"The List"

[sunshine2004]

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We usually have between 15-25 pts on the surgery floor. As a student, I am suppose to know every pt's situation any time I'm asked. I'm looking really bad because I have trouble remembering them all (labs, POD#, surgery, why admitted...)...I always have to look them up and even then sometimes I get confused between pts. Will I get better as the months go by or is it always going to be like this??? I might not be cut out for this!

 

[SteadyEddy]

It's okay...you're going to be fine. Remembering patients is one of those things that comes with plenty of practice and exposure. One of the things that I've found helpful is to use checkboxes on the patient roster. Write down the labs from the morning on this sheet and review pertinent info as the day progresses. Don't stress out though...as I find it a little absurd for someone to expect a student to rotely remember all that info. Just keep pushing on...

We usually have between 15-25 pts on the surgery floor. As a student, I am suppose to know every pt's situation any time I'm asked. I'm looking really bad because I have trouble remembering them all (labs, POD#, surgery, why admitted...)...I always have to look them up and even then sometimes I get confused between pts. Will I get better as the months go by or is it always going to be like this??? I might not be cut out for this!

 

[doc05]

if you spend all day on the floor, constantly checking labs, ancillary studies, and talking with consulting services, you'll get the hang of it in no time.

and p.s. noone expects you to remember every single lab value, but if a patient's white count spikes, or K is suddenly 2.0 (which should never happen), you need to know these things.

 

[fourthyear]

Write everything down - this is the secret to being a good resident and not forgetting to get things done. You'll have a bunch of little tasks every day and constant interruptions with new problems/tasks - if you don't write it down, no way you'll ever remember it all. It's okay to look at your paper when asked a question...better to do that than not have the answer at all.

You can make your team's list to have most of the info you're having a problem remembering right on there - dx, surgery, POD, pt age/sex, pt number and room number should be minimum parts to the list - you can add antibiotics and antibiotic days too if you want, plus a blank space to fill in labs and vitals right on the sheet.

It actually gets a lot easier once you're a resident b/c more of the patients you see from start to finish - if I do the H and P or consult, I have no problem remembering everything about the patient, but if someone else admitted the patient, I have to work harder to learn the details. It does get better though with practice.

 

[Celiac Plexus]

We usually have between 15-25 pts on the surgery floor. As a student, I am suppose to know every pt's situation any time I'm asked. I'm looking really bad because I have trouble remembering them all (labs, POD#, surgery, why admitted...)...I always have to look them up and even then sometimes I get confused between pts. Will I get better as the months go by or is it always going to be like this??? I might not be cut out for this!

When I was an intern on services with a lot of patients I made a card for every patient. I used these big nursing cards, and wrote down a short H&P. Then every morning when I saw the patient I wrote down the VS, i/o, am labs, any relevant physical finding, etc. That way when an attending or my chief asked me anything about a patient, I would just pull out my card on that patient and could answer any question. I didn't do this on smaller services (<10 patients), but on trauma for example, with 20+ floor patients.... i broke out the cards.

good luck.

 

[dr.evil]

A little story if you will: 😴

As a 3rd year student on internal medicine, I rounded on around 6 patients each day. Each day I had to present the patients to the residents and attending as a group. If there was a new patient I had to present their ENTIRE history and physical (including the ROS and PE from hell, I mean, who gives a crap about fremitus or cranial nerve 1). He made me do this with NO notes (that sucked) and expected every single lab value to be memorized as well as vitals.

One day he asked me Joe Blow's ALT level and I said I couldn't remember the exact level but that it was within the normal range. He berated me saying that I only had six patients and I should know every single thing about them.

Needless to say, I'm doing surgery.

Strangely, that guy sent me a copy of a letter he dictated to the dean giving me a glowing letter of accomplishment for the rotation. IM docs are weird.

Just sharing for the hell of it

Cards on a good idea or simply a sheet hitting the pertinents

 

[shahkg]

Don't worry about it dude. As a student the attendings/residents will test you to see how well you hold up and what your tolerance to stress is.

I think that every one of us who did the 3rd yr. surg rotation had to go through with it, but towards the end if you're doing a good job they'll start to respect you and you will find your own system as to how to remember patients.

Good luck.

 

[dry dre]

Chiming in/beating the dead horse....

This comes with time...everyone has been there...in the coming weeks/months you'll be surprised how all the K, Na, etc values just "sink in" such that you'll know today's numbers as well as the trend when asked during rounds.

In the mean time, I agree with using cards. There are pre-formatted sheets on medfools.com that you can print out. They are formatted to insert data such as lab values, med changes, I/Os etc...you can print out a form, shrink it down, copy double-sided, and fit a few patients per sheet. Carry the cards until you get the hang of it.