hitting a wall

[kbrown]

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anyone else out there hitting the wall? i am feeling like i am spinning my wheels sometimes. i am just now in the dept for the first time and it's awesome, but the schedule of residency in general is starting to get old.

in speaking with several of my friends across the country in various specialities intern year can be summed up in one phrase: the most important insignificant person. explanation: you show up to work everyday, busting your backside to largely have your efforts go unnoticed by staff, patients and upperclassmen. but the second that you are not there or don't get your work done, you have royally screwed up and let the 'whole world' down. such a strange existence.

this too shall pass (we call that being an attending) and things will get better, but for now.........sigh.

 

[Apollyon]

To thine own self be true.

You will be (and are) appreciated for what you can contribute - not what you can't.

Do your thing, and learn to do it well. As I told the interns last year, "Your job is to provide excellent patient care - and that may take you some time to start. My job is both to provide excellent care, and to 'move the meat'. There's always someone there to back you up. When you get to where I am, you will pass the torch the same way."

People that put the "you are a bad person" load on you when you're not there or something doesn't get done are dealing with their own issues - although those people are legion, they are certainly not the majority. You have not gotten to where you are by accident or by luck.

Everyone fails, but that is part of the game. As the aphorism goes, "The race is not always to the swift, but to those that keep on running."

 

[NinerNiner999]

There are two guarantees about intern year: It sucks, and time will move on. Enjoy the fact you are an ED intern - you could be a surgeon...

 

[Dr.MISHKA D.O.]

On That note, why do surgeons suck so much. There was this real beotch on last night who got pissy the minute I called for an medium sized gluteal/perineal abcess my attending wasn't comfortable I+d ing. I told them if they didn't think it was OR potential we would just do it, just take a look and let me know. Skip forward several hours later, after I haven't gotten a call back, or seen a consult sheet in the chart after looking several times. I go to check on the guy and he says "oh yeah that surgeon you told me about was in here." What? I haven't got any call!
I look it up in our computer tracking board and the surgical resident has ordered a s^&# load of labs without asking me, very uncool for consultants to do that on my patients in my opinion. So I call them back and ask whats up, and immediate attitude. I mention the fact that they ordered labs without asking, and I get "well we typically don't cut on people without labs." OH Snap! IT's ON. I say First of all I typically don't order $1,000 worth of lab to I+D a simple abcess in the department in a pt who does not clinically look sick, you do remember how to perform a physical exam? Then I get "did you even examine the pt." What are you kidding? "Did you look at the pt." I hope you are not implying that I failed the examine the pt and by that you mean me and my Attending as we did it together and reached a decision to call you together, because if you would like to accuse my attending of this he is standing right here and I can let you talk to him yourself. (My attending is laughing his ^$$ off at this point.) I get a little shotty huh, and she hangs up.
What a beotch.
Why do surgical residents have to be like this. Soooooo unprofessional

The Mish

 

[kbrown]

There are two guarantees about intern year: It sucks, and time will move on. Enjoy the fact you are an ED intern - you could be a surgeon...

Too true.

On a better note, today was so much better. Finally got some sick patients with real problems aside from being hungry, drunk or hearing voices (not that those aren't real problems, but nothing I can do about them). I love being in the ED more than anything, just ready for vacation. Thanks all for words of encouragement. Much help.

GO TIGERS beat the A's

 

[ambientbaby]

The Tigers are world series bound!!

 

[kbrown]

The Tigers are world series bound!!

finally someone with some sense. if their pitching holds up i agree, but anymore lapses like the ones again the bluejays and royals (last two series of the reg season) and they are gonna get their butts handed to them. i think that they might be on track for a championship myself.

 

[dlung]

I'm so happy for those guys... I watched a lot of those guys in AAA (Monroe, Inge, Robertson, Rodney, Walker, Infante, Santiago, etc) and watched those awful 100+ loss seasons...

Torn between my hometown A's and my adopted hometown Tigers...

 

[DrQuinn]

anyone else out there hitting the wall? i am feeling like i am spinning my wheels sometimes. i am just now in the dept for the first time and it's awesome, but the schedule of residency in general is starting to get old.

in speaking with several of my friends across the country in various specialities intern year can be summed up in one phrase: the most important insignificant person. explanation: you show up to work everyday, busting your backside to largely have your efforts go unnoticed by staff, patients and upperclassmen. but the second that you are not there or don't get your work done, you have royally screwed up and let the 'whole world' down. such a strange existence.

this too shall pass (we call that being an attending) and things will get better, but for now.........sigh.

I felt teh same way you did around this time. I think Oct - Feb for an intern is the toughest. You lose the "gung ho I gotta lot of energy, Im' the new doc!" feeling. The calls get to you, and the hours are dragging. I even felt that I didn't have what it takes to be a good EM resident. I even told my PD I felt like quitting.

He said to me: "Quinn, I felt the same way, at the same time."

I ended up talking to a few of the other fellow interns with me, and we all felt the same way.

I warned the interns behind me as a senior residnet, and they all feel teh same way now. So, it sjust a cycle thing. You'll feel much better come spring.

Q

 

[kbrown]

I felt teh same way you did around this time. I think Oct - Feb for an intern is the toughest. You lose the "gung ho I gotta lot of energy, Im' the new doc!" feeling. The calls get to you, and the hours are dragging. I even felt that I didn't have what it takes to be a good EM resident. I even told my PD I felt like quitting.

