Drinking water on clerkships

Burrell College of Osteopathic Medicine
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skiing

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How do you guys hydrate on clerkships? I'm starting third year soon and our orientation said that it is unhygienic to drink water in patient areas (eg. front desk area, patient rooms, hallways). We can only drink water in designated break rooms and non-patient bathrooms. In practice, how does this work out for you? Do people usually go to break rooms multiple times daily to hydrate? Where do you keep your water bottles? It seems like drinking 8 little plastic cups of water out of the hospital water dispenser would get waste-heavy and highly inconvenient.
 
As noted above, it is been my experience that those JCAHO rules are rarely enforced except during an inspection. So there is generally ample time to at least hydrate modestly during the day except when in the operating room.

As an aside, you should never drink in a patient's room. Besides the obvious reason, many patients are NPO and it's just not nice to drink and/or eat in front of them.
 
rubio1.gif
 
URHere said:
Most services will have a central work room with computers, etc. You will likely be spending a lot of time in there writing notes, and you should be allowed to eat/drink unless your school or team is especially anal. Aside from that, go to the break room.
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This. I keep a 1 L water bottle in there during the day and make sure (at least) I drink the entire thing by sign out.
 
I worked in the OR for years. Talk about a place where it is easy to get dehydrated. (Unless you were a particular surgeon who thought rules were for plebes, and would bring his open cups of coffee into rooms, lifting his mask to drink while a large surgical incision was being explored a couple feet away. &@$!@#%)

Our lockers, the breakrooms, and the cafeteria were all on other floors. Everyone had a water bottle stashed in the nearby office area, or in the pocket of a white coat, etc. Fill up from the water cooler in the charting room and you are good to go.

We weren't supposed to have bags with us due to sterility issues, but a small messenger bag would be perfectly acceptable to take on rounds, and be a fine place to stash snacks and hydration. You can generally leave it at a nurses station or break room if you have to duck into a patient room or other place where it would be in appropriate. Don't put anything of value into it. Keep all money, ID, keys, irreplaceable notes, phone, in the pockets of your coat. Just use the bag for fruit, fluids, and any text you feel you need to tote around with you.
 
Tired said:
I hate seeing people walking around with their neoprene bottles of water. Hospitals are quite literally littered with drinking fountains and nourishment areas and water machines, all of which can be used at any time. Is that extra 3 seconds it takes to walk to the closest water source going to tip you over into renal failure? "But I only drink filtered water!" Get away from me.

Every once in a while, one of the new wannabe ortho bruh med students brings their gallon jug of water with them on their first day. What, are you on a cleanse? Get that crap out of here.
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Tap water is life, yo.

Every time I see someone with a bottle of Aquafina, I consider how many people in the world have to walk miles to the nearest clean tap, if they even have one nearby. I think about all the people drinking whatever they can get and not even knowing to question what might be in it. And then I turn on one of the sinks near me and draw a clean, relatively safe glass of water, which has been chlorinated to protect me against disease causing microbes and parasites.

If someone who drinks bottled water complains about the price of gas, I generally punch them. Well. I want to, anyway.

That said, reusable water bottles are just convenient and they make it less likely that you will be stuck in a situation where you have to pay $2/liter or more for one of the most abundant substances on the planet.
 
Tired said:
I like it when they go out of their way to throw the bottle into the recycling bin, because they're concerned enough about the environment to recycle, but not concerned enough to avoid buying the damn plastic bottle in the first place.

Or when they use that bottle of Fiji water (it's always Fiji with these people, because science has shown that drinking more expensive water makes you better hydrated) to fill up their Nalgene bottle.
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But tap water has fluoride! :scared:
 
Dares Dareson said:
But tap water has fluoride! :scared:
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Or legionella... Which happened at our site last year. Seriously. And they emailed us 3 months after. No one touched those water fountains.

But, to answer OP, there are plenty of locations to hydrate before/after rounds. I would normally either re-use a plastic water bottle for the day or just use the plastic cups that they give patients. No one cares if you use the water machine in the break room/nourishment room. It's when you go in and come out with every snack imaginable and stuff it in your pockets. But seriously; you'll learn where to get your water from very quickly and where to keep your water bottle.

Also, if JCAHO is ever around and you're afraid, just take off your badge/white coat and be a patient or patient family member. Jk. Totally.
 
Tired said:
Every once in a while, one of the new wannabe ortho bruh med students brings their gallon jug of water with them on their first day. What, are you on a cleanse? Get that crap out of here.
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But what if it's "bicep day?" Wouldn't the fellow bruhs make an exception?
 
So there are hospitals that don't have those little mini-bottles of water that fit perfectly into coat pockets? Every single lecture at my hospital has those.

Alternatively, casinos are perfect places to pick up the mini-bottles of water.
 
