Intern Bootcamp - Consults

Behind The Knife: The Surgery Podcast

Science, Health & Fitness, Medicine, Education

4.8 • 1.4K Ratings

🗓️ 5 July 2023

⏱️ 15 minutes

🔗️ Recording | iTunes | RSS

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Summary

Buckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency.

This episode, we’ll talk about how to give and receive consults in the hospital like a pro. We’ll also provide some tips on how to make those long call days a little more manageable.

Hosts: Shanaz Hossain, Nina Clark

Tips for New Interns:

GIVING CONSULTS

Clear and Concise Question!
Develop a script, such as:
- “Hi, this is XX with the general surgery team. We’re calling to request an evaluation for a patient presenting with XX. I can give you the MRN whenever you are ready…”
- Follow this with a brief H&P.
If you are asking another team to perform a procedure on your patient, be prepared with the following information:
- NPO Status
- Ability to Consent or Proxy Contact
- Blood Thinners
- Urgency of Procedure

RECEIVING CONSULTS

Make sure you are clear on what the team is asking of you as a consultant.
Clarify if the patient is expecting to receive a surgery before talking to them about an operation!
Quickly gather information about the patient and their hospital course from the consultant, electronic medical record, and, most importantly, the patient!
Note the callback number on the primary team and call them with the plan after you have staffed the patient with your attending.
If you are asked to perform a procedure as a consultant, clarify the following information:
- NPO Status
- Ability to Consent or Proxy Contact
- Blood Thinners
- Urgency of Procedure
Develop a system to stay organized and keep track of your to-do list with consults!

CALL SHIFTS

Bring a survival bag with toothbrush/toothpaste, face wash, deodorant, change of clothes, etc to reset.
Try to nap when you can, but:
- PM round to address non-urgent pages ahead of time
- Set alarms!

Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

If you liked this episode, check out our new how-to video series on suture and knot-tying skills – https://behindtheknife.org/video-playlists/btk-suture-practice-kit-knot-tying-simulator-how-to-videos/

Transcript

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0:00.0	Behind the Night, the Surgery Podcast, relevant and engaging content designed to help you dominate the day.
0:13.0	Hey BDK, Liz Marin, the weather's getting warmer, the days are getting longer, and that can only mean one thing.
0:27.0	It's time for the new interns to hit the hospital.
0:29.0	Don't worry though, we've got your back, I'm Shana Swassan, and I'm Nina Clark, and this series will give you some practical tips and tricks for dominating your internship.
0:38.0	Today, we're going to step into the oft dreaded shoes of the consult resident, both on the requesting and the receiving end.
0:44.0	We'll also give some tips on how to survive those 24 plus hour long shifts in the hospital.
0:49.0	Shana, I don't know about you, but my record is 32 consults in a single 24 hour period with multiple procedures and cases going to the operating room at our trauma hospital.
0:58.0	I don't know what your record is.
1:00.0	I have been a white cloud, so I have not reached a 32 mark, but I also have some pretty busy consult days back to back consults, so it can get pretty hectic no matter what.
1:11.0	For sure, as an intern, I was a huge white cloud, and then immediately upon reaching my PGY two year things went very quickly down hills.
1:19.0	But I would say that regardless of if you are a white cloud intern or a black cloud intern or anything in between the common themes here, I think will be pretty common throughout the rest of our episodes with this series efficiency organization and a good attitude are going to get you through even the most painful consult shifts.
1:36.0	And with these other tips and tricks we'll give you, we'll hopefully make your 24 hour calls a little less painful.
1:41.0	Let's talk about how to call in a new consults. There's definitely an art to it.
1:45.0	You'll be calling new consults for our patients and it's a critical skill to learn how to do it in a friendly but direct it in an efficient way.
1:51.0	You'll be working alongside your consultants for the rest of your career and you're also your colleagues in the hospital.
1:56.0	If you can handle it well, consults are some of the best ways to learn more about your patients, the consultants in a hospital, our little experts in the domain that you're asking them for their help in.
2:08.0	And they can talk you through the reasoning.
2:10.0	The LDR is to have a clear question and give a quick relevant history and document the request and your notes.
2:16.0	Can you expand a little bit more on how you use the concepts and calling a consult?
2:22.0	Yes, I think that when you're calling a new consult, it's really critical to be extremely clear and get to the consult question as quickly as possible.
2:29.0	So I really use the same script for almost every single consult that I call.
2:34.0	I say, hi, this is so-and-so with the general surgery team.
	...

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