Do we as M3's wait with patient's and get them into taxis?

[Somedaydoc]

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So, I go to a state med school and am on night float. My 1st year resident came to ask me if I would take a patient who only speaks Spanish to her taxi and give information to the driver. It was about 10pm and I waited for 40-45 min., called the taxi company several times (no one would pick up) and then finally got the taxi. I had to pull up the directions on my iphone and repeat them to the driver 3 times, because he didn't know where to go (and I guess couldn't get this info from the dispatcher). I just wanted to make sure that the patient got home safely.

The two residents that I work with went on to seeing other patients (one is a second year resident and one is a 1st year intern). It's my first week with this service and I'm on night float. I don't have any of my other group members on this service with me. (There are 2 guys from my group that are in another part of the service but we're in different team rooms and answer to different residents).

So my question is: is waiting all this time for a taxi and giving instructions to cab drivers part of our duties as med students? Not to be "too good for this" or anything, but I just want to know for my sake since I don't have any fellow students with me to ask and both of my group leaders are on the day shift. I have heard that another school in our state made students get patients to taxi's and that this was part of the reason that the hospital's accreditation came under scrutiny.

By the way, I'm a girl and even though the taxi was right outside the hospital, I'm not sure how safe it was to stand there with my head in the cab for a while explaining stuff to the driver (I'm in an urban area).

Any input? Has anyone been in a similar situation? Thanks so much.

 

[ambulancedriver]

I would think of it as still falling under the realm of patient care. true your time could definitely be spent doing other things, and likely where you went wrong is not finding the appropriate person in the hospital whose job it is to handle this type of situation (someone from patient transport for example).

in the extreme circumstance that there is truly no one else available, I would go out of my way to make sure a patient got home safely. if it were my grandmother, I would hope someone else extends the same courtesy

 

[Somedaydoc]

Thanks so much for the input ambulancedriver. It's my 3rd week in an inpatient setting and the first time on night float so I didn't think/know that there were people assigned to this job such as someone in patient transport. I didn't really know what to say to the intern when she asked if I would do it, other than "Yes!" because aren't we graded on being agreeable and doing whatever is asked of us?

I know that nurses were around, but for whatever reason the intern asked me, I figured I should do it. I guess I was also a little disappointed because while I was waiting, the two residents performed an LP on an infant and saw other patients in the NICU, where I have never been. So that would have been nice to see.

What does one say when placed in a situation like this?

 

[calvinNhobbes]

Normally this type of activity is handled by social work, but med students get stuck with all kinds of scut work. Hope you at least had a pocket book to study as you waited.

 

[Droopy Snoopy]

Learning is your first priority, be it at the bedside or studying for the shelf. Helping out the team should be your second, but only if it interferes minimally with the first. Your intern isn't necessarily a douche for asking; our first priority is getting **** done and sometimes we lose perspective a bit. But you're a doctor not a transport orderly, and you should have (tactfully) told your intern this.

And wtf, discharging a patient at 10PM?

 

[calvinNhobbes]

. And wtf, discharging a patient at 10PM?

Whoa, missed that part! When did nightfloat start discharging people?
That is sketchy, even for someone who spent most clerkships at a bankrupt county hospital. Yikes!

I can only imagine:
Primary team: Hey where's my rule out MI, did they die over night?
Night float: nope, I discharged them
PT: You what!

 

[Green Chimneys]

Your job as an intern or a medical student is to make sure that what needs to be done for your patient is done for your patient, not to actually DO it. The hospital hires hundreds of people who get paid to do these tasks, but they won't come unless you call. Your intern or resident doesn't really care how the task gets done, or who does it, just that it is completed.

A quick phone call to the operator and asking them to connect you with patient transport could have solved this problem, you just didn't know it at the time. This actually rings true for most of the problems in the hospital, and 90% of the time the person you call can get the job done faster than you anyway:

Go down to the basement and fetch this patient's old records? Call medical records and ask them to be brought to bedside.

Go down to the OR and find out what time this patient will be out of surgery? Just call the OR and ask the circulating nurse.

This patient needs placement in an LTAC hospital, can you call around and see if you can find them a spot? Call the assigned case worker and give them the lowdown.

There are circumstances where it's just easier to do something yourself, such as a patient asking for a warm blanket, but otherwise delegate the task and then follow up to make sure it is done. This is what your intern is doing, it's what you should do too.

