Just out of curiosity.. not sure if this is in the right section but what are your thoughts on medical schools forcing their med students to stay in their rotations during a hurricane if that area is affected and that state has issued a state of emergency? Especially if the modes of transport are being shut down etc.
Ethical for Medical Schools to force Med students to stay during a hurricane
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I don't think it violates any ethics. I think it's expected that all staff make arrangements of getting to work one way or another during these times. Especially in this industry.
but how would you be expected to get to the hospital in the first place? there is bound to be flooding, down trees, lines, etc. Not to mention how many patients do you think would make it to that hospital?
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More likely: M3 and M4 students are expected to show up before the hurricaine does and stay until the crisis is over. Business as usual. And if you can't leave, you bed down for the night.
M1 and M2 students, I would expect would be sent to their residences. Those who could come in (living within walking distance) might be asked to come in to help as needed (like volunteers) to fill in for employees that couldn't get there because of the weather.
M1 and M2 students, I would expect would be sent to their residences. Those who could come in (living within walking distance) might be asked to come in to help as needed (like volunteers) to fill in for employees that couldn't get there because of the weather.
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Echoing this, at my school M3s and M4s are considered essential staff and must report even during snow closures where the school and non essential hospital employees are off for the day.
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The one you learn from a handbook and a 1 credit course first year of medicine.
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Physicians have a responsibility to their patients and to abandon one's patients is a breech of medical ethics. Do medical students have a similar responsibility to the patients at their clinical sites in the event of a natural disaster or similar crisis situation? Does it matter if you took an oath on the day you received the white coat? (even if you aren't yet a doctor, you may have sworn a an oath to operate under the ethical dictates of the profession.)
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I can't see how it would be an ethics issue. Perhaps the school is mandated to provide X number of clinical hours and they don't want to have to extend school beyond last scheduled day. ? I dunno
I am a critical care RN and a couple of times during blizzards my hospital was concerned that if nurses went home they might not be able to get back to the hospital because of road conditions and no nurses would mean canceled surgeries = lost revenue for hospital. So they paid us our regular hourly wages for eight hours sleep time for a few days. Easy money 🙂
I am a critical care RN and a couple of times during blizzards my hospital was concerned that if nurses went home they might not be able to get back to the hospital because of road conditions and no nurses would mean canceled surgeries = lost revenue for hospital. So they paid us our regular hourly wages for eight hours sleep time for a few days. Easy money 🙂
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I don't know if it's "ethical" or not. What I do know, having been a student at LSU med school in New Orleans during Hurricane Katrina is this: students are considered just that, students. As such, if the school was closing due to a hurricane, and there was an evacuation, the students were expected to leave.
I also know that LSU, being in an area with not infrequent hurricanes, actually has a call system for the hurricanes. When a hurricane is bearing down, the "Grey Team" is required to report to the hospital for duty during that time. Grey team is different from regular call, and alternates throughout the year. Each successive hurricane has a different grey team.
Personally, I think it's dumb to have med students stay during an evacuation. Not to mention it opens up the med school and hospital to liability, but, hey, what do I know?
I also know that LSU, being in an area with not infrequent hurricanes, actually has a call system for the hurricanes. When a hurricane is bearing down, the "Grey Team" is required to report to the hospital for duty during that time. Grey team is different from regular call, and alternates throughout the year. Each successive hurricane has a different grey team.
Personally, I think it's dumb to have med students stay during an evacuation. Not to mention it opens up the med school and hospital to liability, but, hey, what do I know?
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Oh I agree. Most residents texted us to not come in as they were doing power rounds, and cancelled all the non emergent surgeries.
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It depends on the oath. Not all prohibit cutting for stone. (See Declaration of Geneva)
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LOL If laughter is the best medicine, you've cured what ails me tonight.
The visual that goes along with this is amazing. Just be sure to shoot into, not against, the wind. The former is badass. The latter is Darwin Award-worthy.
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Not really for M3 and M4. They told us, to stay home, and if you can't come on Monday, you don't need to come in. Since it's fair, since after all we are med students and aren't a big part of the care compared to residents anyway, so it's not mandatory and such compared to the actual doctors.
Plus, we don't wanna die 😱
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This is hillarious, its not the fact that the rotation site forces you to stay, its that they close down housing. The Southeast Ahec site in North Carolina was evacuated meaning people on rotations in areas near there and Wilmington, etc had nowhere to stay. I know at least at UNC people would look at you incredulously if you said your school forced you to stay in a disaster area. The sites understand that you are a student and wouldn't ask you to put yourself in danger because the utility of you being there during a disaster isn't as great as them having to be there. But not all schools are like this.
