Embarrassing mistakes you've made on rotations

[han14tra]

I'm on OB. Today, I almost inserted my fingers into the rectum instead of the vagina while doing a pelvic exam. I was holding the sheet up with one hand and inserting with the other. Since I didn't spread the labia majora, I couldn't see where I was at. I was poking around the perineum for about a minute until I felt the anus and figured out that I needed to go much more anterior . The attending laughed at me for about 10 min. As a female and owner of a vagina, it was embarrassing that I couldn't find it on another woman.

What is your embarrassing moment?

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[bleeker10]

So far my most embarrassing mistake was when I walked into a room and said "How are you doing, Mr. X, I mean Mrs. X" and then proceded to look at my census and see it is a male patient so I said "Mr. X" again all in the span of about 30 seconds. What's even better is one of the interns made the same mistake the next day haha.

 

[2012mdc]

Mine was on OB but it wasn't entirely my fault.

The intern tells me it's a new OB visit and I go in there and ask how her how many weeks she was and she wasn't pregnant at all (just overweight). She was there for a gyn visit

 

[Hoju]

I'm on OB. Today, I almost inserted my fingers into the rectum instead of the vagina while doing a pelvic exam. I was holding the sheet up with one hand and inserting with the other. Since I didn't spread the labia majora, I couldn't see where I was at. I was poking around the perineum for about a minute until I felt the anus and figured out that I needed to go much more anterior . The attending laughed at me for about 10 min. As a female and owner of a vagina, it was embarrassing that I couldn't find it on another woman.

What is your embarrassing moment?

No biggie. You may have one but I bet you don't get much face time with it.

 

[MilkmanAl]

You may have one but I bet you don't get much face time with it.

I really hope that choice of expressions was intentional, because that's awesome.

For me, I've mixed up more patients' sexes than I care to remember. I've talked to the wrong patient a few times thanks to our VA's habit of randomly moving people around for seemingly no reason. I honestly can't recall anything else. I guess you just get used to making an ass of yourself constantly after awhile.

 

[winkleweizen]

First day prerounding...walk in to see a patient that according to my sheet was S/P cholecystectomy...i start asking him the usual and the guy starts talking about his amputated leg and what not...it takes me two more minutes to figure out that the guy is not delirious but im in the wrong room.

 

[OpalOnyx]

This wasn't really on clinical rotations but when I volunteered at a clinic. I was interviewing prior to the doc coming to see the pt. There was a premed volunteer shadowing me that day. Pt was complaining of severe severe pain after an injury - causing a lot of emotion from the pt and a lot of reassuring on my part. The premed kid actually started to tear up.

Then we came back with the attending who later told us the guy was just a drug seeker.

 

[LovelyBRass]

I had a patient on telemetry who had a run of v-tach overnight. My intern asked me what we should do for him and I said, "start chest compressions! Push amiodarone, no wait, epinephrine! Then we need to cardiovert!!"

We walk into the room and he's sitting on his bed watching TV. My intern turns to me and says, "so, you wanna start doing chest compressions on this guy?"

LOL... in my defense, we'd just finished going over ACLS so of course this is what I had on my mind... I mean you can't possibly have v-tach without being pulseless and unconscious, right?

 

[OpalOnyx]

I had a patient on telemetry who had a run of v-tach overnight. My intern asked me what we should do for him and I said, "start chest compressions! Push amiodarone, no wait, epinephrine! Then we need to cardiovert!!"

We walk into the room and he's sitting on his bed watching TV. My intern turns to me and says, "so, you wanna start doing chest compressions on this guy?"

LOL... in my defense, we'd just finished going over ACLS so of course this is what I had on my mind... I mean you can't possibly have v-tach without being pulseless and unconscious, right?

that's so cute hahaha

 

[turkeyjerky]

I had a patient on telemetry who had a run of v-tach overnight. My intern asked me what we should do for him and I said, "start chest compressions! Push amiodarone, no wait, epinephrine! Then we need to cardiovert!!"

We walk into the room and he's sitting on his bed watching TV. My intern turns to me and says, "so, you wanna start doing chest compressions on this guy?"

