New doctors: how to avoid those rookie errors

TO keep your energy and enthusiasm on the boil beyond the summer, I have compiled a top ten checklist for avoiding rookie errors.

Talk to your patient

It’s so easy to get caught up in administration, filling in forms, sitting at the computer and talking to your seniors that you, in fact, forget to talk to the most important person of all: your patient.

Eighty per cent of your work will be done by establishing a rapport and getting a good history. The simplest questions often deliver the biggest rewards: how are you?, why are you here today?, how can we be of help to you?

If you’re on the patient’s wavelength, all the medical questions and paperwork become simpler and more likely to be correct.

Try not to be a rookie whose patient tells your boss important stuff that you did not elucidate.

Touch your patient

Point 1 was 80% of your work and this is 15%.

The radiology department and pathology laboratory are not physical examinations.

I remember in my first intern rotation, an elderly woman was sent in for admission by a rheumatologist for back pain. I looked. She had shingles. Problem solved.

Bosses can be rookies sometimes.

Veins – be vain or in vain

The cannulations and blood tests will often be on your shoulders, so become guns ASAP!

Strap the tourniquet nice and tight about halfway up the humerus so as to nicely compress the cephalic and basilic veins. All veins distal will then have the best chance to reveal themselves.

A rookie error is to put the tourniquet too low so that you cover some of the veins or not give good veins a chance to fill.

Be familiar with different types of cannulae and different ways to take blood. The old-fashioned straight needle and syringe still gets an old dog like me out of trouble most of the time.

Charts

I have previously waxed lyrical about charts but again, this will be a job passed down the food chain, so know your forms and shortcuts.

A rookie error is omitting the clinical reason for a drug on the medication chart. When something goes wrong, you’ll be asked why you signed for the drug. By inserting the reasons, it will make you learn therapeutics faster and save your backside.

Vitals

They’re not called vitals for nothing. Disregard them at your peril … A deadly rookie error.

Time

Don’t waste time or time will waste you.

Excessive coffee breaks, social media on the job and mobile phones are the rookie errors that will annoy your seniors and see you falling behind.

That said, if you put in a hard day’s toil, don’t be ashamed to claim all your hours on your time sheets. Bosses and administrators who do not pay you for what you work are not rookies. They’re jerks.

Nurses

A nurse can be nice, or a nurse can be your noose. It’s the rookie’s choice.

The ink drying on your medical degree does not confer the experience of a senior nurse. If you show some appreciation and listen to the nurses, the ward is your oyster.

Be sharp

… in every respect, but especially with sharps.

You not only need to protect yourself but those around you. Even with the best of care, accidents can and will happen, as this cautionary tale illustrates.

Tests

Don’t order a test that you do not understand and cannot interpret. If a senior asks you to do so, research fast or ask the senior to order it instead.

A test you order is a test you need to chase and action … Rookies beware.

Back yourself

If the first nine points were scary, they weren’t meant to be.

You’ve entered the most rewarding of professions that will deliver unending fulfilment and stimulation. Use all the knowledge and skills you’ve worked so hard to acquire. Apply them diligently to do the best you can for your patients.

Believe in your knowledge and ability.

Dr Aniello Iannuzzi, FACRRM, FRACGP, FARGP, FAICD, is a GP practising in Coonabarabran, NSW, and a clinical associate professor at the University of Sydney.

 

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