Siggy said:
So there are hospitals that don't have those little mini-bottles of water that fit perfectly into coat pockets? Every single lecture at my hospital has those.

Alternatively, casinos are perfect places to pick up the mini-bottles of water.
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Yeah just hit up a casino. Also you could raid hotel mini-fridges.
 
I'm not someone that regularly carries around a water bottle, so I never tried during clerkships. But, I literally cannot fathom having time to go back to wherever I stored it throughout the day. I'm at a fairly large hospital and spent most of the day traipsing all over it. Going back to any one particular spot with any regularity would have been a major pain in the @$$.

My fluid intake looked something like this MS3:
1. Chug burning hot coffee in my car on the way to the hospital. Try not to spill it all over myself.
2. Sip on a burned, poorly made cup of coffee in the cafeteria during whatever break I got... not sure I'd call it a true "lunch break."
3. Drink a cup of tea on my way home from the hospital... still had studying to do when I got home!
4. Realize my pee was orange, and that I only drank diuretics all day.
5. Drink a large glass of (tap) water right before going to bed.
6. Wake up 5 times a night to pee.
7. Rinse and repeat.

Where are these magical hospitals that give you multiple opportunities a day to stay hydrated??

Pretty sure I've developed some degree of kidney injury after this year...
 
Pacna said:
IT'S A very durable PLASTIC CUP shaped so it is easy to store or carry in your bag WITH A LID AND collapsible STRAW that stays protected when you're not drinking and ensures it will not leak.
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Fixed.

:hardy:
 
SouthernSurgeon said:
(a) Normal kidneys won't get injured by mild dehydration during the day

(b) In all seriousness, how to avoid dehydration without having to carry around a water bottle like a weirdo:
-AM: Chug a glass of water before you leave the house (<5 seconds)
-Breakfast: Get a glass of water with your meal instead of just the coffee (adds zero time to breakfast)
-Lunch (or whatever passes for lunch break): Drink a water or a gatorade (adds zero time to lunch)
-PM Rounds: Snag a cup of water from the nurses/nutrition station, carry it with you on rounds (<5 seconds)

There. You've now consumed 4 large glasses of water in addition to whatever else you've drank for the day, and it's added less than a minute to your day, with no going out of your way.
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When I was a floor nurse, I was chronically dehydrated and hydronephrotic.

I remember being told that I had to cath patients if they didn't void every 6 hours--like it was absolutely life-threatening and their bladders would pop if they hit 7 hours with no void--and being confused because, Hell, I hadn't peed in 12, and no one seemed to care about that.

It isn't healthy, and it is no way to live long term, but it isn't going to kill a healthy young person who does it for a handful of years during training.

EDIT: I think I was actually really spoiled once I transferred to the OR, because we did actually get a lunch break every day... even if our Director had to be the one to come offer it to us, and could only let us out for 20 minutes. It was more than I ever got as a floor nurse, where the boss would just say that if we couldn't find time for our lunches (while caring for an assignment of 8 acutely ill inpatients without any aides or techs to help,) then our time management skills were at fault.
 
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Promethean said:
When I was a floor nurse, I was chronically dehydrated and hydronephrotic.

I remember being told that I had to cath patients if they didn't void every 6 hours--like it was absolutely life-threatening and their bladders would pop if they hit 7 hours with no void--and being confused because, Hell, I hadn't peed in 12, and no one seemed to care about that.

It isn't healthy, and it is no way to live long term, but it isn't going to kill a healthy young person who does it for a handful of years during training.

EDIT: I think I was actually really spoiled once I transferred to the OR, because we did actually get a lunch break every day... even if our Director had to be the one to come offer it to us, and could only let us out for 20 minutes. It was more than I ever got as a floor nurse, where the boss would just say that if we couldn't find time for our lunches (while caring for an assignment of 8 acutely ill inpatients without any aides or techs to help,) then our time management skills were at fault.
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awesome story
 
I remember keeping a bottle of Gatorade or water in the lounge fridge or break rooms while on my floor rotations. Ducked inside to rehydrate and also snack. For operating room rotations, I kept water in the locker room and made an effort to duck in between cases.
 
Siggy said:
So there are hospitals that don't have those little mini-bottles of water that fit perfectly into coat pockets? Every single lecture at my hospital has those.

Alternatively, casinos are perfect places to pick up the mini-bottles of water.
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This ain't no VIP concierge hotel hospital. But you can't bring that bottle around everywhere.
I think the most aggravating comment I got was a resident saying how I brought my coffee on rounds was disgusting (which I guess was habit because everyone did it and never scolded me and I didn't bring it into patient rooms). I was like "and your white coat is clean? You carry everything from patient to patient, where it to lunch, go home with it and think my cup of coffee is gross? Yes, I'm being a jerk. I never said it but I did think it. And I'm probably wrong. But coffee is so delicious.
 
