Anecdotes on the stupidity of doctors, nurses, and students.

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neglect

neglect

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This thread was motivated by the excellent posts in the ER forum: Things I Learn From My Patients. Please check it out if you haven't already.

Come on, I know we've all seen and heard about some good ones.

I'll start things off. I have more.

When you are a nontraditional medical student with a wife, while you may find you can pass time by having an affair on your psych rotation - with a locked down psych patient, it is not a good idea to get caught. Redhanded.

Benign Neglect.
 
When placing a chest tube, the end of the tube with all the little holes in it goes INSIDE the patient. Don't be surprised/angry if you aren't allowed to do any more chest tubes without supervision after you've taken a lung biopsy by putting the pointed end in first.

The jugular vein is not your target when performing a cricothyroidotomy, even if the patient is in a halo. It will bleed. A lot.

Not wearing eye protection in the trauma bay is just asking for it, especially if you're the one doing the rectal.
 
The urethral meatus is not under the clitoral hood (I fess up to not knowing my female anatomy!).

Thus, when the patient yells out in pain, take this as a clue that you are in the wrong location. :wow:
 
When you are a scrub nurse and you are handing the doctor a refilled syringe with lidocaine, don't suddenly hand it to him in the opposite direction. (surgeon had to finish the operation with a numb thumb)
 
Originally posted by LaCirujana
When placing a chest tube, the end of the tube with all the little holes in it goes INSIDE the patient. Don't be surprised/angry if you aren't allowed to do any more chest tubes without supervision after you've taken a lung biopsy by putting the pointed end in first.
Click to expand...

I have to admit years ago I very nearly did my first chest tube that way. In a flury of activity during a trauma my first day of residency I watched a chest tube go in.(the first one I had ever really watched being put in.) The very next day during a similar flury the attending asked me to put in a tube. Fortunately the surgical PGY-2 saw what I was about to do and said, " what the hell are you doing?" I still feel a little embarassed about it to this day.


On another note: If you are a surgical intern banging a tele nurse on your call nights and you manage to fracture your penis the whole hospital will know about your visit to the ER by the next day.
 
Setting: Surgical Intensive Care Cardiac Bay
Resident covering patients overnight asking nurses "I know if it goes flat we shock, but what do we do if he goes into v-fib"
Nurses":wow: "
 
Originally posted by neglect

I'll start things off. I have more.

When you are a nontraditional medical student with a wife, while you may find you can pass time by having an affair on your psych rotation - with a locked down psych patient, it is not a good idea to get caught. Redhanded.

Benign Neglect.
Click to expand...

If this really happened, I think that the medical student could kiss his medical career goodbye. I've read a few state licensing disciplinary newsletters, and an offense that I see over and over that gets doctors license pulled from them is having an affair with a patient. It seems like a remarkable number of psychiatrists have gotten caught doing this in my state. 😱
 
(me) PGY-1: "Ok, before you draw out the foley, make sure you've deflated the saline balloon."


(med student): "Why?"

'Nuff said.
 
Team comes in to see the pt on rounds after the med student has seen her in his pre rounds:

Attending: "So LowlyMedStudent, did you do a rectal exam?"

Student: "Yes, I did."

Female Patient: "Not quite, he was a little bit off."😛
 
Don't drop baby's placenta on daddy's brand spanking new Nike Air running shoes. I got to hear about that at sign out rounds for the rest of the week...
 
A fellow med student was learning pelvic exams on a "standardized patient" volunteer:

He was attempting to do the bimanual exam, when he was greeted with the patient's reply, "Honey, I think you've got the wrong hole there."

But hey - at least he got the rectal outa the way.
 
Originally posted by iwakuni_doc
A fellow med student was learning pelvic exams on a "standardized patient" volunteer:

He was attempting to do the bimanual exam, when he was greeted with the patient's reply, "Honey, I think you've got the wrong hole there."

