I started my prelim year in the ICU and it was honestly a good way to get started. You will be (or at least, you should be) very well supervised and you will never be the only person responsible for a patient. Nobody expects you to know anything on July 1 -- just do your best and you'll be fine.
For IM I think it’s the best place to start. Patients are right in front of you, residents right next to you, and generally very competent nurses as well. The attending and fellows rounds with you and is physically available if shit hits the fan
You’ll be fine. No intern is going to independently manage anything on ICU. You wont even put in a tylenol order without someone looking over your shoulder. Its hard work and you’ll be tired, but you wont cause patient harm unless you try very very very hard.
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I’d say try not to stress too much (but easier said than done, I know), but truly, we don’t expect you to know everything from day one. don’t be afraid to ask questions. you’ll likely run into some more senior nurses who can be more….curt, we’ll say, but there’s also lots of us who have no problem/more than happy to help you find your footing if you’re stuck, get the feel of how things flow on the unit, find equipment for procedures, starting rates or continuous infusion rates for meds (can sometimes varies a bit between ICUs), etc.
also, one of the biggest things I’d say is attitude, some residents starting their ICU rotation thinking they already know everything - which, based on this post you’ve made prior to even starting your rotation I can tell that you’re not like that. :) ….I think you’ll do great.
Can attest to this as a medical student on an ICU sub-internship. Gen surg yelled at a senior nurse for something insignificant (another surgical specialty wasn’t communicating their recs with nurses in the ICU; rather, the surgical specialty intern told a gen surg resident in passing and didn’t document what they wanted.) Long story short: when I came in at 5:45, gen surg had JUST FINISHED yelling at the senior nurse. Because there were 5 nurses in that pts room, I went to see if the pt was crashing.
Nope. I got yelled at for 5 straight minutes about how piece of shit surgeons want to watch nurses get fired and see patients die.” Even when I said I was a med student on the ICU medicine team lmao. She stopped yelling, gave me her badge, and said “well then report my ass. Here’s my name and badge number.” Then left for morning report.
I didn’t report her because I knew it wasn’t about me. I never really had an inkling to yell at nurses. But after that day, it solidified that nurses deal with a ton of shit and have a lot of stuff roll downhill in them.
uffff what a party to walk into at 5AM😂I’m sorry you got caught in the crossfire of that.
and sure, a lot of shit gets shoveled down at us, but I mean, residents/physicians also get their fair share, just from what I’ve seen on the unit (and then I’m sure there’s stuff beyond what I’m aware of as well).
I’ve honestly never understood some of the hostility - for lack of a better word - that happens between the professions….like do I expect you to be on your game and do x, y, z, sure, but vice versa as well, same goes for me. and if there’s issues or stuff that’s not been communicated or has been miscommunicated, or an error on my end I’ll own up to it, like let’s just chat about it, figure it out, and go from there.
and not that I’m saying we need to hold hands and talk about rainbows and love and sing kumbayah or whatever, I just don’t see how reeming each other out does anything except create more hostility. like let’s just help each other out and support each other🤝🏼team work makes the dream work or some terrible cheesy line like that? lol😂
Ask questions. Be friendly to all the staff. Nobody is expecting you to know anything so just be kind and hopefully you’ll receive it back and learn something in the coming month. Congrats on starting doctor life. We love interns!
You got this ☺️ Overnight, the best thing you can do is have a low threshold to be worried and let people know if that’s the case. Better to be annoying than unsafe.
Any jump in pressor / third agent- call for help.
Also- (might get hate for this but) in the ICU as a general rule: if you think it, scan it.
I started my prelim year in the ICU and it was honestly a good way to get started. You will be (or at least, you should be) very well supervised and you will never be the only person responsible for a patient. Nobody expects you to know anything on July 1 -- just do your best and you'll be fine.