I've actually seen a 3rd year student stumble upon a morbidly obese patient in the bathroom who requested help wiping after a BM. She obliged. I'm not saying you're above any task (including this), but if there is someone else paid to do the job (in this case the CNA), find them. You'll be glad you did!😱

 

[Somedaydoc]

Thanks everyone for the info! It is really helpful, please post any other "should know" or "ought to know" hospital facts, I'm really that un-knowledgable about the hospital🙂

 

[Rendar5]

Using your help is key, as is knowing when to do something urself. and the more you learn to do this the more efficient you become.

Stuff I've learned to do efficiently in the ER myself when it doesn't take me out of my way: discharge a patient, take a rectal temp, grab a warm blanket, throw in a line, hang fluids.

Stuff I've learned to use my resources in the ER to save myself useless scut: have the unit cleark get a non-responding consult on the line instead of calling and waiting for a reply, getting the clerk to print me up a pt's ED chart from the prior visit, get a CA or someone to grab me supplies when they're not readily on hand, throwing the discharges in the rack and letting the nurse d/c a pt when I know I can perfectly well do it myself (yes the opposite of the one up there).

I'm sure I"m gonna learn lots more stuff, like how to scut out the medical student to do all my rectal exams 🙂

BTW, something I learned that increased my efficiency? do the damn rectals and pelvics right away while the nurse is still there by the room instead of going away, presenting, asking if I should do one, hoping that I don't, and then going back later on to finish my exam only to realize I need to find someone to chaperone me and wasting a half hour on a 1-3 minute exam.

EDIT: and for inpatient, use the damn social workers. They are wonderful human beings who can make ur life so much easier.

 

[Tiger26]

So, I go to a state med school and am on night float. My 1st year resident came to ask me if I would take a patient who only speaks Spanish to her taxi and give information to the driver. It was about 10pm and I waited for 40-45 min., called the taxi company several times (no one would pick up) and then finally got the taxi. I had to pull up the directions on my iphone and repeat them to the driver 3 times, because he didn't know where to go (and I guess couldn't get this info from the dispatcher). I just wanted to make sure that the patient got home safely.

The two residents that I work with went on to seeing other patients (one is a second year resident and one is a 1st year intern). It's my first week with this service and I'm on night float. I don't have any of my other group members on this service with me. (There are 2 guys from my group that are in another part of the service but we're in different team rooms and answer to different residents).

So my question is: is waiting all this time for a taxi and giving instructions to cab drivers part of our duties as med students? Not to be "too good for this" or anything, but I just want to know for my sake since I don't have any fellow students with me to ask and both of my group leaders are on the day shift. I have heard that another school in our state made students get patients to taxi's and that this was part of the reason that the hospital's accreditation came under scrutiny.

By the way, I'm a girl and even though the taxi was right outside the hospital, I'm not sure how safe it was to stand there with my head in the cab for a while explaining stuff to the driver (I'm in an urban area).

Any input? Has anyone been in a similar situation? Thanks so much.

Getting a pt a blanket when they need one is probably a reasonable thing to do.

Waiting for a taxi for them is completely inappropriate scut work and should probably be reported--this is just like being told to go buy food for the residents or something.

If you think about it you probably pay about a $100/day to be there and learn medicine. Exposing yourself to the risk of being outside at night in an urban environment + wasting your time on this is just completely ludicrous.

You should really be angry about this

 

[FractureFixer]

To me that sounds more like a nurses job rather than a "doctor in training". Tell a nurse to do it next time, and if they try and give you lip, smack the b----h!

 

[DemonDeacon]

You're in medical school, not a high school volunteer. I would not let it happen again, otherwise the residents will get used to you being a subservient student, and they'll end up using you rather than teaching you for the rest of the rotation, which is why you are paying a quarter of a million dollars in the first place.

Back as a 3rd year, my intern had me see 2 patients on my first day, and since I finished quickly, he would ask if I can see another patient, and then another, and then I would have seen nearly 10 patients in one day on my own, without any guidance of anyone. I wrote notes on all of them, and learned almost nothing. I ended up wasting my days looking for charts, writing notes, and looking for the intern. You don't realize how horrible this is until you start studying for the boards. One surgeon told me, "If you're not learning at least 10 things each hour on the floors, then you're wasting time."