SouthernSurgeon said:
(a) Normal kidneys won't get injured by mild dehydration during the day

(b) In all seriousness, how to avoid dehydration without having to carry around a water bottle like a weirdo:
-AM: Chug a glass of water before you leave the house (<5 seconds)
-Breakfast: Get a glass of water with your meal instead of just the coffee (adds zero time to breakfast)
-Lunch (or whatever passes for lunch break): Drink a water or a gatorade (adds zero time to lunch)
-PM Rounds: Snag a cup of water from the nurses/nutrition station, carry it with you on rounds (<5 seconds)

There. You've now consumed 4 large glasses of water in addition to whatever else you've drank for the day, and it's added less than a minute to your day, with no going out of your way.
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That's what I do. Drink a bunch of water in the morning and pee once changing into fresh scrubs and drink at mealtimes and after you get home. Also, water fountains.
 
Kaustikos said:
This ain't no VIP concierge hotel hospital. But you can't bring that bottle around everywhere.
I think the most aggravating comment I got was a resident saying how I brought my coffee on rounds was disgusting (which I guess was habit because everyone did it and never scolded me and I didn't bring it into patient rooms). I was like "and your white coat is clean? You carry everything from patient to patient, where it to lunch, go home with it and think my cup of coffee is gross? Yes, I'm being a jerk. I never said it but I did think it. And I'm probably wrong. But coffee is so delicious.
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Lol i had a preceptor who would carry around a Styrofoam cup of coffee to every room and just drink while interviewing patients. Refilled between each one. Must have gone through at least two pots a day
 
Psai said:
Lol i had a preceptor who would carry around a Styrofoam cup of coffee to every room and just drink while interviewing patients. Refilled between each one. Must have gone through at least two pots a day
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There was once a child neurology resident who knew how to roll like a freaking boss. We needed him to come down to the OR holding area in the middle of the night to do something with the settings on VNS device, I think. He showed up with a ceramic coffee mug in hand, with his news paper tucked under his arm. Like it wasn't even a thing. Like he was just strolling out to his back porch to watch the sunrise. When he had helped us out with whatever we'd called him for, he asked where was the nearest coffee pot... he wanted to top off before heading to his next stop. I took him to a lounge, continuing to gawk at him admiringly as he filled his cup and continued on his very merry way.

That dude knew how to take call.
 
shopping
I take this with me wherever I go. I am not on clerkship though. I put ice in it. On hot days it melts into ice water and keeps cool for hours.
 
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When I was a floor nurse, I was chronically dehydrated and hydronephrotic.
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sounds like something a nurse could say...

I buy a plastic bottle (with diet coke or whatever) every other day and keep reusing the same one during the day. We have tap water in our office.

I don't understand why people go mad about "hydrating". Unless you're geriatric or end stage kidney disease, drinking when you're thirsty is enough. If you drink too much, you'll just pee gallons... Physiology 101.
 
Ceusina said:
My fluid intake looked something like this MS3:
1. Chug burning hot coffee in my car on the way to the hospital. Try not to spill it all over myself.
2. Sip on a burned, poorly made cup of coffee in the cafeteria during whatever break I got... not sure I'd call it a true "lunch break."
3. Drink a cup of tea on my way home from the hospital... still had studying to do when I got home!
4. Realize my pee was orange, and that I only drank diuretics all day.
5. Drink a large glass of (tap) water right before going to bed.
6. Wake up 5 times a night to pee.
7. Rinse and repeat.

Where are these magical hospitals that give you multiple opportunities a day to stay hydrated?
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You know numbers 1, 2, 3, and 5? Yeah, most of us chose water for those stages. Here's how it works: if you go all day without drinking water during third year because you're not thirsty or would prefer another beverage, fine. But if you go all day without drinking water during third year because you THINK you don't have time? You're doing it wrong.

As an intern, I drink and buy bottled water and make no apologies. As an MS 3, I carried a mini bottle in my white coat pocket that I would routinely re-fill from the water coolers in the charting areas or resident rooms. Oh, and I still complain about the price of gas.
 
skiing said:
How do you guys hydrate on clerkships? I'm starting third year soon and our orientation said that it is unhygienic to drink water in patient areas (eg. front desk area, patient rooms, hallways). We can only drink water in designated break rooms and non-patient bathrooms. In practice, how does this work out for you? Do people usually go to break rooms multiple times daily to hydrate? Where do you keep your water bottles? It seems like drinking 8 little plastic cups of water out of the hospital water dispenser would get waste-heavy and highly inconvenient.
Click to expand...

I drink in the hallways, nurses station and computer work areas all the time. Sometimes I am eating there too. Whoever said it was unhygienic needs to get slapped. Or someone who I would chug a drink in their face and smile! I don't drink water though. I drink lots of energy drinks, soda, juices, coffee.
 
