The Intern Musings Thread

[Cinematographer]

Going on vacation soon and decided to make one last mega-thread, this one being for my fellow incoming EM interns. We had a lot of folks participate in this year’s ERAS and RoL threads, so I think it would be neat to keep up/help each other via an intern-specific thread. Let’s get through this thing called life residency together.

Purpose of Thread: This thread will be used to discuss residency-related issues, intern “dumb” questions, intern year frustrations, educational resources, on-service/off-service rotation tips, crazy cases, STEP3 scheduling and prep, in-service exam prep, loan repayment, shenanigans, etc.

Old Thread Recommendations:

• Are You Happy in EM??? (by @SynapticDoctah)

• Educational Resources (by @justaregularmed)

• How are EM Residents Evaluated? (by @holabuster)

• In Debt far Above My Eye Balls!!! (by @AceH)

• Intubation Difficulties (by @MaykoTayko)

• M4 Who Matched EM. Rosh Review Advice (by @OsteoQuack)

• Matched But Unhappy (by @helpmewithrol)

• Sleep Hygiene and Related Tricks (by @RustedFox)

• Things I Learned From My Patients (by @docB)

• Tips For New Docs? (by @Cinematographer)

Recommended Links (Please feel free to suggest other ones):

• Intern Survival Guide 2015 (FREE Kindle Edition)

• AAMC Medloans Organizer and Calculator

• Must Read EM Journals–2016 Edition

• EMRA Student-Resident Mentorship Program (sign up!)

“It's an incredible paradox that being a doctor is so degrading and yet is so valued by society”
Samuel Shem, The House of God​

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[WeeBay]

Sticky

 

[medic4lyfe]

Posting to get the alerts

 

[deleted547339]

Someone's trying to become a mod, lol.

 

[Cinematographer]

I realize I posted this thread a bit early (residency for most doesn't start until late June/early July), but I'm hoping for more activity as June gets closer.

Off to Brazil for now!

Spoiler

where I will obviously spend my time rereading Rosen's a third time.... Of course .

 

[medic4lyfe]

I realize I posted this thread a bit early (residency for most doesn't start until late June/early July), but I'm hoping for more activity as June gets closer.

Off to Brazil for now!

Spoiler

where I will obviously spend my time rereading Rosen's a third time.... Of course .

Bruh... quit slackin. I'm starting my 5th time through.

Spoiler

No I'm not. I'm drinking beer outside in the sun.

 

[Petypet]

You are inbetween 4th year and PGY1, go outside.

 

[Cinematographer]

You are inbetween 4th year and PGY1, go outside.

Never heard of the mobile SDN app?

 

[Cinematographer]

Anyone else have their intern orientation coming up? Mine starts in less than two weeks. My first month will be at our University ED. I'm both excited and HORRIFIED.

 

[Fox800]

Anyone else have their intern orientation coming up? Mine starts in less than two weeks. My first month will be at our University ED. I'm both excited and HORRIFIED.

Our first day is in two weeks. 8 days of hospital orientation and then our entire class spends the first block in the ED, should be a party*.

*goat rodeo

 

[JumpingThroughHoops]

are we supposed to be worried about passing this ATLS/PALS/etc training or is it supposed to be straightforwrd? I wasn't worried but the books were bigger than what I was expecting and I'm still in this MS4 checked-out mode... lol

 

[RustedFox]

Our first day is in two weeks. 8 days of hospital orientation and then our entire class spends the first block in the ED, should be a party*.

*goat rodeo

GOAT RODEO needs to become a staple thing on here. I love it.

 

[BoardingDoc]

are we supposed to be worried about passing this ATLS/PALS/etc training ...?

No. It's stupid easy.

 

[bravotwozero]

No. It's stupid easy.

Don't blow off your ATLS test. It is not easy.


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[Fox800]

No. It's stupid easy.

Don't blow off your ATLS test. It is not easy.

 

[dchristismi]

Ok, to clarify.

ACLS: easy.
PALS: pretty easy.
ATLS: run by surgeons who sometimes just want to be a dick, and a lot harder because it's not dumbed down like the others.

 

[gro2001]

No. It's stupid easy.

Sometimes it's stupid easy, sometimes an entire incoming intern class fails.

 

[Fox800]

GOAT RODEO needs to become a staple thing on here. I love it.

 

[NMonte82]

Not for nothing, but that Goat Rodeo album is actually pretty incredible.

 

[Cinematographer]

Working my first shift today. #InternallyScreaming

 

[deleted720339]

Good luck Cinematographer! I've got another 2 weeks until s**t gets real.

 

[medic4lyfe]

They're happy if you don't actively hurt people.

As long as actively is the key word, I think I can handle that when I start Friday.

You'll do fine.


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[Fox800]

Good luck Cinematographer! I've got another 2 weeks until s**t gets real.

I hate you.

First shift today. One admit, nine discharges. Had to sign an Rx for narcotics for the first time and sign a work note for the first time. Didn't get yelled at by anyone except the crackhead in a wheelchair that wasn't my patient. Have multiple doses of Dilaudid IV and it was fine. Even gave Zyprexa for n/v. That's a win in my book.

My attending left and I wrote eight more notes on my own. I'm sure I left something out. Oh well.

 

[Cinematographer]

I hate you.

First shift today. One admit, nine discharges. Had to sign an Rx for narcotics for the first time and sign a work note for the first time. Didn't get yelled at by anyone except the crackhead in a wheelchair that wasn't my patient. Have multiple doses of Dilaudid IV and it was fine. Even gave Zyprexa for n/v. That's a win in my book.

