ACK! Surgery!
- Thread starter Starflyr
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I'm starting surgery rotation on July 8th, but I'm already having fleeting moments of panic that I'm trying to counterbalance with (false?) sense of confidence..... Please let us know how it goes and if you see sunlight in the next couple months....
Peace~
Lindsey
Peace~
Lindsey
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Don't worry too much about your surgery rotation. I was really worried about it too before I started, but if your school is anything like my school, you will probably just be told to stand there holding retractors during operations and collect vitals for the team for morning pre-rounds. I actually tried to introduce myself to a transplant attending during the first day of my of transplant surgery, but as I started saying "hi, my name is..." he interrupted me holding one finger up while saying "concentrating" while he stood there staring blankly at a kidney in storage for transplant. He had the nerve to write that I was "quiet" in my evaluation, I guess after I never bothered to introduce myself for the rest of the two week rotation after that, I never bothered to talk to him because I didn't want to interupt his "concentration" . 🙄 I found my medicine rotation infinitely more challenging intellectually and physically. The only annoying thing about surgery is getting caught in long procedures holding stuff back for the surgeons. Try to buy a nice pair of dansko clogs before your rotation, they really make a difference when you are standing for hours on end.
Ok. Home. I survived. LOL actually, it wasnt that bad. We had a bunch of people talk at us, then we get a lesson in how to scrub, gown, behave around sterile fields, etc, Hospital supply ran out of scrubs 🙄 Then we got our call and rotation assignments. Then we got a tour of the trauma areas. Then we went to find our attendings and meet our teams
At UTMB, we have 2 months - one month on a general service and one on specialty. I lucked out. I get to do Shriner Burns hospital (peds, mostly) for the first month and pedi surgery for the 2nd month.
At Shriner's, everybody is AWESOME, and they are constantly understaffed, so they LOVE students. I think, for 2 floors, they have 3 attendings, a chief resident, a 2nd year from Baylor (who is leaving) and an intern. Thats it besides students. So we get to do a lot (supposedly). We went on evening rounds, then our intern showed us how to use their information system and their forms (and reviewd us on abbreviations, those stick-figure things for labs and SOAP notes, none of which we were taught before).
We dont have to be there any earlier than 6 am, we ARE NOT allowed to be there past 6pm (in any rotation) unless we're on call (and we dont take call at Shriner's). According to last year's class, we also actually get to assist the surgeon in doing the surgery, not just hold stuff.
Anyways, while Im not looking forward to getting up at 4:45 in the morning, its a heck of a lot better than having to BE there at 4:45 in the morning...
Star
At UTMB, we have 2 months - one month on a general service and one on specialty. I lucked out. I get to do Shriner Burns hospital (peds, mostly) for the first month and pedi surgery for the 2nd month.
At Shriner's, everybody is AWESOME, and they are constantly understaffed, so they LOVE students. I think, for 2 floors, they have 3 attendings, a chief resident, a 2nd year from Baylor (who is leaving) and an intern. Thats it besides students. So we get to do a lot (supposedly). We went on evening rounds, then our intern showed us how to use their information system and their forms (and reviewd us on abbreviations, those stick-figure things for labs and SOAP notes, none of which we were taught before).
We dont have to be there any earlier than 6 am, we ARE NOT allowed to be there past 6pm (in any rotation) unless we're on call (and we dont take call at Shriner's). According to last year's class, we also actually get to assist the surgeon in doing the surgery, not just hold stuff.
Anyways, while Im not looking forward to getting up at 4:45 in the morning, its a heck of a lot better than having to BE there at 4:45 in the morning...
Star
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First, try to relax.
No matter what rotation you start on, everyone knows that this is your first rotation, and you aren't expected to know much. The residents know that you don't even know where things are in the hospital.
Your first days are best served by doing very basic things...being where you are supposed to be when you are suposed to be there and being there on time. Give yourself a little longer than you think you will need to do things at first, like write your morning notes. It will take longer than you think.