LOL... in my defense, we'd just finished going over ACLS so of course this is what I had on my mind... I mean you can't possibly have v-tach without being pulseless and unconscious, right?

I woulda gave the guy a precordial thump

 

[smq123]

When I was an MS3 on OB, I asked the brand-new parents of a newborn if they wanted their baby to be circumcised. They both went like this in response to the question, which confused me.

Once the father was able to get over his horror, he said, "You know that we had a baby GIRL, right???"

Ooops.

 

[AggieSean]

 

[han14tra]

Not really a mistake, but here's my most horrifying experience of 3rd year so far:

CC and HPI: Patient walks in with belly pain, which she tells me is 10/10 and the most severe pain of her life. She hasn't had a bowel movement in 6 days.
My observations: Patient is sitting comfortably laughing on the phone with her boyfriend.

Before I walk out of the room to go talk to the resident-

Patient: Hey doc, I need a percocet. Could you go get it please?
Me: I have to talk to the doctor and see what she wants to do for you. We will be back in to see you shortly and will try to get your pain under control.
Patient: Run! You better be back in here in 2 minutes with my percocet.
(A few moments pass).
Me: The doctor would like you to take this Miralax to help you have a bowel movement.
Patient: You can't let someone sit in pain like this!! This is ridiculous. Go get me a percocet!!
Me: The doctor and I agree that percocet will only make the constipation worse. The miralax will help you have a bowel movement and your pain should resolve.
Patient: I just remembered...I had 2 big bowel movements this morning.
Me: Well that changes things. I thought you told me your last bowel movement was 6 days ago (the patient also told the 2 nurses this).
Patient: No! You people don't listen. My belly hurts bad, and I need a percocet NOW!!
(After I walk out and talk to the doctor, the doctor prescribes 1 percocet to patient for pain).
Me: Here is your percocet.
Patient: This is only 1. I usually get 3. Go get me 2 more. And, come back with my prescription for percocet so that I can take them when I get home! Do you understand me, han14tra?!? Go get my percocet!

 

[smq123]

Not really a mistake, but here's my most horrifying experience of 3rd year so far:

CC and HPI: Patient walks in with belly pain, which she tells me is 10/10 and the most severe pain of her life. She hasn't had a bowel movement in 6 days.
My observations: Patient is sitting comfortably laughing on the phone with her boyfriend.

Before I walk out of the room to go talk to the resident-

Patient: Hey doc, I need a percocet. Could you go get it please?
Me: I have to talk to the doctor and see what she wants to do for you. We will be back in to see you shortly and will try to get your pain under control.
Patient: Run! You better be back in here in 2 minutes with my percocet.
(A few moments pass).
Me: The doctor would like you to take this Miralax to help you have a bowel movement.
Patient: You can't let someone sit in pain like this!! This is ridiculous. Go get me a percocet!!
Me: The doctor and I agree that percocet will only make the constipation worse. The miralax will help you have a bowel movement and your pain should resolve.
Patient: I just remembered...I had 2 big bowel movements this morning.
Me: Well that changes things. I thought you told me your last bowel movement was 6 days ago (the patient also told the 2 nurses this).
Patient: No! You people don't listen. My belly hurts bad, and I need a percocet NOW!!
(After I walk out and talk to the doctor, the doctor prescribes 1 percocet to patient for pain).
Me: Here is your percocet.
Patient: This is only 1. I usually get 3. Go get me 2 more. And, come back with my prescription for percocet so that I can take them when I get home! Do you understand me, han14tra?!? Go get my percocet!

Not to discourage you, but this happens about once a week in clinic.

Don't be . Don't let the patient game you, trick you, or bully you into feeling bad or scared. They know that med students and interns are easily spooked, so they take advantage of that. Don't let them!

 

[2012mdc]

Not to discourage you, but this happens about once a week in clinic.

