My junior is an idiot

My intern, he's an idiot. I mean, I've tried to be sympathetic and tell myself (on an almost hourly basis) that he's just starting, it's only October, but every day, he finds some way to amaze me with his tremendous stupidity. And I don't mean that in a jovial manner. I mean stupid, like when I found one of his charts, I was so angry that the nurses brought me coffee and tried to calm me down.

And the problem is that his deficits are not the deficits one should have as an intern. An intern should not know what to do or which antibiotic. He doesn't know what meds the patients are on. He doesn't know the labs. He's missed stuff like a hemoglobin of 7, a creatinine of 3.

He'll tell me that something was done yesterday, but it wasn't done. It wasn't even ordered. Or that a consultant recommended a medication, but the consultant made no mention of it. Essentially the problem is this: he cannot be trusted to report accurate information.

This would be fine, if he was a medical student. Then, I would see the patients and write my note and that would be the end of it. The problem is that you cannot manage a patient when you don't know the patient. Every day on rounds, I have to tell him something about his own patients.

And today, I couldn't believe it. One patient was off Lantus for 2 weeks. It was lost in an ICU transfer. But for 2 weeks, he's been telling me that he's taking care of her blood sugars, but he's done nothing. Worse than nothing in fact, because we've taken steps backwards. And it's my own fault for trusting him. I should've checked the accuchecks. I should've monitored the doses, but I just believed him. I had sicker patients to worry about.

Frankly, I'm ashamed. We've had multiple consultants on the case, and they must think we're morons. Internists that can't manage diabetes. I sent him home today and wrote all the orders to fix it.