My attending left and I wrote eight more notes on my own. I'm sure I left something out. Oh well.

You saw 10 patients on your first shift??? Boss. I saw seven during my 8-hour shift and was honestly not doing the greatest job keeping track of all lab results/imaging studies.

 

[deleted245139]

I'm sitting on my couch, morning of my last shift as a resident and this thread is like a massive nostalgia bomb. Enjoy the ride guys and girls. You made a great career choice

 

[Fox800]

You saw 10 patients on your first shift??? Boss. I saw seven during my 8-hour shift and was honestly not doing the greatest job keeping track of all lab results/imaging studies.

I was on the lower-acuity side so I guess I was cheating. It was tough to stay on top of labs and imaging. They want us seeing patients that are roomed and waiting instead of writing notes.

 

[Cinclus]

I have my first shift Monday.

 

[HoosierdaddyO]

I don't even know the dosage of Advil at this point in my vacation :/

 

[medic4lyfe]

I don't even know the dosage of Advil at this point in my vacation :/

Get the patient to open their mouth, grab a handful, and throw it at them. Whatever sticks, that's the dosage.


... No wait... that's tylenol...

 

[Cinematographer]

Classic.

 

[Fox800]

I don't even know the dosage of Advil at this point in my vacation :/

1. Start placing order in EPIC, check the default dosages
2. Double-check on WikEM.org
3. Place order
4. Profit

 

[Jlaw]

View attachment 205443

Working my first shift today. #InternallyScreaming

Had my first shift today...felt like puking before hand, and I'm not an anxious person normally lol. Went well, didn't kill anyone, and actually may have saved a couple lives. Still have imposter syndrome but did my best to sound like I knew what I was talking about when the nurses asked me questions.

 

[WeeBay]

I am fluctuating between ridiculous excitement and pure ****ing panic, and I hit both like 10 times per hour.

 

[Swingman]

Where are you guys training where you're already working shifts? My first shift isn't until July 1st.

 

[bravotwozero]

Cruel trick I heard being played on interns on off service rotations by seniors - when they sleep in the call room, page them to the phone number of the telephone in the call room. And when you know they obviously won't be able to return the page, call them yelling 'WHY ARENT YOU RETURNING YOUR PAGES!...'


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[Cinematographer]

How are my fellow co-interns doing?

I've only worked 4 shifts but so far I've really enjoyed it, even if it get overwhelming towards the end lf my shift. Goal atm is to get more efficient at charting (any .dotphrases suggestions welcomed).

 

[Cinclus]

Done two shifts so far. And I feel you on the charting.

 

[shoal]

charting will always be a problem. during second and third year try to make good habits and get your charting done during your shift. youll thank me later.

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[Cinclus]

I am getting pretty much all of the charting done during the shifts, and I am seeing not-very-many patients because of it, haha.

 

[bravotwozero]

We had paper t-sheets during residency. Thank goodness for that, bc that shop was super busy. After I graduated, they started doing dictations and t sheets lol


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[Cinematographer]

Any other interns working 4th of july? Should be fun (read: horrible). Good luck to all other unfortunate intern souls!

 

[Petypet]

Don't forget to sign scrips, my script for norco kept making its way back to me and I kept taking it back to the nurse. "I don't know how to sign scripts"

 

[Fox800]

Any other interns working 4th of july? Should be fun (read: horrible). Good luck to all other unfortunate intern souls!

Afternoon/evening here. No fireworks for me. At least I'm not working in the locked down psych/drunk tank area.

 

[Cinematographer]

Anyone have any tips/suggestions on keeping track of lab and radiology results on EPIC other than compulsively checking the patient's chart? I have a paper checklist that I update regularly, but it gets messy once I start taking care of more than x number of beds at a time. There's gotta be a more efficient way of keeing track of things.

 

[da8s0859q]

Anyone have any tips/suggestions on keeping track of lab and radiology results on EPIC other than compulsively checking the patient's chart? I have a paper checklist that I update regularly, but it gets messy once I start taking care of more than x number of beds at a time. There's gotta be a more efficient way of keeing track of things.

Paper checklist sounds like an annoying waste of time.

I vote Epic itself. Run your list in your head, right off the trackboard. Use side-by-side view if you like it; otherwise, results pane on the bottom as you go through people on the board. When in charts, leaving the results tab open in the left-hand sidebar can be helpful.

 

[hoot504]

Paper checklist sounds like an annoying waste of time.

I vote Epic itself. Run your list in your head, right off the trackboard. Use side-by-side view if you like it; otherwise, results pane on the bottom as you go through people on the board. When in charts, leaving the results tab open in the left-hand sidebar can be helpful.

Exactly this. Make sure you have your trackboard setup so that you can see your results in the separate window pane on the bottom of the screen. Personally I have like 5 or 6 different buttons that I can toggle between, including triage summary/vitals/orders/results/ed notes/ed medications. It's perfect for every time I run the board.

 

[Fox800]

I wish there was an popup in Epic whenever a new lab test or imaging study resulted. Would that make too much sense?

 

[Gither]

I wish there was an popup in Epic whenever a new lab test or imaging study resulted. Would that make too much sense?

With multiple active patients each having multiple pending results. That's way too many boxes to close after each one pops up in a 12 hour shift. With my luck it'll probably keep popping up at the worst times.


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[da8s0859q]

I wish there was an popup in Epic whenever a new lab test or imaging study resulted. Would that make too much sense?

1990s advertising before the advent of pop-up blockers. This would be a nightmare. Just widen the column showing labs resulted and flags if you want something like that.

 

[medic4lyfe]

Intern year off to a start like...