Being Sick on 3rd Year Rotations

[premed071291]

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I'm currently ill with a sore throat, stuff nose, blah blah blah... and I was wondering what will happen when I am on rotations and the same thing happens. On orientation day I'm sure they will say "if you feel sick at all stay home, we don't want you to get the patients sick." But let's be honest, if you can stand up you are expected to be there right?

 

[Ismet]

Having a common cold is really not enough of an excuse to stay home. You always have to wash your hands when entering and leaving a patient's room or bedside, and you can use gloves if you feel like you need extra precaution, so germy hands should never be touching the patient in the first place, whether or not you're sick.

 

[Geebeejay]

Having a common cold is really not enough of an excuse to stay home. You always have to wash your hands when entering and leaving a patient's room or bedside, and you can use gloves if you feel like you need extra precaution, so germy hands should never be touching the patient in the first place, whether or not you're sick.

You should always wear gloves too! I always give med students crazy eyes when they walk into a room and palpate cellulitis or start touching and palpating a patient with obvious contact precautions or nasty fungal infections without wearing gloves.

Residents are a lot better at it, maybe because the attendings emphasize it or because by then they've seen one of their buddies get mrsa on their nose or under their eyes after subconsciously scratching an itch after touching a contact patient.

To answer the original question: If you've had a fever within 24 hours of a shift, you are supposed to call out (I think that's Joint Commission guidelines, but not sure). But I imagine that medical students often come in when they are sick to make that good impression, and I imagine residents/attendings often do the same because they don't want to be the reason why their colleague got called in.

 

[Ismet]

You should always wear gloves too! I always give med students crazy eyes when they walk into a room and palpate cellulitis or start touching and palpating a patient with obvious contact precautions or nasty fungal infections without wearing gloves.

Residents are a lot better at it, maybe because the attendings emphasize it or because by then they've seen one of their buddies get mrsa on their nose or under their eyes after subconsciously scratching an itch after touching a contact patient.

To answer the original question: If you've had a fever within 24 hours of a shift, you are supposed to call out (I think that's Joint Commission guidelines, but not sure). But I imagine that medical students often come in when they are sick to make that good impression, and I imagine residents/attendings often do the same because they don't want to be the reason why their colleague got called in.

Actually, no, you don't always have to wear gloves. Obviously you do if you're going to be touching a rash and certainly if the pt has contact precautions, but all of the physical exams we have done have been without gloves, both on SPs and on real patients.

 

[EmergencyMonkey]

I had pneumonia when I was an intern and on ICU. Got a week off 🙂 Then I had the craps from my levaquin on my on call saturday and the resident had to hold the pager for a few hours. Fun times.

 

[Geebeejay]

Actually, no, you don't always have to wear gloves. Obviously you do if you're going to be touching a rash and certainly if the pt has contact precautions, but all of the physical exams we have done have been without gloves, both on SPs and on real patients.

Yes, you don't always have to....it's your choice. But you should!

 

[Sophocles]

Yes, you don't always have to....it's your choice. But you should!

I've noticed, when I was shadowing in the ED, that the real old school attendings rarely wore gloves. I thought it was kinda like when people used to use mouth pipettes. 😛

 

[Geebeejay]

I've noticed, when I was shadowing in the ED, that the real old school attendings rarely wore gloves. I thought it was kinda like when people used to use mouth pipettes. 😛

Hah....one of my old lab directors mouth pipetted. Really dangerous liquids too! The first time I saw him do it my jaw dropped in horror

 

[Guero]

It's still customary to use your mouth to patch clamp 😉

OP, you'll always negotiate this with your resident/attending. Unless you're febrile and very contagious, as others have already posted, you power through.

 

[survivordo]

Just gut it out. If you are sick enough not to be there someone will notice and tell you to go home.

Survivor DO

 

[CrimsonKing]

To answer the original question: If you've had a fever within 24 hours of a shift, you are supposed to call out (I think that's Joint Commission guidelines, but not sure). But I imagine that medical students often come in when they are sick to make that good impression, and I imagine residents/attendings often do the same because they don't want to be the reason why their colleague got called in.

You're supposed to, but unfortunately that can hurt you. Doing so can end up leading to you failing a rotation at worst, or getting a lower grade/bad evaluation from an attending at least. Unless you are seriously ill, you need to be there every single day for rotations and that's the way the system is built. From what I hear, the same is true of residency.

 

[survivordo]

From what I hear, the same is true of residency.

I would say its even more true for residency. Let's face it, as medical students we contributed but most of our work had to be repeated in someway or another. As a resident the team is relying on you to TCB, it REALLY hurts when there is a resident out as it just piles on additional work for the rest of the team.

Survivor DO

 

[Geebeejay]

You're supposed to, but unfortunately that can hurt you. Doing so can end up leading to you failing a rotation at worst, or getting a lower grade/bad evaluation from an attending at least. Unless you are seriously ill, you need to be there every single day for rotations and that's the way the system is built. From what I hear, the same is true of residency.

Thanks, but that's what the second part of my post implied (or at least I thought so) 🙂. You're supposed to, but most medical students/residents/attendings suck it up instead so they don't look bad.

 

[ralphlauren55]

Honestly, work your ass off even if you are sick. You need to make 100% a GREAT impression 3rd and 4th year to score competitive residencies.

 

[willen101383]

You can easily get away with staying home if you are sick. Nobody wants a (generally worthless) medical student getting the team sick. Ive skipped like 5 or more times this year due to illness, other random stuff I needed to attend to. All honors except 1 high pass and 1 pass. Flame away.

