Wednesday, July 6, 2011

Unsolicited Advice to Interns From a Former RN Who has Gone to the Dark Side: Part 2

After putting up yesterday's post I realized that I missed some sage Julie Andrews advice: start at the very beginning. It's a very good place to start. [Ha! Enjoy having that song in your head all day!] So I am going to back track a little.

This is the second installment on how to ingratiate yourself with your new colleagues as a freshly minted MD intern (or medical student, for that matter). These are just observations on behavior that nurses tend to notice, which can really make a difference on how you'll be received.  I hope some of my suggestions are helpful in making you appear like the Star Intern that you know you are.

Introduce yourself. There is nothing more annoying than having a new batch of people pulling charts off the desk or using the staff washroom without staff having a lick of an idea who they are. Half the time your name tag is either not visible or in such small print that we can't tell if you're here to deliver the wound-vac machine, take bloods, or admit the patient. Make yourself known to the staff. Introduce yourself to people in a polite, humanoid way, and be clear about your role. Say what year you are in, how long you'll be in the department, who your attending is, whether or not you still watch The Bachelor...whatever, just let people know your story. Do this especially with people like the charge nurse or the nurse who is taking care of your patient. They deserve to know who is doing that rectal exam on Ms Jones (as, by the way, does Ms Jones!)

Never assume that anyone knows you're the new intern / medical student / attending. They probably never got the memo, or if they did, it is tacked on the same board with staff party photos from 1997, the ACLS guidelines that advise a precordial thump, and the Thanksgiving pot luck sign up sheet. Talking about food brings me to my next point...

"There is no love sincerer than the love of food” according to G.B. Shaw. A special amount of love will be reserved for you if you contribute sustenance to the insatiable, gaping maw of the staff appetite.

The culture of food is central to the communal harmony (and sometimes survival) of the unit.  And blood sugar levels are directly correlate to measures of civility. We are well aware that you are run off your feet, working 30hr+ shifts, living on a line-of-credit, and sleep deprived but hey--if you are regularly feeding at the trough then consider making the odd contribution!

This sounds obvious, but I can count on one hand the number of interns / residents who actually brought food for the staff. Something as simple as a bag of oranges, crackers and hummus, money for the coffee fund...anything is highly appreciated. We're happy to keep you going when you haven't had a meal for countless hours, just show a little appreciation and return the favor once in a while.

Oh, and if you're in Canada never bring in Timbits. Once you've worked in healthcare for about 20 mins your lifetime Timbit capacity has maxed out. And try not to bring things that people put their hands in like giant bags of chips or other MRSA receptacles [shudder]. Germaphobes delight in individually wrapped morsels of chocolate or hands-free access, like fruit on toothpicks.

Remember, at the hospital food = friends. I can safely predict the staff will be dazzled with your thoughtfulness.

Hope today's installment was helpful and informative. Back to the pit of study hell for me (I may have a snack first).


Christopher said...

I don't think I remember a happier ED staff than one day during clinicals when an attending sent out one of the float nurses with his credit card and said bring back snacks/food/something for everyone. Those 12 hours flew by!

In the US Timbits are called doughnut holes or Munchkins (depending on where you get them from). I think I did a double take the first time my girlfriend asked me if we had "something like Timbits" in the States.

Liana said...

My secret weapon for ingratiating myself with the nurses is mini cupcakes.

Dr Sunshine said...

I very much plan on either bringing in a big box of cookies or cupcakes on my first day as a junior doctor. Even though it's the most obvious form of sucking up I hope it'll make everyone think I'm friendly as well as cutting me some slack.

Absentbabinski said...

Oh goodness, yes. Wrapped candy >>>>> a bag of jellybabies/ whatever.

Anonymous said...

I will continue to scoff down those Timbits until either my windpipe or my LAD clogs.

Solitary Diner (Also Known as The Frugalish Physician) said...

Brownies are an awesome treat to bring into the ward. It takes about five minutes to mix up a boxed mix, but they give the appearance of being homemade (and they're brownies!). That being said...I bought a box to make for my ward last weekend, and it's still sitting unbaked on my counter.

Unknown said...

Some unsolicited advice from an MT (hope you don't mind):

1. Speak clearly. Some can speak fast and do well. Others, not so much. Speak at a comfortable pace for you to be heard clearly. We often wonder if you talk to the patients the way you do your dictations. If you're trying to speak so fast you're stumbling over your words, SLOW DOWN.

2. We're not morons, so we don't need everything spelled for us when you dictate. New drugs, devices, etc, sure. We could use the help with that, and even some of the OTC stuff, but not every drug.

3. Please, know what you're going to say before you start the dictation so you don't have pauses all over the place. This also helps so you're not backing up and correcting too much, which can lead to #4.

4. GIGO. Garbage in, Garbage out. If you dictate crap to us, you'll get crap back.

Better dictations for medical records means better patient care.

This is, of course, assuming dictations are still done.

Albinoblackbear said...

Chris--I love the credit-card runs (especially with someone else's card). Gets one through the worst of night shifts.

Liana--Good call!

DrS--I'd do it more than just your first day. ;) But yes, it will be appreciated.

AB--Yeah, ew.

IANH--You'll hit your Tmax one day my friend, one day... ;)

SD--Good point-the homebaked are def more thoughtful. I brought mini-pavlovas in once (on a night off when I was bored) and got 2 marriage proposals.

Elise--Thanks for that! I don't know if Irish clerks do any dictation but when I *do* get there I'll keep those pointers in mind.

It is always good to ask the members of the team what drives them nuts--I usually ask office admin, lab / radiology that when I start somewhere new.

Anonymous said...

T that would be a great lab value

"Shit, Shirley's T-Max came back at 24! Hang a litre of Second Cup wide open, and get a muffin in!"

Mike N. said...

Excellent series of posts; I shared them with several nurses on on my unit and everyone enjoyed them immensely!

Albinoblackbear said...



Oh right, because your school didn't give me even an interview *both* times I applied. :[

Mike: Thanks! Glad to hear it! :)

Kate Theriault said...

What an awesome series of posts! I'm just about to start medical school, so I will be able to refer to these posts when I start clinical stuff in six months.