I just finished intern year and I feel like the hardest thing is keeping oriented on what is going on *right now*. Especially in the ICU but even floors, as you said “what did we do yesterday.” The one liner is key for that. 1. Who they are 2. Presenting symptoms 3. Reason for admission 4. WHY ARE THEY STILL HERE TODAY. The reason I separate those is they can all be different and not necessarily obvious for a student or intern to understand. Example - presenting symptom may have been vague like “weakness” but reason for hospital admission was actually AKI, and maybe it’s all done but they’re still here pending insurance auth for short term rehab. Those things are not logically related in the same way that medicine is (example: here for heart failure, diuresing still) so it’s hard for me to remember without being systematic. And if I leave out any one of those I might miss what’s actually going on. Example, if I left out point #4 I might not know our main goal today is to talk with case management not necessarily doing anything medically
I just finished intern year and I feel like the hardest thing is keeping oriented on what is going on *right now*. Especially in the ICU but even floors, as you said “what did we do yesterday.”
The one liner is key for that.
1. Who they are
2. Presenting symptoms
3. Reason for admission
4. WHY ARE THEY STILL HERE TODAY.
The reason I separate those is they can all be different and not necessarily obvious for a student or intern to understand.
Example - presenting symptom may have been vague like “weakness” but reason for hospital admission was actually AKI, and maybe it’s all done but they’re still here pending insurance auth for short term rehab.
Those things are not logically related in the same way that medicine is (example: here for heart failure, diuresing still) so it’s hard for me to remember without being systematic.
And if I leave out any one of those I might miss what’s actually going on. Example, if I left out point #4 I might not know our main goal today is to talk with case management not necessarily doing anything medically
Super helpful to have a basic format that has everything you'd like in a one-liner. Thanks.
About to start my medicine sub-i, this is super helpful!
How about the structure for new patients (H&P presentation) rather than established patients (progress presentation)?