What to do as an intern?

[NJWxMan]

I'm posting this here since A) I'm technically a PGY-I psychiatry resident and B) I think I'll get the most useful responses here.

I completed my last day of IM intern orientation today which included reading some of the charts, getting the details for expectations from my PGY-III resident, etc. Tomorrow, when I go in at 5:30AM and complete my note with attending rounds looming at 8:30AM, do I go ahead and order the K-Dur 40 mEq PO x 1 or should I wait for rounds or check with my PGY-III resident first? For comparisons sake, at my current IM site, interns complete the H and P in the ED, but the resident writes the orders. I wasn't truly expecting this, so now I'm a bit concerned about stepping up my responsibility or instead looking incompetent.

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[OldPsychDoc]

I'm posting this here since A) I'm technically a PGY-I psychiatry resident and B) I think I'll get the most useful responses here.

I completed my last day of IM intern orientation today which included reading some of the charts, getting the details for expectations from my PGY-III resident, etc. Tomorrow, when I go in at 5:30AM and complete my note with attending rounds looming at 8:30AM, do I go ahead and order the K-Dur 40 mEq PO x 1 or should I wait for rounds or check with my PGY-III resident first? For comparisons sake, at my current IM site, interns complete the H and P in the ED, but the resident writes the orders. I wasn't truly expecting this, so now I'm a bit concerned about stepping up my responsibility or instead looking incompetent.

Ask the resident right away: "Is it OK if I go ahead and put in orders, or do you check them out first?" There may be some things that are no-brainers, but other things that as a matter of local institutional culture just aren't done."

Don't be afraid to ask. It's everyone's first day in a new job.

 

[NJWxMan]

Thank you so much!

 

[masterofmonkeys]

I would mirror what OPD says.

I've been an intern for a week now on the psych side, and I've just been going off of if it is a simple routine thing or not.

Increasing the dose of trazodone for sleep I'll do myself. PRN lorazepam for agitation same thing.

Switching a patient from Zyprexa to Risperdal...well that I'll talk to my attending about first.

Dunno if concrete examples help or not.

For K-Dur I'd just put the order in myself. Which blood pressure med to start I'd run by the attending first (lisinopril, or some other pril, always IMO, but that's just me).

 

[fMRI]

Thank you so much!

Congrats NJWxMAN -- you're an intern now!
Time to update from "medical student"...

... and don't forget to treat us med students nicely -- we'll be looking up to you!