信人: tangpusa (4cure), 信区: MedicalCareer
标 题: 感谢麦地intern-to-be talk笔记
发信站: BBS 未名空间站 (Tue Apr 28 23:30:02 2015, 美东)

非常感谢Peter, Jenny, Coffee, 和 Pathodream 大牛前辈
给我们分享发自肺腑的宝贵经验和精彩的演讲指导！
感谢版主Newman迅速组织这么精彩的演讲！

下面是笔记(对不起有些地方没有记下来，不全)，仅抛砖引玉
期望其他同学能够补充，指正！造福大家。

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Forget your USMLE score; ask and learn from your co-intern

Form a Tx plan by yourself and then, compare and learn from other
people’s
critique, and why the new plan is better.
头三个月决定别人对整个residency的评价。
重要的实验室结果，不要等, 自己去查
Fever --- pan culture, CBC, C/S, Electrolyte ---
凡事多和resident商量。

Must follow THROUGH your order (Tx/lab/procedure),
esp. the UNSTABLE patients !!! Mare sure you GET the results, not
just
place the orders.

夜班，on call…., 一定要亲自assesse 病人
病人transferred from other team --- ask for A/P ----- assessment/plan
from
your colleagues who take care of them before.

*****
一定要在病人名字旁边写上护士的名字， charge nurse ?--- 护士长。
Unit clerk --- 管文秘工作, call counsel…
Discharge planner ---- 出院带药，设备。
Off-loading shoes --- diabetic ulcer. Rehab.
Lab ---- 病理，C/S,

每年10月，in-training exam, very important !!! ----
Ask for feedback, evaluation!
Rapid Response Team --- RRT (relatively lower level), nurse have
severe
concern over pt’s condition (AMS)
Run Code --- Code blue/ code 3, pulseless, (ALS).
Most important part,
A/P: assessment and plan , issue by issue…
---- Reason/cause of admission (MCC)
---- potentially lethal DDx

DDx ---- most likely Dx, most dangerous Dx,
Time course – acute (new onset) vs. chronic , pt is stable vs.
unstable,
Receive what treatment?
Think common problem first
Note: 前三个DDx作为billing
Sepsis ---
Length of stay --- why/should this patient continue to stay in
hospital?
Think D/C plan early.
HIPAA ----
Check box ---

intern准备体检和写病历。
看病人要亲历亲为。

How to get good evaluation!!!

Evaluation sheet: block 刚开始，give attending a 1min “tell me about
yourself”, I will start the rotation with you. My own goal of this
rotation is xxx medical knowledge, I am impressed/xxx.....you and
resident’
s int’x with patients… … What is your expectation? …..

Half-way on the road ---- ask what area you think I need to improve?