An Intern’s Tale: The First Day of Internship
I’m sure there are many of you who are wondering what being an intern in a modern-day Australian hospital is like. Over the next few weeks, I will be writing about some of the things that happened during my first year on the job.
The First Day – “Your job is to push the trolley”
I’ve lived through over 1,200 Mondays, but the first day of internship was the first I have ever looked forward to.
What exactly does an intern do? One intern suggested to his consultant on a ward round that his patient was anaemic, probably due to folate deficiency. The consultant replied ‘your job is to push the trolley.’
First, let me say, I much prefer being an intern to a final year student. This is despite the fact that the majority of time spent as an intern is doing thankless tasks…including pushing the trolley. For example, “get a CTPA for this patient” asked the consultant. It took two seconds to ask, but nearly two hours to organise. And it will take two minutes to view the results and chart the appropriate dose of enoxaparin. Still, if you didn’t put in those two hours, the patient might deteriorate.
The nurses bombard you with tasks: charting fluids, replacing cannulas, writing discharge letters, and clarifying medications. This is in between the patients who need medical review for hyperglycemia, hypotension, chest pain, broken nails and everything in between. The to-do list grows until the evening shift begins, then it quietens down and you can concentrate on tying up the loose ends so the even busier after-hours intern doesn’t trip over them. All the while, however, you are making a difference to patient care, and knowing that you’re contributing is a great feeling.
The most time I spent with a patient today was during a cannula insertion. What I missed the most was the patient contact time. It’s not that I didn’t want to be around them, they have interesting histories to share and a need for therapeutic listening from their doctor. There just isn’t time during your shift, and it would take an extraordinary person to stay back well after their shift ended to spend time with their patients and ignore the rumbling in their stomach or the numbness in their mind. Again, it’s not for not wanting to, but after a certain time of non-stop activity, your brain demands you to retreat home, where you know you can let the world spin for a while.
When you walk out the hospital door into the setting sun – if you’re lucky – or the night if you’re not, it feels good. Because no matter how unglamorous, tedious or repetitive the tasks, by doing them you are one step closer to sending your patients home. Your patients, for the most part, are sincerely grateful for your hard work and appreciate whatever little time you spend with them. There’s no better way to help people or improve their quality of life than to get them out of the hospital – as long as you don’t think the same thing about yourself.
The intern is a facilitator, an organiser, a checker and a doctor. They are the link between the nursing and the medical teams. It’s a challenging job, busy too (unless you are doing urology), but you have responsibility, and at the end of every day, you have achieved something, even if you feel like you haven’t.
I’ve enjoyed it so far, I still look surprised when someone addresses me as ‘doctor,’ I still can’t believe my bank account has grown by $4,000 in a month and I am hoping the novelty doesn’t wear off soon.
Watch this space:
Part 2: Australia Day – “The Whiteboard Always Wins”
Part 3: A night in aged care – “that’s not the doctor, that’s my son”