So, as we all know, July is when the new interns start. All the fresh-faced, nervous new med-school grads come in and start working their zillion shifts a month. It's an interesting time.
Some of the other ED doc bloggers have posted their advice for recently graduated residents about to start their first "real" jobs. Check out what 10/10 and Shadowfax have to say about that.
I have no advice for the new ED grads; if you don't know by now that the nurses in the ED can be your best friend or your worst enemy, my telling you isn't going to help you. And as for you new interns, you'll hear that bit of advice over and over from your colleagues.
Here is my advice to the new interns: dispo, dispo, DISPO!!!
This is the way to endear yourself to your upperclass colleagues, to the attendings, to the managers, to the nurses. I know that as med students you may not have gotten in as many procedures as you could have. But when the ED is packed, and everyone is busy, we all appreciate efforts to move the patients along as quickly as possible.
Every July I have to give several new interns my standard speech: Hey, it's GREAT that you want to help me out by starting that line and drawing blood. And it's awesome that you want to administer meds yourself. And thanks for trying to put that NG tube in. And that Foley catheter. But these are all things that I can do. What I CAN'T (officially) do is interpret x-rays and lab results, I can't present to the attending MDs, I can't call the patient's primary doc, I can't put in admit or discharge orders, and I can't fill out your t-sheet for you. And that's what needs to be done to get this patient where he or she needs to be so we can bring in some more bodies to fill stretchers, since the wait out in the waiting room is approaching four to five hours, and people are starting to get really cranky. Go forth, young intern, and DISPO!!
SO: when it slows down a little, like in the late evenings or early mornings, we'll get you aaaallll the practice you need with all those little things. Believe me, I love to teach interns how to do stuff. Because when you're a second-year resident and it gets busy, us nurses LOVE it when you stick an IV in when you're doing your assessment (if we haven't gotten there first), we love it when you do all those little things to help us along. But when you're an intern, and are still getting hung up on where the IV starter kits are, and people are howling "How come I've been here for three hours and haven't seen a doctor yet!!" please concentrate on doing your doctor things that, as a nurse, I can't do.
We've got to whip you guys into shape before cold and flu season starts!
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5 comments:
I thought you were saying, "Go forth Ditso!" Nice, logical post!
Great post. I tried my best at work to recreate this posting for my co-workers. Made me laugh, thanks for writing this!
My o so wise brother in law type ER.MD once told me that July is a good good month to avoid the hospital, in particular the emergency room because, well, the new interns haven't yet been whipped into shape by the nurses and don't know what they're doing.
I chose to ignore those words of wisdom one year and to this day still sing praises to the ER nurse that ripped intern #42 that stared at me that afternoon, a new bung hole. She was awesome. I love her. I'd have married her on the spot if I could have.
So to all of you that set intern straight and get them rolling on their illustrious careers. Thank you.
Dear GG,
I love your blog, keep up the great work. I too live and work as a resident in an ED near you (from some of your descriptions). I have also had the opportunity to rotate through many of the ED's in our area both city (HHC) and private. I will say that while what you say makes sense it is the exception not the rule. It is impossible to get many nurses to do anything. I am very respectful, I always say please and ask nicely; yet I can never recall a time recently where an order was performed promptly even when the nurse was not busy (any yes I have been around a bit and can tell when someone is busy). Getting a blood draw or IV placed is a nightmare. The other day after waiting a half hour while the nurse yakked on the phone, I started putting in the IV myself only to have said nurse tell me she was 'about' to do it and then proceeded to stand over me the entire time. So while this clearly does not apply to you, you are in the minority.
I would love to work with you one day-- we would seriously move the meat together.
Good Job! :)
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