New resident physicians who have earned their MD degrees will be heading to hospitals to start their residencies during the last two week in June and the first week in July. What can a beginning doctor do during the first month of internship to get his or her career off to a good start, and in so doing, also learn to provide the best care to patients? Here are 10 important tips:
1. Start early. Show up earlier than asked. If you’re supposed to be there at 7 a.m., arrive at 6 a.m. Use the time to schedule and pre-plan your work. This can help you to attend conferences and seminars during the day.
2. Ask for help. There’s always help available at any time. Don’t be afraid to ask. Don’t be afraid to look stupid. Asking for help is not a sign of weakness it is a sign of strength.
3. Clarify and verify. Double-check everything you do regarding patient care, and make sure about patient-care-related activity. Ask a senior resident.
4. Learn from everyone. Nurses, pharmacists, social workers and other hospital personnel are not your enemies, they are your friends. They can stop you from making errors.
5. Be thorough and effective rather than efficient. Prioritize and triage your communications, especially in the ER, OR, or ICU. But don’t cut corners to get things done quickly. Be more thorough, even if it takes longer. In the early part of your career it may take more time to do things. Do them right.
6. Document everything you do and why. Every action taken in patient care should be documented succinctly and should include the reason you decided to do it. Also, if you have a criticism of anyone on the health care team, don’t write it on the patient’s chart. Pick up the phone and speak directly to the individual. Avoid “Cut and Paste” on EMR/EHR.
7. Seek to prevent complications, not to rescue. Develop the habit of trying to foresee complications and crises and plan to avoid them, instead of reacting to situations by trying to rescue the patient.
8. Always ask about allergies, over-the-counter medications (OTC), and herbal/natural medications. For every prescription you write, ask the patient whether he or she has allergies that might be triggered. Also assess whether the drug can affect kidney or liver disease.
9. Remember, you’re being watched. There is no room for you to go unnoticed in a hospital setting. Be aware that everyone is observing you all the time. If you engage in unprofessional behavior, your supervisor will know.
10. Give the patient and family (caregivers) 100 percent. Do not text or use the phone when you are with a patient. If it’s critical, ask to be excused to take a call or reply to a message. When you’re in a patient’s room, give your full attention to the person. Sit down, even if you have only few minutes. Update the caregiver after getting permission from the patient. Always end conversations with, “Would you like to discuss anything else with me today about the care plan?”
Vijay Rajput is an internal medicine physician.
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