Tag: m4

Practical Tips for Intern Year

Posted on by Analise

July 1 is here! You’ve likely started your first job as a doctor and you are scared (petrified).

Some VERY normal questions that may be going through your mind…

How do I write notes again?

Where is the bathroom on this floor?

Will there be lunch at this lecture?

All of these were questions that were swirling through my mind as I entered my 3rd week of residency (recall that I had 2 weeks on night float to start out).

I have some practical things that I would share with myself if I could do it all over again.

Continue reading “Practical Tips for Intern Year” →

Starting on Night Float

Posted on by Analise

I know that it has been quite literally 6 months since I “put some ink” on my blog, as one of my friends puts it. I have been so busy doing some major ADJUSTING to my new schedule and my life as not a med student but a newly minted doctor, New Jerseyan, and apparently adult. It has been so hard but so good and so rewarding and I will have to write about that in another post.

Anyway, I thought that I would write this post to discuss one of the rotations that I have completed already this year. I’ve actually done it twice by the time that I am writing and editing this post because I was one of the fortunate people to have a whole month of it in my intern year. I wanted to talk about this one both to provide some encouragement and so people can see what I did wrong and maybe make better decisions. Enjoy!

My intern year (first year of being a resident) began at night. I came into orientation that glorious morning and got my pager (an indestructible device resembling a small brick that rings when people want to contact you, for you generation Z people). Then I went home, took a nap, and showed up bright and early for my 7 pm shift.

Teams came in and began giving me the signouts for their patients. In other words, they gave me the pertinent information that would help me (or not) when I got paged for their patients. I took them all, attentively listening to the stories for all the patients because they were all so unfamiliar and interesting. At the end, I was drowning in lists of patients from all the medicine teams.

After all the teams left and it was just me and my two senior residents who were busy admitting new patients, reality and panic set in.

Me: Wait a minute, how do I log into the computer? Which team was I supposed to order a CT scan for again? *PAGE* Where is the bathroom? Where can I find this patient? *PAGE* How do I even order things? What blood pressure do I need to treat overnight?? *PAGE* Do I need to call the fellow on this patient? *PAGE* Am I hungry or just anxious? Are those fireworks outside? *PAGE* *PAGE* *PAGE*

My nights were crazy but I can honestly say that there were some things that I did to try and make logical decisions at 3 am.

 

Get organized early

At the beginning of each shift, before any of the teams came in, I would have a blank sheet that I would label “To Do” on one side and “Pages” on the next.

The to-do side would have labs that I needed to follow up on, the patient’s name, medical record number (MRN), and the patient’s team. This really helped me because I would just go through the whole list of things for follow up anytime I was at a computer and because all of the MRNs were there, I could run through them quickly.

The pages side of my sheet held the number that paged me, which patient it was for, and the problem that they were having along with what team they were on. This was so helpful because I could just call back the number without having to guess which one was for which patient. Also, it just helped me stay on top of my pages.

The learning point here is that you need a system. The first night I didn’t have a system in place yet. It was a mess. I’ll just leave it at that.

Go see the patient.

I first heard this when I was in medical school and it is something I have taken with me into residency. Frequently a patient will have abnormal vital signs or an abnormal symptom that requires evaluation. These patients, after I got a page I would put a red “I” with a circle around it to remind me to go see that patient. I had to go “lay eyes on them”, if you will. This gave me time to think about what I needed to possibly do for this patient and time to text my seniors if it was someone who was potentially decompensating. This leads me to…

Your seniors are here to help you!

No, they are here to admit patients. However, if you need help, don’t hesitate to ask them. There were some times that I really just didn’t know what to do from lack of experience (I was a medical student like yesterday!!), and other times, a patient’s symptoms were really concerning and I needed them to help me with the next steps to evaluate a patient overnight. Each time I needed their help, they were extremely gracious toward me because it was my first time being a real doctor and trying to make decisions.

 

Now, for the practical, non clinical stuff

 

Eat now, ask questions later

So night float was a funny beast, in that I wanted to eat at normal times at first, but couldn’t because my stomach was confused. I would get really hungry in the middle of the night when nothing was open, and when I would bring a large meal, my stomach was still confused because it isn’t used to eating oxtail, rice and peas, cabbage and a large drink at 3 am (I realize I am probably the only one with this problem). Anyway, I had to eat at some point. What I ended up doing that helped was eating small meals during my shift and a small meal when I woke up around 3 pm. I was able to eat in small portions much better than larger ones. I still ended up losing some weight on night float, but I wasn’t a hangry person during my shifts.