But hey - at least he got the rectal outa the way.
Click to expand...
Originally posted by Whiskey Barrel Cortex
Team comes in to see the pt on rounds after the med student has seen her in his pre rounds:

Attending: "So LowlyMedStudent, did you do a rectal exam?"

Student: "Yes, I did."

Female Patient: "Not quite, he was a little bit off."
Click to expand...

:laugh: :laugh: :laugh:

I guess the no-life gunners really DO get called out in rotations.
 
When doing your first delivery as a med3 don't whack the babies head against the stirrup causing a large cephalohematoma when transferring the baby to the peds team. (this was actually done by one of my classmates)
 
Don't put Metamucil, MEANT FOR THE GT, down the central line. OUCH!!!! Needless to say the patient didn't survive that one. Don't worry this wasn't done by a physician.
 
How about something simple:

Males should ALWAYS wear underwear (preferably briefs or boxer-briefs) when wearing scrubs.

A friend of mind doesn't grasp the concept.
 
Don't try to make a venotomy for a Port-a-cath using a 15-blade, ignore your resident, then try to blame him when you transect the vein, even though he was virtually wrestling you to get you to use the 11-blade, especially when the resident had already called the Department of Surgery Chairman to come down to the OR because you are a "danger to patients."

Bad attendings are scary.
 
As a med student, don't just walk out of ER, when attending tells you to manually pull foot-long worms protruding from 3yr old's rectum.
 
Originally posted by iwakuni_doc
A fellow med student was learning pelvic exams on a "standardized patient" volunteer:

He was attempting to do the bimanual exam, when he was greeted with the patient's reply, "Honey, I think you've got the wrong hole there."

But hey - at least he got the rectal outa the way.
Click to expand...

Okay, I now KNOW that I don't want to sleep with an MD.

My favorite is the ER intern that drew blood from a portacath with a regular (coring) needle. And the patient was pancytopenic.
 
Can't top the Metamucil down a central line story, but here's my most recent one:

3:00 am Phone call:

Nurse: Doctor, I think you might want to come in and see this post-op patient. His sternum is clicking every time his heart beats.

Doctor: What was the procedure?

Nurse: Aortic Valve replacement

Doctor: With what type of valve?

Nurse: Biomechanical

Doctor: Well, do you think that strange clicking noise could be THE F----ING MECHANICAL VALVE IN HER HEART?!?!

Next story -- first day of my surgery rotation, I'm scrubbed in on a CABG. Pt starts to fibrillate, surgeon calls for defibrillator. I'm standing there, waiting for the paddles to be passed to the surgeon. Little do I know that the paddles are applied to the patient before the drapes are placed at the beginning of the case. As I'm leaning on the patient trying to get a good look at what's going on, waiting for the paddles to be passed, I suddenly get a strange sensation as the patient's entire body bucks off the table and I am on the business end of 300 J. The nurses didn't let me forget about it for the rest of the rotation. Good times.
 
And where *exactly* was your sense of self-preservation at that moment? 😉


I've got a new one - my med student was helping me fill out some admission paper work on an ER patient. When I asked him to give me the consent for Release of Information (we needed her charts from another hospital), the student handed me a form with his signature already affixed in the "witness" category. *THEN* he asks, "Is it ok if I sign for this?". When I told him he probably shouldn't witness a consent form before: a) the patient has seen it, b) the patient has read it or c) the patient has signed it, his response was "Why?".

*sigh* out of the mouths of babes...
 
3:00 AM phone call

Tele nurse: I was calling to let you know your patient, Mr Smith, is in Bigeminy.

Me(cross covering tele): How long has he been in Bigeminy.

Nurse: I don't know let me check... ...rustling noises... ...Since he was admitted 3 days ago.

Me: Thanks, Bye.

Another 3:00 AM phone call

Medical ward nurse: I'm calling you about your patient, Mr Washington.

Me (now an intern on the neuro service): He's not my patient.

Nurse: Well you're neuro aren't you?

Me: Yes

Nurse: Well he's ******ed

Me: Just because he's ******ed doesn't make him a neuro patient.

