Paging Etiquette

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Wow, you guys are still at it. This issue is quite simple.

Who are the people responsible for the medical students?

Residents, Fellows, Attendings.

Respect them.

Who do you work with?

People above plus nurses, administrative people, techs, etc.

Respect them.

Who do you work for?

Patients.

Respect them.

And finally, being professional and respecting others doesnt mean you always have to take crap from them nor does it mean that you have to be a "teacher's pet" in front of them. You can stand up for yourself while still being professional and respectful.

Easy!
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I'm about to switch teams...med student land to residency land. That being said, if I ever go off about some punk student calling me by my first name, I will give all the students in their class the go-ahead to kick me in the balls. Being bossed around not only by residents and attendings but also by everyone from nurses down to housekeeping sucks enough.

True respect flows up AND down the chain of command. Otherwise it's not really respect, just *****-kissing. Demanding respect based on your just being "higher in the food chain" makes you a d-bag. Sorry. The way I was raised, respect is to be earned, not demanded.
 
On the topic of paging etiquette, there was one time when I waited over an hour for someone to return a page, only to realize when I caught him in the hall that he never received it. How long should I wait before I page someone a second time? I don't want to be annoying/sound impatient because I know residents are extremely busy. At the same time, I just want to be sure they received it.

Also, is there a general rule for within what time period a page should be returned?
 
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albe said:
On the topic of paging etiquette, there was one time when I waited over an hour for someone to return a page, only to realize when I caught him in the hall that he never received it. How long should I wait before I page someone a second time? I don't want to be annoying/sound impatient because I know residents are extremely busy. At the same time, I just want to be sure they received it.

Also, is there a general rule for within what time period a page should be returned?
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An hour is waaaaay too long. I don't have a set time, but thinking about it I guess it's no more than 10 minutes for the first page, ignore 2 and/or I'm post-call and the hammer-paging starts sooner. Typically I'm doing other things, paging folks, realize so-and-so hasn't paged me back yet and shoot them another page. You never want to be just sitting at the phone staring at the wall, always have something else you're working on so that the time spent waiting isn't tagged directly onto the end of your day.
 
albe said:
On the topic of paging etiquette, there was one time when I waited over an hour for someone to return a page, only to realize when I caught him in the hall that he never received it. How long should I wait before I page someone a second time? I don't want to be annoying/sound impatient because I know residents are extremely busy. At the same time, I just want to be sure they received it.
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I would never wait an hour. Half an hour is about the most I would wait for anything that was remotely important. If it's someone on my team, I probably wouldn't wait more than 10 minutes.

Also, is there a general rule for within what time period a page should be returned?
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If I don't know the number, I've probably never waited >5 minutes.
 
wagy27 said:
I've had a MS-4 doing a sub-I in the ER page me for a consult and then put me on hold. I made a point to come down and talk to his resident about it.
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Wow that's pretty harsh.
 
albe said:
On the topic of paging etiquette, there was one time when I waited over an hour for someone to return a page, only to realize when I caught him in the hall that he never received it. How long should I wait before I page someone a second time? I don't want to be annoying/sound impatient because I know residents are extremely busy. At the same time, I just want to be sure they received it.

Also, is there a general rule for within what time period a page should be returned?
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I'd say you should be called back in <10m, but make that ~20min if you said "medical student" or "MS3".
 
Aphasic said:
I'd say you should be called back in <10m, but make that ~20min if you said "medical student" or "MS3".
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Maybe I'm skipping a step in the logic here but...

Isn't this kind of like saying the patient's care is less urgent if they happen to have a medical student following them?

Yes, I do have an attitude about the whole hierarchy of the medical system to begin with. I won't deny that it biases me in this case. But weren't we always told (generally in the super-formal fields like surgery) that the purpose of the hierarchy itself was for the betterment of patient care? And I don't see that happening here in this thread.
 
Exactly,

I've had 1-2 instances in the last 2 years when I had some down time on service and while checking in on a few patients I was worried about found that I had good reason to be worried about them. Luckily I've had mostly great residents who did not think they were above responding to the medical student's page about a decompensating patient. I wonder how often the "respond to med student pages no sooner than 20 minutes" crowd experiences the page -> page -> code 10 over the loudspeaker -> enter room and med student is doing chest compressions sequence of hilarity. But hey, at least you enforced the hierarchy, right?

