Keeping track of a team patients

[Guillemot]

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How do people keep track of (remembering them) an entire team (20 or so) patients. Im going to be an intern next year and this seems mind boggling.

 

[mimelim]

Most teams do not have interns or even senior residents keeping track of 20+ patients by themselves. For example, currently we have 28 patients on service, but we have two interns, a PGY2 and a PGY5 on service. I keep track of ~15 patients down to the smallest detail. The rest I know the basic management and what is going on with them, but since I don't necessarily see them every day, I don't know what every wound looks like or remember every drain output. I have it all written down on my list from rounding, but I don't remember it.

That having been said, you remember patients when you really take care of them. You end up with a story which dictates what you are doing. I usually put little reminders on my list that help. Everyone ends up with their own system.

Now, on the other hand, I was covering our Vascular service and had to cover 45 patients including 15 ICU patients last weekend. I was the only resident in house overnight with a fellow at home as backup. I got signout and the basics on the ICU + floor trouble makers and just went with the flow. It all ends up working out

 

[Textbookversion]

I thought the cap was 10 patients / intern now with the ACGME rules? Or is that just an institution specific rule?

 

[Guillemot]

Okay how about 10 patients then. That still sounds hard. And also the team might have like 20 or whatever and just remembering the name of the patient and their basic story is hard.

 

[Stellar Clouds]

Okay how about 10 patients then. That still sounds hard. And also the team might have like 20 or whatever and just remembering the name of the patient and their basic story is hard.

I bet you felt overwhelmed with the amount of information you needed to learn when starting med school, but now, does it not seem much easier?

I'm sure at first it will be difficult to keep track of that many patients, but you will learn to manage.

 

[Smurfette]

I thought the cap was 10 patients / intern now with the ACGME rules? Or is that just an institution specific rule?

Surgical residents/teams don't have caps. The trauma service follows all trauma patients, vascular service follows all vascular patients, etc. You learn what to write down, and how to keep track of the important stuff. Becomes easier with experience and caring for the patients day in and day out.

 

[evilbooyaa]

Just carry your team's list with you, and when you're rounding, write down any new issues or relevant details. That's what I see all the residents I'm currently working with. If the attending asks a question on someone with the med student/intern who is primarily seeing that patient not present, the junior/senior surgery residents just pull out their list and give a short synopsis.