REal advice to a future Intern

KimberlyT · May 19, 2005

Hi Everyone,
Sorry to have "infiltrated" this forum, but I really was seeking some sound advice from you.
I am starting as an IM Intern this July and would like to get some advice from you on what to do or not to do. I have tons of respect for nurses and I am not an arrogant person but what are other small things that bother you about Interns?
Thank you for your time.

Hello,

Thanks for your note. I work in a teaching hospital, and I deal with interns every day. So far, my experiences with the interns have been very favorable. What I appreciate most is that these doctors are very courteous to me and promptly return my pages. Also, it is, of course, extremely helpful if your orders are complete so that we don't have to track you down for clarification. If you can manage those three things, you will be off to a great start.

Kimberly

rntg · May 19, 2005

Hello,
Thanks for your note. I work in a teaching hospital, and I deal with interns every day. So far, my experiences with the interns have been very favorable. What I appreciate most is that these doctors are very courteous to me and promptly return my pages. Also, it is, of course, extremely helpful if your orders are complete so that we don't have to track you down for clarification. If you can manage those three things, you will be off to a great start.
Kimberly

Those points are excellent. I would like to add that, when we call you, please take our calls seriously. Most experienced nurses that work, at least on our unit, call for a reason. Yes, try to return our pages quickly, but also, try to make time to come see your patient if we suggest it. Time is of the essense alot of the time, and we are your eyes and ears on the floor. I have had too many patients who have ended up in worse shape than they needed to be, because residents did not think they needed to see a patient with symptoms I have described to them over the phone, even with a suggestion that they come see them, then they end up sicker than they needed to be or crash later in the day or week, for something that could have been taken care of earlier.

Also, don't think we are criticizing your knowledge if we suggest something to you, or question an order. It is our job to do that if we think something is inappropriate, or if we just need clarification on something. We are all part of the healthcare team, and have the patient's best interest at heart.

One more thing, that is definitely a pet peeve of mine. Please don't ask us to call you with labs or test results you have ordered if you have access to a computer throughout with the same results in them. Check them when you have the time. Of course, most nurses will call you with abnormal results as soon as they can, but if there is something you need to know right away, look it up. In our hospital, some of the residents will ask us to call them with routine results of labs, they have the same access to the computers as we do, and it is just another thing that takes time from the bedside, and really time from your day also, when you have to get the page and get to a phone to answer it.

Sorry to share a few pet peeves of mine...but hopefully they will help. Good luck with your internship. Anyone caring enough to come on here and ask, will do a great job I am sure.

Serenyd · May 19, 2005

Hi Everyone,
Sorry to have "infiltrated" this forum, but I really was seeking some sound advice from you.
I am starting as an IM Intern this July and would like to get some advice from you on what to do or not to do. I have tons of respect for nurses and I am not an arrogant person but what are other small things that bother you about Interns?
Thank you for your time.

You've probably heard this before, but if you're handwriting your orders, be sure to print clearly and neatly. This can make a world of difference, especially to a new nurse like me who does not have a lot of practice deciphering handwriting!

And I just want to say, it shows what a considerate person you are to post + ask for suggestions on how to work well with nurses. If only more doctors had your great attitude and desire to work as a team with nursing staff then everyone would benefit, especially the patients.

Seren

cardsDr · May 19, 2005

You've probably heard this before, but if you're handwriting your orders, be sure to print clearly and neatly. This can make a world of difference, especially to a new nurse like me who does not have a lot of practice deciphering handwriting!
And I just want to say, it shows what a considerate person you are to post + ask for suggestions on how to work well with nurses. If only more doctors had your great attitude and desire to work as a team with nursing staff then everyone would benefit, especially the patients.
Seren

Seren, RNTG and Kim,

thank you for your thoughts and time, I have copied all of your suggestions and adding them to a list that I am compiling. As a testament to your profession, this forum is very friendly, helpful, relevant and responsive.

