The End of an Intern Era

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OB1🤙

Breaking Good
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So at our program, one out of the last 3 intern year months are spent doing anesthesia. That for me starts on Thursday. My final intern rotation in June is an ICU month, which I'm gonna consider to be critcal care and therefore under the anesthesia umbrella.

So the way I see it, my intern year ends on Wednesday.

Wow.

I'm excited and definitely scared. But mostly excited. It's been a five year (!!!) run up to this point. FIVE YEARS, just to accumulate the foundation of knowledge for this gig. Some of our nursing colleagues might belittle those five years and say they don't count for anything besides some fancypants book learning, but what do they know.

This year has been crazy, frustrating, rewarding, exhausting, and uplifting. We spend most of our intern time at a VA, and it really is a true privilege to take care of these guys. The nurses drive me bat$hit insane, but I like the vets a lot, the crotchety cantankerous bastards. They deserve the best care available to mankind, and the system fails them at every turn. Sickening.

But all that is finally coming to a close, and the rest of my life starts on Thursday. I hear they waste no time in dropping us newbies into the fire and brimstone and making us sweat. Bring it on, I say. Will it be stressful? Hell yeah. Will it be busy? Hell yeah. Will I miss H&Ps, bull$hit r/o MIs, academic internists, incompetent nurses, SOAP notes, dispo planning, and mind-numbing 6 hour long rounds? Heeeeelllllllllllllllll no.

Anesthesia starts Thursday. The rest of my career starts Thursday. The promised land starts Thursday.

Holy Hell am I excited for this.

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WOW.

What a cool way to look at things.

Sometimes its all about perspective, huh?

Congratulations!

Very well done. :thumbup:


now if you could get into some cash games with the donkey tourists that be icing on the cake, huh?:laugh:
 
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Hey I'm gonna be a new incoming 'tern, from UCLA med. Any tips on how to work around the va nurses...survival tips? I've taken CCU at UCLA as a student, so I've seen how painful that is for interns. Any suggestions??
 
Hey I'm gonna be a new incoming 'tern, from UCLA med. Any tips on how to work around the va nurses...survival tips? I've taken CCU at UCLA as a student, so I've seen how painful that is for interns. Any suggestions??

Assume nothing.

Actually, you should assume that nothing will get done.
 
Ah, intern year. I'll miss some aspects of you.

Anyone know how much importance residencies place on the initial ITE we take in early July?
 
Thanks, Jet. Actually, LA has a bunch of casinos right here in the city, and Vegas is only a 4 hour drive, so there are donks-a-plenty around here. Been too busy to go donk it up with them recently though...

mdqueen- do it yourself. That is the mantra for anyone starting up at this or probably any VA. You're probably used to the way things work at UCLA- you write "CT thorax with contrast" in the order sheet and walk away, and a couple hours later your patient magically has been scanned.

At the VA, you enter the order in the computer and walk away, the scan might be done in a week, if at all. If you want it to happen, you put the order in the computer, you call the scanner to see if they're open, you call escort to come get your patient, then you call the nurse and tell her your pt is going for a scan, and escort will be there in 2 minutes. You could have bypassed the other steps and just called her to tell her about the scan, but she'd go off on a break and forget about it and it wouldn't happen. When called out on it, she'd say something like "oh doctor, nobody answered downstairs and I had to take care of my other patients," this while relaxing at a desk with People magazine open in front of her.

The bottom line is that asking nurses, techs, or anyone else to do things doesn't guarantee anything. You can ask people things face to face, they'll say "sure no problem," then walk away and forget. If something is important, you MUST do it yourself or watch it happen with your own two eyes.

It's like this because there is zero accountability in the VA system. I've seen nursing errors that could have resulted in deaths easily, and I've seen nurses lie in the charts to alter the way things happened to make them seem not at fault for adverse events. They can't be fired, so there's no incentive for them to work hard, do what you say, look after their pts, etc.

This is mostly true on the general medicine floors and in the step-down units. The ICU and ER nurses are leaps and bounds better.

So what you gotta know is: never trust anyone but yourself to do anything. Once you accept this and the extra work it means for you, life at the VA gets much less frustrating.

Overall it's a good intern year, and the VA computer system really really really makes your life easier in terms of looking up pts' histories, labs, old notes, films, EKGs, etc. But nursing will be a thorn in your side all year long. You just gotta grin and bear it.
 
