A year ago today, it was my first day of intern year, my first time being Dr. Ramsey. I started on the Heme/Onc service and was assigned one of the sickest patients on the unit. I remember walking into his room and stumbling over my words as I tried to introduce myself.
"Hi, I'm Tas.....I mean Dr. Ramsey. How are you feeling today?" They could probably hear the fear and uncertainty in my voice.
Looking back, the beginning of intern year was nerve racking but through it all there is so much I learned.
This is the first and most important thing I learned. Through the process of residency, you will discover so much about yourself, how you deal with stress, you will learn so many new things, and become a new person. But in that process, you should never forget who you are at your core. You are not just a doctor. You were someone before you became a doctor, and will continue to be someone after you finish your training.
Take care of your self
Medicine is an unforgiving field. You will spend much of your time taking care of other people and ensuring that your patients are healthy, but as a result have little time to take care of you.
Try to exercise regularly, even if it's 1-2x a week. It will help to relieve your stress and prevent you from gaining or losing too much weight. Trust me, my scrubs that were lose in July are now too tight.
Try to eat healthy when you can because there will be plenty of opportunities for free food and snacks. And when you are on nights, you will want to eat anything in your path. So when you can, go for the fruits and veggies.
Don't forget to drink water! Ain't nobody got time for kidney stones and dried cracked lips.
Don't forget maintenance things like hair cuts, mani's and pedi's, eyebrows. Don't be walking around with jacked up hair, caterpillar eyebrows, and crusty toes. Just because you will be sleep deprived doesn't mean you should be walking around looking crazy.
Lastly, if you are really sick don't be afraid to call out of work. Take that sick day if you need it to get better. Your patients and colleagues do not want the stomach flu you picked up.
Make time for friends and family
Your family and friends will keep you grounded. After getting yelled at by everyone and working countless hours, it's nice to come home to people who are interested in how work is going and what amazing things you are doing. Plus they know the real you, and will humble you real quick.
Take a vacation
This advice was given to me by one of my mentors. She encouraged me to take time to get away from work, even if it was the next town or state over or to see my family. Start looking early to get the best deals.
Make a budget and stick to it
In order to afford said vacation, you have to plan. Make a budget and stick to it! I calculated all my bills and set aside money for vacation, savings, and even spending so that I could still enjoy myself. Take out cash when you can. Pay your bills with one account and personal things with the another. Limit your credit card use and pay your credit card down. And don't forget to factor in your loans, because the loan collectors will be coming for you like Rihanna.
Be nice to the staff
Notice how I said STAFF. Not just the nursing, but the secretary, the janitor, the transport person, the person in the cafeteria, everyone. Introduce yourself when you walk in the room and be polite, because you never know when you will need their help. This also goes back to the 1st point, don't forget to be yourself. Don't be afraid to let your personality shine through. Be enthusiastic and have a sense of humor. You are a human just like they are so be humble and don't pretend to be a someone you are not (i.e. an expert doctor who knows everything).
Spend time with your co-residents
On that same token, be nice to you co-residents as well. You will spend a lot of time together and it's important to look out for each other and learn from each other. Try to get to know each other outside of work and understand who they really are. It makes for a better and richer work environment. Also, you can complain about being hung over at work after an epic happy hour the day before.
Make lists, stay organized, and prioritize
Interns are notorious for their long lists with little boxes next to everything. Realize that each person does things a little different. I have to write everything down and always start with the skeleton list NOSE: Notes, Orders, Sign Out, Exam. This mnemonic helped me to stay organized. However, this is not in order of priority and Orders and Exam (taking care of the patient) and then Sign Out (allowing for safe transitioning of care) take priority over Notes. Intern year is all about prioritizing. In med school your most important role/task was completing the note. Now your priority is taking care of the patient, which may mean stepping away from the computer and being at the bedside. Regardless of how you chose to make your list, make a system and stick to it. If you see something someone else does that you like, incorporate it.
Take time to get better
Realize that there is a lot you don't know. But you are not alone. That is what residency is for. They didn't ask if you were a life long learner on interviews for nothing. Question every thing and everyone (not out loud, lol). Stay hungry for knowledge. Do practice questions to keep you engaged, or flip through your old medical school text books. Look up the diseases your patients have so you never forget it. Be enthusiastic about learning new things and tasks. Try to get the IV, give a try at getting the blood. Some things are not your job, but you also are not above certain tasks either. You will be surprised how much of a difference it makes to the patient and the rest of the staff that you are willing to go that extra mile for your patient.
Trust your gut
If you think something is wrong, speak up, it's better to be wrong and no harm be done to the patient than be right, not say anything and something gets missed. You may be an intern and be at the bottom of the totem pole, but as a new doctor you have a certain outlook that others may not have. You have a fresh set of eyes, a new perspective, and things that people may be used to doing may not always be the right way. Always escalate to your senior resident or attending if you are concerned.
It's OK to make mistakes
You will make many. The most important thing is to learn from them and prevent them from happening again. No one is perfect, so don't be hard on yourself.
It's also OK to cry
Medicine is hard, sad, and scary. Some of your patients will get really sick, some may even pass away. You are not a robot and it's ok to let yourself feel. It's ok to be upset because your attending gave you criticism that you felt was harsh or the nurse yelled at you because you ordered something wrong. It's ok to have good days and bad days. It's also ok to seek help if you need it.
Take a break
Take 10 minutes to walk outside and see sunlight , get a breath fresh air. Stop and get an afternoon coffee or even some candy from the gift shop. Take a moment to unwind and not be a doctor. Stop and smell the roses.
Don't forget the big picture
You will spend the whole year managing minutiae. Changing the timing of medication , increasing the fluids , decreasing the dose. Every little detail is in your hands. But don't forget the big picture. Why is the patient there? What needs to happen for them to go home to their family? What can make their experience better? Remember they are a person not their disease. Spend time with your patients, even if it's for 5 minutes to check in and see how they are feeling. It makes a huge difference for them and for you. It reminds you why you went into medicine.
Need more advice? Or maybe you been there done that and have other tips? What things did you wish you knew as an intern? Drop a comment below.