QofQuimica
Seriously, dude, I think you're overreacting....
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Snow days are one thing, but that's a pretty unrealistic policy for a major emergency situation. Medical students are not hospital staff, and they shouldn't be asked to put themselves in danger for no reason. Even as a third month intern, I'm probably more of a liability than I would be a help in this scenario, never mind a medical student. Who is supposed to take time off from seeing patients to supervise you? Who is supposed to take care of you as an additional casualty when you hit a downed powerline on your way in to the hospital? Good grief.
My advice to students in the path of the hurricane is that you should stay home. The fewer people on the road during an emergency, the better.
It's unethical for a trainee to needlessly put him/herself into harm's way, thereby forcing others to put themselves into harm's way and diverting necessary resources from people who need them.LizzyM said:
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My own frame of reference is at schools where student housing is a short walk from the hospital (sometimes connected by tunnel) and where the hospital is not evacuated but may have staff shortages due to travel difficulties. In those situations, students can be of assistance in moving material from place to place, providing simple assistance as a volunteer would, etc. I wouldn't say "force med students to stay" but requesting their assistance seems reasonable if they are housed in close proximity to the facilities.
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Agree with this. I know for a fact that during Katrina, the 3rd and 4th years at Tulane and LSU were told/commanded to leave before the storm.
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Disagree with this. A hurricane has the potential of being a major disaster. It can be quite dangerous, and you may find yourself without a home in the immediate aftermath. Asking medical students to stay, even for clerical work, is not right. It's one thing if you're essential staff, but it's quite another if you're asking students to stick around.
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How many hurricaines have you lived through and where? I think that a lot depends on where you are and where the students would be if they weren't in the hospital.
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1: Katrina. I know what I'm talking about. How about yourself?
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This is actually done in Texas... Quite fun.
* as for what's stated above ^ we are talking about a cat 1 here...not a cat 5.
Long time lurker, but I felt compelled to respond to this. For the record, I live on the coast of Florida and have lived through several hurricanes of varying strengths. Most notably, the hurricane season of 2004 where four storms made landfall within two months and my home was damaged and made unlivable after one of these storms.
In my opinion, the answer to this question really depends on location of the hospital, the strength of the storm, and how fast it's moving. For a lower strength storm (cat 1 or 2), if the students don't live too close to the beach and it's safe to travel (and after a cat 1 it most likely is), I think it's perfectly reasonable to ask med students to come in to help. For a cat 4 or 5, if the hospital is relatively close to the shore, probably not. This situation really has to be taken on a case by case basis. I know that the hospital near my home, which is located a ten minute drive away from the ocean, would not ask non essential staff to stay at the hospital during a hurricane lock down. However, there are no med schools near me, so I don't really know how this policy would extend to med students.
While I don't want to minimize Katrina in any way, I don't really think you can use that one very unusual experience to determine the ethics of this situation in places that are regularly hit by hurricanes. While I agree that it would be unethical for nonessential staff to stay in that situation, most storms are no where near that level of danger.
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Katrina made landfall as a category 3 storm. The danger was not in the storm itself, but its sequelae (i.e. the levees). There's not anyway of knowing beforehand what the true danger is. So why keep people there unnecessarily? And seriously, med students don't know enough to help in any meaningful way. They have to be supervised, which just adds to the work of the already-overworked staff. You're just asking them to put themselves in harm's way for no compelling reason.
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For me, 2 hurricaines (Cat 2 and 3) in the Northeast in the 1970s-80s. Katrina was a different story. I'd love to hear from students at the NYC schools today... any around to help out?
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Interesting thread. I'm definitely going to side with LizzyM on this one, because she hit the nail on the head: medical students should stay not because we're essential medical personnel, but because we can help with logistical issues during the hurricanes.
We just had a pretty bad spate of tornadoes in Alabama. The morning after the storms hit, I put on my old VFD uniform and headed out to volunteer at one of the FDs in a badly hit town -- not because I thought they would need me to work as an EMT, but because I thought they would need me for exactly what they did: I hauled cases of water around, helped clean up the station, changed a couple of response vehicle tires that had been punctured by debris on the roads, etc. A few of my classmates went in to help at the ED -- they didn't do a lot of clinical work, but mostly helping organize people, sign in, set up disaster supplies, etc. The ED in Tuscaloosa saw 650 patients in 8 hours... I'm sure they appreciated any help they could get at the time.