Try your best to get oriented quickly and learn how to check labs, xrays, etc. NO matter what rotation you are on, you can always score points in the following manner: If there is a lab or xray that the team needs but isn't back yet (and it should have been back by now) pick up the phone, dial the operator, and ask for the respective department. Then ask very politely when you can expect it. Sometimes the problem is a logistics one (like a lost requisition) and you can easily fix it yourself. As a student you can do things to expidite ordered items without asking a resident (you can't do new orders but you can try to make things happen in a timely fashion)
Now, specific to surgery: things that we want to know about pts include vitals, in put and output (break output down into urine and any drains. Often pts have multiple drains and then you break down by the drain number). We also want to know the post op day and if the patient is passing gas, as well as the type of diet and if they are tolerating it. (so you'll say something like Mr so and so is s/p small bowel resection for obstruction, POD 2, and doing well (or not as the case may be). You'll then list the vitals (unless told not to) . Always look over the past 24 hours and get the max temp (aka Tmax) and report that. List the in and out I/O as total first, then break it down. You'll also want to know the hourly urine output (UOP). Then you'll say "She is tolerating a clear liquid diet (or whatever diet there is). If you pay attention, you'll quicky figure out what issues are important for whatever service you are on ...then start including those things in your daily notes.
The most important thing for any rotation is attitude. Even if you wind up hating your surgery rotation, there are valuable things to learn. If you don't want to do surgery, you will be referring pts to us and you'll need to learn how recongize when to call a surgeon and when not to (eg not all belly pain requires a surgery consult the minute the pt gets to the ER...they need a workup first!). If you see yourself as part of the team, and desire to provide good pt care, you will do well.
pay close attention when you learn to sterile techinque. Obey the circulator/scub nurse. If they say you contaminated yourself, you probably did. It will take a lot of experience for you to really be able to tell.
Also, if at any time you feel yourself starting to feel faint (narrowing vision is often a warning sign), speak up and excuse yourself and go sit down! Yes, it's embarrasing, but it has happened to many of us (even us surgeons!). Even more embarassing, however is to actually pass out! Preventative measures include eating a good breakfast and keeping snacks in you pocket for those busy days/nites when you don't get to eat. Passing out happens most frequently with hunger, fatigue and being hot.
Finally, most residents (and attendings, for that matter) are reasonable people and that goes for surgery residents as well. There are jerks in every specialty. Try to go into each rotation with an open mind. You may be pleasantly surprise.
Most people are nervous before their first rotation, no matter what it is. And you think you are nervous now, wait til your first day of residency!! (mine was yesterday!)
No matter what rotation you start on, everyone knows that this is your first rotation, and you aren't expected to know much. The residents know that you don't even know where things are in the hospital.
Your first days are best served by doing very basic things...being where you are supposed to be when you are suposed to be there and being there on time. Give yourself a little longer than you think you will need to do things at first, like write your morning notes. It will take longer than you think.
Try your best to get oriented quickly and learn how to check labs, xrays, etc. NO matter what rotation you are on, you can always score points in the following manner: If there is a lab or xray that the team needs but isn't back yet (and it should have been back by now) pick up the phone, dial the operator, and ask for the respective department. Then ask very politely when you can expect it. Sometimes the problem is a logistics one (like a lost requisition) and you can easily fix it yourself. As a student you can do things to expidite ordered items without asking a resident (you can't do new orders but you can try to make things happen in a timely fashion)
Now, specific to surgery: things that we want to know about pts include vitals, in put and output (break output down into urine and any drains. Often pts have multiple drains and then you break down by the drain number). We also want to know the post op day and if the patient is passing gas, as well as the type of diet and if they are tolerating it. (so you'll say something like Mr so and so is s/p small bowel resection for obstruction, POD 2, and doing well (or not as the case may be). You'll then list the vitals (unless told not to) . Always look over the past 24 hours and get the max temp (aka Tmax) and report that. List the in and out I/O as total first, then break it down. You'll also want to know the hourly urine output (UOP). Then you'll say "She is tolerating a clear liquid diet (or whatever diet there is). If you pay attention, you'll quicky figure out what issues are important for whatever service you are on ...then start including those things in your daily notes.
The most important thing for any rotation is attitude. Even if you wind up hating your surgery rotation, there are valuable things to learn. If you don't want to do surgery, you will be referring pts to us and you'll need to learn how recongize when to call a surgeon and when not to (eg not all belly pain requires a surgery consult the minute the pt gets to the ER...they need a workup first!). If you see yourself as part of the team, and desire to provide good pt care, you will do well.
pay close attention when you learn to sterile techinque. Obey the circulator/scub nurse. If they say you contaminated yourself, you probably did. It will take a lot of experience for you to really be able to tell.
Also, if at any time you feel yourself starting to feel faint (narrowing vision is often a warning sign), speak up and excuse yourself and go sit down! Yes, it's embarrasing, but it has happened to many of us (even us surgeons!). Even more embarassing, however is to actually pass out! Preventative measures include eating a good breakfast and keeping snacks in you pocket for those busy days/nites when you don't get to eat. Passing out happens most frequently with hunger, fatigue and being hot.
