So, for the last three weeks I've been working as a surgical intern in the Norwegian equivalent to the British "Foundation year 1". In our system, medical graduates must complete 1 year of hospital rotation (6 mo surgery + 6 mo medicine, or 4 mo surgery + 4 mo medicine + 4 mo psychiatry) and then further 6 mo of general/family medicine before being eligible for surgical/medical residency.
I've started at a mid-sized general hospital and my work is primarily in the ER. Doing diagnostics, stabilizing/treating and either admitting orthopaedic/gen. surgical patients for further diagnostics/treatment or discharging stable patients who don't require hospitalisation.
While I do have residents and senior doctors to confer with, most of the time the interns are the only doctors from the surgical department present in the ER.
And the ER is bloody busy. I'm especially struggling with:
1) creating a sustainable and effective system to keep track on the multiple patients I'm in charge of at any given time (their problems, vitals, workups, working diagnosis, initial treatment in the ER etc). Do any of you have any cool templates you could share with a funky fresh intern?
2) documenting effectively. In average I spend 10-15 minutes with one patient, and then 30-40 minutes writing the patient note and filing charts – and that's just not efficient enough. Especially when there are four other patients I've not yet examined.
3) doing an effective neuro exam in head trauma patients, especially elderly who've syncopated. What do you ER-docs/neurologists/neurosurgeons believe are the minimum requirements in an initial neurological assessment?
And then, I'm generally curious on what you guys believe is a good junior doctor/FY1/intern? What should be in his or her toolbox? When do you seniors approve of your junior collegues?
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