Look, I'm entering one of those super-hierarchical specialties next month. And I agree with a previous poster, if I ever treat medical students as if they were undeserving of respect, professionalism, and basic courtesy simply because of their training level, I hope they do kick me square in the balls. A PGY4 surgery resident demonstrated the right attitude, in my opinion, in my 3rd year clerkship once. I responded to something he said with a 'sir', and his response was that he found that offensive, I should call him <first name>, and that we were all partners in medical training, just at different points along the path. He pointed out that yes he was senior to me and that should be recognized, but that that didn't make him 'better' than me. Now, I did and still do think it was a bit of an overreaction and that there is certainly nothing wrong with calling a senior resident 'sir', but I admire the attitude and the sense of humility that led him to feel that way.
 
MattD said:
Exactly,

I've had 1-2 instances in the last 2 years when I had some down time on service and while checking in on a few patients I was worried about found that I had good reason to be worried about them. Luckily I've had mostly great residents who did not think they were above responding to the medical student's page about a decompensating patient. I wonder how often the "respond to med student pages no sooner than 20 minutes" crowd experiences the page -> page -> code 10 over the loudspeaker -> enter room and med student is doing chest compressions sequence of hilarity. But hey, at least you enforced the hierarchy, right?

Look, I'm entering one of those super-hierarchical specialties next month. And I agree with a previous poster, if I ever treat medical students as if they were undeserving of respect, professionalism, and basic courtesy simply because of their training level, I hope they do kick me square in the balls. A PGY4 surgery resident demonstrated the right attitude, in my opinion, in my 3rd year clerkship once. I responded to something he said with a 'sir', and his response was that he found that offensive, I should call him <first name>, and that we were all partners in medical training, just at different points along the path. He pointed out that yes he was senior to me and that should be recognized, but that that didn't make him 'better' than me. Now, I did and still do think it was a bit of an overreaction and that there is certainly nothing wrong with calling a senior resident 'sir', but I admire the attitude and the sense of humility that led him to feel that way.
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I may be wrong but calling someone "sir" in a certain tone or context can be misconstrued as sarcastic and therefore disrespectful.

The whole first name-last name thing has just never made sense to me unless it involves a patient. I think it is respectful and appropriate to address a patient by their last name, and I think it is a good idea to refer to any intern or resident as "Dr. X" to the patient because it clarifies that they are in fact a doctor. Among us medical folk, we already know who is who. I suspect the level of formality that was discussed earlier may be geographic as some of the more formal-leaning posters had profiles suggesting they're from the South. I myself am from the Northeast and we tend to be somewhere in the middle between formal and casual. Residents are strictly first-name with hardly any exceptions, and attendings write their own rules. Many are quite OK with residents and fellows they know well calling them by their first name, and some even extend that invitation to students they've worked with.
 
the fat man said:
I may be wrong but calling someone "sir" in a certain tone or context can be misconstrued as sarcastic and therefore disrespectful.
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That's certainly true, although not the case in my example.

I definitely believe in referring to patients as Mr. or Mrs. (or Dr...). Referring to other medical professionals in the presence of patients should also be Mr./Mrs./Dr. As far as I'm concerned personally I don't expect anyone to call me anything other than my first name when conversing outside of the above situations. However, as a resident, if you are an attending I am calling you Dr. X, even if we play golf weekly. Fellow residents will be Dr. X until instructed otherwise, including residents junior to myself.

I don't think this is the point though. The principle of professionalism is not tied to titles and honorifics. It's tied to treating everyone else on the patient care team, from the people cleaning the rooms to the attendings (and yes, even medical students) with respect. Professionalism is assuming that the resident/intern/medical student is not paging you out of a desire to annoy you, but because they have a genuine concern about a patient. It is not the fellow who refuses to speak to medical students or junior residents. Yes, professionalism includes making every effort not to put the consult who just returned your page on hold, but it also includes not jumping to the conclusion that just because it was a medical student who did so, they must not have had a valid reason. Sometimes stuff happens. I'm certainly not trying to lecture anyone, and perhaps I'll be jaded in a few years myself, but I just don't understand why so many people feel the need to assume the worst in their colleagues at all times.
 