Nurse: Are your sure he's not your patient?

Me: Yes

Nurse: Oh never mind, I see now he's on medicine for pneumonia.
 
Here are some ones that stand out to me:

Over the phone-

ER resident: "It looks like she has a tooth growing out of her tonsil."
Me: It's not a tooth.
ER resident: "Well, what is it?"
Me: "It's not a tooth, that's for sure."
ER resident: "How can you tell over the phone?"
Me: "Generally teeth don't grow there."
ER resident: "Well, right; what is it though?"
Me: "Tonsillith."


Me to NP: "So, when is the baby due?"
NP to me: "She was born back in December."
Me: [gotta go.]


ER resident: "There's a white mass inside the ear."
Me: [looks] "I don't see it."
ER resident: [looks] "It's circular."
Me: "That's the TM."


[in the office]
Me: What brings you here to see us today, sir?
Pt: My sinuses is congested...
Me: [HPI taken.] Do you have any medical problems?
Pt: Well, my balls -- well, you in your profession would probably call them "testicles" -- is too f---ing big, man.
Me: Ok. [mumbles as writing] "Big testicles."
Pt: Yeah...
Me: [further history]. Smoke?
Pt: No.
Me: Drink?
Pt: No.
Me: Any drugs?
Pt: Just weed. Just mutha f---in' weed.


[in the office]
Me: Ok, why don't you sit here so I can take a look at your ears?
Pt: Before you do that, can I ask you an unrelated question?
Me: Sure.
Pt: I got this thing hanging out my butthole.
Me: I'm sorry?
Pt: I got this fleshy thing hanging out my butthole.
Me: Does it itch? Are you constipated.
Pt: Yeah, all the time.
Me: Probably a hemorrhoid.
Pt: Can you do anything about that?
Me: Ma'am, do you want me to look at your ears?
Pt: [frowns] Ok....


[as a third year med student on my first rotation, family medicine. interviewing a bipolar patient]
Pt: my doctor says I can't take birth control with my diabetes.
Me: sounds right
Pt: she also says I can't drink with my diabetes.
Me: probably better that you don't.
Pt: are you married?
Me: [internal struggle as I try to say "yes"] No.
Pt: Oh...You're handsome.
Me: Thanks.
Pt: Do you think I'm pretty?
Me: You're an attractive person.
Pt: Will you go out with me?
Me: Ah, no.
Pt: Why, do you have a girlfriend?
Me: [2nd internal struggle] Not right now.
Pt: [raises voice] You're a liar and you're lying to me and I hate liars!!!
Me: Dr. X?!? I'm ready to present.
 
1) When your chief tells you to pull a patient's Shiley, he means the dialysis catheter and not the tracheostomy (both made by Shiley)

2) Don't give someone succinylcholine for an AWAKE bronchoscopy on the floor

3) A rectal exam is not done with 3 fingers (saw a German medical student do this to someone, you could hear the poor guy screaming across the ER)

4) When you do a colonoscopy thru a stoma, that little sphincter effect you get normally @ the anus is not there. I was covered head to toe with explosive colonic discharge wen I took the scope out.

5) Do not sit at the head of the bed looking to see if anything is working after giving neostigmine for Olgolvie's colonic pseudo-obstruction. It's not pretty -> explosive diarhea

6) true story @ colo-rectal clinic:
Pt (attractive young girl s/p hemmrhoidectomy):
"So Doctor (she says sheepishly) when can I start having anal sex again? I really, reaaaaaaly miss it."
Me: Uh....... Is it getting hot in here?

7) I saw an ICU nurse get talked into searching thru central supply for a "flatometer" which would go off every time the patient passed flatus. We were coughing up blood we were laughing so hard as she spent hours asking everyone about it.

8) Don't inflate a gatric tonometry baloon up inside the lungs, the resulting pulmonary arrest is very quick.
 
Originally posted by droliver
1) When your chief tells you to pull a patient's Shiley, he means the dialysis catheter and not the tracheostomy (both made by Shiley)
Click to expand...

