I would like to ask a question based on a post from Natalie in on of the other forums. She said that she was surprised that the staff DOES what you tell them to do , and then you have a sinking feeling you have made a huge mistake.
About that first time when you are in charge… did you have anyone as a sounding board when you had trouble making a decision? An “older” resident or attending? Or were you simply thrown in the mix? And if you were simply thrown in, did you feel prepared?
When I think about that first day, I am excited!! But SCARED. I am hoping someone will tell me that all the training they get really does prepare them for that first day of being in charge and making crucial decisions about someone’s health.
DRD
| QUOTE (drd @ Apr 11 2003, 01:32 PM) |
| I would like to ask a question based on a post from Natalie in on of the other forums. She said that she was surprised that the staff DOES what you tell them to do , and then you have a sinking feeling you have made a huge mistake. About that first time when you are in charge..... did you have anyone as a sounding board when you had trouble making a decision? An "older" resident or attending? Or were you simply thrown in the mix? And if you were simply thrown in, did you feel prepared? When I think about that first day, I am excited!! But SCARED. I am hoping someone will tell me that all the training they get really does prepare them for that first day of being in charge and making crucial decisions about someone's health. DRD |
Hey DRD,
There is always a more senior resident on duty with you but you don't want to bother them with little things that you should know like orders for pain meds and the like. Here at UVA, my residency director requires the outgoing interns to spend a week with the incoming folks and be available by phone at night. Since my last rotation is Night Float General Surgery Intern, I will be shadowed by an incoming intern that will draw a rough assignement right out of the gates. We will have a week of overlap, then they will be on their own.
As second year, we have more responsibility and we can't use the excuse that we don't know something. You are expected to know things as a second year surgical resident. While you will still be at the junior level, you are expected to carry your weight and be a resource for the interns who will be somewhat overwhelmed for the first few months.
Every resident is required to take ATLS/ACLS so you know, in general, how to handle the worst disaster. There is a 5th year Chief and a third year consult resident in house at all tiems. In the units, will be the second-year folks so there are resource folks around. I found that no one minded me asking questions but I carried a solid knowledge base from fourth year. I hope you chose your fourth year elective well.
Natalie
DRD,
You will never be as prepared as you’d hope the first day. Medical school does build some muscles, though. First year you accomplish more than you’d concieve possible, and the level you are learning at is almost a joke compared to the level you will achieve in the next few years.
As a fourth year resident, I love when stuff goes wrong in the hospital. I know it is my time to just sit down in a chair and ask my intern “well, what are you going to do?” (It’s especially fun when the patient is seizing in front of you or just threw a run of V tach: you can really see the intern’s sweat glands open up and run!) I’m not trying to be mean, it is a learning process and you are not expected to be perfect the first time. (Remember, see one, do one, teach one.) Usually when there is the smell of trouble in the hospital (or a code) everyone comes running. The last few codes I’ve run, the nurses are doing the right thing before you even ask them to do it. When you have to make tought decisions, when you are paged out of a dead sleep at 4.30 in the morning, always ask the nurse “what do you think we should do?” You will find the staff is more than happy to do what you decide, as long as you have listened to thier concerns and addressed them. Plus it gives you a few seconds to wake up and look at the list of your patients and remember why the heck they are in the hospital in the first place…
You will make mistakes (esp in July, when the death rate is highest), however, luckily, it is hard to kill patients. You will always have a senior ready to help you (unless you train in a county hospital like I did). What you don’t do is make mistakes twice.
99% of our training is in what is common and what is dangerous. Remember, you are 800% better trained and more knowledgeable than any other staff in the hospital. What you do as a physician is make tough choices that affects your patients and their quality of life. That is your role. Staff will listen when you talk; that is their role.
Your first night on-call you step up to the plate and face the curve balls and the heat. Swing if you see a good pitch, otherwise CYA and ask a lot of questions.
David