10 Tips To Survive Wards

Wards often cause much consternation for medical students, interns, and residents. This post will be half humorous, half serious, but hopefully all helpful. These are going to be practical tips about your workflow. If you're worried more about looking good on rounds, might I suggest First Aid for the Wards. You might also want to check out:

• Pocket Medicine: The Massachusetts General Hospital Handbook of Internal Medicine
  
• 250 Biggest Mistakes 3rd Year Medical Students Make And How to Avoid Them
• First Aid Radiology for the Wards

Anyway, without further adieu, here is my list:

1. Do no harm. Heh, gotta pay tribute to Hippocrates, no?
   
2. Buy one of those clipboard/organizer deals. Unless your hospital has a full EMR, you will be filling out forms. A clipboard with storage lets you carry around forms so you don't have to hunt for them on each unit where they will be inevitably hidden a different, illogical location.
3. Find out where the good/clean restrooms are. I remember hearing this on the interview trail and thinking it a joke, but it is so so true.
4. Same goes for figuring out where to get food quickly and cheaply.
5. Sometimes people get all worked up on keeping notecards with every single lab value their patient has had. This is a giant waste of time. All you need are the latest labs, and perhaps the previous values for labs that come back abnormal. If someone asks you a sodium level from a week ago, they are being unreasonable and should look it up themselves.
6. Figure out how to round in a path that makes sense. Start with the sickest patient, but then walk around in a logical way.
7. Keep snacks in your pockets. You will need them at some point. I recommend Quaker Chewy Granola Bars
8. Do as complete an exam as you can during your initial H&P, and then do as little as possible while still addressing the patient's major issues during each follow up. There's no point in not checking pulses initially, but then doing fully neuro exams everyday, unless you're specifically asked to do so.
9. Use the time when you page or return a page and are put on hold to do other mindless things, like collect labs.
10. Don't stress too much. Things could be worse - at least you're not the one who is sick in the hospital, right?

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