Finally, most residents (and attendings, for that matter) are reasonable people and that goes for surgery residents as well. There are jerks in every specialty. Try to go into each rotation with an open mind. You may be pleasantly surprise.
Most people are nervous before their first rotation, no matter what it is. And you think you are nervous now, wait til your first day of residency!! (mine was yesterday!)
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I just completed my surgery rotation at a school with a competitive surgery program that has a reputation for being tough and inhumane. I was intimidated going in because of hear-say among students, and at first my goal was just to survive it so I could move on to 4th year.
I couldn't have been more wrong in my presumptions. After 10 months of life as a professional s*it taker, I had almost forgotten what it was like to be treated like a human. For the first time, an attending actually knew my name and noticed me at times other than when I (apparently) screwed up. After I finished my general surg rotation, my attending (who has a reputation as a jerk who eats students for breakfast) actually pulled me into his office and spent an hour talking about career decisions. Unbelievable! I asked an upper level a question during surgery, and he answered it without trying to make me feel stupid.
Of course the work was hard, and I spent > 100 hours in-house, but being treated well made it bearable. At first, I showed the appropriate amount of enthusiasm for a student to demonstrate when rotating through an area where she/he has no interest, but I was hooked before long. My longest continous shift (i.e. in-house with no sleep) was 42 hours after a fun filled night of trauma call 🙂, and actually forgot how tired I was when the orthopod was observing me using the bone drill.
Anyway, I could go on and on. While surgeons tend to be hard nosed and sometimes downright rude, you will do well if you don't take it personally. Most house staff, and even attendings, will take time to teach as demonstrated md03's extensive post (I'm guessing 03's a surgery tern).
The key to surviving is keeping a good attitude and reading up on procedures before you scrub in. If you get a suprise assignment, hopefully you will have the forsight to have a Surgical Recall in your pocket so you can do a 5-min cram to keep from looking like an idiot. By demonstrating that you have done your homework (answering pimp questions or asking pertinent questions at appropriate times), you will significantly increase your chances of having an enjoyable rotation.
Good luck on your rotation, and keep an open mind.
I couldn't have been more wrong in my presumptions. After 10 months of life as a professional s*it taker, I had almost forgotten what it was like to be treated like a human. For the first time, an attending actually knew my name and noticed me at times other than when I (apparently) screwed up. After I finished my general surg rotation, my attending (who has a reputation as a jerk who eats students for breakfast) actually pulled me into his office and spent an hour talking about career decisions. Unbelievable! I asked an upper level a question during surgery, and he answered it without trying to make me feel stupid.
Of course the work was hard, and I spent > 100 hours in-house, but being treated well made it bearable. At first, I showed the appropriate amount of enthusiasm for a student to demonstrate when rotating through an area where she/he has no interest, but I was hooked before long. My longest continous shift (i.e. in-house with no sleep) was 42 hours after a fun filled night of trauma call 🙂, and actually forgot how tired I was when the orthopod was observing me using the bone drill.
Anyway, I could go on and on. While surgeons tend to be hard nosed and sometimes downright rude, you will do well if you don't take it personally. Most house staff, and even attendings, will take time to teach as demonstrated md03's extensive post (I'm guessing 03's a surgery tern).
The key to surviving is keeping a good attitude and reading up on procedures before you scrub in. If you get a suprise assignment, hopefully you will have the forsight to have a Surgical Recall in your pocket so you can do a 5-min cram to keep from looking like an idiot. By demonstrating that you have done your homework (answering pimp questions or asking pertinent questions at appropriate times), you will significantly increase your chances of having an enjoyable rotation.
Good luck on your rotation, and keep an open mind.
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You got it, shag! I am a surgery intern and, man, do I feel clueless!
Whatever rotation you start on, it doesn't take a lot of knowledge to be a helpful team member. Remember that your interns are struggling this month with figuring out how to organize the multitide of things that must be done, and there is a LOT about pt management we dont' know. Plus, if we have students on the service, we are expected to help teach (even though we feel like we know nothing!). Just pay attention the first couple days to the routine and you will be able to see small things you can do that would be a big help.
You can help your pts by helping your team members get things done. This action also helps your evaluation. Plus, it's good practice for when, all too soon the responsibility for making sure everything gets done falls to you! Even if you aren't required to do things like, say, discharge summaries, it would be excellent for you to ask to do some of these things. (Don't ask to do discharge summaries on your first rotiation, though, save that for a later). Today I had to dictate a bunch of dicharge summaries. I wished i had done a few more during med school. It took me forever, and, frankly they suck cuz I really didn't know how involved to get about the hospital course, etc.
