AT ST. LUKE’S-ROOSEVELT HOSPITAL A Day in the Life of an Intern

St. Luke’s Morning Get Vitals at Roosevelt or St. Luke’s  All lists are available on the Surgery Database which can be accessed at both hospitals 6 AM jitney from Roosevelt Arrive at St. Luke’s  One intern gets signout from nightfloat intern  One intern gathers supplies needed for rounding/last minute vitals Round with team 7 AM conference  Monday: chief meeting (chiefs only)  Tuesday: Vascular  Wednesday: Basic Science  Thursday: Colorectal  Friday: Trauma Conference or Basic Science Quiz

St. Luke’s Daytime 7:30 AM: OR starts  Prior to starting the OR, the entire team “runs the list”  Discuss plans for each patient (studies, consults, post op care)  Ask any questions about patients/plans  Pre-op paperwork should be completed PRIOR to 7:30 Morning Notes  S.O.A.P. note format Execute Plans  Place orders (diets, meds, ambulation, studies)  Call consults  Ensure orders are carried out—sometimes requires the intern to go beyond just placing the order (bring a patient to CT scan, call echo or IR, draw labs, walk the patient, etc)

St. Luke’s Daytime Labs  Labs appear in PRISM between 9-11 AM  Labs should be recorded on paper and presented to the senior resident  Electrolyte abnormalities should be corrected  Labs for tomorrow should be ordered after discussion with the senior resident Update  Throughout the day, the senior residents should be updated about the patients– run the list between cases  Keep the List up to date throughout the day

St. Luke’s Afternoon Prepare for afternoon rounds  Gather current vital signs and note any abnormal vitals during the day  Chart check (look for notes from attendings, consults, PT)  Pre-Round on patients Afternoon Rounds  The whole team meets and discusses what went on with the patients during the day  See patients (faster than AM rounds) Run the List  The whole team runs the list again with any plans for the evening/night  Update the list Signout  One intern signs out the list to the nightfloat intern (brief summary of the patient, post op checks, follow up plans, nightchecks)

St. Luke’s Clinics Monday 1:00PM: G1 clinic (Wedderburn, Lorieo) Wednesday 10AM: Breast clinic Wednesday 1:00PM: bariatric clinic (G2 interns) Thursday 1:00PM: G2 and colorectal (Koshy, Talbert, Gandhi) Vascular (interns on vascular only go to vascular clinic):  Monday – Benvenisty  Tuesday – Lantis  Wednesday – Lee  Friday – Lantis

Roosevelt Morning Arrive at Roosevelt and get signout from nightfloat Pre-Round  Split the patient list  Get vitals, examine the patient, take down dressings Round with team around 6:00AM  Senior residents and one intern examines patient together and does dressing changes  One intern writes the notes (S.O.A.P. note format) 7AM conference  Monday: chief meeting (chiefs); Moore rounds (blue)  Tuesday: Vascular  Wednesday: Basic Science  Thursday: Colorectal  Friday: Trauma Conference or Basic Science Quiz

Roosevelt Daytime 7:30 AM: OR starts  Prior to starting the OR, the entire team “runs the list”  Discuss plans for each patient (studies, consults, post op care)  Ask any questions about patients/plans  Pre-op paperwork should be completed PRIOR to 7:30 Execute Plans  Place orders (diets, meds, ambulation, studies)  Call consults  Ensure orders are carried out—sometimes requires the intern to go beyond just placing the order (bring a patient to CT scan, call echo or IR, draw labs, walk the patient, etc)

Roosevelt Daytime Labs  Labs appear in PRISM between 9-11 AM  Labs should be recorded on paper and presented to the senior resident  Electrolyte abnormalities should be corrected  Labs for tomorrow should be ordered after discussion with the senior resident  BELGRAIER patients– put labs in chart!!! Update  Throughout the day, the senior residents should be updated about the patients– run the list between cases  Keep the List up to date throughout the day

Roosevelt Afternoon Prepare for afternoon rounds  Gather current vital signs and note any abnormal vitals during the day  Chart check (look for notes from attendings, consults, PT)  Pre-Round on patients Afternoon Rounds  The whole team meets and discusses what went on with the patients during the day  See patients (faster than AM rounds) Afternoon Conference  Monday 4:00PM: chest/thoracic  Tuesday 5:00PM: Hepatobiliary  Thursday 5:00PM: tumor board Run the List  The whole team runs the list again with any plans for the evening/night  Update the list Signout  One intern signs out the list to the nightfloat intern (brief summary of the patient, post op checks, follow up plans, nightchecks)

Expectations Know what is going on with the patients at all times “Make It Happen” – ensure the plans are executed Keep the senior residents up to date Learn how to prioritize and multi-task Be Prepared  All OR cases are assigned the night before – this allows the intern to read about the case  READ – be prepared for basic science lecture, quiz, trauma, rounds Practice makes perfect – suturing, knot tying Ask Questions  Never be afraid to ask the senior residents questions  Prepare educated questions to ask attendings during a case Think ahead  Anticipate the plan  Formulate your own plans or solutions to problems and discuss them with chiefs