on call without a senior

[MLB2000]

---

Members don't see this ad.

Any of you done a prelim/transitional year as an intern where there was no IM/FP resident on call with you overnight? How did you handle those first few anxious months on your own?

 

[mysophobe]

Lots of Xanax and lots of praying.

 

[Solideliquid]

Any of you done a prelim/transitional year as an intern where there was no IM/FP resident on call with you overnight? How did you handle those first few anxious months on your own?

Throwing interns to the wolves like this never made any sense to me. There should be someone you can call if you need help.

 

[Mumpu]

Can you say indefensible in malpractice court?

 

[deleted87716]

Any of you done a prelim/transitional year as an intern where there was no IM/FP resident on call with you overnight?

No, and I can't imagine any program allowing that to happen.

 

[DrRobert]

I would hope that programs who allow this to happen would be placed on probation.

 

[Koko]

When I interviewed at a NYC transitional program, I was told point blank by the resident giving the tour that SICU overnights were solo. Didn't hear that anywhere else.

 

[toxic-megacolon]

As a transitional year, I took overnight call with patients in the SICU. The closest help was the senior resident, who was on home call sleeping.

 

[alina_s]

I'm in a psych program and all of our intern year call on inpatient psych is solo. There's an attending on phone call but... I think this is fairly common in speciality programs. We took neurology call with phone support only as well, but at least the neurology first years have a year of medicine behind them.

 

[Solideliquid]

I'm in a psych program and all of our intern year call on inpatient psych is solo. There's an attending on phone call but... I think this is fairly common in speciality programs. We took neurology call with phone support only as well, but at least the neurology first years have a year of medicine behind them.

What about the IM months?

 

[Blade28]

I've taken lots of call where the backup was at home.

 

[Smurfette]

I've had several rotations as an intern where I was the only one in house. My back-up was available by phone/pager at any time. These were surgical rotations...kind of scary at times to be the only one around to deal with things, but it makes you a better intern when you look back on it. (and I was NEVER afraid to call my back up. LOAD THE BOAT!!!, and document that you informed your senior...)

 

[Idiopathic]

No, and I can't imagine any program allowing that to happen.

It happens at Baptist Integris in OKC, at the PGY-1 year linked with the OU anesthesia program, consistently regarded as one of the best intern years in the country. Its something like q7 call, where the intern is the only physician in a 100+ bed hospital (except for the ER staff). They regaled us with stories of 100 central lines during intern year and often running 2-3 codes per call shift. I would imagine its really hard to get that kind of experience elsewhere.

At least this is how the interns described it to us when we interviewed there.

 

[DOtobe]

My only call month when I was completely alone in the hospital was during my surgery month. My chief was more than willing to help me if I needed her, even when she was soundly sleeping and I was panicking...

 

[OUsooner]

I'm doing a transitional year at Swedish Covenant in Chicago. Supposedly a fairly laid back intern year, well other than the fact that I think two interns cover the 300 bed hospital alone on call. Maybe I'm wrong?? I should check into this but don't want to sound like an incompetent sally with the PD. 🙁

i feel bad enough about myself after using that stupid purple face. i have no chance intern year.

 

[mysophobe]

Don't worry, no one else knows what they're doing either. Just smile and say, "thank you sir, can I have another".

 

[madcadaver]

the intern is the only physician in a 100+ bed hospital (except for the ER staff). They regaled us with stories of 100 central lines during intern year and often running 2-3 codes per call shift.

2-3 codes per shift in a 100ish bed hospital? It's a good experience to run codes, but somebody should consider taking care of the patients before they code...

 

[Mumpu]

The hospital with 2-3 codes per 100 beds per night is probably the same place that has interns with no in-house support running the SICU. Considering that the only surgical interns who get OR time now are the dweebs on Grey's Anatomy, I'm really curious what a solo intern will do if that gunshot wound in bed 3 decides to blow their femoral artery aneurysm at 4 am.