Stay connected

One of the hardest things about night float is the isolation. I think this was the one that I had the hardest time getting around. Honestly, I didn’t see Rome for almost a week when I was working for my last week. Plus, when you are awake and want to talk to all your family and friends, they don’t answer, because it is literally 3 am and apparently calling working people during that time isn’t polite. *rolls eyes*

Some things I did to combat this was facetimeing when I had my awake and not at work times. So when I first got into the house in the morning and Rome was at work, I would facetime him briefly and talk to him about my night and whatnot. I would call my mom when I woke up from my nap, and call my friends when I got to work, etc. I would work around my schedule, per usual. Telling everyone that I had a crazy schedule at the time helped so much too because people understood that I wasn’t ignoring them, I was just hibernating.

Don’t be unpleasant

It is easy to complain about how you’re tired, how you’re hungry, how the vending machine doesn’t have the special doritos that you like. If you do this, however, you’re forgetting that you have 2 other people who also are going through the same things that you are. Bringing up how uncomfortable you are won’t make you feel better, if anything it will make you even more upset. This is not the way to happiness and success, my friends.

Instead, try to be a light. Don’t be another grumbling, complaining person. It won’t help anyone.

Take a Walk

There is a blissful time between 3 and 5 am that the patients who were in pain in the beginning of the night have finally fallen asleep and no one is checking vitals in order to call you about hypertension. This is the time that I found myself in the basement of the hospital, walking laps. At first, the staff down there thought I was crazy, and eventually those same people were looking for the doctor in all purple to go down to the basement and walk a couple of laps.

It was a fabulous thing to do for my stress level and for my step counts. I did this every night that I had a free moment and I would always make a deal with myself and say that I would only stay down there until I got the next page (the blessed pager works in the basement). I would sometimes have 5 minutes before *BEEP BEEP BEEP* would sound and I think one time I had a full 30 mins. Either way, whether it’s 5 or 30, the effect was still the same.

 

I know I’ve been MIA, and thank you for showing me grace while I figure out my ever changing schedule. I’ll try to be posting once every two weeks or so as my schedule and my sanity allow.

 

Love you guys,

Lise

 

7 Things to Bring to New Resident Orientation

Posted on by Analise

This post is mostly for the current student doctors who will be residents next year (Or if you haven’t done orientation yet for this year). Congratulations in advance! This time is extremely busy with moving and all the random onboarding things that are required to start your first job as a doctor. Here are some things that helped me get through orientation without any snags.

  1. Planner/notebook/pens– Last week was full of important dates that were thrown at me along with emails that I needed to send to people for parking, IDs for other medical centers, etc. Using a planner helped me to remember that I was supposed to email John and what I was supposed to be telling him. I had a little to-do list within my planner so I would be able to knock out all my tasks and prioritize them by importance. The notebook is a hit or a miss- I used the papers that were in the folders already to jot down any notes I had. There were so many maps in my folders that I just flipped some over and scribbled on the back to organize my thoughts. However, having a notebook was beneficial for electronic medical record training to try and remember some of the cool shortcuts.
  2. Multiple forms of identification– To prove that you are cleared to work in the United States, schools/programs must fill out an I-9 verification form for each employee. They usually recommend bringing 2 forms of ID (social security card, passport, etc) so they can complete this form for you. I am type A and unfortunate events occur in my life, so last week I brought 3, just in case. Your school will send an email with the acceptable forms of identification, but don’t forget these because it will just be a headache to go back and grab them.
  3. Health information– At some point during the week, people are going to ask you if you have been vaccinated and if you have proven immunity to various illnesses. Bring your health information for quick reference for when they ask you. Even if you upload them or email them ahead of time, it is always a good idea to be safe when it comes to this stuff. Bring it with you so no one can say you didn’t send it in. It is so easy to lose someone’s information when it is swimming in a pool of information from ~500 other residents.
  4. Tote Bag/Backpack– So this one seems like a no-brainer, however, I tried to be cute and bring my smaller purse and was drowning in folders by the end of orientation. The folders couldn’t fit in my purse, so my arms were full for multiple hours of waiting in long lines. I had a feeling this was going to happen, but I ignored my intuition and went for the smaller purse. Don’t be me! Bring a larger bag or even a backpack to hold the folders and binders that your program will give you.

