First Order

[turtle md]

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Just wondering how anybody else felt when they wrote that first order that didn't need to be co-signed. Mine was for a simple UA and U-HCG, but it felt like it was symbolic of much more. No need to find some authorit-I to back me up. Anyone else please share your experience... 😀

 

[GeneGoddess]

Mine was a d/c order that my (fabulous) med student wrote out and just said "sign here". Of course, since then, I've written tons of others. I'm still waiting to use my prescription pads, though! Maybe next week on my first continuity clinic??

 

[dchristismi]

I dictated my first discharge summaries yesterday, and wrote some scripts for said patients.

And the pharmacy called on one of them, saying that there was an interation, and was I sure I wanted both prescribed. I wrote it EXACTLY like the standard orders stated. (the OB service I'm on made up standing order sheets, but you write out the scripts.) I told them to hang on and asked my senior about it. He looked at me like I was crazy, and said that they always write for that combination, and no one has ever been called on it. We decided to just drop one of them.

Just my luck, I suppose.

 

[southerndoc]

I dictated my first discharge summaries yesterday, and wrote some scripts for said patients.

And the pharmacy called on one of them, saying that there was an interation, and was I sure I wanted both prescribed. I wrote it EXACTLY like the standard orders stated. (the OB service I'm on made up standing order sheets, but you write out the scripts.) I told them to hang on and asked my senior about it. He looked at me like I was crazy, and said that they always write for that combination, and no one has ever been called on it. We decided to just drop one of them.

Just my luck, I suppose.

Congrats on your first adverse drug event. Many more to follow, trust me.

(At least it didn't make it to the adverse drug reaction status!)

 

[Blade28]

I also dictated my first discharge summary (ever!) yesterday. First ever order? To switch a patient from Phenergan to Zofran. 🙂

 

[Apollyon]

I also dictated my first discharge summary (ever!) yesterday. First ever order? To switch a patient from Phenergan to Zofran. 🙂

Strong work. People here in the south go crazy for the Phenergan, but several (many?) of use here now go crazy with all the Phenergan people get, and push the Reglan and Zofran (as I say, the only side effect of Zofran is the cost).

 

[DOtobe]

My first order was nothing too interesting - ordering a 500 cc bolus of normal saline.

Today I discharged two patients and dictated my first discharge summary since my peds rotation of my MS-3 year. My dictation was a little rusty (on a surgery patient I had never seen until this morning) but there will be many more dictations to come...

 

[Blade28]

Strong work. People here in the south go crazy for the Phenergan, but several (many?) of use here now go crazy with all the Phenergan people get, and push the Reglan and Zofran (as I say, the only side effect of Zofran is the cost).

Yeah, it is expensive, that's true. Strong work, indeed!

 

[fuzzyerin]

When I wrote my first postop note, I thought about showing it to my senior resident "just to make sure." And then I said screw it, I've written these so many times as a med student. I wrote for lots of Percocet so far...but man, it is so weird to not have anyone else sign it. Makes things move much faster. Not that I'm going that quickly right now....

 

[Smurfette]

I can't remember what mine was...but everytime I write one, I want to verify it with someone else--of course I don't actually do this---but I am so used to needing a cosigner it feels wrong to be able to write it myself. I wrote for tylenol on someone with a fever today and freaked out about whether I should have or not without running it by someone else---as a student I wouldn't have questioned this at all and I know a resident would have cosigned it without problem.

I wrote admit orders today and felt shaky about it. I've done it a bizillion times before as a student...

Anyone else freaked out by being called "Dr."? I return pages and hear "who paged Dr. Smurfette?" even though I don't say "this is dr. smurfette". I still don't feel right calling myself a doc.

And my signature on orders is terrible---it's legible in progress notes and on personal stuff (checks, etc.), but I just squiggle the pen across the order sheet b/c I'm so sick of signing that damn line.

I'm sure in a month or so, I won't be feeling funny about these things anymore.

 

[fuzzyerin]

I had to call two people yesterday who had questions. Both times, I called myself by my "normal" full name instead of dr. fuzzyerin. I had to correct myself, because obviously, these people didn't know who I was from Joe Schmoe. It's so weird.

 

[southerndoc]

I had to call two people yesterday who had questions. Both times, I called myself by my "normal" full name instead of dr. fuzzyerin. I had to correct myself, because obviously, these people didn't know who I was from Joe Schmoe. It's so weird.

And don't introduce yourself by first and last name to your patients either. Introduce yourself as Dr. so and so. I know it sounds pretentious, but people may not know you're a doctor. Too many people wear white coats in hospitals now. I once had a patient write a letter to my chief saying how great care she received in the ED, but commented that she never saw a doctor the entire time she was there. At the time, I introduced myself by first and last name and told people I was a resident. Despite the white coat with my name embroidered on it (followed by "MD"), my badge that said "Dr. so-and-so," and the fact that the patient was seen by a senior resident with a white coat on and an attending physician, she still claimed to have never seen a physician.

