Burnt out and not retaining

[chickensoupdr]

I started ICU as my first rotation, and I am already feeling burnt out. I feel like I am managing my patients fairly well, haven't had much issue with fellows/attendings. But I don't feel like I am learning much or retaining anything although I'm spending my life in the ICU. Anyone ever felt the same way? How do I get over this stump? What are some good resources/recommendations?

---

Members don't see this ad.

 

[Fatalis]

Felt the same way while I was an intern but you are learning in ways you haven’t realized. Just keep doing what you are doing

 

[jurassicpark]

ICU as a first rotation would be pretty rough. As a first month intern the general feeling is already lost/hopeless and compound that with critically ill patients and a huge amount of things to remember to keep track of it is understandable that you feel this way. Doesn't seem like you're learning anything as you feel you're barely keeping your head above water. But remember, IT'S NORMAL. Believe it or not, you're learning but you're just not feeling that way right now.

 

[dawrhino]

Wow, I am surprised that any program would put intern in his first month to do rotation in ICU. In my opinion its just bad organization as you need to learn how to manage basic staff first before you jump into deep water, unless You have senior / fellow/ attending always checking every order , and really experience nurses. My program starts interns in ICU after 6 months with senior and no fellows and attendings mostly rely on senior to make sure everything is done correctly.

 

[rokshana]

Wow, I am surprised that any program would put intern in his first month to do rotation in ICU. In my opinion its just bad organization as you need to learn how to manage basic staff first before you jump into deep water, unless You have senior / fellow/ attending always checking every order , and really experience nurses. My program starts interns in ICU after 6 months with senior and no fellows and attendings mostly rely on senior to make sure everything is done correctly.

Good grief! 6 months??!!!sounds like your program doesn’t have much confidence in the interns they match...

While not 1st month, I was in the icu the second month of intern year (after 2 weeks of floor...started out on a GI elective) and yeah, i was half stupid and fully scared the whole month, but I had great seniors and attendings that spelled out exactly what their expectations were for an intern...and so help me to have icu early...I learn SOoOo much that month and it help for NF and floor service....I was so much more comfortable...not comfortable, but better than if I had not had taken care of crazy crazy sick people ...

 

[mvenus929]

Wow, I am surprised that any program would put intern in his first month to do rotation in ICU. In my opinion its just bad organization as you need to learn how to manage basic staff first before you jump into deep water, unless You have senior / fellow/ attending always checking every order , and really experience nurses. My program starts interns in ICU after 6 months with senior and no fellows and attendings mostly rely on senior to make sure everything is done correctly.

I mean, when you have enough interns to staff the ICU for the full year, someone has to start there. Many programs try to put home students in the ICU first because they at least don't have to worry about learning the system.

The key is making sure there are good seniors there those first couple months because they have to help the interns adjust to both intern year and the ICU environment.

 

[Raryn]

Wow, I am surprised that any program would put intern in his first month to do rotation in ICU. In my opinion its just bad organization as you need to learn how to manage basic staff first before you jump into deep water, unless You have senior / fellow/ attending always checking every order , and really experience nurses. My program starts interns in ICU after 6 months with senior and no fellows and attendings mostly rely on senior to make sure everything is done correctly.

I mean. if everyone has to rotate through the ICU, someone has to do it first. I don't know of any IM program where the first few months there's no interns in the unit - who would be running the service, multiple seniors? The seniors would probably revolt.

Our program would typically put the "best" seniors starting the year on night float and ICU (and more likely to be a third year than a second year) so that the interns who started on those rotations would have the strongest backup, but interns could start on any rotation.

 

[NotAProgDirector]

I don't know of any IM program where the first few months there's no interns in the unit - who would be running the service, multiple seniors? The seniors would probably revolt.

Actually, we do exactly this. We increase the number of residents in the ICU during day shifts for the first few blocks so no one gets "screwed". Those residents interested in Pulm/CCM want these eraly blocks -- no interns = more face time with faculty and better letters.

 

[Kakoy]

I mean, when you have enough interns to staff the ICU for the full year, someone has to start there. Many programs try to put home students in the ICU first because they at least don't have to worry about learning the system.

The key is making sure there are good seniors there those first couple months because they have to help the interns adjust to both intern year and the ICU environment.

It's a double edge sword. I was a home intern and had ICU nights as first rotation and felt like i was drowning! Had an last minute disaster floor transfer 2 hr before morning rounds started ( as in pt had been hospitalized for 3 months) and I was freaking out with no idea what was happening. Had the best senior ever ( she presented for me the pt instead of me, best senior ever)...

The attending and senior also has a lot lower expectations when you are a ICU night first month intern. The next floor rotation also was much easier to handle after THAT disaster... so silver linings.

 

[mvenus929]

It's a double edge sword. I was a home intern and had ICU nights as first rotation and felt like i was drowning! Had an last minute disaster floor transfer 2 hr before morning rounds started ( as in pt had been hospitalized for 3 months) and I was freaking out with no idea what was happening. Had the best senior ever ( she presented for me the pt instead of me, best senior ever)...

The attending and senior also has a lot lower expectations when you are a ICU night first month intern. The next floor rotation also was much easier to handle after THAT disaster... so silver linings.

Sure, but you know where the bathrooms are, you know how to use the computer even if you aren’t sure how to put in orders or what orders to put in. You’re ten steps ahead of your cointerns on day 1. That gap closes super quickly, but that’s why a lot of home grads are started in the ICU.

The ICU isn’t easy... no one is claiming it is. But if you’re not focused on knowing all the things about being an intern in a new hospital system, you can focus a little more on the patients and medicine.