Want to survive Internship? Follow these simple guidelines for success!!
Page your attending and ask if it is ok to order Tylenol for a patient
Use the charge nurse’s computer station if available, preferably with your feet on the desk
Order Q1 neuro checks on every patient, never know when they will stroke. Be vigilant.
Order Lasix immediately after removing a Foley catheter, helps get the kidneys working
Write for 0.031 mg of Dilaudid for an adult
Scope out every ginger ale refrigerator and cracker bin area in the hospital in the first week
Tell an ICU nurse how to do their job on your first day and to address you as “Doctor”
Call the anesthesiology attending at 2 AM and ask them to place an IV, stating you haven’t tried yet and plan to go back to bed after hanging up
Locate a convenient yet slightly distant stairwell to eventually do your crying in
Place your pager precariously on your hip so that it immediately pops off into the toilet when you try to squat
Stuff your white coat full of reflex hammers, tuning forks, beef jerky, tissues, random pieces of paper, and lots and lots of pens
Add “Appreciate (insert consulting service name) recs on this patient” to EVERY single note you ever write
Read the The House of God or take the quiz
Call for an OB/GYN consult on a patient without getting an HCG
Call for an orthopedic consult without ordering X-rays, ortho loves to order xrays
Order CMV, leukocyte-reduced blood products every single time somebody needs blood
Order a CT scan and call the radiologist every 5 minutes after that to see if they have read the exam yet. They NEED reminders
At a code, check your own pulse and then slowly step away to the nearest commode to release your bowels
Don’t perform back compressions
Attempt to write a no-word SOAP note
Copy and paste your note from the previous day and change nothing in the note for weeks
Ask your attending to describe “how much harder residency was” back in their day
Use the term “in my practice” right out of the gates
Don’t write for NPO orders the night before for your pre-surgical patients
When asked by a patient “How many of these procedures have you done?” answer “Depends, does the pig lab count?”
Write for more narcotics if a patient comes in stating that they either dropped their meds in the toilet or if those two guys stole them
Gloat to your resident that ACGME doesn’t allow you to take overnight call
Order 400 mEq of potassium
Order 2mg of Dilaudid fast push for that 95 yo 50-kg hip fracture patient
In the ER, when a consultant is called down, use the phrase “Hey, while you are here, do you mind seeing another one?”
Start off a call to a consultant with “I’d like to order a consult for a patient. I’m not sure what is going on, but my attending said to call.”
Hold on to your sphincter tone if you every have to push adenosine for SVT
Walk right into the nurses’ potluck like a boss and just pile up a plate of food
Ask your resident if you can cap at 2 admissions a day
During a central line placement, typically your forehead sweat drips on the location of the IJ; stick the needle there
If you need lead for a surgery, make sure to only use lead labeled with an attending’s name
While placing an A line, the preferred technique is performing the Singer sewing machine method
At a trauma, grab everything that you will need including an ET tube, IVs, an ultrasound probe, a chest tube, and then promptly move to the corner that is farthest away from the patient
Order a PT consult without an OT consult
Order an insulin sliding scale by doing a slide emoji
Write a transfer summary for the next hospital on a dirty napkin
Send a patient to the ER without calling anybody down there. EM physicians love surprises, and rock climbing
Give a seasoned ICU nurse your password so that they can enter correct orders, specifically at 3am while you are sleeping
Get your resident or attending coffee in the morning instead of pre-rounding
Don’t drop a baby on your OB/GYN rotation
Ok, if you made it this far you just might survive internship year after all! Best of luck! You will make it and be stronger after this nutty, yet rewarding year, we PROMISE!
