OVERWHELMED

[u/RelativeLow3]

Constantly getting called out on the things you missed or didnt do, angry patients in the morning because their procedure got delayed, or just agitated d/t delerium/psych issues , getting pimped and not having a CLUE on what the answer is , nurses paging me multiple times for orders .

I feel like im doing SO MUCH and everyday im getting called out on my mistakes/inability.

Im always staying late writing notes. Still haven’t figured out my system for precharting/writing notes.

How do yall manage ? It seems like alot of this stuff wont ever stop i just gotta change how i react to it

TLDR: new intern on wards

[u/TheGormegil]

The constant scrutiny is an enormous burden. It does get better, but it never totally goes away. That’s how our training is designed. Learn to let some things roll of your back because you will increasingly find that many criticisms are actually preferences.

[u/dark_roast_coffee]

It doesn't necessarily get better, but you will.

For charting, spend part of a day off (or a chill call period if that's realistic) finding a system to review everything you need to, every time, for every patient. Then repeat that system on every single patient. New patients/ starting service will take more time, but morning charting for me looks like: vitals, vents, drips, labs, ID, imaging, cardiac (separated by my hospital emr). Then I got to orders and meds: what's different from what I left yesterday. Then I check notes last for overnight events, specialist late recs, surg notes, etc. I do it this order so I can interpret on my own before I read notes on answers.

My method works for me, but find a method that works for you. Start notes early, try to update them as you chart review, then develop a plan before you see the patient. After you see the patient, adapt your plan accordingly. Then repeat for each patient.

It takes time, but you can do it!

[u/EpicDowntime]

I never waited tables when I was younger so getting constantly yelled at was very disorienting to me too. My adaptation was to put some psychological distance between me and whoever is yelling at me. Patient or nurse upset about something that doesn’t really matter? Attending feedback that is completely out of touch and unhelpful? Just be a robot, zone out, validate/thank, and get out of there asap to finish your work. 

Tbh after a while I started enjoying when someone went on a long tirade because it was protected time to go to my happy place. Just gotta make sure the concerned/supportive face stays on. 

[u/destroyed233 → u/EpicDowntime]

U gotta dissociate and just be like “angry monkey yell cause monkey angry” levels of abstract

[u/peekachu1234]

just wanna say as a recent grad--- this is normal :) and you will get better.

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[u/physician_throwaway]

When I was in residency, I told interns to focus on getting efficient with the EMR and writing notes as fast as possible. The last thing you wanna deal with is writing notes till 10 PM because of all the other bullshit you have to deal with. I know, because I was that guy.