty slow at the whole admission and in the meantime I'm getting paged nonstop for random stuff on the floor. I feel uncomfortable putting in orders for patients I don't actually know. Then throw in a patient emergency like a code or whatever and the night is just shot to hell. I had a near code the other day and I was pretty much shaking in fear because I really didn't know what to do. Thankfully the senior "buddy" resident was there to help me through it, but she ended up having to do a lot of work too - putting in orders, fielding phone calls for consults. The senior resident is really supposed to be more like a person on the sidelines you can call for help if you need. I felt bad that I couldn't really handle it all especially since in a few weeks we will be expected to take call by ourselves (there will be 1 other senior resident but they are assigned to the ED so they can't really sit around and help you). Obviously you are supposed to prioritize..manage the emergency first and then put in orders for colace and tylenol last. But I feel like I'd NEVER get out on time if I didn't have the help of the senior resident. On average I've been staying an extra 30-1hr or so to finish up work and thats if everything went smoothly. Hoping this gets better too!!
 
Siggy said:
Most (essentially all) of the services at my hospital lives and dies by patient lists on Excel, which includes why they're there, PMH, and what has left to be done. My experience so far is that most of the time sign out consists of talking about the long term plan. I don't care what the the discharge criteria for ___ lab is, or the placement issues. Let me know what lab tests I need to follow up on that are currently in process if I need to take action on and any likely calls that I'm going to get overnight about. Telling me the patient needs PT isn't useful.
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If you're not getting this, signout is worthless.

Por ejemplo... we have a guy who had extensive surgery, developed a rather large thrombus (that should have killed him) who went to the unit, came back out, and is now on the floor. Telling you what his discharge criteria are is useless; instead they should be telling you what to do if his sat drops <92% or BP goes under 90/50. They should be giving you ideas to manage pain without narcotizing the patient. You get my point. If that's not happening, whomever is signing out to you isn't doing a good job.

I survived my CCM rotation 1) because of the nurses 2) because of the attendings and 3) because the god-damn sign out sheet said sedate with propofol over precedex or use levo instead of epinephrine or give some albumin.

I'll say it another time. If you're not getting this on signout, you're not getting a useful signout. Yeah you'll have to shoot from the hip from time to time, but Day 5 of intern year is not the time to do it.
 
In general, the floor patients tend to be pretty much on the stable side and the answer to anything significant this early is "call the senior," even if it's a quick, "Called to beside for nauea/vomiting in post op patient, found distension, want to drop an NG tube and make NPO." What was happening early on (I started on a surgery month), especially since everyone now has had night float, was that there tended to be a lot of "We ordered a CT that we need for tomorrow... follow up read please," which led to "Ok, so there's a small pleural effusion, which is what you're looking for. Now that we've caught an effusion, what did you want me to do with it?"

That's a bit different than following up the CXR for the patient that just had a pig tail drain removed or the CBC on a post op patient that might (even if extremely extremely unlikely) be bleeding out.
 
eastcoastdr said:
During the day, I feel fine. I feel like I've adjusted to the workload and I can manage the usual things like writing notes and putting in orders. I mean my notes could definitely be better, hoping I can improve on that as time goes by. But taking call is very stressful for me...Managing 40 patients on the floor WHILE taking admissions makes me so freakin stressed out. First off, I'm pretty slow at the whole admission and in the meantime I'm getting paged nonstop for random stuff on the floor. I feel uncomfortable putting in orders for patients I don't actually know. Then throw in a patient emergency like a code or whatever and the night is just shot to hell. I had a near code the other day and I was pretty much shaking in fear because I really didn't know what to do. Thankfully the senior "buddy" resident was there to help me through it, but she ended up having to do a lot of work too - putting in orders, fielding phone calls for consults. The senior resident is really supposed to be more like a person on the sidelines you can call for help if you need. I felt bad that I couldn't really handle it all especially since in a few weeks we will be expected to take call by ourselves (there will be 1 other senior resident but they are assigned to the ED so they can't really sit around and help you). Obviously you are supposed to prioritize..manage the emergency first and then put in orders for colace and tylenol last. But I feel like I'd NEVER get out on time if I didn't have the help of the senior resident. On average I've been staying an extra 30-1hr or so to finish up work and thats if everything went smoothly. Hoping this gets better too!!
Click to expand...
It will get better. It's nice to have autonomy. We don't let our interns rip free until the second half of the year and then we still keep a short leash. Obviously this is possible with an FM census where a bad night is covering 10-15 patients exacerbated by a patient in active labor with a pending peds admission. Our program makes us write senior notes until June 30 and if you're on FM call you're never alone. Unfortunately, this whole pay it forward thing is tough. I'm hoping to not baby our pgy1s as much as we were. Starting out however it is expected. My real moment of security didn't really happen until I had finished CCM and did multiple calls where I was the only resident. Once I got through that, I got over my floor scaredycatness almost immediately.

The biggest thing you can do now is ask for help when you're unsure. If the senior gets mad then they are an dingus.
 
Siggy said:
Most (essentially all) of the services at my hospital lives and dies by patient lists on Excel, which includes why they're there, PMH, and what has left to be done. My experience so far is that most of the time sign out consists of talking about the long term plan. I don't care what the the discharge criteria for ___ lab is, or the placement issues. Let me know what lab tests I need to follow up on that are currently in process if I need to take action on and any likely calls that I'm going to get overnight about. Telling me the patient needs PT isn't useful.
Click to expand...

I would straight up ask the person (nicely of course) who is signing out to you these questions. Ask them what to look out for, and how to treat any issues that may come up. I think it's fine to write the long-term plan on the sign out.. there have been times where I've been asked to speak to a family member who's come to visit after hours and it's nice to know that kind of stuff. Or during an emergency..its nice to be able to explain more about the patient. but there should definitely be a specific column or highlighted section that spells out exactly what the on-call person needs to do.
 
eastcoastdr said:
I would straight up ask the person (nicely of course) who is signing out to you these questions. Ask them what to look out for, and how to treat any issues that may come up. I think it's fine to write the long-term plan on the sign out.. there have been times where I've been asked to speak to a family member who's come to visit after hours and it's nice to know that kind of stuff. Or during an emergency..its nice to be able to explain more about the patient. but there should definitely be a specific column or highlighted section that spells out exactly what the on-call person needs to do.
Click to expand...
Oh, that's definitely on the list (as well as current meds, med problems, surgical problems, endpoints/things to do). That's a completely different situation than sitting down at sign out and running the list verbally.
 
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