 

Extras:

  1. Breakfast– Rome and I have a motto that we stick to: never go to events hungry. This motto has saved us more than once from being miserable hungry people at long events. Orientation was no different. Your program may serve you breakfast, they may not. After doing the breakfast gamble one time and losing royally, I don’t suggest gambling. Be prepared for anything. Bonus points for bringing snacks. I know I sound like your West Indian grandmother, but I care about your well-being and your stomachs. It’s hard to focus on resident benefits when your stomach is growling, just saying.
  2. People’s names– This is my extroversion speaking, but seriously, it was fun to meet new people. While I was meeting my co-interns in clumps, I made a genuine effort to remember their names. The next time I started a conversation, it was much easier to jump right in because I already had their name down.
  3. Your photo ready face– We took SO MANY pictures during orientation. Every ID that we obtained needed its own picture. Don’t make the mistake I made in forgetting about the composite. This picture will be posted everywhere… EVERYWHERE! This composite is for other services to know who they are calling for consults/who is being exceptionally rude on the phone. This was the day, of course, that I didn’t wear makeup because I thought we were done with pictures. Nope. Surprise!!

 

Hope this non-exhaustive list helps you! The general idea is just that it’s better to be safe rather than sorry and that you shouldn’t make some of the mistakes I did.

 

 

Love you guys,

Lise

Match Week

Posted on by Analise

Every year in March, type A personalities all over the country find out where they are going to be spending the next 3-7 years of their lives. To say that this month is filled with tension, anxiety, and excitement is not quite wrong, but incomplete. It is more accurate to say that this month is all of the excitement from an entire year bottled up and being shaken to Coke+Mentos proportions.

 

This is the story of my experience.

 

On Monday, March 13, we found out if we even matched with a residency program. I was having breakfast with a friend for the first time and we spent the entire morning avoiding the topic that was undoubtedly on our minds- Did we match??? I found myself having the word vomit I always have when I am trying to distract or fill silence unnecessarily. She was forgiving and we are still friends because we have been through tough times like these together.

We got the email, which, cruelly had “Did I Match?” in the subject line.

Thankfully, we both matched.

 

Then ensued a weeklong celebration designed to distract us from the looming results of WHERE we matched, which were to be revealed on Friday.

First up was Karaoke night at Fenians Pub. We revisited 1st year memories of Med School Mondays, when we used to hang out after Monday exams. Monday night is a strange night for partying for normal people, hence, our #medschoolmondays tag. Our classmates crooned and swayed to the sweet melodies of “Thong Song” and “Hit Me Baby One More Time” this time around.

 

Next up was High Heaven, a trampoline park. My classmates insisted that this was a dangerous event, but most of them showed up anyway because the champions all walk across the Match Stage with a limp. Although most of us were careful, one poor guy did injure his toe.

 

After the bounce at High Heaven came the Crawfish Boil where we got to practice our “barbaric” eating techniques. My friend K, on eating crawfish, “You must rip the animal in half. Look it in the eye and throw its head into the garbage. Peel the exoskeleton off the tail for this small amount of tail meat. Then repeat x 50 at least because it takes forever to get full.” Love that K girl and her antics. She was totally eating the crawfish, in case you wondered.

 

Moving on, we attended a Happy Hour at Hal and Mal’s, a popular haunt for many of our medical school parties and a Jackson staple, to be honest. This one was full of tense giggles and encouraging elbow squeezes about the day that lay ahead.

 

Match Day started with a beautiful breakfast with our classmates and some family members. My stomach was in knots but I made myself eat because passing out on stage is embarrassing.

Walking up the many stairs of Thalia Mara Hall  in downton Jackson was surreal. I kept telling myself that this was just another lecture or random medical school event to keep myself calm. Before I knew it, someone called my name and I walked across the stage.

I read where I matched.

I matched in Internal Medicine in New Jersey.

I. Was. Thrilled.

I was so happy to be starting residency somewhere. Also, going somewhere my husband and I would both flourish was the cherry on top of my proverbial cupcake.

 

Match week was full of events trying to help us ignore the fact that it was match week. I had a great time participating in every single one of them and getting to be that young fun girl I imagine myself to be. I now get to be young and fun in New Jersey.

 

Adventures await.

 

Lise

 

Some friends and I at Fenians on Monday Night after learning that we all matched!

 

Rome and I pointing in the general area of New Jersey, where we will be moving!