Remerciez-le!

Remerciez @Admin pour avoir partagé cet document gratuitement, de la manière la plus simple, en partageant sur les réseaux sociaux.

INTERN SURVIVAL GUIDE BECAUSE YOU GOT THIS TOP TEN RULES FOR INTERN SUCCESS 1.

INTERN SURVIVAL GUIDE BECAUSE YOU GOT THIS TOP TEN RULES FOR INTERN SUCCESS 1. Eat Breakfast 2. Don’t Lie 3. Be on Time 4. Know your patients 5. Communicate frequently 6. Always ask: what’s keeping this person in the hospital. 7. If you don’t know the answer, ask the question. 8. Never underestimate how poorly someone will do their job. 9. Do not forget to care for yourself 10. You only need to be 3 things as an intern: reliable, hard- working, and a team player. SIMPLE THINGS TO DO BEFORE INTERN YEAR STARTS Home Life  Automate all and any bills or things that require payments  Create a schedule for: cleaning, chores, groceries, etc.  Even if you can’t adhere to schedule, when you’re exhausted after a long day, you don’t want to think. Let the schedule think for you  Update or maintain all your tech. Get an external battery.  Unpack as much as you can (bribe with pizza and beer if you must), you won’t have time to unpack once intern year begins Personal Life  Let the people in your life know that intern year is a black hole. Repeatedly. Over the year. They forget.  Significant others: I’m not going to speak to this because I have never had a significant other so just communicate honestly and frequently  Dry shampoo is magical  Get your car maintained before intern year starts  Commit to doing at least one non-work activity once a week. For sanity.  Work clothes: scrubs and clinic clothes o Scrubs: Get >3 sets. Minimum 4-5 so you’re not washing them all the time o Clinic clothes: Comfortable, easy to launder and maintain o Shoes: COMFORT above all. you better be able to walk quickly and/or run in them. At least have one pair of sneakers for overnight calls and ICU rotations. Work Life  Decide on how much time you’re willing to spend after work studying/taking stock in the day. It doesn’t have to be tons of time. But commit to, for example, fifteen minutes a day. And stick with it.  Vent as needed but also remember that your loved ones do not want to hear about your work life 24/7  Try to make some friends with your co-interns  Get the names and phone numbers of people from different specialties. And nurses. And therapists. Make them your allies. Or at least know who the hell they are when so you can hunt them down when shit is going crazy. WHITE COAT ESSENTIALS OBJECTS BOOKS APPS SITES OBJECTS MEDICAL STUFF  Your tools: Stethoscope. Reflex hammers for neuro peeps. Surgeons and ER docs: holsters for your stethoscopes (surgeons, do you guys still use stethoscopes? JK), trauma shears. Peds: cute pen-light or toy, stickers.  Pen light or your phone  Pager  At least two black pens, and a colorful pen or two to highlight things on your list  A notebook for rounds, lectures, personal to-dos  YOUR LIST  ACLS manual  Pocket Medicine or a small reference text. Unless you’re like me, you can always put that on your phone  Directory. Which you can always put on your phone as well  Badge/ID NON-MEDICAL BUT ESSENTIAL STUFF  Your wallet and keys!  Gum and/or ibuprofen. Trust me.  Lotion. Sanitizing solution.  YOUR PHONE  Charging cable  Headphones BOOKS Every discipline has its books. Here are some books (because I’m an internist) that I can’t live without, nor can my colleagues across several disciplines.  The ICU Book and The Little ICU Book both by Marino (I got the small one.)  The Ventilator Book by William Owens (for all ICUs, including SICU, PICU)  Pocket series (Pocket medicine, pocket pediatrics, etc.)  The only EKG Book You’ll Ever Need by Thaler OR Dubin’s Rapid Interpretation of EKG’s book  Harrison’s for my internal medicine brothers and sisters  The Red Book for my pediatricians  The Chief Complaint by Feier and Mallon for my ER people. APPS Some apps I’ve picked up along the way that I’ve come to rely on (not an exhaustive list, but my personal favorites) 1. Uptodate 2. Translator. It talks, writes, and converts your spoken words into the language of your choice 3. Epocrates. Especially the interactions checker. 4. Qx Calculate 5. Qx Read (tailor your reading and learning, it will collect papers on topics you are interested in and forwards it to you!) 6. Figure 1 (Instagram for medicine people) 7. CDC Vaccine Schedule 8. Journal Club (has made me look smarter than I actually am all year. This is worth the money.) 