Tricks of the Trade
Ouli Xie
Intern
My year so far
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Nights (5 weeks)
VIDS (5 weeks)
Horsham general surgery (10 weeks)
Vascular surgery (10 weeks)
• To come…
• Gen med
• ED
A typical surgical day
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Pre-round
Round
Jobs
+-Theatre
+- PAC
LUNCH!
More jobs
(Discharge summaries)
Mornings
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Start early! (may require coffee +++…++)
Prepare for the day
Update the list
Check what’s on for theatre
Collect files
Round
– Surgical rounds can be hectic
– Most important thing is the plan!
– Don’t forget to check the obs, meds, drains etc.
Jobs
• Prioritise!
• Some things can only be done during working
hours
– Get radiology in early
– Get referrals in early
• late referral = angry reg = sad intern
– Patient care comes first
• Organise jobs by location
Theatre
• Surgery is about operating
• Your job is to make sure patients are ready
for theatre
• Checklist
– Fasting
– Meds
– Fluids (if required)
– Pre-op investigations eg. FBE, UEC, coags, G+H
– Consent
In theatre
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Fun time!
Introduce yourself
Make yourself useful
Time out
Get involved
D/C summary, script, post-op investigations,
meds
PAC
• Make sure patients are ready for procedure
• Check patient having correct surgery
• Make sure patient is safe for surgery
– Read the anaesthesist’s recommendations
– Meds
– Investigations
– Consent
– Liaise with GP
LUNCH!
• There is always time for lunch (*almost)
• Symptoms include the 3 Gs
– Grumpiness
– Grouchiness
– (G)upset
• You may not feel hungry
• You will be more efficient
• Also don’t forget to hydrate!
Communication
• You’re not alone!
• Nurses are your friends
– Be nice and they will make your life so much
easier
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Ward clerks are your friends
Pharmacists are your (*best) friends
Allied health staff are your friends
Communicate well and your life will be easier
Ask for help
• You will often be out of your depth
– This is NORMAL
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There is always help around
Don’t be afraid to ask for help
Don’t be afraid to call a MET
It doesn’t always have to be your reg
– Don’t forget your co-interns
– Nurses etc.
It’s not just medicine
• Don’t neglect your life
• There’s still time for things outside of
medicine
• See your friends
• Keep up your hobbies
• Don’t just live your job
Referrals
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Be prepared
Refer early in the day
Have everything in front of you
Know the reason for referring
ISBAR
Golden Rules
1. Be nice, communicate well
2. Ask for help
3. Hydate hydrate hydrate (ARF = bad)
Enjoy being an intern
• It’s great fun
• You do make a difference
• You get to work with your friends
• And you get paid!