So now I introduce myself as Dr. to avoid any confusion.

 

[AJM]

I had to call two people yesterday who had questions. Both times, I called myself by my "normal" full name instead of dr. fuzzyerin. I had to correct myself, because obviously, these people didn't know who I was from Joe Schmoe. It's so weird.

But remember that if you are calling the consult fellow/resident, make sure you don't introduce yourself as dr. fuzzyerin, unless you want to be the butt of several jokes. 😀

 

[factoid]

so i'm not the only one who is feeling weird about writing orders without checking with someone else first. strange transition! my fear is writing something that i'm not too sure about but which is not important enough to ask an upper level about, then having my head bitten off. ah those blasted gray areas...hey, what's residency for, right? 🙂 still have a couple of days before the first day, so probably will be a little better once i get in there f'real.

 

[DOtobe]

Another thing that is odd for me is writing "DO" at the end of my name when I write my notes. When I wrote my first note on Friday I almost wrote "MS-4" at the end of my name

 

[supercut]

Folks,

You should really make sure to introduce yourself as Dr Lastname. Even if you dont' "feel" like a doctor yet, you are. It is imporant to establish yourself as a doctor. This is a credibility/authority issue.

Especially important for females. Even after you introduce yourself as Dr, there are a number of people for whom it wont' sink in. They will think you are a nurse, NP/PA (if there are a lot of them at your institution) or even the unit secretary. I just finished PGY 2 and still I am regularly mistaken for all of these, based soley on my gender. A common scenario last month, during rounds with the rest of (male) burn team in the ICU...A family member of a pt we weren't following would come out of that pts room and come up to me and ask, "are you his nurse" or state "he's ready to get back in bed now" or something like that.

 

[Apollyon]

Folks,

You should really make sure to introduce yourself as Dr Lastname. Even if you dont' "feel" like a doctor yet, you are. It is imporant to establish yourself as a doctor. This is a credibility/authority issue.

Especially important for females. Even after you introduce yourself as Dr, there are a number of people for whom it wont' sink in. They will think you are a nurse, NP/PA (if there are a lot of them at your institution) or even the unit secretary. I just finished PGY 2 and still I am regularly mistaken for all of these, based soley on my gender. A common scenario last month, during rounds with the rest of (male) burn team in the ICU...A family member of a pt we weren't following would come out of that pts room and come up to me and ask, "are you his nurse" or state "he's ready to get back in bed now" or something like that.

Heh...I ALWAYS thought you were a guy!

 

[pikachu]

the excitement of getting to write my own orders wore off real quick -- right around 3 am on my first day of call --

 

[fuzzyerin]

Folks,

You should really make sure to introduce yourself as Dr Lastname. Even if you dont' "feel" like a doctor yet, you are. It is imporant to establish yourself as a doctor. This is a credibility/authority issue.

I plan on it, but after introducing myself as just a med student for four years, it's weird to start with doctor - I just go into introducing myself and after I do it, correct myself and say I'm a doctor. It'll take some getting used to, but I'm sure it'll be a habit in no time. 🙂

 

[debvz]

When I wrote my first postop note, I thought about showing it to my senior resident "just to make sure." And then I said screw it, I've written these so many times as a med student. I wrote for lots of Percocet so far...but man, it is so weird to not have anyone else sign it. Makes things move much faster. Not that I'm going that quickly right now....

I didnt have the pleasure of dictating my first detailed operative report, since my dictophone code hadnt been entered into the system yet. So instead, I had to type it in its entirety. Logged my 1st "major procedure" yesterday, an AKA revision, with pulse lavage and debridement..... Had to ask my chief for the names of some of the instruments... Now what was the name of that saw I used? Time to brush up on my instrument names.

As for my very first order, I've forgotten already!!

 

[fuzzyerin]

I didnt have the pleasure of dictating my first detailed operative report, since my dictophone code hadnt been entered into the system yet. So instead, I had to type it in its entirety.

That's better than dictating the whole thing and then pressing the wrong button at the end which, instead of giving me a confirmation code, asked me to re-enter the medical record number. So much for a successful first dictation. So I had to do it again....

 

[Doczilla]

When I walked in to see my first patient, I introduced myself as Dr. Soandso, and I actually started chuckling. The patient gave me a bizarre look. If only she knew, she might not think it funny.

'zilla

 

[Amxcvbcv]

This is a great thread. 🙂

I'm excited enough right now to say, "I'm starting medical school in the fall" instead of "I want to go to medical school."

😛