Stamping this on my brain...

I am putting this here mainly to remind myself later down the road. Mom, remind me! I overheard some attending physicians discussing residents today, and what they said needs to be stamped on my brain. Here's what they expect:

#1- A resident needs a get-it-done modus operandi. YOU are responsible for the patient, and you need to follow through all the way every day. A resident cannot be passive. If your patient has a problem, get up and go see them. If you order an intervention for your patient (transfusion, for instance), watch them during, after, and check them periodically YOURSELF. In general, do stuff YOURSELF. Don't ask the nurse to do it. Don't tell another resident to do it. DO IT.

#2 - Really an extension of #1 - Get your skills under your belt (checkoffs done EARLY) and use them whenever you need them. This means: blood draws, lumbar punctures, rectals, pelvics, paracenteses, and the rest. If your patient needs it, JUST DO IT. No getting someone else to help you/ sort of do it for you and then saying "can I check it off?" Do it yourself.

#3 - Have your clinical reasoning down pat. We follow algorithms sometimes, but we think it through...that's our ROLE. Thinking, reasoning, knowing why we do A not B. Knowing why A didn't work and when to switch to B. If you can't reason it out, read until you can. Again, take responsibility for your ability to think it through.

#4 - If you think you are 4's and 5's out of 5's on any self-assessment, you may want to re-think that. Look for areas to improve rather than thinking you've arrived at a "5". Ask those senior to you: How could I have done _________ better?

#5 - (This was my own observation): Communicate about expectations very clearly with examples and concrete terms. Do this for your interns' and students' sake.