Best patients

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bobbyseal

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  1. Attending Physician
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This is going to sound like a strange post, but I'd like to get people's opinions of who they'd most like to have as a patient while a medical student.

My favorite has got to be somewhat elderly/senior citizens. Every elderly patient I have followed has always been willing to let me draw bloods, do exams, explain what tests mean, etc. They've always been great for my education.

By far, my most disliked patient is the young, highly educated, upper class, obstetric/gynecology patient. I've been thrown out of more delivery and exam rooms during this rotation than any other.

The other night I followed a lady until she fully dilated. We (the doc's) left the room. The nurse stayed behind for a minute and when she came back to the desk, she says, "The patient doesn't want any students or junior residents in on the delivery. Only the chief and attending." Of note, her husband was a fellow at the hospital. How's that for a clincher? Her husband can benefit from the educational opportunities at the hospital, but no one else.
 
Any patient that speaks English.
 
Originally posted by Teufelhunden
Man! I can't believe 100 or so of you didn't jump in this thread to agree with me!

Maybe I just have hypersensitive olfaction 😕

I thought that I would not be able to tolerate stinky patients after I had such a hard time with the stench of anatomy lab, but surprisingly, it isn't so bad.

My least favorite patients are those who get very irritable when they aren't feeling well (especially addicts). I like elderly male patients the best 🙂
 
Originally posted by Teufelhunden
In general, my favorite patients are non-smokers who bathe on a regular basis, use deodorant, wash their hair, wash their clothes, etc, etc.

I don't like smelly people.

😡 <-- me walking into a smelly patient's room

I agree! Smell gets to me. I try to hold my breath, but it doesn't help. The smell of vomit is the worst for me. But I once had a patient with a very widespread candidiasis. Definitely a smell that I will never forget. 😱
 
Originally posted by DOtobe
The smell of vomit is the worst for me. But I once had a patient with a very widespread candidiasis. Definitely a smell that I will never forget. 😱

Personaly, I think the smell of burn human flesh is the worst. 😱
 
After one month on the GI service, I found that my sense of what's gross was drastically reduced. The first few weeks I had big time issues with poo and puke. But now, they don't bother me so much. After sticking my finger in places it's never been before, my perception of normalcy is quite different from what my friends' believe. I found this out on Wednesday night before T-day at the bar while discussing my job as compared to my high school buddies' jobs.

A fair share of psych patients who rolled into the ER tended to have a certain "outdoorsmen" smell to them. But for the most part they weren't too bad.

But above all the smells and gross stuff coming out of orifices, I still really hate stuck up patients who don't want to be seen by a med student even when the name of the med school is the same as the name of the hospital they're in. Give me a break. If you don't like, go take yourself to Beverly Hills private foo-foo hospital.
 
Originally posted by Teufelhunden
In general, my favorite patients are non-smokers who bathe on a regular basis, use deodorant, wash their hair, wash their clothes, etc, etc.

I don't like smelly people.

😡 <-- me walking into a smelly patient's room

I'm with you, man. I can understand not bathing if you are paralyzed or otherwise incapacitated but good personal hygiene requires very little effort, just an inexpensive bar of soap, a washcloth, and the will and knowledge to use them.

And I wish patients would take better care of their feet. What does it take to reach down during a shower and scrub the cheese out from between your toes? Hell, if you can't bend then get a long handled brush.

And clip yer friggin' toenails while your at it.
 
Originally posted by Panda Bear
And I wish patients would take better care of their feet. What does it take to reach down during a shower and scrub the cheese out from between your toes? Hell, if you can't bend then get a long handled brush.

And clip yer friggin' toenails while your at it.

I agree with this too. Feet gross me out. 😱
 
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My favorite patient during my internship was the zonked out nursing home patient with a feeding tube. The history was obtained from the nursing home records. The physical was basically making sure they are in their contracted baseline state with a pulse and spontaneous respiration.

5 minute trip to the ER, write quick orders for big gun antibiotics (as it seems these patients are always septic) and back to sleep I go! Ahh, saving lives was never better!!!
 
Well, lets see about this one. I feel like I know the kinds of things I DON'T like in patients, so here's a list in no particular order...

The perfect patient:
1) doesn't talk much, and answers most questions with a "yes," or a "no"
2) is thin, so you can get a good exam off of them
3) has a rock-solid belief in western medicine, and understands that alternative medicine is crap
4) doesn't do any "research" about their condition or new therapies for it
5) does not have fibromyalgia, irritable bowel syndrome, or chronic pain
6) does not have diabetic, or PVD feet, yuck!
7) does not require a rectal or a hernia check
8) is compliant
9) decides not to stay another night in the hospital "just to be safe"
10) doesn't have any contagious illnesses

that's it for now, if I think of more I'll add them on to this endless list...
 
Let me add the following requirements for the perfect patient:

11) Can accuately and concisely state their past medical/surgical history
12) Knows or has written down their medications
13) Knows why s/he is in the hospital for this admission and can explain their presenting symptoms without going back more than a month
14) Does NOT need a pelvic exam
15) Most important: Needs an operation!
 
In response to jadedsoul's "one that speaks English" comment, I'd have to say that from my experience, most of the immigrants (Hispanic, Russian, Asian, African) that I've taken cared of are the ones that really appreciate your care, and actually say "thank you."

So I'd rather have a patient that doesn't speak English but appreciates what I do, and the health care that they get here in the US.
 
I'll post yet another questionable comment...

The best patient has got to be one that doesn't have TB.

How many times have I heard, "You've got to think about what's going to harm the patient most and rule it out."

Screw that, the question to ask is "what can the patient have and happens to omit in their history which will harm ME the most?"

I just love it when I go into a patient's room and she's coughing all over the place. As we proceed to discuss the possibilities, then she brings up the fact that she had a nice induration on her last ppd.
 
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