Articles and Case Studies

10 Things I Wish I’d Known as a New Intern

27 Nov 2013

by Dr Karmen Kokkinn

After years of university education, long nights of study and stressful exams you’ve arrived at the start of your intern year. All your training to this point has been in preparation for this moment. So why is it that you feel so completely unprepared? Dr Karmen Kokkinn has some valuable insights to share with you.
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Watch our new Things I Wish I’d Known as a New Intern video.

From me to you, this is what I wish I’d known from the start to make PGY1 a less bumpy ride!

1. You are not superhuman

Water and glucose are fundamental components of metabolism. You are not exempt from this.

  • Get a big water bottle. Drink on the way to work and then at every opportunity. Use your MDA National water bottle!
  • Get to know your local food options, and I don’t mean vending machines!
  • Consider buying lunch at morning coffee time and put it in the fridge near your office.

2. Sleep is never overrated

Never feel embarrassed about having an early night. A long shift needs preparing for.

  • Carbohydrate loading, an early night and pocket snacks are essential.
  • Get to know your cover team. It’s easier to call someone for help when it’s not the first time you’ve ever spoken to them.

3. Don’t run down corridors

Nothing is ever worth running for. It only panics people. It may also result in knocking someone over.

4. Ticking boxes makes my day

The little tick boxes on job lists give a sense of control.

  • Prioritise consult requests and discharges early in the day.
  • Invest time in your medical students. They will feel involved and it will lighten your load.
  • Develop an easy method for following up results. A notebook is popular, but keep it safe at work to maintain patient confidentiality.

5. SOAP* is not always enough

It takes a long time to wade through the notes of long admissions.

  • Summarise patient progress and issues at least once a week, especially before requesting a consult.
  • Write dates and times and include your pager number clearly so that staff can contact you easily.
  • Surgeons will be difficult to contact for long periods, so it’s important that you have a clear plan during morning rounds.
  • Write legibly. Please!

(*Subjective; Objective; Assessment; Plan)

6. Allied health, know thy names

No man is an island.

  • Introduce yourself to the allied health team and have their contact numbers on your lanyard or attached to your pager. Knowing someone’s name makes it easier to ask for help and it makes you more approachable, easily avoiding miscommunication.
  • Cake. Bake lots of it! If the nurses associate your name with cake you’ll be amazed at the doors that will open.

7. Trust your guts

Your instincts are usually right. If you’re worried, ask for help early.

  • The phrase “I am worried” is helpful at expressing that a patient is deteriorating and that you feel inadequate to manage them with your current level of experience.
  • If a management plan doesn’t make sense, politely ask for clarification. It will probably be a teaching point for you, but it may reveal something that has been overlooked in the patient’s assessment.

8. Another man's shoes

Rumours can spread when workloads are high and personal issues compete with work responsibilities.

  • Avoid commenting on the efficiency of other interns.
  • Offer to swap shifts or help with ward jobs.
  • Catch up after work to offer support. You never know, it might be you needing it one day.

9. Hand hygiene is not just an online module

I was not alone with infective gastroenteritis in intern year. Hand hygiene is good for patient health but is also excellent at keeping you off the bathroom floor.

  • Gel and wash hands at every opportunity, particularly before you eat.
  • Stop chewing pens and biting your nails.

10. A sharps container can never be too close

I had a needle stick injury this year. Fortunately the outcome was okay; however, it was still a harrowing experience. When taking blood:

  • Get comfortable; position the patient and bring the bed up to your height.
  • Prepare a clear path from needle to sharps container.
  • Don’t poke sharps through when the container is full.
  • During procedures, wear safety goggles to avoid splashes to the eye.

 

Internship is a hard but fun year. Make sure you take time to enjoy the little things. They are what I remember most of all.

Dr Karmen Kokkinn, physician trainee, internship survivor and MDA National Member

 

Check out the MDA National Things I Wish I’d Known as a New Intern video for more first-hand advice.

If you have any good tips that you’d like to share about managing your internship or training in general, email us at firstdefence@mdanational.com.au.

 

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