For the new residents
-
For the newly matched (especially in surgery), here are some things no one teaches you about functioning in the hospital:
-
The EMR is not the place to battle things out with another service or take out any other frustrations- pick up the phone and call
-
YOU are “OSH” to everyone else…treat (and document) the way you’d want to be discussed. Check your assumptions and lead your chart digging with genuine curiosity and openness to being wrong.
-
Lead everything with empathy, genuine curiosity, and openness to being wrong
-
Never ever ever tell someone they’re having surgery/a procedure unless you’ve heard it DIRECTLY from THE PERFORMING service. Ex: if GI said gen surg was gonna take a pt to the OR, check w gen surg. Do not tell the patient/fam they’re going to the OR.
-
Similarly, never ever tell a patient they NEED a surgery/procedure unless you’re the one doing it. Surgeons are not technicians - they will evaluate the patient and provide their plan, which may or may not include the surgery you referred the patient for.
-
Nothing is magically foolproof or done better because it’s done at a top academic institute. The human body doesn’t change based on which hospital it went to; an artery is an artery anywhere. Recognize the crutches you have in a well-resources hospital.
-
If you don’t understand the plan in the morning, you’re not gonna understand it during the day. If you’re responsible for executing a plan, make sure you understand “the big picture.” This will actually be more efficient/time effective in the long run.
-
July 1 does not actually grant you elevated respect, adoration, or competence. These are hard-earned life-long things. Most of the ppl you interact with in the hospital have been doing their jobs longer than you. Everyone deserves your respect. Don’t take anything personally.
-
Don’t take anything personally. If someone is acting weird towards you, 1) reflect on if you could have done something that made their job harder or easier 2) recognize that most tantrums come from a place of insecurity
-
You will feel insecure often
-
If you’re having a tough conversation, be mindful of your surroundings. If you’re telling a funny story, be mindful of your surroundings.
-
If you’re putting a lot of force on an instrument or having to Jerry rig it, consider that you’re using it wrong.
-
If you’re calling a consultant and they ask you something you don’t know (I.e. when did the patient last eat? Are they on blood thinners?), don’t guess.
-
If you’re calling a surgical service, know when the patient last ate and if they’re on blood thinners.
-
If you have two choices and one of them feels harder, it’s probably the right choice.
-
Load the boat. Don’t be a cowboy. Ask for help early and often. Your staff and chief likely do not know what you know about a patient because you got the first page- make an assessment, but don’t sit on it.
-
-
For the newly matched (especially in surgery), here are some things no one teaches you about functioning in the hospital:
-
The EMR is not the place to battle things out with another service or take out any other frustrations- pick up the phone and call
-
YOU are “OSH” to everyone else…treat (and document) the way you’d want to be discussed. Check your assumptions and lead your chart digging with genuine curiosity and openness to being wrong.
-
Lead everything with empathy, genuine curiosity, and openness to being wrong
-
Never ever ever tell someone they’re having surgery/a procedure unless you’ve heard it DIRECTLY from THE PERFORMING service. Ex: if GI said gen surg was gonna take a pt to the OR, check w gen surg. Do not tell the patient/fam they’re going to the OR.
-
Similarly, never ever tell a patient they NEED a surgery/procedure unless you’re the one doing it. Surgeons are not technicians - they will evaluate the patient and provide their plan, which may or may not include the surgery you referred the patient for.
-
Nothing is magically foolproof or done better because it’s done at a top academic institute. The human body doesn’t change based on which hospital it went to; an artery is an artery anywhere. Recognize the crutches you have in a well-resources hospital.
-
If you don’t understand the plan in the morning, you’re not gonna understand it during the day. If you’re responsible for executing a plan, make sure you understand “the big picture.” This will actually be more efficient/time effective in the long run.
-
July 1 does not actually grant you elevated respect, adoration, or competence. These are hard-earned life-long things. Most of the ppl you interact with in the hospital have been doing their jobs longer than you. Everyone deserves your respect. Don’t take anything personally.