Speaking of Shileys, when you're removing a Shiley tracheotomy tube and want to inspect the stoma closely, don't actually stick your face right in front of the stoma. Some of us still haven't learned that lesson...
 
Originally posted by droliver
2) Don't give someone succinylcholine for an AWAKE bronchoscopy on the floor
Click to expand...

After talking to a few people who did this (or a variant like giving pavulon to a guy on trach collar); I realize that this happens surprisingly more often than I thought.

I think that sometimes people don't immediately recognize *why* this is a bad thing, so when I take students through bronchs, I explain what we are using for sedation/analgesia and that you only want to give paralytics to someone who is on the vent because the patient *will* stop breathing.


My other personal favorite is not too stupid; just funny. A resident wrote, "Will plan to have PICK line placed in the AM."

I thought 2 things:

1. Maybe they don't know what PICC stands for (percut. inserted central catheter). Probably the most likely.

2. If they do (and still chose to spell it PICK), how do they spell "catheter?"
 
Funny story:

I go see a really good-looking young lady stabbed a number of times with a nail file by another girl. She has a bunch of superficial cuts & I'm doing her exam & she's got some tatoos, and breast implants, and multiple piercings (nipples, clitoral hood). I was kind of doing my thing not really putting all this together (tatoos + clit ring + implants = stripper) & I asked her where she worked & she says "The Cookie Store" (a local strip club not the chain of stores @ the malls which I was thinking). And I say "Oh yeah, I love that place their cookies are great, my son loves them". She gave the surliest look & says "No you ***** we sell ass!". I took a second look @ her and the light-bulb went on. It was about about this point I decided I had officially become uncool! Mocked by a drunk stripper - good grief!🙄 My wife loves this story.


Funny story 2:
When I was a junior resident, FAST ultrasound for trauma was the new thing & we were being asked to record them on VHS to document them. This was December & interview season is going on & my chief resident thinks it would be neat to show one of these during a big group walk-rounds we do with our chairman, a bunch of staff & residents, & the applicants (a group of about 30-40 people on interview days). I was the intensivist who was responsible for getting the TV/VCR & another resident grabbed a tape of his FaST ultrasound's. The tape he'd recorded on & previously been the property of another resident whose new fiancee had made him purge a large porn collection. The night before when he'd done the tape, a student had been sent to grab one out of the call room & selected one of these unlabled VHS cassets which he used. Literally 2 minutes before rounds, my chief is buffing up the details on all these patients to present in the ICU for the group & says let me see the U/S real quick. I push play and there's 5-6 seconds of ultrasound before it turns a porn video with a dramatic money shot close up on the screen. I think my chief needed to be cardioverted @ that point. We quickly pushed the TV out of the ICU right as we started rounds. This moments was so close to becoming an immortal story..... Can you imagine having put a porn video on in front of an applicant day! I still laugh when I look back on it
 
Me (MSIII): all proud of myself, I point out my patient's pneumothorax to my ever-so-helpful resident.

Resident: Damn, that's about the prettiest scapula I've ever seen.

Me: Well, that certainly explains the bilateral breath sounds.


Good thing that's the only stupid thing I've ever said, huh? 🙂
 
When presenting your OB patient never tell the attending that she smells so bad seven the little man in the boat is holding his nose.
 
When pulling the baby out during a C-section, and your attending yells "suction" DO NOT jab the big long vaccum suction hose into the baby's nostrils and mouth. Use the little blue rubber bulb.

Something I learnt the hard way.😳:idea:

Peace
 
bump, let's hear some more 😛
 
Neverever stand at the end of the table when your classmate is lancing a "boil" on a 6 month old's bottom. Poor John was covered on one side from shoulder to knee with blood and butt puss.
 
Me during my first rotation during Neuro rounds:

Attending(after I finished presenting my patient): So what's their disposition?

Me : She is a very nice happy older lady, Dr.---, but why do you ask?


