Welcome to my tips on doing well in rotations! This installment covers surgery.
Disclaimer: I am talking from my experiences at my institution, mileage may vary where you are!
- Understand how to do a post-op progress note. We’re programmed in the beginning of medical school to follow a certain order in the patient interview: chief complaint, HPI, PMH, FH, SH, and ROS. That goes out the window when you’re doing post-op progress notes. Really all you want to know is how the patient is doing post-operatively. Essentially, is the patient pooping, peeing, passing gas, eating, walking and complaining of any pain. Note any events that happened overnight. Did the patient get a transfusion? Did the patient have a fever? Basically, you want to know things that can complicate the post-op recovery process. Know the time courses for post-op complications. Structure your notes as a SOAP note! Think about your plan in terms of systems!
- Anticipate! Anticipate! Anticipate! Surgery is all about figuring out what your team is going to need and then doing that. Determine which patients will need their dressings changed. Go and change the dressings. Turn your white coat into a supply closet; stock it with gauze, tape, suture removal kits, and dressings. You never know when you’ll be called to help drain an abscess or to tend to a patient! Your team will appreciate not having to go to the supply closet time and time again to get materials. Anticipate in the OR! Offer to put in the Foley. If you’re new to the OR, check out my post on tips for scrubbing in!
- Speak up! Surgery is one of those rotations where you can really establish yourself as being invested in patient care. If you rounded on a patient, just start presenting the patient when you’re rounding with the team. Sometimes things get so busy they forget that you’ve rounded on a patient.
You will either love or hate surgery. I hope those tips point you in the right direction! Good luck!