-
Don’t take anything personally. If someone is acting weird towards you, 1) reflect on if you could have done something that made their job harder or easier 2) recognize that most tantrums come from a place of insecurity
-
You will feel insecure often
-
If you’re having a tough conversation, be mindful of your surroundings. If you’re telling a funny story, be mindful of your surroundings.
-
If you’re putting a lot of force on an instrument or having to Jerry rig it, consider that you’re using it wrong.
-
If you’re calling a consultant and they ask you something you don’t know (I.e. when did the patient last eat? Are they on blood thinners?), don’t guess.
-
If you’re calling a surgical service, know when the patient last ate and if they’re on blood thinners.
-
If you have two choices and one of them feels harder, it’s probably the right choice.
-
Load the boat. Don’t be a cowboy. Ask for help early and often. Your staff and chief likely do not know what you know about a patient because you got the first page- make an assessment, but don’t sit on it.
@George-K said in For the new residents:
- July 1 does not actually grant you elevated respect, adoration, or competence. These are hard-earned life-long things. Most of the ppl you interact with in the hospital have been doing their jobs longer than you. Everyone deserves your respect. Don’t take anything personally.
Way back in the dim mists of time, when dinosaurs roamed the earth, I first started on the day shift after my obligatory time working nights. I worked as galley slave in Immunohematology (that's the Blood Bank for you ignorant suckers) and my first boss was Jane.
Jane stood about 4'11", if she was wearing heels, which was pretty common. Always with a dress, she never woe pants. I don't think she would weigh 85 pounds, if she had lead shot in her labcoat. My ASCP number, from the 1981, has 6 digits. Jane's had 2. A proud 1929 graduate of Loyola, she literally oozed educated Old South. Those folks had their own accent, recognizable in an instant. Jane liked classical music, but she loved opera. A perfect vacation for her would be to catch Placido Domingo singing at the Met.
She called all the residents by the same name, "Little Boy". For the rare female resident we had in those days, she'd call them "Little Girl". Don't recall any resident ever giving her grief about it, for as the French say, Jane was formidable.
Some of her legend stemmed from a single incident...We had an old round Jewett blood refrigerator, the kind that had a door which must have weighed 100 pounds. The shelves were on rollers, and you could spin the shelf to where you wanted it, with your units facing outwards. Surgery residents were really bad about coming down from OR to check on blood for pending cases. Usually, it was the junior resident checking for all cases, since they were low man on the totem pole. Often, they wouldn't even ask us about blood availability, they'd just open the blood bank frig door and spin the shelves looking for units. Many times, this would set the high temp alarm off, which necessitated calling the switchboard to clear the alarm and created a stack of paperwork to please the AABB about the integrity of the stored units.
One particularly busy morning, we had a HO I drop by to play spin the shelves. The more he spun, the more Jane's face became red and her features started to set in that certain look.
"Doctor, please close the door".
No response. The doc kept on spinning.
"Little boy! Close the refrigerator door!"
The doc ignored her.
At which point, the 85 pound woman grabbed the 100 pound door and swung it shut as hard as she could. Caught the doctor right behind the ear and dropped him like a shot steer. As he looked up at her with unfocused eyes, she told him, "I told you to shut the door", as she spun about on her heels and went back to her desk.
We never had another resident come down and spin the shelves...
-
-
One of the most feared rotations as an intern was the month you spent in the medical ICU. If you were unfortunate enough to have drawn that rotation in July, 2 days after getting "MD" behind your name, it was 31 days of anxiety, panic, fear and humiliation.
If you were lucky, you knew what you didn't know. If you were really lucky, and behaved yourself, the nurses liked you and would help you out of a jam by "suggesting" things that might be helpful.
I was lucky in three ways.
-
I had already done 6 months of my anesthesia residency (remember, I graduated early). Sudden events didn't scare me.
-
My ICU rotation was in February - so I already had a fair amount of experience with non-surgical stuff.
-
I was engaged to one of the nurses. We didn't tell anyone until my last day of the rotation.
If the nurses didn't like you, it was a god-awful time. They would call you at 2 AM, about 15 minutes after you finally fell asleep to let you know that Mrs. Edwards' blood sugar was 105. Normal.
Make friend with the staff - they were there before you, and they'll be there after you. You're the visitor.
-
