Climbing a Mountain

1
Climbing a Mountain

• Anne Hudson Blaes, M.D.

2
Objectives

• Purpose
• Professionalism
• Differences between being a student and a
  resident
• Common cross-cover

3
Professionalism
4
Professionalism

• Nursing Staff
• Other Residents
• Other Specialities
• Working with Medical Students
• Dress

5
Student vs Resident
6
Student vs Resident

• Responsibility
• Demands on your time
• Teacher

7
Student vs Resident

• magic of both
• Paddling through the waves, while making it look
  easy

8
Student vs Resident

• Making mistakes
• Dont be afraid to call for help
• Nurses can have useful and practical information
  they have wonderful experience but maybe not as
  much knowledge as you
• Other interns, other residents, attendings
• Acknowledge mistakes
• Learn from mistakes
• We all make them

9
Cross-Cover

• Chest pain
• Shortness of Breath
• Pain
• Constipation
• Fever
• Nausea

10
Chest pain

• DDx ischemia, PE, pneumonia, PTX
• EKG
• Oxygen
• Nitro 0.4mg SL

11

• Shortness of Breath
• PE, Ischemia, pneumonia?
• CXR
• EKG
• ABG
• Oxygen

12
Constipation

• All patients on narcotics should at least be on
  stool softeners

13

• Nausea
• Fever
• what kind of host do you have?
• Do you need blood cultures drawn, or antibiotics
  started?
• HTN does it really need treated in the middle
  of the night?
• OB maybe
• Chronic htn maybe not

14
Student vs Resident

• Codes

15
Surviving your Internship

• Efficient sign-outs what needs to be on them?
• Pt name, ID, location
• Code status!
• Allergies, current medications
• Current medical issues, relevant history
• Any recent procedures (i.e. thoracentesis)
• Anticipate what calls will be made any
  suggestions?
• If something can wait until tomorrow (i.e.
  nothing will be done about it at night), then
  dont sign it out
• Make sure your blood consents are signed

16
Surviving your internship

• Whats in your pocket?
• Whats on your palm?

17
(No Transcript)
18
Most importantly

• Enjoy it! This is what youve been waiting for

19
(No Transcript)