It wasn't until my whole team broke out in laughter and the social worker started shaking her head that I realized that they wanted to know when she could go home. I tried to play it off as if I was just making a joke.....
 
Hi there,

One of the more annoying psych residents (he used to lean over the patients and say "hi there sweetie" to little old men) that I had while I was a medical student walked into an ICU patient's room at 0600h to pre-round. The patient had been admitted for a stroke the night before. While we (the medical students) were waiting next to the nurse's station, we heard screams and shrieks coming from the room. When we rushed in, we found that the patient had grabbed the resident's testicles in a death grip that make me grimace (and I don't have any testicles). Needless to say, prying his hand off the testicles caused even more pain. After about five minutes of struggle, the chief resident was able to free the junior resident but he was absent from rounds for a couple of days. The nurses posted a sign above the patient's bed that said, "Caution, ball grabber"

Just remember guys, fasten up the family jewels and keep them away from patient's hands or you will regret it.

njbmd
 
as an M3 during psych rotation....

ME: so how are you doing today Mrs. Butters?
PT: I have an urge to jab stuff.
ME: how do you mean?

Patient then punches me in the family jewels.

Later, my attending tells me tourettes patients often have profound motor tics.
 
Originally posted by aphistis
:laugh: :laugh: :laugh:

I guess the no-life gunners really DO get called out in rotations.
Click to expand...

Maybe you should rethink your statement...everyone has trouble telling them apart on a 450 lb woman, even the nurses. Even the patient.
 
Hey, Foxxy,

Nice try. It's "peripherally-inserted central catheter.":clap:
 
Nurse on phone: Doctor you have to see this patient, he has chest pain.
Me: OK, what are his vitals?
Nurse: I don't know.
Me: *Sigh* Ok, get his vitals and I'll be right up. Are you sure it's chest pain?
Nurse: He is a cardiac risk and if you don't see the patient I will have you written up on an incident report.

A few minutes later...

Me: His vitals seem ok...

Walk into 36 y.o. male shoulder scope patient's room, where he's having, uh, relations, with his girlfriend...

Me: I'm sorry, but do you have some chest pain sir?
Pt: Uh, not really.
Me: Any previous heart disease? (While averting my eyes)
Pt: Uh, no.
Me: Any family die of heart attack or heart diseases?
Pt: No.
Me: I'm sorry, but may I check you out for just a second?
Pt: Sure doc, but can my girlfriend get dressed?
Me: Sure, sorry.

After taking vitals.

Me: So you seem ok, but the nurse told me you had chest pain.
Pt: I'm fine doc.
Me: Anything I can do for you?
Pt: Get me a new nurse, this one is not too bright.
Me: I'll see what I can do.

And...

Nurse: Something is wrong with this patient's continuous irrigation.
Me: He had a TURP right? What's wrong?
Nurse: It's not working.
Me: Ok, let me check it out.

I open the clamp on the outflow tube... 🙄
 
So I walk into a room to see my umpteenth elderly demented patient pt of the day:
Me: "Hi Mrs. Whoever. I'm Dr. B"
Pt: "Lublublublublublublublub." (she made that sound for 11 straight hours)
Nurse: "No Dr. B this is Mrs. Someone. Mrs. Whoever is next door."
Me: "Oh, OK. Well Mrs. Someone do you know what day it is?"
Pt: "Lublublublublublublublub."
Me: "No, it's actually Wednesday afternoon."
Nurse: "No doctor, it's now Thursday morning."
Me: "Oh, OK. Well Mrs. Someone do you know what hospital you are in?"
Pt: "Lublublublublublublublub."
Me: "Well actually you are at Suburban Memorial."
Nurse: "Actually doctor we are all at Community General." (my group covers four hospitals)
Me: "Oh."
At this point I realized that I was A+Ox0 so I handed the patient my clipboard and stethoscope and laid down on the next gurney over and said "Lublublublublublublublub."
 
