HealthMarch 16, 2020

Starting residency? Get to know your hospital

By: Julia Michie Bruckner, MD, MPH
Getting to know your hospital when you’re starting residency goes beyond the standard orientation. It means meeting people and finding your comfort zones.

The invigorating aroma of coffee drifted through the pediatric emergency department, drawing us to the back hallway, where we chatted and poured hearty cups of the dark, strong brew. Sergio, one of the most dedicated environmental services workers in the department, made the best coffee. Even my co-residents who weren’t rotating in emergency medicine would come down from their floors to grab a cup.

When you’re starting residency, you’ll be oriented to your hospital—a tour of the units, the cafeteria, the call rooms. You’ll be introduced to the residency program administrative staff and your rotation directors. But truly getting to know your hospital goes further. After all, during residency, you’ll spend more time in the hospital than at your house. Here are some ways to get to know your second home and make your time there as comfortable as possible.

Find the food

Starting residency is intense; you need to find the best fuel to keep your belly full, your mind sharp and your energy up. As hospitals aren’t known for their cuisine, you need to do some research to find your best food options. Much of the advice senior residents passed along to us interns was related to food: what time the cafeteria brought out the fresh macaroni and cheese, which floor had the biggest stock of peanut butter and hot chocolate and, of course, where to find the best coffee (the frequent pots brewed by Sergio in the ED). We also shared our findings around the hospital—the best post-call brunch spots, the coffee shops with the speediest morning lines, the sandwich and pizza places open past midnight.

Find the stairs

Hospital elevators are generally slow and crowded. You’ll often be caring for patients on a variety of floors, so finding the stairways will let you zip up and down easily. The climbs will help you stay awake on call and ward off the calories from the doughnut holes you may be wolfing down between admissions. Stairways can also provide a quiet, secluded space for a moment to breathe, cry or just sit in the midst of a stressful call.

Find the charge nurses

Getting to know your hospital means getting to know the charge nurses. They run each floor or unit and are the true managers of the hospital. They’re generally the first to know everything, so get to know them and you’ll be in the know as well. Then aim to meet the house supervisor, known as the “COPP” (coordinator of patient placement) at one of my residency hospitals, who has the bird’s-eye view of the hospital at all times. Despite the name, our COPPs were approachable and key to helping sort out admissions, discharges and all manner of flow issues in the hospital.

Find the unit coordinators

Unit coordinators generally know how to get anything done—not just in their unit, but in the entire hospital. They know the practical secrets; appreciate their wisdom and they may share it. They’re also often interesting people: One from my residency also worked as a nightclub bouncer, one was an accomplished artist and another was in graduate school for anthropology. Our conversations always made my calls more fun.

Find the radiologists

Of course, if you’re a radiology resident, you already know where the radiologists are. But otherwise, it can feel as if they’re mysterious voices on the phone or names on a reading, existing in some secret hideaway. In reality, they’re smart and helpful colleagues who generally sit in a room not too far away. Meeting them in person and reviewing concerning or complicated images together can make a big difference for patient care.

Find your own spot

Seek out a personal comfort zone in your hospital. This may be a location—a particular break room, nurses’ station, call room, corner of the cafeteria, even a stairwell—where you feel you can sneak a moment of relaxation. If a physical place is hard to find, bring your own creature comfort on call: a box of your favorite tea, a stash of your favorite chocolate, your own blanket or pillow for the call room. Or perhaps your spot is actually a person.

Remember, the hospital isn’t just a building; it’s a community of people all working to care for others. Building caring relationships with all—unit secretaries, food service staff, nurses, respiratory therapists, environmental services workers, rotating medical students, attendings and especially your co-residents—will make your hospital feel a bit more like a home.

Julia Michie Bruckner, MD, MPH