How to Get Good at Placing Orders

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MNCASC

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New intern. Starting in the ICU. Just wondering when you all started to get comfortable placing orders on your own without asking your senior resident? Orders for pain meds, electrolyte replacement, ect? I am a few days into residency but I feel like I should be more comfortable with orders and determining what I can do on my own vs asking my senior.

Also is there a good guide you used for common medical issues. Something similar to this: Night Float Survival Guide - Fresno Intern Bootcamp - Wiki@UCSF

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I started getting more comfortable by the fall (October-December), but note that mid-year interns can get complacent and a bit too confident that they can still make major mistakes that harm patient care. Thus, always run by your senior or attending about what you want to do before placing the order.
I used this for cross cover shifts but this can also help for ICU (albeit a bit outdated): http://chicago.medicine.uic.edu/wp-content/uploads/sites/6/2017/09/survivalguide.pdf

Really mastering the electronic health system is key to efficiency. Ask your colleagues or seniors for tips on how to place orders super quick.
 
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The UCSF Hospitalist Handbook app (usually costs money, but is currently free due to the pandemic - search for it on your phone app store) is a really good reference for common medical issues, particularly the "Night Calls" section. And the Appendix has commonly used sliding scales.
 
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