first on call - please help

[tachy]

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hi everyone

i will be on call for the first time next week, i will actually start my residency next week so i am a complete newby. i will be on an internal med. floor.

can anybody give me advise about what sort of material i should carry around with me on the ward and when i am on call?
i mean what books etc., anything that can help me.

also i know many people carry palmpilots. i have no idea about that because i am img. so can anybody name some software that you are commonly using on your palm pilot? is it any good? how much is it? does it expire? etc.

thank you so much for your advice
i am just so nervous about my first call.

 

[jennyboo]

can anybody give me advise about what sort of material i should carry around with me on the ward and when i am on call?
i mean what books etc.

Let's start with the basics. You need:

1. 2 black pens. In reality you need just one, but you will inevitably misplace it and you will have a hard time finding another one, so keep a spare one in your pocket.

2. Your computer login & password. Especially if your hospital has a computer system and you need to check daily labs on it.

3. Your stethoscope. That is hopefully obvious, but you know what, I forgot mine on the first day of work.

4. Your pager. Another thing you shouldn't forget. Also, if they gave you a sheet of instructions on how to use the paging system, bring that too. You'll find it useful for the first few days.

5. Your medical license number. Carry a copy of your medical license number with you. You can put it on a card along with your computer login and password and your DEA number. I needed mine all the time in event of pronouncing deaths and filling out death paperwork.

6. Your DEA number. Again, put it on a card with your medical license number and your computer password. You need this to prescribe narcotics.

7. Your dictation system login & instructions. You will probably have to discharge people pretty soon, and you will need to dictate summaries of their hospital stays into the telephone dictation system. You won't remember how to do this right away, so bring the instructions with you.

8. A card or guide on electrolyte replacement. If your hospital or your supervising resident gives you one, carry it with you -- this will be very useful to you, probably for the first several months!

9. Your ID badge. It's against hospital regulations to work without wearing it and, inevitably, some nurse will complain at you about not having it on you.

The above are the essentials. These are far more important than any book. All references on diseases or drugs are usually found online (uptodate.com and MicroMedex are usually offered online by the hospital and you can look up most diseases or prescription doses on these web sites). The less you carry in your pockets, the better -- you will have no time to read during your first few weeks anyway, the days are long and your coat will inevitably feel very heavy.

Optionals include:
- Tarascon's Pharmacopeia, to look up drug doses (but you can look these up on MicroMedex which is at every computer in my hospital).
- Sanford antibiotic guide (but you can look these up online too).

 

[tachy]

jennyboo

wow, thank you so much for this checklist.
sometimes people forget the obviouse things.
i had no idea about the dea number. i will check that out tomorrow.
i will also check out what kind of websites the hospital offers for us residents. that would be so much easier than having to buy a PDA or carrying my little library in my pockets.
thank you again, that was super kind of you.

 

[sepsis]

don't buy a PDA, just carry tarascons phamacopea, maxwells, harvards little blue book and use google otherwise. PDA's are a waste of money.

I was on call day 1. Don't worry, it will be a blur, just count on your senior and go from there.

 

[46&2]

I thought you needed a license to get a DEA number (requirement are state dependent, but generally require passing Step 3 and doing an intern year). We have to get outpatient scripts for narcotics from an upper level.

 

[gutonc]

Your hospital should have a universal DEA number. Even attendings at our hospital use that one unless they have pre-printed scrips w/ their name and # on them already.

 

[jennyboo]

Your hospital should have a universal DEA number. Even attendings at our hospital use that one unless they have pre-printed scrips w/ their name and # on them already.

That must've been the one I carried around -- the hospital's one, with a unique identifier for me to distinguish it from every other MD/DO in the same hospital.

Either way, if it has been given to you, carry it around. You don't want to go digging for it in your locker or your car while you're about to discharge a patient.

that would be so much easier than having to buy a PDA or carrying my little library in my pockets.

You definitely do not need a PDA and you will probably find that you'll be glad you saved money by not buying one. You'll need very little in the way of books, and I confess *cough* that when there was a basic medical condition that I hadn't treated before and didn't know the orders for, Google was my friend. If you search for "COPD admission orders" or "small bowel obstruction admission orders" or "rhabdomyolysis admission orders" it will turn up loads of sample order sets from other hospitals.

 

[onceinawhile]

You got some excellent advice from Jennyboo. I would like to add that, as an IMG, you will absolutely need a pharmacopoeia because many of the brand names of the medication will be new to you. My Tarascon pharmacopoeia and the Stanford guide for antimicrobial therapy (get the most updated one) were the 2 resources I couldn't live without. You can probably use a PDA instead, but if you are not familiar with it by now, I doubt it will be very useful.
(We actually had a contest, and I was able to look things in the Tarascon as fast as the other guy in his PDA.😀)
Good luck!

 

[Tired]

You got some excellent advice from Jennyboo. I would like to add that, as an IMG, you will absolutely need a pharmacopoeia because many of the brand names of the medication will be new to you. My Tarascon pharmacopoeia and the Stanford guide for antimicrobial therapy (get the most updated one) were the 2 resources I couldn't live without. You can probably use a PDA instead, but if you are not familiar with it by now, I doubt it will be very useful.
(We actually had a contest, and I was able to look things in the Tarascon as fast as the other guy in his PDA.😀)
Good luck!

Bleah, I'm much faster with my epocrates than you are with Tarascon. And Sanford, while good, is very difficult to navigate unless you know exactly which page you want. I like the Johns Hopkins Antibiotic guide for the PDA, much more intuitive organization.

 

[tachy]

sounds good so far, thank you for your advise everybody.
you guys are funny ... doing look up stuff contests

well, i have a little pharmacopeia, i have sanford but only from 2003, have the maxwell, and an old washington manual of medical therapeutics.
that will cover me i guess

thanks a lot

 

[Apollyon]

Bleah, I'm much faster with my epocrates than you are with Tarascon.

I raced a guy with my Tarascon vs. his PDA and I won. I wrote to Tarascon about it, and they published it in one of their pamphlets and sent me a free pharmacopoiea!

 

[Tired]

I raced a guy with my Tarascon vs. his PDA and I won. I wrote to Tarascon about it, and they published it in one of their pamphlets and sent me a free pharmacopoiea!

I would totally waste you in that race.

Step 1: power on
Step 2: Click epocrates logo on main screen
Step 3: Click "Rx" section
Step 4: Write first 2-4 letters of drug name
Step 5: Click drug name

Never timed myself, but when I was scrounging for 3rd-year honors, I routinely burned my classmates in the defacto races (signalled by the attending asking, "What was the renal dose of this drug again?").

 

[Tired]

you guys are funny ... doing look up stuff contests

How do you think they determine Honors on Surgery?

 

[Jalopycat]

Keep in mind that you'll only have one first day. It gets better after that.

 

[LADoc00]

LMAO! Im sure there will be someone piloting your admits with you your first night. If there isnt, then tell us the name of the hospital so we can warn everyone we know NEVER TO GO THERE.