Thanks a lot hawaiian bruin! I assumed as much. I had surgery at the VA, so didn't get to experience the medicine side, but I now know that the book with dept phone numbers will be my best friend. I'm doing my best to mentally prepare myself since I'm already pretty jaded as a med student, and haven't done any real work in awhile....I'm enjoying it while it lasts.;)
 
You lucky Hawaiian Bastard. I, on the other hand, get dealt my call schedule for May. It's my 4th and last surgery month of intern year...pediatric surgery. Team consists of two other interns and one upper level resident, all of which are taking a week vacation during the month. What does this translate to for excalibur? 11 calls with Q2 FOR TWO WEEKS STRAIGHT!!!

...Serenity now...serenity now...
 
...Serenity now...serenity now...

I've been saying this for ten months.

Q2? I thought that was outlawed these days. Hopefully you can stay awake enough to take care of the young'uns.

Hang in there bro- sounds like they work you guys over there. You need another Tunica run, my friend...
 
So I guess those of us getting ready to start our intern year have a lot to look forward to...:laugh:
 
So I guess those of us getting ready to start our intern year have a lot to look forward to...:laugh:

Funny you say that because this time last year was awesome! 4th year was good all around and the end of it was a huge party and lots of good times.

But I do remember seeing my friends that were a year ahead of me struggle through their intern years...and all through 4th year, part of me was jealous of the fact that although 4th year was so great, my friends would be finished with that hellish year when I would just be starting. So just remember, the yuckiness can never end if it never begins. Remember that this time next year when your internship is drawing to a close...just think about those 4th year students that don't know what they are in for and smile to yourself because the year will simply fly by. It will suck, it will be hard, you will work a lot, you may learn a lot, you will get frustrated but you will get better at being a doctor (no where to go but up) and you will be so busy that the year will simply fly.

Good Luck!!

27 more days for me followed by a 2 week elective in outpatient private allergy (Sweet!) and 2 weeks vacation (for relocation) and it's time for CA-1!
 
Good post and I concur. Intern year does fly-by fast, and you will most likely learn a lot. Do your best to pick up everything you can, and try not to get frustrated along the way.

Funny you say that because this time last year was awesome! 4th year was good all around and the end of it was a huge party and lots of good times.

But I do remember seeing my friends that were a year ahead of me struggle through their intern years...and all through 4th year, part of me was jealous of the fact that although 4th year was so great, my friends would be finished with that hellish year when I would just be starting. So just remember, the yuckiness can never end if it never begins. Remember that this time next year when your internship is drawing to a close...just think about those 4th year students that don't know what they are in for and smile to yourself because the year will simply fly by. It will suck, it will be hard, you will work a lot, you may learn a lot, you will get frustrated but you will get better at being a doctor (no where to go but up) and you will be so busy that the year will simply fly.

Good Luck!!

27 more days for me followed by a 2 week elective in outpatient private allergy (Sweet!) and 2 weeks vacation (for relocation) and it's time for CA-1!
 
Hit the absolute bottom of my intern year today. I mean rock bottom.


Elderly lady + oral pain meds for zoster = constipation

constipation + me in ED = disimpaction


:barf:
 
Hit the absolute bottom of my intern year today. I mean rock bottom.


Elderly lady + oral pain meds for zoster = constipation

constipation + me in ED = disimpaction


:barf:

that is the rock bottom, man. I hit it back in november on inpatient geriatrics (demented hispanic lady). I'm in the peds ED now and my friggin attending is like hell bent on getting me to disimpact someone. F that. I flat out refuse to do butts anymore. I started enough friggin foot IVs and EJs for the internal med residents that they owe me about 6 dig-in-someone's-butt each :smuggrin:
 
Hit the absolute bottom of my intern year today. I mean rock bottom.


Elderly lady + oral pain meds for zoster = constipation

constipation + me in ED = disimpaction


:barf:

I GOTCHA BEAT, DUDE!

Although, uhhhh, that aint good! :laugh:

I was at DA U from 1988-1992....so my 3rd year of med school circa 1991 was during part of the huge AIDS time....before treatment really did much....pts still had huge viral loads compared to pts with current-day therapy...

anyway, I had to dig a buncha poo outta this poor young guys butt that was dying of AIDS...really sad case....and that was back when fear of catching the disease was pretty rampant in the medical community....

I triple gloved and went to town on this guys bootie which btw wasnt too hard since his sphincter was pretty obliterated from da bone rollercoaster up............uhhhhhhh..:)scared:)..you get the picture.
 
Well, after a whole 5 days of anesthesia, I'd just like to come back and report that I'm in fu(king nirvana.

This job is frigging awesome.

Hang in there, fellow 'terns. The light at the end of the tunnel shines very bright, even if you have to disimpact that tunnel to get there.
 
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