As you progress through your rotations, and esp in your 4th year, ask to try your had at the intern tasks. Example, on one of my sugery electives, I was allowed to carry the intern pager for several hours each call. The intern was nearby, but I was the one that answered the call and talked to the nurse. Then I told the intern what I wanted to do then if he approved he told them to do it.
Whatever rotation you start on, it doesn't take a lot of knowledge to be a helpful team member. Remember that your interns are struggling this month with figuring out how to organize the multitide of things that must be done, and there is a LOT about pt management we dont' know. Plus, if we have students on the service, we are expected to help teach (even though we feel like we know nothing!). Just pay attention the first couple days to the routine and you will be able to see small things you can do that would be a big help.
You can help your pts by helping your team members get things done. This action also helps your evaluation. Plus, it's good practice for when, all too soon the responsibility for making sure everything gets done falls to you! Even if you aren't required to do things like, say, discharge summaries, it would be excellent for you to ask to do some of these things. (Don't ask to do discharge summaries on your first rotiation, though, save that for a later). Today I had to dictate a bunch of dicharge summaries. I wished i had done a few more during med school. It took me forever, and, frankly they suck cuz I really didn't know how involved to get about the hospital course, etc.
As you progress through your rotations, and esp in your 4th year, ask to try your had at the intern tasks. Example, on one of my sugery electives, I was allowed to carry the intern pager for several hours each call. The intern was nearby, but I was the one that answered the call and talked to the nurse. Then I told the intern what I wanted to do then if he approved he told them to do it.
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Hey folks, I have a year to go until my Surgery rotation, but I'm already starting to worry about something: my feet. I'm flat-footed and if I'm on my feet for more than about 30 minutes without sitting down for a couple of minutes, my feet, ankles, and lower legs start to just kill me. I can and have stood without moving for a couple of hours before, but I can barely walk afterwards and the next day I'm limping. Since this isn't an issue in everyday life, I've never tried any shoe inserts or anything. Have any of you struggled with the flat-foot issue?
I am staring surgery next week! I don't know, after all that studying in 2nd yr, I am looking forward to it, no matter how hard it is. My concern? Shoes....haha...I was recommended Dansko clogs but I am stuck on whether to get shiny or oily leather. Someone else told me not to spend so much on shoes since they are going to get lots of crap on them. I am more concerned about comfort since we're going to be on our feet all day and night. So, what do you all think, shiny or not? Any recommendations?
At our uniform shop,they sell these rubber clog things. They actually got some in that arent teal blue and look kindof fashionable. I got some brown ones. They are NOT good for walking long distances, but they are FABULOUS for standing in for hours. They are also hose-able if need be.
You can also take a pair of old tennies and put the booties on over them - and then leave them in the locker room at the hosp and pitch em when done.
Star
You can also take a pair of old tennies and put the booties on over them - and then leave them in the locker room at the hosp and pitch em when done.
Star
I'd recommend shiny because if you do drop something on them the oily is a pain to clean. Shiny don't stay all that shiny for long unless you polish them, but the oily is almost a suede and not very stain resistant. Danskos are great. Yeah they are a bit on the expensive side, but what else can you wear for 14 hours or more straight running up and down stairs on tile or concrete and not have your back killing, legs, feet killing you at the end of the day? (I was a shoe salesperson and that's where I discovered mine and by the time I was quitting that's almost all I was wearing lol).
Good luck!
--Jessica, UCCS
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I didn't pose the original question in this thread, but thanks for the reply. Very helpful! I asked the same question (shiny vs. oily clogs) in another thread, but it went ignored.
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It's not just surgery where there's lots of standing. Wait til you experience 4 hour medicine rounds...ugh.
My back hurts a lot too, no matter what shoes I wear. Dansko, tennis, birkenstock...it doesn't matter. However, on medicine rotations, the back pain made the whole experience worse. With surgery, I don't notice it nearly as much since I'm having so much fun (hits me hard when I get home, though)
My back hurts a lot too, no matter what shoes I wear. Dansko, tennis, birkenstock...it doesn't matter. However, on medicine rotations, the back pain made the whole experience worse. With surgery, I don't notice it nearly as much since I'm having so much fun (hits me hard when I get home, though)
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Well, if I'm moving around even a little, it doesn't hurt so bad. It's standing in one place without moving that absolutely kills me.
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