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"Hello, my name is Dr. Ledesma." - My First EM Shift

Hey everyone!


As you may (or may not) know, July 1 marks the first day of residency for first year residents. It is a time when fresh new interns begin to introduce themselves to their patients as "Dr. ___" instead of "medical student." I felt the same exact way during my first emergency medicine shift. Here's how it went!


As a backstory, we are given our schedules during rotation, however, ALL interns start their first month (July) in the ED. We just don't get many shifts and have more EM bootcamp lectures tailored to EM (i.e cardio, OB, Peds, ACLS, Ultrasound). After July, most of the interns end up either having off service rotations or rotations elsewhere such as Peds, Trauma, ICU, Ultrasound and more.


Anyway, my first shift was 12-10 right after our EM bootcamp lecture. It was a little nerve wracking because I had to arrive at 7:30am for lecture and then go straight from lecture to the ED. But nonetheless, I went and arrived about 15 minutes early in order to get a WoW (workstation on wheels). I also talked to one of the secretaries to receive a phone for calls during my shift. After introducing myself to the scribe, attending, and nurses I began to sign up for patients and see them. It was such a weird feeling to say "Hi, I'm Dr. Ledesma, one the EM residents who will be taking care of you." I was just so used to saying "Hi, I'm Kandria, one of the fourth year medical students." However, I continued my work and began to present to my attending with differentials and workup, placing the orders. I ended up working with two physicians that day so it was slightly overwhelming, but I luckily had rotated in that hospital with the same system before so I was familiar with most of the EMR except orders and discharging patients. I fortunately had one of the chief scribes guide me again through it as a refresher.


Working with two different attendings was interesting. One of them pretty much told me his plan and the dosages of the medications to order however the other attending asked ME what type of pain medications as well had me speak to the nurses whenever they had questions about my patients. For example, I had discussed ordering a fluid bolus for a patient and thought that was what I ordered (it ended up being maintenance fluids) & so the nurse asked if I wanted a bolus or maintenance dose. -___- (I'm so dumb sometimes...)


I also participated in sign out for the next group of physicians and residents once my shift was order. After sign out, I continued to finish my charts and signed them off to my attendings. It was definitely a unique learning experience for my first shift.


All in all, as a first shift, I felt very comfortable speaking with my patients and reassessing them. I only saw 4-5 patients but as an intern, I felt that it was appropriate. I even did a straight catheterization and swab and admitted two patients. I received great feedback from my attendings and it helped me become more confident for my future shifts. I'm still a work in progress, for sure, but each shift is a unique learning experience and I only know I can keep on improving and growing from here!


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If you have any comments or suggestion on what else I should blog about, let me know! Some other ideas I've been asked to do was talk about my schedule as an EM resident and applying to emergency medicine. I also plan to talk about reviews of certain companies/products related to medicine, running, and even some of my other hobbies so definitely stay tuned!



-Kandria









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