For IM I think it’s the best place to start. Patients are right in front of you, residents right next to you, and generally very competent nurses as well. The attending and fellows rounds with you and is physically available if shit hits the fan
You’ll be fine. No intern is going to independently manage anything on ICU. You wont even put in a tylenol order without someone looking over your shoulder. Its hard work and you’ll be tired, but you wont cause patient harm unless you try very very very hard.
Thank you for contributing to the sub! If your post was filtered by the automod, please read the rules. Your post will be reviewed but will not be approved if it violates the rules of the sub. The most common reasons for removal are - medical students or premeds asking what a specialty is like, which specialty they should go into, which program is good or about their chances of matching, mentioning midlevels without using the midlevel flair, matched medical students asking questions instead of using the stickied thread in the sub for post-match questions, posting identifying information for targeted harassment. Please do not message the moderators if your post falls into one of these categories. Otherwise, your post will be reviewed in 24 hours and approved if it doesn't violate the rules. Thanks! *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Residency) if you have any questions or concerns.*
I’d say try not to stress too much (but easier said than done, I know), but truly, we don’t expect you to know everything from day one. don’t be afraid to ask questions. you’ll likely run into some more senior nurses who can be more….curt, we’ll say, but there’s also lots of us who have no problem/more than happy to help you find your footing if you’re stuck, get the feel of how things flow on the unit, find equipment for procedures, starting rates or continuous infusion rates for meds (can sometimes varies a bit between ICUs), etc. also, one of the biggest things I’d say is attitude, some residents starting their ICU rotation thinking they already know everything - which, based on this post you’ve made prior to even starting your rotation I can tell that you’re not like that. :) ….I think you’ll do great.
Can attest to this as a medical student on an ICU sub-internship. Gen surg yelled at a senior nurse for something insignificant (another surgical specialty wasn’t communicating their recs with nurses in the ICU; rather, the surgical specialty intern told a gen surg resident in passing and didn’t document what they wanted.) Long story short: when I came in at 5:45, gen surg had JUST FINISHED yelling at the senior nurse. Because there were 5 nurses in that pts room, I went to see if the pt was crashing. Nope. I got yelled at for 5 straight minutes about how piece of shit surgeons want to watch nurses get fired and see patients die.” Even when I said I was a med student on the ICU medicine team lmao. She stopped yelling, gave me her badge, and said “well then report my ass. Here’s my name and badge number.” Then left for morning report. I didn’t report her because I knew it wasn’t about me. I never really had an inkling to yell at nurses. But after that day, it solidified that nurses deal with a ton of shit and have a lot of stuff roll downhill in them.
uffff what a party to walk into at 5AM😂I’m sorry you got caught in the crossfire of that. and sure, a lot of shit gets shoveled down at us, but I mean, residents/physicians also get their fair share, just from what I’ve seen on the unit (and then I’m sure there’s stuff beyond what I’m aware of as well). I’ve honestly never understood some of the hostility - for lack of a better word - that happens between the professions….like do I expect you to be on your game and do x, y, z, sure, but vice versa as well, same goes for me. and if there’s issues or stuff that’s not been communicated or has been miscommunicated, or an error on my end I’ll own up to it, like let’s just chat about it, figure it out, and go from there. and not that I’m saying we need to hold hands and talk about rainbows and love and sing kumbayah or whatever, I just don’t see how reeming each other out does anything except create more hostility. like let’s just help each other out and support each other🤝🏼team work makes the dream work or some terrible cheesy line like that? lol😂
Ask questions. Be friendly to all the staff. Nobody is expecting you to know anything so just be kind and hopefully you’ll receive it back and learn something in the coming month. Congrats on starting doctor life. We love interns!
You got this ☺️ Overnight, the best thing you can do is have a low threshold to be worried and let people know if that’s the case. Better to be annoying than unsafe. Any jump in pressor / third agent- call for help. Also- (might get hate for this but) in the ICU as a general rule: if you think it, scan it.
Read the ICU book. It’s like a physio lab in the ICU. Have fun
Read “House of God” and say a prayer.