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Tricks of the Trade

Tricks of the Trade. Ouli Xie Intern. My year so far. Nights (5 weeks) VIDS (5 weeks) Horsham general surgery (10 weeks) Vascular surgery (10 weeks) To come… Gen med ED. A typical surgical day. Pre-round Round Jobs +-Theatre +- PAC LUNCH! More jobs (Discharge summaries).

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Tricks of the Trade

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  1. Tricks of the Trade OuliXie Intern

  2. My year so far • Nights (5 weeks) • VIDS (5 weeks) • Horsham general surgery (10 weeks) • Vascular surgery (10 weeks) • To come… • Gen med • ED

  3. A typical surgical day • Pre-round • Round • Jobs • +-Theatre • +- PAC • LUNCH! • More jobs • (Discharge summaries)

  4. Mornings • 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.

  5. 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

  6. 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

  7. In theatre • Fun time! • Introduce yourself • Make yourself useful • Time out • Get involved • D/C summary, script, post-op investigations, meds

  8. 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

  9. 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!

  10. Communication • You’re not alone! • Nurses are your friends • Be nice and they will make your life so much easier • Ward clerks are your friends • Pharmacists are your (*best) friends • Allied health staff are your friends • Communicate well and your life will be easier

  11. Ask for help • You will often be out of your depth • This is NORMAL • 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.

  12. 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

  13. Referrals • Be prepared • Refer early in the day • Have everything in front of you • Know the reason for referring • ISBAR

  14. Golden Rules • Be nice, communicate well • Ask for help • Hydate hydrate hydrate (ARF = bad)

  15. Enjoy being an intern • It’s great fun • You do make a difference • You get to work with your friends • And you get paid!

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