Hi there,
Here is my list in no particular order:
1. Know how to treat a-fib. Know when to cardiovert and when not to.
2. Know how to work up: fever, change in mental status, low urine output, respiratory distress, wound dehis and pain management.
3. Know how to put in a central line; subclavian, IJ and femoral. Know how to draw both venous and arterial blood. Know how to put in a chest tube and know when not to put in a chest tube. Know how to put in an a-line. Know how to put in a MAC or cordis. Know the complications too.
4. Know how to write TPN orders.
5. If you think you should call the chief, do it. "Load the boat if your patient is sinking."
6. If you don't know, ask a more senior resident to help you. If you are unsure of how to do a procedure, ask for help.
7. Nurses will help you; try to understand and appreciate their input. We are all on the same team, just different jobs.
8. Never lie and never whine. Never complain about a situation unless you are ready with a solution. Complaining doesn't help and it make you feel bad longer.
9. Help your colleagues and watch each other's backs. Be happy, internship is fun and you get to do things that are fun. Smile!
10. Write down everything and learn to dictate a good discharge summary. (Include the things that you want to know if you were working the patient up in the middle of the night in the ER. List all medications and their dosages.
Finally and most important: Take some time for yourself. It can be as simple as a 5 minute walk outside to breath some fresh air. Laugh, go to a movie, work-out, don't eat junk and hug your significant other often. Internship flies by like greased lightening and soon you will be a PGY-2. Enjoy yourself.
njbmd