KnuxNole said:
I drink in the hallways, nurses station and computer work areas all the time. Sometimes I am eating there too. Whoever said it was unhygienic needs to get slapped. Or someone who I would chug a drink in their face and smile! I don't drink water though. I drink lots of energy drinks, soda, juices, coffee.
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It's a JAHCO rule, which is why when they visit, hospitals are extra strict about it.
 
Mass Effect said:
It's a JAHCO rule, which is why when they visit, hospitals are extra strict about it.
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Yes, which is why they always warn us and everyone acts COMPLETELY different in that timeframe, then everyone breaks the rules left and right 😛
 
I always brought a water bottle with me that I left in the workroom and would go into the "nourishment" rooms on the patient floors to get cups of water while I was out on the floors if I needed to get a drink then. I agree that bringing water into patient rooms isn't a good idea.

I imagine some attendings will be a pain and have ridiculous rules like "no drinking on rounds" or other similar things. On our anesthesiology rotation, our attending didn't want us drinking anywhere near patients because it was "cruel" to drink in sight of patients that are NPO. I can appreciate the empathy, but you've gotta stay hydrated, man.
 
Winged Scapula said:
As noted above, it is been my experience that those JCAHO rules are rarely enforced except during an inspection. So there is generally ample time to at least hydrate modestly during the day except when in the operating room.

As an aside, you should never drink in a patient's room. Besides the obvious reason, many patients are NPO and it's just not nice to drink and/or eat in front of them.
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The beauty of night shift aid... Always ate dinner at the front desk, no one complaining about JCAHO
 
This was the bane of my existence on internal medicine. Painful team rounds all day with the rules saying students can't eat or drink aside from designated areas (e.g. the cafeteria). Meanwhile, the residents and attendings would always have coffee, or a bottle and a snack. Torture! I love staying hydrated. I'll have some water in the morning before rounds, go to the OR, drink water between cases. If it is a longer case it still is not as bad, because no one else in the room is eating and drinking while you can't.
 
Sorry,
But I find it rude and disrespectful to say a student can't drink while everyone else is doing just that... In front of them.
 
SouthernSurgeon said:
I assume this is a case of the residents being comfortable breaking rules that the students aren't?

The students have many masters and more people to potentially get in trouble with. They also sometimes have external policies placed on them by the school/dean/whoever
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Perhaps I misread @neusu s post: it sounded to me like the residents and attendings were enforcing the medical school rules for the students and flaunting them while drinking themselves. But you're right - it was probably more like the students self-enforced and the staff and residents either simply didn't notice or knew what was going on.
 
Winged Scapula said:
Perhaps I misread @neusu s post: it sounded to me like the residents and attendings were enforcing the medical school rules for the students and flaunting them while drinking themselves. But you're right - it was probably more like the students self-enforced and the staff and residents either simply didn't notice or knew what was going on.
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That's what I thought. But, honestly, if the hospital I was at was okay with drinks and I saw medical students ducking away to get a drink or whatever, I'd probably say just bring a bottle or cup with you.

Only because it severely hampers my attempt at breaking world record for rounding
 
I thought of this thread when I witnessed a grown man giving his dogs Fiji water on a walk. People are out of ****ing control.
 
Chug two tall glasses of water before you leave the house in the morning. Pee off the excess while pre-rounding, then hit up water fountains/ice machines when available through the day. I also look askance at people carrying water with them: why carry a big, uncomfortable bottle when water's freely available?

Besides, if you're carrying food or drink into patient care areas, it's just a matter of time until you meet an early, gruesome death: http://www.gomerblog.com/2014/10/nurses-station/

SouthernSurgeon said:
I assume this is a case of the residents being comfortable breaking rules that the students aren't?

The students have many masters and more people to potentially get in trouble with. They also sometimes have external policies placed on them by the school/dean/whoever
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I remember getting coffee with the residents just before rounds with the inpatient family medicine team early third year and feeling really uncomfortable carrying it around even though everyone else on the team was doing the same. I'm sure nobody would have thought anything of it, but I finished it as quickly as possible because I somehow felt I hadn't earned that right yet or something.

Fast forward two months to surgery, and I remember stopping the vascular attending who grabbed my coffee and telling him his was at the other side of the nursing station, making frequent dips into the nutrition rooms to snag whatever I could, and my morning routine of a chocolate milk, diet coke, two saltines, two graham crackers, and on a good day, a pudding on my way from the call room to the surgery office when I had to stay in the hospital overnight.

As quickly as I became comfortable taking things from the hospital during those clerkships, I'm pretty sure I'd start walking off with furniture from the hospital to fill my own home if I was a surgery resident.
 
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