Don't be . Don't let the patient game you, trick you, or bully you into feeling bad or scared. They know that med students and interns are easily spooked, so they take advantage of that. Don't let them!

the most disturbing part of the whole exchange is that the patient succeeded in getting the percocet

 

[ArcGurren]

Not really a mistake, but here's my most horrifying experience of 3rd year so far:

CC and HPI: Patient walks in with belly pain, which she tells me is 10/10 and the most severe pain of her life. She hasn't had a bowel movement in 6 days.
My observations: Patient is sitting comfortably laughing on the phone with her boyfriend.

Before I walk out of the room to go talk to the resident-

Patient: Hey doc, I need a percocet. Could you go get it please?
Me: I have to talk to the doctor and see what she wants to do for you. We will be back in to see you shortly and will try to get your pain under control.
Patient: Run! You better be back in here in 2 minutes with my percocet.
(A few moments pass).
Me: The doctor would like you to take this Miralax to help you have a bowel movement.
Patient: You can't let someone sit in pain like this!! This is ridiculous. Go get me a percocet!!
Me: The doctor and I agree that percocet will only make the constipation worse. The miralax will help you have a bowel movement and your pain should resolve.
Patient: I just remembered...I had 2 big bowel movements this morning.
Me: Well that changes things. I thought you told me your last bowel movement was 6 days ago (the patient also told the 2 nurses this).
Patient: No! You people don't listen. My belly hurts bad, and I need a percocet NOW!!
(After I walk out and talk to the doctor, the doctor prescribes 1 percocet to patient for pain).
Me: Here is your percocet.
Patient: This is only 1. I usually get 3. Go get me 2 more. And, come back with my prescription for percocet so that I can take them when I get home! Do you understand me, han14tra?!? Go get my percocet!

This is where you kick the patient out of your office for drug-seeking behavior. You've gotta develop something of an eye for this stuff obviously, but you shouldn't have given them that single percocet in the first place... just tell the doctor next time that this patient's behavior is suspicious and that it's inconsistent with someone who's in that much pain.

Of course, if you told the doc that and he prescribed it anyway... you've got some problems right there which are more of a legal nature

 

[McGillGrad]

the most disturbing part of the whole exchange is that the patient succeeded in getting the percocet

It's just one pill. Pain relief actually discourages drug seeking behaviour. Especially when you prescribe exactly 3 pills that will get them through to their PMD (or pain clinic) appointment that you make for them.

 

[2012mdc]

It's just one pill. Pain relief actually discourages drug seeking behaviour. Especially when you prescribe exactly 3 pills that will get them through to their PMD (or pain clinic) appointment that you make for them.

I was more commenting on the fact that the patient is constipated and was given more narcotics. I don't know how much 1 pill would add to the problem but it wouldn't help. Seems a little irresponsible to me but what do I know? (Being serious here not sarcastic, I don't have much experience with situations like this outside of lecture/theoretical questions)

 

[Pegasus1731]

EM gunner here, 1st day on my second EM rotation, post 2 months of easy/random electives. Working with attending, patient with chest pain.

Attending "So what to you want to give her if she bumps her troponin?"
Me "Start with ASA and a nitro, maybe some morphine"
Attending "What else?"
Me totally blanking out "...oxygen...?"
Attending "Uh huh...and?"
Me still blanking "...um"
Attending "How about some Heparin??"

 

[turkeyjerky]

EM gunner here, 1st day on my second EM rotation, post 2 months of easy/random electives. Working with attending, patient with chest pain.

Attending "So what to you want to give her if she bumps her troponin?"
Me "Start with ASA and a nitro, maybe some morphine"
Attending "What else?"
Me totally blanking out "...oxygen...?"
Attending "Uh huh...and?"
Me still blanking "...um"
Attending "How about some Heparin??"

You shoulda dropped some knowledge on his ass:

http://www.thennt.com/heparin-for-acute-coronary-syndromes/

 

[K31]

I was more commenting on the fact that the patient is constipated and was given more narcotics. I don't know how much 1 pill would add to the problem but it wouldn't help. Seems a little irresponsible to me but what do I know? (Being serious here not sarcastic, I don't have much experience with situations like this outside of lecture/theoretical questions)

Your mistake is believing without evidence a single word coming out of a drug-seeking patient's mouth. They made up a story that they thought would be hard to disprove and believable enough to get them narcs (although the constipation part was a rookie mistake--any experienced opioid addict would know they stop you up). Then they tried to change course midstream instead of the usual approach of storming out screaming that they were going to sue everyone, then going to the closest ED.

