Tomorrow, your world will end!
Okay, so perhaps I’m being a bit melodramatic, but tomorrow truly is the beginning of your first day of actual practice as a physician in the U.S., and it is healthy to have a bit of fear mixed in with your excitement (or, for some, dread).
Last year, I was in your shoes as a newly minted orthopedic surgery resident. The questions that ran through my mind included, “Will I have to use that ACLS stuff on my first day?” “How in the world do I modify PCA orders?” “How long will it take before I get yelled at?” The answer to the last question is “not long,” lol, but since I am now going into my PGY-2 year, I thought it would be helpful to give you some advice before your first day:
- Become detail oriented. You’ll notice that I did not say “pay attention to details,” because that is entirely too passive. Your job as an intern is to actually change your personality to become more detail oriented so that nothing about a patient’s care escapes you. The first step to this metamorphosis is to write everything down and then review what you have already done and still need to do at least every two hours. Once your seniors notice that you are on top of the patient’s details, your reputation of being on top of your game will be solidified.
- Read about your patients. When you first start, you will be terribly inefficient at doing most tasks and will find that you barely have time to do any reading when you get home. This is why it’s especially important to do some on-the-job reading about the patients that you are caring for. This will allow you to put a face to the disease process and hopefully help things stick in your memory
- Don’t increase work for your fellow interns. Nothing garners more disdain than an intern who passes off their own work onto other interns. Yes, in this era of 16 hour shifts, more things will need to be signed out, but make a point of staying later to take care of some tasks if it will help your fellow interns out.
- Don’t lie, ever. This may seem like a no brainer, but you would be surprised how easy it is to say you checked a minute value when you didn’t because you didn’t want to appear like a bad intern. Even if you plan to actually check it as soon as your senior walks away, it’s a bad idea to lie. Lying, even with the best of intentions, will destroy your reputation, and, in residency, as subjective as it can be, reputation is everything. Sometimes, in the rush to give senior residents an answer, it’s tempting to tell them what they want to hear, even if what they want to hear isn’t, in actuality, the truth. As much as you may dread doing so, it’s better to admit that the you haven’t completed the task but that you will take care of it asap. Honestly should prevail…always!
- Treat your nurses with respect. Not every nurse you will meet will have been at the top of their class if you know what I mean, but, on your first day of internship, even the not-so-great nurses know a lot more about what to do for certain aspects of patient care than you do. Treat them with respect, befriend them if possible, and patient care and your overall sanity will improve.
Oh, and… GOOD LUCK TOMORROW, YOU INTERN ROCKSTAR!!!