 

[deleted87716]

2-3 codes per shift in a 100ish bed hospital? It's a good experience to run codes, but somebody should consider taking care of the patients before they code...

Funny, I was thinking the same thing. 🙂

 

[NYGasGirl]

I was alone while on call during my intership year, but we had house doc for back up so not too bad. I'd be panicking to be on call just by myself without backup .... 😛

 

[Gauss]

ACGME has rules against this, additionally the supervisor has to be IM if the intern is IM, ER can't cover IM, nor can FP cover IM

 

[Back34]

I won't bore you with the billions of questions I have nightmares about, regarding my first night on call as an intern (by MYSELF ?!?!). Suffice it to say, I'm going to find the most senior nurse on duty and offer to pay for food that night. The ensuing conversation will go something like this:

Me: "I have two favors to ask of you: please don't let me kill anybody and please make sure I wake up if something happens"

Nurse: "No problem"

Me: "God Bless You"

It's all cream cheese after that 😎 ...I hope

 

[Mumpu]

Better hope there's a place that sells breakfast burritos at 11 pm. 😛

 

[Blade28]

Why?

 

[UHS05]

Just found out that I'm going to be completely alone in a 150 bed hospital during my surgery month for 2/10 call nights...apparently patient care isn't exactly paramount to them since I am a transitional and the last time I did surgery was as a third year med student...furthermore, this hospital pissed off all their GI docs so surgery covers all the GI bleeds. So when that code comes a-calling and they want the surgery intern on call to place the central line in a 450 lb little flower, they can probably kiss the patient goodbye...

I mean I'm a fast learner, but that kind of patient care is just nuts and I'm pretty sure the ACGME doesen't allow such practices... 👎

 

[Mumpu]

Perhaps in your neck of the woods the nurses do not have an unhealthy obsession with that delectable?

 

[toxic-megacolon]

, I'm really curious what a solo intern will do if that gunshot wound in bed 3 decides to blow their femoral artery aneurysm at 4 am.

Uhh, put pressure on it, run the fluids, and pray until help gets there.

 

[fab4fan]

I won't bore you with the billions of questions I have nightmares about, regarding my first night on call as an intern (by MYSELF ?!?!). Suffice it to say, I'm going to find the most senior nurse on duty and offer to pay for food that night. The ensuing conversation will go something like this:

Me: "I have two favors to ask of you: please don't let me kill anybody and please make sure I wake up if something happens"

Nurse: "No problem"

Me: "God Bless You"

It's all cream cheese after that 😎 ...I hope

Nurses are not house pets. You don't need to give us treats. Just be respectful and clean up your messes (we're not maids, either). Most nurses know that new interns have anxiety about call, and most of them will be glad to help you.

 

[San_Juan_Sun]

Nurses are not house pets. You don't need to give us treats. Just be respectful and clean up your messes (we're not maids, either). Most nurses know that new interns have anxiety about call, and most of them will be glad to help you.

If they were, would you be a snapping turtle? 😉

In all seriousness, I took that post as a compliment to good nurses keeping a young doc out of trouble.

 

[fab4fan]

Nope, not a snapping turtle. Now, a snapping chihuahua, maybe. My bark is usually worse than my bite, though. 😉

Honestly, there really is no reason to feel the need to bribe nurses with food. Just play nice. We don't want bad things to happen to our pts. either, so of course most of us (there are always exceptions) are going to be vigilant, particularly when new interns are taking call. We're not going to let someone make a mistake just out of spite.

 

[Blade28]

Nurses are not house pets. You don't need to give us treats. Just be respectful and clean up your messes (we're not maids, either). Most nurses know that new interns have anxiety about call, and most of them will be glad to help you.

So true. I've learned that after any messy procedure (difficult Foley placement, I&D, lac repair, etc.), the fastest way to make enemies is to leave all your garbage everywhere. You gotta pick up all the sharps, chux, dirty 4x4s, etc.