 

[2012mdc]

Your mistake is believing without evidence a single word coming out of a drug-seeking patient's mouth. They made up a story that they thought would be hard to disprove and believable enough to get them narcs (although the constipation part was a rookie mistake--any experienced opioid addict would know they stop you up). Then they tried to change course midstream instead of the usual approach of storming out screaming that they were going to sue everyone, then going to the closest ED.

Yeah I've had the fortunate experience of never dealing with a drug seeker (at least not one that obvious). I'm sure my time will come intern year

 

[FunnyCurrent]

Have you guys ever had one fake a fall? I've seen that while working in the ED. It was like the guy slipped on a banana. His legs just went up in the air as he threw himself on the ground.

Still didn't get any narcotics though. Just some ibuprofen.

Long history of addiction and drug seeking behavior

 

[smq123]

You shoulda dropped some knowledge on his ass:

http://www.thennt.com/heparin-for-acute-coronary-syndromes/

Interesting website. I'll have to check it out. Nice link.

 

[wannabeOBGYN]

I'm on OB. Today, I almost inserted my fingers into the rectum instead of the vagina while doing a pelvic exam. I was holding the sheet up with one hand and inserting with the other. Since I didn't spread the labia majora, I couldn't see where I was at. I was poking around the perineum for about a minute until I felt the anus and figured out that I needed to go much more anterior . The attending laughed at me for about 10 min. As a female and owner of a vagina, it was embarrassing that I couldn't find it on another woman.

What is your embarrassing moment?

I was asked to put a foley in a female patient before surgery started and thought everything was going great so I said "Wow that went in easy." I missed the urethra and put it in the vagina.

 

[MilkmanAl]

If you've already taken to doing things like that during surgery, you'll fit in very well with the OB/Gyn crowd.

 

[Dissected]

You shoulda dropped some knowledge on his ass:

http://www.thennt.com/heparin-for-acute-coronary-syndromes/

I ordered an xray of the wrong foot the other day...the nurse totally covered my ass right before they were taken in to get it done though. She's agreed to keep that one our little secret . Be nice to nurses!

 

[Rollo]

I ordered an xray of the wrong foot the other day...the nurse totally covered my ass right before they were taken in to get it done though. She's agreed to keep that one our little secret . Be nice to nurses!

That's okay, you're an exception since you actually can order studies.

 

[45408]

I was asked to put a foley in a female patient before surgery started and thought everything was going great so I said "Wow that went in easy." I missed the urethra and put it in the vagina.

eh, don't sweat it. I've seen nurses do that more than once.

 

[45408]

I woulda gave the guy a precordial thump

I ask if we can discontinue the damn telemetry.

 

[namethatsmell]

Spoiler alert: ultimate brain fart ahead...

My attending and I see a patient with croup and I start thinking about all the "associations" from my pre-clinical years in case I'm pimped--you know things like"seal-like cough," "steeple sign," "Rx with racemic epi and steroids" blah blah blah...so then she nicely looks at me and asks:

"What virus is the most common cause of croup?"

My idiotic knee-jerk reply: "moraxella." I knew I had immediately flubbed up but didn't want to dwell.

My attending corrected me without flinching and we pressed forward. During a lull later that afternoon I briefly mentioned that I felt like a total ****-head for naming an unrelated BACTERIA...she was like "ain't no thang" and we both chuckled and moved on. Meanwhile I was committing mental seppuku...

 

[KSDeacon]

This wasn't as a med student, but...

