internship starting... i can't even do an IV!

[europeman]

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Hi,

I used to be competent, but it will have been 2 years since i touched a patient when i start internship in june/july. Anyway, I'm involved in this weird research thing which funds me and I'm not allowed to do a rotation. So, in short, i can't do a rotation to catch up on my skills.

I'm actually not worried about the knowledge aspect, I just took step two after a long delay of clinic and did really well (thank god). Not that that means I know anything for real life internship, but it's something.

I'm actually worried about stupid stuff like drawing blood and IVs. Anyone think it's a good idea if I go to the ED one morning and introduce myself to the attending and ask if I can have the nurses let me do their bloods/ivs for a day?

Any other suggestions?

haha, I'll have to learn how to put in NG tubes, pull drains/central-lines, and suture and stuff ASAP too.. but that's another day

 

[Pir8DeacDoc]

Bro I couldn't put an IV in my own veins and I'm an easy draw. I could put a central line in but who cares about drawing blood?? Find a program where you don't do your own blood draws, that's lame and a waste of your time.


I had never placed an NGT until the first one I put in as an intern on call. Couple of tips because I'm bored and it's a slow friday:

-Warm the NGT if possible by running it under warm water at the sink
-Use plenty of lube (preferrably xylocaine but surgilube is ok) Often I put the xylocaine in the nose and let it "work" while I warm the tube.
-have the patient sit up in bed and put their chin to their chest
-Have the patient sip water from a cup (via straw) once you are in the nasopharynx and ready to go down the goose.

Good luck. No one expects you to know much of squat so just be willing to learn and work hard and you'll be fine

 

[XoQo]

No one expects you to know much of squat so just be willing to learn and work hard and you'll be fine

god i hope this is true...or i'm screwed next year hehe.

 

[Winged Scapula]

The above advise is excellent and I concur.

There is HUGE variation in clinical skills and knowledge when you start as an intern. Hopefully by mid year this will even out some. I'll bet you won't be the only intern who hasn't placed an NGT or done a central line. There are many programs in which medical students either don't have a chance or minimal chances to do procedures.

As for starting IVs...I haven't done one since medical school myself (ok maybe a couple during residency) and can only recall a few occasions in which I had to do morning blood draws on transplant patient (physicians can stick the fistula, nurses generally can't) or an ABG. Honestly, as above, find a program where there are people who do these things for you. I used to "joke" and say if they call ME for an IV, the patient is getting a central line because I'm much better at those.

I rarely placed an NGT during residency either - our nurses did all of that; if a resident was called it was a tough one. Still its a good skill to have and there are plenty of opportunities as a surgical resident to get them.

I wouldn't worry about it. I WAS (knowing that some of my colleagues had trained at trauma heavy med schools and I figured they knew how to do it all...some did and some didn't. So what? We all eventually evened out.)

 

[balaguru]

So our school started offering an MS4 elective to address just this issue. It's a prep course for surgical interns. Proficiency based open and FLS skills lab. Surgically oriented cadaver dissections. Live IV's and intubations. Tons of intern appropriate didactics.