Things I have learned the past couple of weeks:
1. You need both of your thumbs. We had a patient with both amputated on the same day.
2. Some interns are nice and understand their limitations. Most are not and need daily reminders that 4 years in medical school doesn't teach you everything. We just got the new herd of fresh graduates, some of them are arrogant and dumb.
3. If you are a resident and your patient is circling the drain and you don't know what is wrong, it might behoove you to listen to the nurses who have been working in the ICU for 20 years. They just might know what they are talking about.
4. Even if the pulmonary fellow tells you it is ok, you cannot leave a Swan-Ganz catheter in your patient's right ventricle. They will go into v-tach. And if they are already compromised, it just might kill them.
5. If your patient has a penile implant, it makes it very easy to put on a condom cath.
6. Butt cream made with stoma adhesive paste does not work as well as that made with stoma adhesive powder.
7. If you are putting a rectal pouch on someone, it helps if you warm up the wafer first.
8. You cannot bolus feed through a Dubhoff tube. I didn't do this, but I heard of someone who did.
Addendum:
9. If you are an intern, don't piss off the nurses on your first day, this will make your residency a painful experience. Don't talk to them like they are idiots, they went to school also to get their degree. Chances are they have more experience than you have years. Respect runs both ways and the "MD" after your name doesn't entitle you to some. It is kind of like an officer/enlisted relationship. As an officer, your enlisted can make or break you, and the same can be true of nurses and doctors. Nurses wouldn't do anything to endanger their patients, but they can make the new doc's life very difficult.