 

[mvenus929]

You're supposed to, but unfortunately that can hurt you. Doing so can end up leading to you failing a rotation at worst, or getting a lower grade/bad evaluation from an attending at least. Unless you are seriously ill, you need to be there every single day for rotations and that's the way the system is built. From what I hear, the same is true of residency.

I disagree, at least from the med student perspective. If you are sick enough that you can't focus, you're going to leave a worse impression than if you just stayed home. It's okay to miss a day or two of a rotation, and you aren't going to fail because of it. Unless someone finds out that you called off only to be out partying.

 

[willen101383]

I disagree, at least from the med student perspective. If you are sick enough that you can't focus, you're going to leave a worse impression than if you just stayed home. It's okay to miss a day or two of a rotation, and you aren't going to fail because of it. Unless someone finds out that you called off only to be out partying.

Exactly. In fact, I sort of feel like its impossible to fail a rotation unless you are a complete fck up.

Honestly all you need to do well on rotations is A. Show up, B. Read a bit, and read up on anything you didnt know that day, C. Not be a zombie machine like super memorizer med student and actually act like a human, D. Be nice to the staff and patients, and be helpful. Hasnt really failed me yet.

Acting like a gunner or a kiss ass is what is going to get you a bad grade. Ive rotated a month after some straight up great students who killed boards and M1/M2, but act like total douchebags who know it all...and heard many residents/attendings ripping on them behind their backs.

As long as you arent going to somehow let the team down via bailing on some responsibility (unlikely as a med student), next to nobody is goign to fault you for being sick and not wanting to come in.

 

[yehhhboiii]

If you're not sick enough to be in the hospital, you better be in the hospital.

 

[image187]

Actually, to be honest, you shouldn't have a problem taking off if you're too sick to come in. I haven't missed any days this year so far for being sick (just went in anyway) but I've had super cool teams so
far, and one of which that actually encouraged me to attend a wedding I ha to go to and had no problem picking up the extra slack. I mean, you're not really important as a med student anyway, but it's great to be around supportive people. Theres so much to do and so much to learn however, that aside from 2 or 3 days I took off for personal things this year, I actually find myself wanting to come in anyway even when I don't feel that great (Not completely ill obviously, I would just stay home if I really physically couldnt come in). there's so much to do you sort of forget that you feel like crap

 

[Law2Doc]

I disagree, at least from the med student perspective. If you are sick enough that you can't focus, you're going to leave a worse impression than if you just stayed home. It's okay to miss a day or two of a rotation, and you aren't going to fail because of it. Unless someone finds out that you called off only to be out partying.

The med student perspective is the one that doesn't count. You are evaluated by attendings and senior residents. In many specialties the culture is to be at work every day, period. Nobody cares as much about how well you can focus, it really has been known to hurt people when they called in with a cold.

 

[Law2Doc]

Actually, no, you don't always have to wear gloves. Obviously you do if you're going to be touching a rash and certainly if the pt has contact precautions, but all of the physical exams we have done have been without gloves, both on SPs and on real patients.

Incredibly foolish in this era of MRSA.

 

[PTPoeny]

It really depends on your team. On some rotations the resident clearly see students as extra work and will be delighted if you call out sick. On other rotations you will get looked down upon. Residents will also be much more pissed off if you get them sick than if you miss a day in my experience. The rotation matters as well, doing an inpatient sub-i in gen peds in January you are going to be expected to be much sicker to not come in compared to doing a heme onc elective.

At least as my school if we miss time from a rotation unless we are admitted to a hospital we have to be seen by our university health services and cleared by them before we return to patient care. So if you try to stay home with just a cold you are going to get sent back to your rotation and if they decide you shouldn't be on rotation you get a formal letter to give your attending once you get back and your rotation coordinator is notified. Don't know if this is standard other places.

 

[CyberMaxx]

It's still customary to use your mouth to patch clamp 😉

Guero, are you a fellow patch clamper?? I don't find many people who do this type of research very often.

My PI still mouth pipettes/uses mouth suction. The other day he was using a tube to drain the hot water bath into the sink and got the flow going by providing a little bit of suction using his mouth. He timed it wrong and got a mouthful of old, rank water bath fluid. 😱

 

[Law2Doc]

It really depends on your team. On some rotations the resident clearly see students as extra work and will be delighted if you call out sick. On other rotations you will get looked down upon. Residents will also be much more pissed off if you get them sick than if you miss a day in my experience...

actually you can't win. They will be pissed if you come in and get them sick. But they will regard you as weak/lazy if you stay home and call in sick. And I sure wouldn't do this more than once. Having been on both sides of the equation, I promise you that when it comes time to evaluate you, the fact that you "blew off" work is going to be more memorable than the fact that you gave everyone the flu. And being sick on a Monday or Friday or a day you are supposed to have call or do a presentation is always going to be regarded as suspicious.

 

[yehhhboiii]

actually you can't win. They will be pissed if you come in and get them sick. But they will regard you as weak/lazy if you stay home and call in sick. And I sure wouldn't do this more than once. Having been on both sides of the equation, I promise you that when it comes time to evaluate you, the fact that you "blew off" work is going to be more memorable than the fact that you gave everyone the flu. And being sick on a Monday or Friday or a day you are supposed to have call or do a presentation is always going to be regarded as suspicious.

Why can't you just come in and wear a surgical mask all day?

 

[Law2Doc]

Why can't you just come in and wear a surgical mask all day?

You can. That's actually what you are supposed to do.