advice for new interns

  1. Hi everyone,

    I will be starting my internship in july and wanted to get nurses' perspectives of "do's and dont's" for new doctors. Any anecdotes illustrating the kinds of behaviors/practices of new interns that work or don't work (for the team) would be really helpful. I would really appreciate your input and advice!

    Thanks,
    L.
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  2. 15 Comments

  3. by   WashYaHands
    Just the fact that you came here to get this information impresses me. Do be open to learning from nurses. We have a wealth of knowledge to share. Nurses can be a great resource for information. Treat the nurses with respect. Don't discount our intuition and nursing knowledge. Your patients are our patients too, so don't forget to ask us what's going on with them.

    Linda
  4. by   fedupnurse
    I couldn't agree with Linda more! I've been an RN in an ICU for 10 years in a teaching hospital. The best residents are the ones who are thoroughly UNimpressed with themselves and their chosen fields and those who ask questions. Be nice to the nursing staff and they will save your butt. Example: We have a 1st year medical guy now. Really nice guy, great to work with, blah,blah,blah. I came in to work my 7p-7a shift and was assigned a 25 year old who was literally exsanguinating. This resident spent a lot of time on the phone trying to get various attendings in to see her and save her life. Finally the original surgeon came in and I noticed that the ROC hadn't written any notes about all the phone calls in the progress notes. I went and told him, you need to document everything you did for that patient today because I have no doubt that family is going to sue (and they SHOULD!). I told him you put forth the effort and made the calls so take credit for it in your notes. I also documented his assistance heavily in my notes.
    We have another resident who was nice his first rotation thru the unit but came back with a chip on his shoulder. He thinks he knows everything and will purposely go against something if you suggest it (I am not the only nurse he does this to). Nurses have no use for someone like that.
    The most important thing for you to know is this: Know what you DO NOT know and ask questions. Remember, many of the nurses you will be dealing with may be new to nursing as well. Find nurses and other residents you trust and refer to them often.
    Good Luck. Get some sleep now, my friend cause you won't be getting much sleep for the next year!
    I too, am impressed that you are asking! You will do fine if you maintain this attitude!
    Regards,
    Last edit by fedupnurse on May 29, '02
  5. by   fedupnurse
    Oh yeah! When you put an order in the chart, let the nurse know. You will be highly regarded if you do this routinely.
    Good luck!
    Last edit by fedupnurse on May 29, '02
  6. by   petiteflower
    Good luck to you. First and foremost--treat the nurses like people instead of idiots--listen to us--we spend more time at the patient's bedsides and most of the time know what's "really going on". Let us make suggestions and contribute to making care decisions--and if we are wrong-educate us----don't berate us.
  7. by   suzannasue
    I am very impressed that you have thought to ask nurses the do's and don'ts...you are such a smart fella...give your fellow interns this site...they will learn much...
    I agree with the above posters...and some additions...
    don't raise your voice to me in anger or fear...I am only one person and the louder you yell, the slower I go... don't be afraid to touch the patients,pull up a chair...listen to the person in the bed,they know their body better than any text book. If a nurse calls you and tells you that something is going on with the pt,but just cannot get a handle on what exactly is presenting, respond...we nurses have intuition...pay attention...If you have a problem with a nurse,you can come to us (most of us anyway) and actually talk "with" us, not down to us,let us know your concerns...DO NOT go to our manager,we are all adults(well,most of us are, anyway) and if there is a problem,don't run to your fellow dr's and kill the nurse's reputation by talking about her/him. NEVER undervalue the contributions of the nursing staff to your practice...WE make YOU look good...the words "thank you" can make our worst day/night a little better. We are all on the same team. Our level of respect for you wil be given in direct proportion to the respect you give us.
    Best wished for ya, DOC!!!!! Welcome aboard!!!!! :hatparty: :blushkiss
  8. by   purplemania
    I once worked for a surgeon who like to intimidate staff and embarrass them in front of patients. He complained a lot about our ineptitude and how the "right person" was never where they should be. He never caught on that the grapevine alerted us to his presence and we WENT OUT OF OUR WAY to make his day long or tiresome.(losing papers, phone calls being cut off, wrong chart on his desk, etc. etc. etc.) It would have been so much easier to work as a team. We might have been dumb but we were smart enough to get his goat a lot! Another surgeon in same clinic was polite and reasonable and personable. He got extra niceties, including referrals from staff (never would I refer anyone to surgeon "A"). It pays to be nice.
  9. by   canoehead
    I second all the above and wanted to wish you luck and easy call nights. If you are respected by the nurses you are guaranteed (almost) to come out of the year with a little less stress. I can't think of a med student, resident or doc who hasn't had their butt saved by an alert nurse. Good nurses will also appreciate the time you take to answer questions or discuss the plan for a complicated patient. You'll be able to share your "book" knowledge and they will have experience/familiarity with common problems that can help you.