MattD said:
That's certainly true, although not the case in my example.

I definitely believe in referring to patients as Mr. or Mrs. (or Dr...). Referring to other medical professionals in the presence of patients should also be Mr./Mrs./Dr. As far as I'm concerned personally I don't expect anyone to call me anything other than my first name when conversing outside of the above situations. However, as a resident, if you are an attending I am calling you Dr. X, even if we play golf weekly. Fellow residents will be Dr. X until instructed otherwise, including residents junior to myself.

I don't think this is the point though. The principle of professionalism is not tied to titles and honorifics. It's tied to treating everyone else on the patient care team, from the people cleaning the rooms to the attendings (and yes, even medical students) with respect. Professionalism is assuming that the resident/intern/medical student is not paging you out of a desire to annoy you, but because they have a genuine concern about a patient. It is not the fellow who refuses to speak to medical students or junior residents. Yes, professionalism includes making every effort not to put the consult who just returned your page on hold, but it also includes not jumping to the conclusion that just because it was a medical student who did so, they must not have had a valid reason. Sometimes stuff happens. I'm certainly not trying to lecture anyone, and perhaps I'll be jaded in a few years myself, but I just don't understand why so many people feel the need to assume the worst in their colleagues at all times.
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Disagree. If we respect everyone respect loses value. If we disrespect people as a rule, and reserve respect for people who are further along in training or more powerful than us, than that respect is more meaningful.
 
cpants said:
Disagree. If we respect everyone respect loses value. If we disrespect people as a rule, and reserve respect for people who are further along in training or more powerful than us, than that respect is more meaningful.
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This is the most ******ed sentiment I've read on here all morning, maybe all week, and I've been reading some really ******ed nonsense.

EDIT: Retracted

cpants said:
I was joking.
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jdh71 said:
This is the most ******ed sentiment I've read on here all morning, maybe all week, and I've been reading some really ******ed nonsense.
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You might want to put that in the "oops" file. Before I decided to spout off too, I went back to the earlier parts of the thread and found the poster had already contributed. Read what he/she had to say from before.

Sadly, there are those out there in our field who actually seem to take it seriously. Go back to the earlier parts of the thread and read what...
 
Oh and MattD,

If I could somehow be paid well enough to even afford to golf with my attending I'd be OK calling him "your majesty." :laugh:
 
the fat man said:
You might want to put that in the "oops" file. Before I decided to spout off too, I went back to the earlier parts of the thread and found the poster had already contributed. Read what he/she had to say from before.

Sadly, there are those out there in our field who actually seem to take it seriously. Go back to the earlier parts of the thread and read what...
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I fail to see how anything said earlier makes the statement any less ******ed.

cpants can come back with either more context or a better way to word things, but as it stands: ******ed
 
jdh71 said:
I fail to see how anything said earlier makes the statement any less ******ed.

cpants can come back with either more context or a better way to word things, but as it stands: ******ed
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Me thinks cpants was being sarcastic? That's why I suggested going back and reading some of the stuff he/she wrote--mainly stuff like bashing residents who flip a $hit for some minor med student transgression. It clarifies the context (or at least the poster's general POV on this subject).
 
the fat man said:
Me thinks cpants was being sarcastic? That's why I suggested going back and reading some of the stuff he/she wrote--mainly stuff like bashing residents who flip a $hit for some minor med student transgression. It clarifies the context (or at least the poster's general POV on this subject).
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If sarcasm, then I shall retract my statement. I'll wait for clarification.
 
jdh71 said:
If sarcasm, then I shall retract my statement. I'll wait for clarification.
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I was confused as well... doubly so when your edited post above shifted the flow of the conversation and responded to later posts LOL


fatman: I agree. I'm about to live 15 minutes from TPC, but I know I'll never play there :(
 
MattD said:
I was confused as well... doubly so when your edited post above shifted the flow of the conversation and responded to later posts LOL


fatman: I agree. I'm about to live 15 minutes from TPC, but I know I'll never play there :(
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I don't actually play golf myself so you're starting to lose me. Is TPC is a famous golf course?
 
