Sounds like nbjmd operated a lot more than I did as an intern! I held camera quite often; as a matter of fact, in the old days when I was an intern (pre 80 hr or 30 hr shift restrictions), it was said to be a priviledge to be a post-call intern on the Peds Service holding the liver retractor for a Lap Nissen Fundoplication rather than being out on the floor doing work. Some priviledge. Sitting on a stool in a dark room being yelled at if I slipped my grip a little or heaven forbid fall asleep, when my colleagues who weren't post-call got their work done quickly and might even be able to nap to at least rest.
At any rate, good advice above.
Scut work is traditionally defined as work that is not clinically useful. Things like wheeling patients to radiology; fetching films for conferences, etc. Hopefully you won't have to do much of that.
Remember: an order is just a suggestion. Its not necessarily taken off, done or reported back to you in any sort of timely fashion. I learned the hard way that the Chief doesn't want to hear that you don't know what time the CT Scan will be done or what the results were when an NGT was placed in one of your patients. Check and make sure orders are taken off the chart; get the nurse to do it for you if its urgent or your ward clerk a little on the slow side. Call radiology yourself with a request; oftentimes, especially if the residents know you, things will get done quicker. Ask the techs when the tests will be done; check on results asap.
If you do any intervention - send labs, place an NGT, etc. KNOW the results. Otherwise, why bother. For afternoon rounds, try and have all test results back and an update on the patient's progress.
Don't stack up discharge summaries. Do them everyday. You might get a mean Chief like me who will make you stay late on your last night on rotation to finish all those discharges you've been carrying around. My reasoning is that if you don't do them, I have to.
Have some sort of organization system. You probably figured one out as a student. It doesn't matter if you use a PDA or a piece of paper to track patient data. I have a system of checkboxes - they are crossed off as each task is done.
Keep the patient list updated whenever you can. Especially important if you cross cover at night. PLEASE put new admissions on the other service's list. Its really distressing to find a new patient on am rounds you didn't know about because they weren't on the list.
Teaching medical students should be your responsibility. They are there to learn; not to do your work. Therefore, try and give them some teaching if they are pre-rounding with you, or show them how to tie knots, etc. Obviously they will be doing the same with the more senior residents and in the OR, and your time is precious, but don't treat them like your slaves. If they don't know how to remove a JP or staples, show them but don't keep them from the OR or lectures to do it for the 100th time. I hate it when I see interns scutting medical students. At the same time, I hate it when I see medical students kissing my ass and treating the interns like crap. I notice it. We all do.
Help your fellow intern. If you are cross-covering and doing nothing, consider seeing if the other service wants to sign out an extra half-hour or so early. Its really no big deal to you and the good will it generates will earn you a lot of love and respect from your fellow residents. Don't shaft another intern on your service; decide amongst yourselves who will be in the OR and who is doing floor work, and divide the work evenly. Be adults about it; I cannot be bothered to settle disputes about this kind of thing...but sometimes I have to.
Try and be in radiology when your studies are being read. You can learn a lot going over the films with the attendings and residents.
EVEN IF YOU AREN'T GOING TO BE ABLE TO STAY OR SCRUB IN. As one of my attendings said, "I want to see every intern's face every day they're here". Get them to know you and act interested. Come to the OR to talk to me or the attending if you have a question; don't page into the OR with it unless the patient bedside cannot be left
Do as many procedures as you can. Don't be scared of hurting the patient. You will. I was scared and it took me longer to get comfortable with central lines and chest tubes than it did my more aggressive colleagues.
become comfortable with the attendings; you'll be working with them for 5+ years. Often interns fall into the student habit of being intimidated by the attendings. They're people...usually.
Old saw: don't be a jerk to the nurses and other allied health professionals. If you are, they will page you at 300 am for a renewal on some Cepacol lozenges for the patient. You don't have to socialize outside of the hospital with them but always be respectful, even if you disagree with their patient management or if they are rude to you. Yelling gets you nowhere and you may be suprised when the faculty doesn't support you in this type of behavior.
So a GS intern should daily do as njbmd notes:
see patients and write notes on them
keep track of their daily progress and the results of any tests
get to the OR as often as possible
pre and post op patients
get consent for procedures (ask if you don't know the complications)
work on discharge plans and summaries
admit patients
on some services you might see ER or other consults
read daily...I didn't do this and made studying for the ABSITE harder. Carry a photocopied chapter in your pocket, so you can peruse it while on hold or during other down times.
try and get to know all other residents in house, especially the radiology, gastro fellows and anyone else you might have frequent contact with. Its so much easier to get help when you can call and say, "hey its Kim, I was wondering if you can help me with something." People love to help people, especially those they know
best of luck...