Originally posted by neglect
This thread was motivated by the excellent posts in the ER forum: Things I Learn From My Patients. Please check it out if you haven't already.

Come on, I know we've all seen and heard about some good ones.

I'll start things off. I have more.

When you are a nontraditional medical student with a wife, while you may find you can pass time by having an affair on your psych rotation - with a locked down psych patient, it is not a good idea to get caught. Redhanded.

Benign Neglect.
Click to expand...

Did this really happen!!! You are killing me!!
 
As a 2nd year med student, I was learning pelvic exams on a standardized patient. I fiddled around with the bimanual for several minutes trying to palpate the ovaries. My hand keeps moving from side to side. Finally the nurse says," you need to keep your thumb off of the clitoris, your stimulating the patient."
 
as a 2nd yr i was doing the testicular exam with 2 other girls on an older old standardized patient. he explained to us how to examine the testicles and said 'okay whose first' - the other 2 girls pushed me to be the first to start the genitalia exam.

i examined, nervous, continued to examine, examined some more, left and right meticulously, more palpation, squeezing, twisting, scrunching, examining a bit more, pinching, dozing off, grabbing some more, dozing off and examining, pinching and stretching, rolling balls under my fingers, examining - i then realized it had been about 5 min or so and quickly got up in embarrassment.

the girls behind me gave me this shocked look and the guy said, 'well it doesn't have to be quite that extensive'... holy crap i was embarassed, and later they mentioned to me about the freudian complex. i prayed to god the rest of the class wouldn't find out about my 'extensive exam'.
 
Our class learned male genital and rectal exams this year on standardized pts. Well, the exam rooms were kept so damn hot because it was winter and these pts were naked (or close enough) half the time.

So a friend of mine in one of the rooms is, of course, all dressed up...shirt, tie, white coat, etc. and he is sweating like a pig.

It comes time for him to do the rectal so the pt. assumes the position and my friend goes in for the kill.

student: "ok Mr. soandso, I am going to insert my finger now, just try to relax"
pt: "ok, im ready"
student: ok, im in
pt: "yes, I can tell"
student: "is there any pain when I press here?" (sweat now literally pouring off of his face)
pt: "no, but you can stop drooling on me"

A quick explanation and the pt. had a good laugh.
 
I was performing a prostate exam on an 60-something, married patient. I told him he would feel some discomfort. He asked his wife to leave the room and then remarked to me and the attending "now I know why my girlfriend doesn't want me to be the 'backdoor explorer'." The wife wondered why the doctor left the room with tears rolling down his face. Thank God I did not have to explain that one.
 
I was on a radiology rotation as a student sitting there reviewing radiographic images with the attending. Suddenly, walked into the room, a group of people from the Surgery service (Attending, resident, intern, student). The attending surgeon asked the radiologist to pull up some Xrays to be reviewed. The radiologist asked for the name then pulled up the images through the computer.

After a long debate between the surgeon and the radiologist, both side pretty much agreed on the findings. As the session was about to come to a close, the radiologist then pulled up the CXR (lateral view), the surgery student excitedly bursted out pointing to the film noting "oh my God, why is his heart so big?". The radiologist responded "that's because it's his STOMACH". 😳
 
a true story

When in med school me and a very good friend of mine had to present in grand rounds pt that our team had amited the night before. Well neddles to say it went something like this

First pt yada yada yada

Second pt 32 yo WF with a history of chills. In Er pt is incoherent she can speak but is disoriented. history per Husband. this is the conversation I witnesed btw my friend and pt husband
Q When did the fever start sir?
A Well i could not say i really was not paying much attention to her.
Q did she feel hot last nite in bed
A yes she was

HPI read pt husband reported that she was exceptionally hot in bed last nite and besides a few bathroom breaks she moaned through the whole night.

Cheif of medicine had a good laugh and then got up and said lucky man her husband is.

Anyways we did do a LP and she had menigitis

she recovered and went home and never knew that she was the object of one of the funniest stories of my med school time :clap:
 
bump.....................
 
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