Well thank you for just wasting 5 minutes of my life.

Maybe I should make you look up Stowe's "Front Four" or Killington's "Outer Limits." There are some great photos out there where somebody stands at the top and aims the camera straight down the trails.
 
You're very welcome ;)

All of my skiing experience has been in the Rockies, it's good to hear about some good slopes in the east. I'll have to add vermont to my list of places to visit and attempt to kill myself :)
 
jdh71 said:
I believe I had a copy-pasta snafu . . . strange, that . . . let me try and fix it again
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yeah i figured.... but don't you mean a copy-pasta ragù?


HAAAAAAAhahahaha oh my I'm on fire today
 
MattD said:
You're very welcome ;)

All of my skiing experience has been in the Rockies, it's good to hear about some good slopes in the east. I'll have to add vermont to my list of places to visit and attempt to kill myself :)
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I've never been out West for skiing but truth be told I'd bet slopes are scarier-looking out there on average. Certainly steeper. However I've heard the trails are much wider and not icy so you can stay more perpendicular to the fall line if you're not comfortable barreling straight down. I cut my ski teeth in NH and it gets really icy, Vermont is a little better in terms of that.

Whatever the hobby, I don't think either of us are going to have much time for them starting very soon. However my specialty seems to hold a lot of conferences in fun areas--ski resorts, beaches, Vegas.
 
the fat man said:
I've never been out West for skiing but truth be told I'd bet slopes are scarier-looking out there on average. Certainly steeper. However I've heard the trails are much wider and not icy so you can stay more perpendicular to the fall line if you're not comfortable barreling straight down. I cut my ski teeth in NH and it gets really icy, Vermont is a little better in terms of that.
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I can't compare, but I can say I've rarely felt pinned in by an overly narrow trail out there, so you're probably correct.

Whatever the hobby, I don't think either of us are going to have much time for them starting very soon.
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Agreed
 
Apparently I screwed up with paging etiquette today, so I did a search to find out what is proper.

Questions:

1. So I guess it's required that I leave both my first and last name, per earlier posts, and merely saying "MS3 on Team A" would not be sufficient? I ask this because I know that being concise is the key with text pages (and I have a long name).

2. How long do I wait before re-paging?

3. Is this the way to send a proper page?
"Would like to speak to you regarding pt John Smith, MRN 12345.
-Jane Doe, MS3, ext. 1234"

Thanks.
 
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ForeverandEver said:
Apparently I screwed up with paging etiquette today, so I did a search to find out what is proper.

Questions:

1. So I guess it's required that I leave both my first and last name, per earlier posts, and merely saying "MS3 on Team A" would not be sufficient? I ask this because I know that being concise is the key with text pages (and I have a long name).

2. How long do I wait before re-paging?

3. Is this the way to send a proper page?
"Would like to speak to you regarding pt John Smith, MRN 12345.
-Jane Doe, MS3, ext. 1234"

Thanks.
Click to expand...
1. Putting "med student" on there certainly doesn't make you a priority call, so I'd just leave it off. First and last name are fine.

2. Probably 15 minutes.

3. Just say "From Jane Doe: please call 1234 re: pt in W320."
 
cpants said:
I have never been on a team or heard of a team where the med students were expected to call the residents Dr. ____ . Using the title just is not the default in the med student resident relationship. I have seen medical students call the resident "Doctor" and it comes off way douchey and ass-kissy.
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If i dont know the resident (or they are the chief resident, no them or not) I'm calling them doctor. But if you're PGY1-PGYnotyetchiefresident and we've met, I'll go with first names. But only because we've met.
 
Medical students are subordinate to residents but If I ever heard one of my residents patronize a medical student to call them "Doctor" I'd bash down that little bastards egotrip so fast their head would spin. You're a resident, a trainee. If a student calls a resident they should address them as - "Are you the resident on for......."You just were walking in that medical students shoes and don't know S#$% though you make think you do. Nurses, secretaries, patients should address a resident as doctor.

I know things are different now- more digital and technologic but a consultant, IMO, should be simply paged to a number and the info given person-to-person. That avoids mistakes, HIPPA issues and displays proper courtesy.
 
tomboard said:
Hi this is tom from UK..........................................................................................