I used to work as a tech in the ED at one of the hospitals in my city. One morning we had a late teenage girl brought in after an MVC on a backboard and neck brace (standard protocol) although she wasn't critical. I go in to put the BP cuff and pulse ox on her (mind you she's still strapped to the backboard) and put the nurse's call button next to her hand. At this point, just out of habit, I tell her that it's also the remote for the TV in the room in case she wants to watch it while she waits...at which time I realize she can't exactly see the television bc her head is strapped down...
Of course, I casually say, "well, nevermind, I guess you aren't really able to see it..."
Queue patient starting to cry
Queue me slowly backing out of the room thinking Oh ****...

 

[DrDrToBe]

This wasn't as a med student, but...

I used to work as a tech in the ED at one of the hospitals in my city. One morning we had a late teenage girl brought in after an MVC on a backboard and neck brace (standard protocol) although she wasn't critical. I go in to put the BP cuff and pulse ox on her (mind you she's still strapped to the backboard) and put the nurse's call button next to her hand. At this point, just out of habit, I tell her that it's also the remote for the TV in the room in case she wants to watch it while she waits...at which time I realize she can't exactly see the television bc her head is strapped down...
Of course, I casually say, "well, nevermind, I guess you aren't really able to see it..."
Queue patient starting to cry
Queue me slowly backing out of the room thinking Oh ****...

that's funny

 

[DrDrToBe]

Total brain fart- a few days ago I had a really long day (had a end of clerkship test at 7am that I stayed up most of the night studying for, then went and saw patients all day) and was just exhausted by the time 6pm rolled around. Of course, this is the time my attending chooses to ask me "friendly questions" as he likes to call them. My patient was on coumadin so he asked me something about things I need to watch out for related to the patient's diet. I am very comfortable with the pathophys of warfarin, so I confidently say, oh you want to make sure to watch out for the potassium levels. Attending looks at me kind of quizzically and say, hmmm, more importantly, you want to monitor the vitamin K levels.
I was totally thinking "K", don't know how the hell one confuses vitamin K with "K+". I was just kept my mouth shut and nodded as he went on to explain the basic pathophys of warfarin to me.

 

[mandinca]

First week on General Surgery rotation at a level 1 trauma center, I was observing my 3rd-year surgery resident assisting the CT surgeon with a pericardial window. It was totally awesome. I'm contemplating all subspecialties within Surgery so I quietly turn to the CST and whisper, "Is Dr. X a cardiologist or a CT surgeon?" (don't know why the confusion. I knew full well that a cardioligst doesn't do CT surgery. Brain just bleeped that info) I am kindly answered, and I continue my observation. At the end of the case, I'm helping to move the patient back to the stretcher when the circulator informs me that the support staff, including me, was written up by CT surgeon, Dr. X. His reasoning? "Nursing staff should know who I am."

Thankfully, the staff was reassuring and laughed it off. "He does stuff like that all the time". Gotta love your CSTs and circulating RNs

 

[Rollo]

First week on General Surgery rotation at a level 1 trauma center, I was observing my 3rd-year surgery resident assisting the CT surgeon with a pericardial window. It was totally awesome. I'm contemplating all subspecialties within Surgery so I quietly turn to the CST and whisper, "Is Dr. X a cardiologist or a CT surgeon?" (don't know why the confusion. I knew full well that a cardioligst doesn't do CT surgery. Brain just bleeped that info) I am kindly answered, and I continue my observation. At the end of the case, I'm helping to move the patient back to the stretcher when the circulator informs me that the support staff, including me, was written up by CT surgeon, Dr. X. His reasoning? "Nursing staff should know who I am."

Thankfully, the staff was reassuring and laughed it off. "He does stuff like that all the time". Gotta love your CSTs and circulating RNs

LoL that surgeon just sounds like a total douche. I'm glad the staff is cool about it.

Easiest way to lose respect from people is to try and assert your perceived self-importance!

 

[RapplixGmed]

I learned that "y" should never be added to the word "pus" in to make it an adjective.

The other day on ENT rounds, I presented a patient with the epic sentence "Mr. X has some pus-y fluid below his tongue."

 

[Sheldor]

I learned that "y" should never be added to the word "pus" in to make it an adjective.