    I've been a nurse 10 years and the best tip I can give you is that parents and experienced nurses are usually right when they get that feeling that a patient is going south. Just conciously stop and look again at the situation, find out if they can say exactly what makes them concerned, and then make your decision. We all appreciate that extra step, and about 80% of the time there is substance behind the concern.
  10. by   mattcastens
    1. Write legibly. I'm serious. I know many nurses (myself included) who have absolutely no problem with waking a doctor at four AM to clarify an order.

    2. If you don't write an order for it, don't get angry when we ask you for one. I had a patient who desperately needed a foley (this was before I worked in ICU). I called the physician-on-call (who was out with his friends) and requested an order. He went off on how "it was only a foley" and "g*dd*mmit, why were we bugging him for an order??" I replied, "Because we legally need an order for one, you jackass -- and you didn't give one!"

    3. As someone mentioned, be nice to the nurses. Doctors who aren't get called for everything from an enema to a temp of 99.1.

    4. On a less adversarial thread ... be ready to learn from the nurses. They are with your patient 24-hours-a-day. If the slightest thing changes, they know about it. The good physicians will find the nurse and ask, "Is there anything I need to know?" before they look at the patient, and "Is there anything you need from me?" before they leave. We're a team!

    5. If a nurse refuses or questions an order, ask why. I've caught and stopped many lethal orders. Rule of thumb: if you aren't willing to give the med or perform the procedure yourself and face the consequences, then don't expect a nurse to do it.

    6. Be willing to teach. The greatest doctors I know love to sit down with nurses and answer questions about physiology, pharmacology, disease processes and a bunch of other stuff (when they have time, of course).

    7. Foster the team mentality. I am on a first-name basis with most of the doctors I work with. It's great! We get to know more about each other and it helps work as a team. Avoid falling to the "us versus them" trap.

    It speaks very highly of you that you searched out this site before starting your residency. Stick around and learn! I for one would love to have a little physican input on some of the issues we discuss here.
  11. by   fergus51
    Amen on the legible writing comment. My favorite doctor to work with actually block prints all the drugs he orders!!! It can save a med error which can cause a lawsuit.

    Good luck with your internship, we need more respectful considerate docs out there!
  12. by   interntobe
    Thank you all for your responses - you have been VERY helpful. This is a great site!

    L.
  13. by   live4today
    Originally posted by WashYaHands
    Just the fact that you came here to get this information impresses me. Do be open to learning from nurses. We have a wealth of knowledge to share. Nurses can be a great resource for information. Treat the nurses with respect. Don't discount our intuition and nursing knowledge. Your patients are our patients too, so don't forget to ask us what's going on with them.

    Linda
    You put it exactly like I was thinking it, but my shortened version to say to every intern is: Listen up and pay attention! You just might learn a thing or two or three or four or....":chuckle :chuckle
  14. by   dawngloves
    If you don't know something, just say so! Ask one of the nurses or the Senior. Don't try and fake it. And if we queston an order, don't get offended. We are just trying to cover our butts as well as yours.
    And if you are going to take a 15 minute nap, make a quick round and ask if anyone needs orders for anything (ie, sleeping meds, pain meds) or has any concerns so we don't call you 5 minutes after your head hits the pillow for a Colace order.
    Good Luck!!

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