He said to me: "Quinn, I felt the same way, at the same time."

I ended up talking to a few of the other fellow interns with me, and we all felt the same way.

I warned the interns behind me as a senior residnet, and they all feel teh same way now. So, it sjust a cycle thing. You'll feel much better come spring.

Q

thanks Q, you are always full of wisdom. i actually ran into one of my seniors last night while leaving the hospital. she looked so tan, so i asked where she had been (there's no sun in detroit). she said that she had just come back from a month long vacation in san diego and other very nice places. then she added, it only took three days of this place (the hospital) to wipe away what it took one month of vacation to accomplish. so it looks like these 'tern blues extend throughout residency for some. after she told me that i felt normal.

 

[Jeff698]

There was a great op-ed in, I think, EMResident awhile back about the 'intern blues'. As you're reading here, this is a very common feeling. Almost universal.

Hang in there. As a PGY2 who hasn't been out of the department since June, I'm happy as a clam. As an intern, all I wanted to do was sleep. I'd all interest in medicine. Studying? Yeah, that's funny.

For me, intern year was about survival (primarily for me, secondarily for my patients). This year has been great. Hang in there.

Take care,
Jeff

 

[dlung]

This was a conversation on rounds with one of my chiefs in December of last year, after my worst month of the year...

Chief: "What's wrong?"
Me: "Oh, I'm just sad."
Chief: "That's okay. That's just intern year."
Me: "Great."


I'm still amazed at how happy I am now and shudder when I think about how miserable I was last year...

 

[8744]

Let me just step in and defend the Surgeon. I am on a consult service this month (pulmonary). It seems that every single patient in the hospital with any respiratory problems gets a pulmonary consult. I understand that acute onset of SOB or coughing up blood might be a good reason but Asthma, well controlled on the current regimine, shouldn't need one. I mean, it's Asthma. I learned how to manage that as a family medicine intern.

So people casually write for a consult, the effect of which is to drag the resident out of bed at which point he must look up labs, check the chest x-ray, and spend a good deal of time examining the patinet and writing the consult before he calls his attending to present.

And it's for asthma. Not that thrilling. A lot of work at 4 AM from one casual stroke of the pen.

 

[8744]

Oh, and as a PGY-2 (but an Emergency Medicine Intern) the OP needs to hang in there.

I don't know if it's being a PGY-2 or not being at Duke but I'm enjoying this year a lot (a lot) more than last year.

There is no comparrisson between being a fresh intern who doesn't even know where they keep the blank progress notes to being a PGY-2.

 

[EctopicFetus]

agreed with all said above.. starting to get tough..

 

[docB]

There are two guarantees about intern year: It sucks, and time will move on. Enjoy the fact you are an ED intern - you could be a surgeon...

Not true. During March of my intern year time itself stopped for about 6 weeks. NASA and JPL were very concerned for a while until they realized the universe was just torturing me.

 

[docB]

I hit the wall about half way through second year. Just ran out of gas. Got through it though. Remember: That that doesn't kill me kills me a little.

 

[docB]

You will likely hit the wall as an attending too. I hit one at a year and one at three years. I think the year one was because you don't get any variety as an attending. It's not like you have "easy" blocks every now and then. It's ER month after month. At three years I realized that I'd been doing the attending gig longer than I was in residency. I got a little bored and had to find some other things to get into. For me it was administration and EMS. Anyway, the short story is that you'll go through these periods as time goes by.

-BTW I'm not trying to pad. I just keep thinking of other stuff that doesn't seem right for an edit.

 

[Hercules]

Not true. During March of my intern year time itself stopped for about 6 weeks. NASA and JPL were very concerned for a while until they realized the universe was just torturing me.

That's great! Glad to hear that the universe picks on other people out there as well...

 

[LotaPower]

I had one of those moments today. I'm on anesthesia this month finally starting to get some experience with intubations. I've been on it for 2 weeks and am starting to feel more comfortable but by no means an expert. This lady comes in, normal sized, and looked like an easy tube. just as i start, the anesthesiologist starts breathing down my neck " what do you see what do you see!!?" i haven't even got to the epiglottis when he starts rushing me even more and starts bitching about the teeth i was barely touching. for some reason i didn't have a full view of the cords and had to pull out and go in again where i got it in 10 seconds. the entire time the guy made me feel like an idiot for not gettin the tube in quickly the first time... while im thinkin "wtf?!? i've only been doing this for 2 weeks a$$hole" what a bastard. 😡

 

[anonymousEM]

I remember vividly one night shift at the end of intern year with the PD as attending...it was the usual, signed out tons of patients and 40 more in the waiting room and it was one of my first nights in a "senior" shift. I'd gathered up 3-4 bogus charts and was going to hurry them out when the PD stopped me....

PD"How are you tonight?"
me "Fine"
PD " You always say you're fine, but I get the feeling that under your breath you're looking at me saying DR. PD I hate your guts, you've ruined my life, work sucks and I hope you die."
me "Dr. PD...I would never say I hope you die!"

we both laughed and somehow the night, and the rest of residency for that matter, seemed much better...

 

[beyond all hope]

Said it once, say it again.

Your intern year you'll think about quitting a hundred times. I thought about changing specialties, quitting medicine and becoming a computer guy, faking a seizure, anything to escape.

Once you realize everyone else is in the same boat, and all of us who have gone through it had been in the same boat, it's not as bad.

It's like uphill both ways.

 

[Arctic Char]