During the snowstorms in DC last year, Washington Hospital Center rented out several floors of the conference center hotel next door and started sending employees over to sleep 6 hours and come back to work another shift... rinse and repeat until their relief could make it in. Some of those docs/nurses worked for 4 days straight with periodic breaks. Yes, I understand that medical students are not physicians. That said, at some point you have to reconcile yourself to the fact that you're going to be required to go above and beyond at times, especially in disasters. If you really want to skip out during a disaster at the hospital as a 3rd or 4th year, they can hardly kick you out of school for it. But if that's really your attitude, I agree with an above poster that I think that's unfortunate for someone going into medicine -- and when you're on staff, you won't have a choice.
We just had a pretty bad spate of tornadoes in Alabama. The morning after the storms hit, I put on my old VFD uniform and headed out to volunteer at one of the FDs in a badly hit town -- not because I thought they would need me to work as an EMT, but because I thought they would need me for exactly what they did: I hauled cases of water around, helped clean up the station, changed a couple of response vehicle tires that had been punctured by debris on the roads, etc. A few of my classmates went in to help at the ED -- they didn't do a lot of clinical work, but mostly helping organize people, sign in, set up disaster supplies, etc. The ED in Tuscaloosa saw 650 patients in 8 hours... I'm sure they appreciated any help they could get at the time.
During the snowstorms in DC last year, Washington Hospital Center rented out several floors of the conference center hotel next door and started sending employees over to sleep 6 hours and come back to work another shift... rinse and repeat until their relief could make it in. Some of those docs/nurses worked for 4 days straight with periodic breaks. Yes, I understand that medical students are not physicians. That said, at some point you have to reconcile yourself to the fact that you're going to be required to go above and beyond at times, especially in disasters. If you really want to skip out during a disaster at the hospital as a 3rd or 4th year, they can hardly kick you out of school for it. But if that's really your attitude, I agree with an above poster that I think that's unfortunate for someone going into medicine -- and when you're on staff, you won't have a choice.
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I agree that doctors and nurses should come in during emergency. i don't agree that they should not be paid. I don't understand why they shouldn't be rewarded for their efforts during a crisis. off-duty Police, firefighters, doctors etc should absolutely be reimbursed for their work during a disaster. if my off-duty cop neighbour intervened while my house was being robbed, I would demand the city pay him overtime for those hours, if not, i'd write him a check myself.
b-real: the location of Katrina's landfall is one of the things that
made it so unusually catastrophic. How many cities in the southeastern
US are partially below sea level, are surrounded by large bodies of
water, and are protected from flooding by a system of levees?
Hurricane Charley was a category 4 storm, Frances was category 2 and
Jeanne was a category 3 when they made landfall in 2004, but they
didn't cause the flooding that happened in New Orleans. The geography
of the areas they hit meant that these storms didn't have the same
risk of flooding (though they were all dangerous storms for different
reasons). It is quite possible to determine the risk of damages from
storm surge and flooding caused by a hurricane; the flood prediction
is what led to the response in NYC in preparation for Irene. Like I
said before, location is something that has to be taken
into consideration in planning the response to a hurricane.
Like sanityonleave, I'm not arguing that medical students should be
required to stay to give care that they are not qualified to give.
However, if the hospital determines that they can be of assistance,
and its easier for the med students to reach the hospital than other
non essential staff, why not help? Not all hurricanes have the same
level of risk and require an evacuation.
made it so unusually catastrophic. How many cities in the southeastern
US are partially below sea level, are surrounded by large bodies of
water, and are protected from flooding by a system of levees?
Hurricane Charley was a category 4 storm, Frances was category 2 and
Jeanne was a category 3 when they made landfall in 2004, but they
didn't cause the flooding that happened in New Orleans. The geography
of the areas they hit meant that these storms didn't have the same
risk of flooding (though they were all dangerous storms for different
reasons). It is quite possible to determine the risk of damages from
storm surge and flooding caused by a hurricane; the flood prediction
is what led to the response in NYC in preparation for Irene. Like I
said before, location is something that has to be taken
into consideration in planning the response to a hurricane.
Like sanityonleave, I'm not arguing that medical students should be
required to stay to give care that they are not qualified to give.
However, if the hospital determines that they can be of assistance,
and its easier for the med students to reach the hospital than other
non essential staff, why not help? Not all hurricanes have the same
level of risk and require an evacuation.
