My first rotation - Family medicine inpatient service

I started on Wednesday bright and early (although it wasn't that bright). Getting up was hard. Once I arrived at the call room where everyone gets together, I realized that this was the end of my vacation/freedom. I will be practically living in the hospital for the next 3 years.

I got a pre-checkout of my patients the previous day so I can get an idea of what to expect. I was really hoping for a short patient list. But it was almost FULL. Maximum is 8 patients per person. I had 7 to see. We round at 10 am and so I felt the pressure to start seeing my patients and be back on time. I got there at 6:30 but didn't really get started until 7am. After seeing one patient and about to see my next patient, my senior resident told me to discharge one of my patients this morning. She was really helpful and showed me how to write discharge orders and other paperwork I needed to fill out. So I finally discharged the patient which included discharge orders, seeing the patient, writing a note, writing new prescriptions, and calling the clinic to set up a follow-up appointment. Now I learned how to discharge a patient and it was almost 10 am. I still had 5 more patients to see. Yikes! My senior said to be quick and that we'll start rounding at 11am instead since it's our first day. I'm not used to feeling so rushed and overwhelmed. I finally finished a little after 11am. They were fine with me showing up late.
It was just crazy to go from not using my brain for most of 4th year, moving at a comfortable slow pace, and then to feeling like I'm running a marathon (not that I know what that's like). During rounds, I was finishing up the notes. I barely read most of the H&Ps of my patients to find out what to do next. btw, we do table rounds which is nice. When we finally finished, we had lunch around 2pm.

Afterwards, I had to put in orders in the chart or call the nurse to do it. We carry hospital phones and pagers. The hospital phones (called banana phones because they are yellow) are like pagers but the nurse can call you directly to ask a question. I also had to consult a few of my patients whom I knew very little about for GI consult or surgery consult. I finally got to sit down and rest at 6pm when my shift ended. My senior helped big time because I didn't have time to put in all the orders and she organized the checkout list of my patients for the incoming on call residents. This rotation is a lot of paperwork. I had 3 discharges on day one. Now I had to dictate 3 discharge summaries within 48 hours (that's the rule). I had Friday off this week so I spent most of my Friday working on discharge summaries (I had already accumulated 6 of them).

Day 2 was much better. I finally got a break at 5pm and had time to update the check out patient list. It was also easier to wake up on day 2.

Friday - day off, but technically I had a pile of catch up paper work to do.

Saturday (day 4) - I learned it was a short day. Yeah! I still need to work on my speed in seeing patients. We round earlier at 9 am. I had 2 new patients plus 4 old patients. I felt super rushed to see them all. Plus I had 2 discharges to do before noon. Overall, it was nice to be done by 12:30 pm and just hang and chat.

Then I went home to write this blog so I can remember what my first week as an intern was like. In a few words - crazy busy, overwhelming, clueless.