9. USMLE Qbank 10. EyeMD 11. iBooks/Evernote. Something to manage documents. I download tons of pdfs and papers onto iBooks for future reading. 12. Whatsapp or another secured texting app for team texts. 13. Photos. Genius because of the simplicity. Take photos of good EKGs, CXRs and save images or good tables from the internet. Make yourself a “Medical” album for all these goodies. SITES/LINKS If I want to learn how to do ANY procedure: http://www.nejm.org/multimedia/medical-videos http://radiopaedia.org/ for radiology findings http://www.medfools.com/downloads.html scutsheets to keep you organized https://onlinemeded.org/index you don’t need to register to use the great videos! http://lifeinthefastlane.com/ amazing EKG library. If you can read these, you are officially an EKG master Strong Medicine youtube channel. I swear by the EKG section INTERN 101 DAY-TO-DAY EXPECTATIONS  Know your patients medically and as people.  Keep your senior and your team updated on your patients  Communicate with your nursing staff and consultants to coordinate plans during hospitalization  Take admissions by completing an H&P, placing admission orders, and writing out a plan you go over with your senior.  Keep your patients updated in regards to the day’s plans, anticipated discharge, education on changes in their medications  Complete the tasks you said you would complete for your patients  Tell your team if you CAN’T complete the tasks you said you would complete so that they can help you  Learn to plan one, then two steps ahead  Anticipate and order the tests that your consult services will need to do their job prior to consulting them (if possible). You will be able to this by the end of the year, but likely not at the start. MY GENERIC WARDS DAY (ADAPT TO YOUR NEEDS) Time 0430- 0530 Wake up, get ready, get to work 0600- 0630 Get breakfast Print out the list. 0630- 0700 Sign-out with night-team 0700- 0930 Review: sick/unstable, anticipated discharge, medically stable How to review: overnight vitals, events charted or told to you by nursing, labs, pending items for overnight, new labs and imaging. Run the list with your senior to assess the priority tasks for the day. See your patients. Prioritize what must be done by the COLD or DCOL method. Discharges: Get the 5D’s ready (discussed later). Consults: place consults before lunch hour, out of courtesy Orders: imaging studies, lab studies, patient care, etc. Labs: either to follow up, order, or address 0930- 1100 or 1130 Round with the attending. The 6 things you must know on ALL your patients:  Overnight events  Vital sign abnormalities overnight  Labs (if they’re up)  Imaging studies  Cultures  What your consult services want 1130- 1230 Run the list with your senior to confirm: -what orders need to be placed now -what labs/imaging/studies must be followed-up now -what appointments and other things must be arranged for discharging patients now 1230- 1330 Eat food. Pee. Breath for a second. Answer calls and pages, follow up with consult services, place new orders, remove old ones, adjust orders. 1330- 1730 Run through the list with your senior or yourself to confirm what has been done, what needs to be done. Follow-up on pending items. See your new day-time admissions, your sick patients, anyone who needs anything from an MD. Finish your notes, discharge summaries. 1730- 1800 Sign out to the overnight team MY GENERIC SHORT CALL Time 0600- 0700 Wake up, get ready, get to work 0700- 0800 Get breakfast Print out the list/lists Review: sick/unstable, anticipated discharge, medically stable 0800- 0830 Sign-out from the night-team about old patients and new patients overnight. 0830- 0930 Familiarize yourself with overnight admissions. Run the list with your senior to assess the priority tasks for the day, the patients who will need the most attention. See your patients. See the new ones first to confirm the story and do your own exam. See your old patients. Again, using the COLD/DCOL method to get through tasks 0930- 1100 Round with the attending and team 1130- 1230 Run the list with your senior, complete tasks 1230- 1330 Eat food. Take sign-out from overnight team who needs to leave. Ask/confirm if they need help tying up loose ends. 1330- 1800 Complete tasks for your patients. Print out the other teams’ lists, contact teams to confirm when and where they want uploads/Geographie/ intern-survival-guide-because-you-got-this.pdf