Tom

Ruby Vee, BSN · May 19, 2005

hi everyone,
sorry to have "infiltrated" this forum, but i really was seeking some sound advice from you.
i am starting as an im intern this july and would like to get some advice from you on what to do or not to do. i have tons of respect for nurses and i am not an arrogant person but what are other small things that bother you about interns?
thank you for your time.

i've been working in teaching hospitals for 28 years, on the east coast, the west coast and the midwest. congratulations, dr.! that said, the only time i ever call an intern "doctor" is when i'm less than happy with them. (as in "are you sure you really want to do that, doctor?") usually, we'll call you by your first name, except to a patient. every year, there's an intern who tells us his first name is "doctor", and it's a great way to get off on the wrong foot!

if the experienced icu nurse tells you something, listen. in fact, after seeing 28 groups of interns come through, i can tell you that the ones who turn into good doctors are the ones who listen! even if you don't agree with me and want to do things your own way, listen. then take the time to explain to me your rationale for doing it your way. i may not agree with you, but if you have a rationale that makes some sense, i'll help you make it happen.

the nurse is your friend. we can make or break your intern year, and i'd prefer to make it than break it. we can help steer you toward right decisions and away from wrong ones, make suggestions and protect you from unnecessary phone calls. we can also wake you up at 3am to draw blood gases on a dead patient. if you piss us off enough. (i've only done that once, and he was really asking for it!)

please socialize with us. chat a bit when you encounter us in the break room. come to our potlucks. i know you don't have time to cook, but bring the soda or the paper plates or make some contribution. order a pizza for the potluck. if we're ordering chinese food and ask you if you want to participate, say yes sometimes. then we know you're part of the team.

if you wander off with my patient's chart to read it in a nice, comfortable break room, bring it back when you're done. it really ticks me off to have to hunt for my patient's chart several times a day. if i'm using the patient's chart and you want it, ask nicely. don't monopolize my bedside computer or my icu flowsheet or whatever charting form we're using. if i can't get the numbers in, you won't have them to look at.

the fact that you care enough to come to our forum and ask this question makes me think you'll do just great! i look forward to working with you. please print out this thread and hand it to some of your comrades who may need a little help!

ruby (looking forward to my 29th batch of interns in a few weeks)

UM Review RN, ASN, RN · May 19, 2005

I am starting as an IM Intern this July and would like to get some advice from you on what to do or not to do. I have tons of respect for nurses and I am not an arrogant person but what are other small things that bother you about Interns?

Oh man, now you did it. :chuckle You're gonna get an earful from this corner because I'm a night shift nurse, and most of the cardiologists are definitely daytime people.

Here goes:

Please don't yell at the nurses. Please understand that I don't really want to call you in the middle of the night, but there's a protocol order that says I have to. Corollary: you cannot "fire" nurses, slam charts down in anger, or treat nurses like they're too stupid to qualify as life forms. There will be Hell To Pay. Nurses can be extremely subtle in their revenge and they have really long memories. On a more serious note, I have to add that patients of docs who treat us badly have delays in treatment while we make dead-darned-sure we should call that doc.

Please don't give us weird orders like "Nursing staff please shave patient daily at 0600." Ummmm....no, I'm not dropping my A-Fib with RVR Pt's Cardizem bolus to run over and give Mr. B a shave. Neither is my tech, who is busy getting vitals on patients. Especially if Mr. B is confused and doesn't really give a fig about a shave and will fight tooth and nail to avoid it.

And talk about stress? We are human and we also have health problems. A lot of us quit because of the way we're treated. Cruise this board and you'll see what I mean.

If a doc can remember all of his patients, why can't he remember to thank the nurse who saved his patient's life?
In the same way, why is it that docs who yell at nurses always find time to apologise to the Manager, but not the nurse who got yelled at?

Use preprinted protocols whenever possible. Two reasons: One, any idiot can read them, so there's less chance of calling for clarification of orders. Two, it'll save you from having those lovely 3 a.m. wake-up calls for a Tylenol order for a NTG patient's headache.

Please remember that at all times, the nurse is protecting three people here: the patient, the doc, the nurse, and therefore the hospital. Some calls will be CYA calls, yes, but if they're not made, there could be legal problems later on.

UM Review RN, ASN, RN · May 19, 2005

PS I might add that the above post was not directed at you personally, but as another poster suggested, might best be shared with some of your fellow interns.

I think that because you took the time to ask us, you'll make a wonderful doc!