Intern year! It can be a big, scary proposition: soon you’ll be there on night float managing 50 patients, cross-covering multiple teams, when in medical school you only had to carry 3 patients max. Instead of vignettes about crashing patients, you will be the first responder to crashing patients. No longer will you merely be responsible for cataloging information, you’ll have to process it, and make a clinical decision that the care team will enact. It’s a lot of responsibility right out of the gates.
By now, you’ve probably heard from everyone around you how challenging your intern year is going to be. Learning how to put in orders, dose medications, stay awake for 27 hours at a time, and just how to function when working 80 hours a week is a steep learning curve. So how are you supposed to study for another Step exam at the same time? Believe me, it can absolutely be done! You just might need to be more proactive in planning out your study time in advance.
Noncompliant, difficult, unreasonable... all words that we hear on a daily basis to describe patients who do not agree with our treatment plan. It is incredibly easy (and convenient) to stereotype a patient as noncompliant and defer the blame of his or her disease process to the patient. It is incredibly difficult for a clinician to take accountability in the situation, and suggest to his or herself that they have an active and evolving role in the patient’s noncompliance.
It’s a cold December morning in New York City. I arrive at the hospital at 6 am and inhale my bagel as I ride the elevator up to the 3rd floor telemetry unit, slightly tachycardic myself. As an intern, I ask myself: out of the ten patients I will care for, how many will be critical? How many families will I have to console regarding their loved one’s illness? How many stat blood draws/IVs will I have to help the overworked nurses and lab techs with? Will I even eat a lunch today?