How normal is it to still need your “hand held” as an intern by month 3?

[Latteandaprayer]

---

Members do not see this ad.

It’s month 3, first time on floors. I’m getting better at the flow and ordering things without asking first (adjusting insulin, potassium supplementation, etc). But I am struggling still with discharge orders. Specifically making sure everything is clear and safe. I still ask my senior to eyeball my orders. Typically there’s 1-2 things that need to be corrected and I don’t repeat the mistake but still.

How much handholding is normal? Especially at this point?

 

[GoSpursGo]

Honestly it sounds like normal intern stuff, esp if this is your first rotation on the floor. But why don’t you ask your senior and trending for formal feedback?

 

[gutonc]

It’s month 3, first time on floors. I’m getting better at the flow and ordering things without asking first (adjusting insulin, potassium supplementation, etc). But I am struggling still with discharge orders. Specifically making sure everything is clear and safe. I still ask my senior to eyeball my orders. Typically there’s 1-2 things that need to be corrected and I don’t repeat the mistake but still.

How much handholding is normal? Especially at this point?

If this is your first floor rotation, you're essentially a first month intern. My first floor rotation was my 4th one, I started with ICU, went to hem/onc clinic and then VA SNF rotation. Virtually none of them prepared me for wards.

You're exactly where you're expected to be.

 

[comp1]

Goodness, extremely normal. As an attending I am still reviewing PSYCH discharge stuff for them at the end of intern year.

 

[DrMetal]

How much handholding is normal? Especially at this point?

Quite normal, press on. Your senior is also a trainee, so technically they have to monitor everything you do and check it, take no offense. You'll be in their shoes soon. That you care to ask demonstrates maturity on your part.

By the way, the "hand holding" never ends. As an Attending, my hand (or rather, some other body part) is often held by insurance companies, administrators, or various nurse mafias.

 

[comp1]

The above is very true. Your work will always be checked. I have been saved many times by nurses and pharmacists.

 

[LucidSplash]

Intern year is intern year, not intern 3 months.

 

[smq123]

It’s month 3, first time on floors. I’m getting better at the flow and ordering things without asking first (adjusting insulin, potassium supplementation, etc). But I am struggling still with discharge orders. Specifically making sure everything is clear and safe. I still ask my senior to eyeball my orders. Typically there’s 1-2 things that need to be corrected and I don’t repeat the mistake but still.

How much handholding is normal? Especially at this point?

I'd be worried if you felt super confident in yourself by this point. That's a sign of a stupidly overconfident and dangerous intern.

 

[AlbinoHawk DO]

You should be handheld on your first month on the floors. How would this not be normal?

 

[gutonc]

You should be handheld on your first month on the floors. How would this not be normal?

I actually get where the OP is coming from. As I mentioned above, my 3rd rotation of intern year was on the VA SNF service. It was a fairly high level of care SNF but still a SNF. My 2 prior rotations were university ICU and outpatient hem/onc. I had no clue what to do with old wobbly people with no real problems, but also no way to go home. My senior on that rotation was a complete d-bag and pulled me aside almost every day for the first 2 weeks questioning my clinical reasoning in a non-educational/supportive way. If the OP is getting that kind of "teaching" from their senior and/or attending, I can totally understand the self-doubt.

 

[HemeOncHopeful19]

I actually get where the OP is coming from. As I mentioned above, my 3rd rotation of intern year was on the VA SNF service. It was a fairly high level of care SNF but still a SNF. My 2 prior rotations were university ICU and outpatient hem/onc. I had no clue what to do with old wobbly people with no real problems, but also no way to go home. My senior on that rotation was a complete d-bag and pulled me aside almost every day for the first 2 weeks questioning my clinical reasoning in a non-educational/supportive way. If the OP is getting that kind of "teaching" from their senior and/or attending, I can totally understand the self-doubt.

I would be questioning my sanity if I ended up rotating on a VA SNF early in my career.

 

[gutonc]

I would be questioning my sanity if I ended up rotating on a VA SNF early in my career.

It was a standard rotation for everyone. Not my favorite, but better than the VA ICU. Plus, I got it out of the way early.

 

[NotAProgDirector]

The standard intern needs intense direct supervision for the first three months, lazy direct supervision for 6 months, and then should be largely independent for the last 3 months. This is service dependent -- if you only get one ICU block as an intern and it's in the last three months, no one expects you to be "largely independent" there at any time.

It becomes a problem when interns need intense direct supervision beyond 6 months. Then there may not be enough "dwell time" to develop independent skills.

 

[Apollyon]

It was a standard rotation for everyone. Not my favorite, but better than the VA ICU.

Disagree! Oh, wait - I rotated in the VA SICU. Not the same.

 

[comp1]

I feel like a VA SNF would a really good place to start out as an intern. It has mostly the acuity of outpatient with the safety double checks of inpatient.