 

[APACHE3]

Never, never, allow nurses or ancillary staff to clean up after your procedure! You made it, you clean it up. Even after 30 years on the job, I'll clean my mess. I could never live with myself if something happened to one of my colleagues because I didn't pick up my sharps. This did happen to a nurse I worked with who was helping another nurse start IV on aids patient. The first nurse was sticking her used needles in the mattress. The 2nd nurse did not see it. She converted..she was only 24 years old..I'll never forget it. 🙁

 

[fab4fan]

Just last week a resident (who I really like) not only tossed a used angio on the floor, but threw the sterile towels covering the pt's arm (pt was prepped for an ortho procedure) in the trash. Hello!

I let it slide because he is a nice guy and I think he was just having a bad day. I hope it doesn't happen again, though.

 

[signomi]

I saw it in SICU when I was a med student - a lonely intern covering with no senior and no attending in house. And the attending would come in in the morning and rip them a new assh*le, but god forbid the intern called for help! Then I saw it in my medicine residency - I was running a service of 12 ward patients with no senior off and on (entire weekends) and I was in the ICU with residents that would leave and refuse to come help. Same went for CICU. It depends on the program I guess, some programs just don't mind high M&M rates.

 

[Mumpu]

Yikes Signomi.

Yikes.

 

[mysophobe]

Nurses are not house pets. You don't need to give us treats. Just be respectful and clean up your messes (we're not maids, either). Most nurses know that new interns have anxiety about call, and most of them will be glad to help you.

Where in his post do you get that he thinks you are house pets? He is banking on the nurses being skillful and knowledgable and hopes they'll help him. The "cream cheese" statement isn't literal.

 

[12R34Y]

I don't think it is that uncommon to be the only intern on call covering the general floors with your senior doing short call and then goes home at 8 or 10p..m. then they're on home call if the intern needs them.

that's how it works at my hospital.

Of course in the ICU the interns are on call by themselves as well, but you have a fellow on phone call that comes in for all admits etc...

so you do have some back up at least.

later

 

[Blade28]

Almost all of my calls are with the backup resident/fellow/attending at home, taking home call. I've covered anywhere from 15-90 patients at a time.

 

[signomi]

Well, this was a program that actually fired a girl during her third year when they finally decided she was natural selection in action. Survival of the farthest away from her.
😱

 

[fab4fan]

Where in his post do you get that he thinks you are house pets? He is banking on the nurses being skillful and knowledgable and hopes they'll help him. The "cream cheese" statement isn't literal.

Maybe he wasn't being literal, but this sort of bribery goes on all the time. The "house pets" wasn't literal, either.

Now that we've dispensed with debating literary devices, let me just say something nice about the med student who just finished his rotation in my dept. He came up to each of us (nurses) individually and thanked us for helping him over the last 4 weeks. It wasn't necessary, but it was appreciated by all.

Believe me, if he comes back as an intern, that will be remembered! 👍

 

[mysophobe]

We CAN all get along!

Seriously though, it might be because I've had experience on the ancillary side of the fence, but I never saw any reason to be mean or short with any nurses or techs or anything. I know a lot of people do, and it kind of embarrasses me, but whatever floats your boat, I guess.

 

[Plastikos]

We CAN all get along!

Seriously though, it might be because I've had experience on the ancillary side of the fence, but I never saw any reason to be mean or short with any nurses or techs or anything. I know a lot of people do, and it kind of embarrasses me, but whatever floats your boat, I guess.

It is embarrassing, and i dont see many reasons for ppl to be rude in general, too bad its just accepted.

 

[mysophobe]

Amen. I see people yelling and screaming and getting all hot under the collar, and I just laugh.

 

[Blade28]

No one ever intends to be rude or mean (for the most part, anyway). The times I've seen people lose their cool is when they've had a bad day, or are sleep-deprived, or post-call, or it's 3 in the morning.

Sometimes it's a struggle to maintain your composure in these types of conditions.

 

[mysophobe]

Really? I know plenty of people that are just mean for no reason.