CICU Tips

BE NICE. Especially towards the nurses. You would be surprised to know how much the collective opinion of the nurses impacts upon your evaluation.

BE AVAILABLE. The more the staff/senior sees you, the better.

BE SAFE. Ask your senior when you are not sure. The worst criticism that can be levelled against you is that you are a hazard to your patients.

DON'T BE SHY. Being quiet during rounds is a sure fire way to make your senior/staff think you are uninterested.

KNOW YOUR PATIENTS WELL. Even if you don't care about cardiology, knowing the ins and outs of your particular patient shows enthusiasm and is a prerequisite for any physician. Hint: always touch base with the nurses. It is important to understand that even if you are a surgeon or other specialty resident, most mortality is medical (no one ever dies on the operating table in the modern era) – patient mortality is based on medical comorbidity and in that often cardiac comorbidity – knowing medicine well is what will give you the tools to provide the best care for your patients. Remember also that your rotations through Medicine, Cardiology, and ICU will often be the last ever opportunities for many non-Medicine residents to learn medicine for your whole careers.

KNOW YOUR NEIGHBOUR'S PATIENTS. Junior residents who know the basics of all the patients in the CICU (not just their own) are helpful, especially on weekend rounds.

TAKE YOUR TIME IN OBTAINING A COMPETENT HISTORY AND PHYSICAL. This is your basic currency as a doctor; a poorly done history and physical prolongs rounds and frustrates everybody.

COME UP WITH A PLAN FOR YOUR PATIENT AND EXPRESS IT DURING ROUNDS. Stopping at the history and physical is OK for a medical student, but not enough for a resident.

BE CURIOUS. Reading around your patient and raising questions pertaining to his/her care makes you look interested.

HELP YOUR FELLOW JUNIOR RESIDENT. When your colleague is not around to write an order or transfer note on a patient, try not to say: "He is not my patient". Instead say: "I can help out with that". You are working as a team and the better that the team functions, the better care that patients receive. Moreover, efficiency tends to improve and there will often then be more time for bedside teaching.