{

clinical rotations

A. During the third and fourth years at LECOM, students are required to complete a total of 24 clinical rotations (12 per year). Each rotation is four weeks in length and is classified as either core, elective or selective. All core rotations (internal medicine, pediatrics, obstetrics/gynecology, surgery, psychiatry, emergency medicine and ambulatory medicine) and fourth-year selectives must be completed with a LECOM affiliate. Electives can be based in any specialty and at any domestic medical facility. Other rotations (family practice and rural/underserved medicine) are similar to electives.
}
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origin_Dazas-WTF-bildes-6.jpg
 
sirenomelia said:
I know things are different now- more digital and technologic but a consultant, IMO, should be simply paged to a number and the info given person-to-person. That avoids mistakes, HIPPA issues and displays proper courtesy.
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Agreed. We had someone text page a resident with a consult. Except that it was in the middle of the night, and that resident wasn't the one on call. Nobody knew about the consult until the next morning when someone called again.
 
sirenomelia said:
I know things are different now- more digital and technologic but a consultant, IMO, should be simply paged to a number and the info given person-to-person. That avoids mistakes, HIPPA issues and displays proper courtesy.
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While I agree about the face to face, I have heard the exact opposite from the fellows I know. They prefer the text message with some room number and initials.

As an example, one ID fellow (who was on by herself for the entire hospital for a month) actually told me that she prefers the text message (clarify: cell phone to cell phone). Since its not an emergency, she can let it sit, and get to it when she can get to it. The immediacy of the page means that she has to stop what she's doing (within the 5 minute courtesy window) and call back right then. Also, if she needs more information than my text has, there's my number, sitting in her phone, so she can just call me, or, to give the same courtesy of leisure, text me for more information.

Text paging, when available, is the worse of two worlds. The pager goes off (inducing the PTSD that has been so engrained in the residents and fellows who did overnights), the text is hard to read, scrolls through 9 "screens" and then you usually STILL have to call the person back.

Pagers are obnoxious. The only people I don't mind getting paged by is the nurses. They are charting or doing something patient related and always have their portable on them. So when I call back, it takes all of two rings before I have them on the phone. People who page and walk are irritating. The worst is being paged to a general number where some automated recording picks up.

And being paged to a strip club is amusing. The first time.
 
sirenomelia said:
If I ever heard one of my residents patronize a medical student to call them "Doctor" I'd bash down that little bastards egotrip so fast their head would spin. You're a resident, a trainee.
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Some places require it (i.e. UT Southwestern). One of my classmates is from there.

sirenomelia said:
Nurses, secretaries, patients should address a resident as doctor.
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I call the nurses by their first name, so i started returning pages to the one's i know by my first name. You know, to try to be more friendly, "we're in this together" sort of thing. It is interesting, though, that they are very uncomfortable with first name for residents. One calls me by my last name without "dr." I think she's warming up to the first name, though I feel like there may be another etiquette, a nursing etiquette, that I'm unaware of that makes it awkward for nurses to refer to any physician as something other than "Doctor."
 
:shrug: I dunno, I mean I go there, been in all the departments. Can attest to the fact that there is no such requirement and that is truly anecdotal.
 
OveractiveBrain said:
Text paging, when available, is the worse of two worlds. The pager goes off (inducing the PTSD that has been so engrained in the residents and fellows who did overnights), the text is hard to read, scrolls through 9 "screens" and then you usually STILL have to call the person back.
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What I hate most about text pages is when they text you a request in the form of a demand.
 
smq123 said:
You know what? They probably aren't!

At our MS3 orientation, we were given lectures with chirpy titles like "How to avoid burnout!" "Dealing with dying patients" and "Delivering bad news."

Then they released out onto the wards without telling us how the d*mn paging system even WORKED.
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This is so true. I'm half way through MS3, and I didn't even know that medical students paged residents..
 
TheLesPaul said:
:shrug: I dunno, I mean I go there, been in all the departments. Can attest to the fact that there is no such requirement and that is truly anecdotal.
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Then i apologize for spreading of false information.
 
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