The other day on ENT rounds, I presented a patient with the epic sentence "Mr. X has some pus-y fluid below his tongue."

Wow, this was one of the funniest posts I've ever read on SDN...

Freaking hilarious!

 

[45408]

I learned that "y" should never be added to the word "pus" in to make it an adjective.

The other day on ENT rounds, I presented a patient with the epic sentence "Mr. X has some pus-y fluid below his tongue."

Nah, you can say it without a problem. Just pronounce it "pus-ee"

It's when you try to write it that you run into problems.

 

[Bacchus]

Pt's son: My wife is delivering twins tomorrow.
Me: Congratulations! B/B, B/G, or G/G?
Pt's son: Boy and Girl
Me: Identical or fraternal?
Pt's son: Well, it's a boy and girl so I don't think they're identical...

 

[drizzt3117]

This wasn't exactly my fault or embarrassing, but I don't recommend becoming a patient on the service you're rotating on...

 

[Jolie South]

This wasn't exactly my fault or embarrassing, but I don't recommend becoming a patient on the service you're rotating on...

We're going to need the deets here.

 

[drizzt3117]

We're going to need the deets here.

Not that much to hear, I got acute cholecystitis while I was on an abdominal imaging rotation and some of the people on my service saw my scan... I had surgery and was in the hosp for 3 days, not the best way to spend an away rotation but oh well.

 

[Jolie South]

Not that much to hear, I got acute cholecystitis while I was on an abdominal imaging rotation and some of the people on my service saw my scan... I had surgery and was in the hosp for 3 days, not the best way to spend an away rotation but oh well.

I was hoping you were on surgery and the surgical team you were on admitted and operated on you or the like.

 

[drizzt3117]

I was hoping you were on surgery and the surgical team you were on admitted and operated on you or the like.

No such luck, but I'm considering prelim surg here and the gen surg program director "did my surgery" although one of the chief residents seemed to be running the show...

 

[KarateSocks]

I had an outpatient clinic rotation this week. I knew it was going to be a great day when I walked in to see the fellow I was working with and he said "oh hi, you look familiar, have we met before?"
Me: "um, we worked together last week"

He then spent the rest of the day introducing me to patients as "Sharon" despite the fact that it is not my name, doesn't sound like my name and isn't spelled like my name, and my name is spelled out on my white coat and name tag. I kept trying to introduce myself before he could, but he managed to beat me to it almost every time.

 

[SB100]

I learned that "y" should never be added to the word "pus" in to make it an adjective.

The other day on ENT rounds, I presented a patient with the epic sentence "Mr. X has some pus-y fluid below his tongue."

This "adjective" was used in written exam vignettes I had during MS2, several times.

 

[Mace1370]

I had an outpatient clinic rotation this week. I knew it was going to be a great day when I walked in to see the fellow I was working with and he said "oh hi, you look familiar, have we met before?"
Me: "um, we worked together last week"

He then spent the rest of the day introducing me to patients as "Sharon" despite the fact that it is not my name, doesn't sound like my name and isn't spelled like my name, and my name is spelled out on my white coat and name tag. I kept trying to introduce myself before he could, but he managed to beat me to it almost every time.

You didn't correct him in the hallway between patients?

 

[mandinca]

I had an outpatient clinic rotation this week. I knew it was going to be a great day when I walked in to see the fellow I was working with and he said "oh hi, you look familiar, have we met before?"
Me: "um, we worked together last week"

He then spent the rest of the day introducing me to patients as "Sharon" despite the fact that it is not my name, doesn't sound like my name and isn't spelled like my name, and my name is spelled out on my white coat and name tag. I kept trying to introduce myself before he could, but he managed to beat me to it almost every time.

I'm always afraid of embarrassing someone. I might choose to ask him kindly, in private and with a big, warm smile on my face, "Do I remind you of someone, because I heard you call me Sharon." That gives him the perfect opportunity to see his mistake for himself....hopefully.

 

[KarateSocks]

yeah, it got to the point I didn't know if it'd be more embarrassing to keep going as we had and let him call be by the wrong name or to correct him.