How annoying are surgical rounds?

[bobbyseal]

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I'm six weeks into surgery, and I'm just getting sick of morning rounds.

Everyday, there are bandage changes, and we, students, are encouraged to race against each other as to whom can be the first one to crack a 4x4 or rip off some of the highly covetted large paper tape. I hope my skills whipping out the staple remover gets noted on my Dean's letter. I think that's really going to be what might get me that Derm residency at UCSD. Am I the only one who sees the ridiculous nature of this

 

[Kalel]

Yup, I hated surgery rounds too. I don't understand how surgeons can make fun of medicine folks for their rounds when surgery rounds are so much more painful. Besides the wound care (which is handled by nurses on medicine floors), going around asking every patient if they passed any gas was definitely not my idea of fun at 4:30 in the morning. At least medicine rounds involved some amount of teaching and thinking of differentials. And then a lot of surgical services at my school are humongous, particularly trauma and transplant. We had some 60 patients some days which would take 5 hrs of painful rounding from floor to floor, looking for ins and outs, removing bandages and then rebandaging, and making sure that things were still draining.

 

[Blade28]

I don't know...I didn't find removing staples or changing dressings THAT demeaning. In OB, we had to remove staples (for C-sxn) or check lochia in post-partum patients...MUCH more awkward. 🙂 And medicine rounds always took longer than surgery ones.

 

[huktonfonix]

Let the ass kissing lap dogs have their tape removal. Most residents and attendings aren't stupid. They know whats up and whos on it. For those who feel they have to race to do these things at their fellow students expense, let them trip over their dignity and self respect they have left lying on the floor.

 

[Asher]

My favorite part of surgery rounds was racing ahead of the team to the nurses station, grabbing and carrying the eight or ten notebook charts to the team, being expected to hold all of them and still manage to hand the correct one from the pile when at each patients door, racing back to the nurses station to drop the charts off, and racing to the next ward to start over. Of course, if the team made it to the next ward before I did, I would get fussed at.

 

[bobbyseal]

That could be one of the most ******ed things that can happen to med students. When I was on medicine, we had to collect the films before attending rounds. Afterwards, they would all zip away while the students put the films back away. Then, they'd be all cranky because they had to wait for us to give our little presentations on a topic before rounds. I hate this the most about med school.

 

[irlandesa]

Originally posted by bobbyseal
I'm six weeks into surgery, and I'm just getting sick of morning rounds.

Everyday, there are bandage changes, and we, students, are encouraged to race against each other as to whom can be the first one to crack a 4x4 or rip off some of the highly covetted large paper tape. I hope my skills whipping out the staple remover gets noted on my Dean's letter. I think that's really going to be what might get me that Derm residency at UCSD. Am I the only one who sees the ridiculous nature of this

either we did surgery at the same place or this is a universal phenomonen.🙂 I don't mind at all changing bandages, but I do mind having to compete against other students. We had a PA student in our group on OB/GYN who was always trying to show us up and compete against us cause she had a chip on her shoulder; needless to say I was enormously glad when she finished her time with us.

 

[Jaded Soul]

Originally posted by Asher
My favorite part of surgery rounds was racing ahead of the team to the nurses station, grabbing and carrying the eight or ten notebook charts to the team, being expected to hold all of them and still manage to hand the correct one from the pile when at each patients door, racing back to the nurses station to drop the charts off, and racing to the next ward to start over. Of course, if the team made it to the next ward before I did, I would get fussed at.

Even better is when they decide to round out of order without telling you. One time, another student and I were scutting something on one ward, got left behind by our team, and scurried to the next ward only to find they weren't there. We had to page the intern to find out where the team was, and when we hooked up with them we got chewed out by the chief for not knowing where we were going.

 

[shag]

Gunner medical students and unappreciative residents will unfortunately be encountered on any rotation. The previous posts paint a very painful picture concerning surgical rounds, and I 'm sorry that you guys had / are having such a negative experience.

To counter this on my surg rotation, the students on my team got together and agreed that each student would be responsible for the wound care of the patients that she/he was carrying or presenting. It worked well because it created order out of chaos, and everyone ended up looking good. In addition, this pre-assignment of woundcare kept us from looking stupid by jockying for postion at the bedside.

As far as medicine rounds go, I would much rather change surgical wound dressings than write 2 page annotated daily medicine progress notes that no one but the lawyers will ever read.

 

[Blade28]

Originally posted by shag
As far as medicine rounds go, I would much rather change surgical wound dressings than write 2 page annotated daily medicine progress notes that no one but the lawyers will ever read.

Exactly. Amen to that. 🙂

 

[Whisker Barrel Cortex]

Originally posted by shag

As far as medicine rounds go, I would much rather change surgical wound dressings than write 2 page annotated daily medicine progress notes that no one but the lawyers will ever read.

Not true. I read many medical student notes as a medicine intern when cross covering on a patient and when the resident note was too short or incomplete. The worst cross cover cases were always the one when no one bothered to write a good progress note during the entire stay and I had to dig through orders, etc in order to figure out what the heck they were doing for the this patient and why. Quite a pain in the butt.

 

[Galaxian]

What about tag teaming dressing changes before the residents show up? Four hands are better than two... Ortho rounds huktonfonix?

 

[Mirror Form]

Originally posted by irlandesa
We had a PA student in our group on OB/GYN who was always trying to show us up and compete against us cause she had a chip on her shoulder; needless to say I was enormously glad when she finished her time with us.

Yeah, what the heck is up with some of those PA students? The one I rotated with on surgery was so gung-ho that she had read all of surgical recall before the rotation even freaking started!

 

[huktonfonix]

True, true galaxian. Dressing changes go a lot smoother and more efficiently if you tag team them on certain patients that require more effort, esp. ortho dressings. I think this let us sleep in an extra half hour each morning. Still if someone wants to be gung ho and change my patients dressings for me I say the smart money is to let them and sleep in. I'm changing them out of a courtesy to the attending and resident for letting me in on the surgery not to kiss their ass so I frankly don't give a crap if someone else does it for me. Makes life easier.

 

[Galaxian]

Yeah, what the heck is up with some of those PA students? The one I rotated with on surgery was so gung-ho that she had read all of surgical recall before the rotation even freaking started!

Hey, they got all the time in the world to read surgical recall, so let 'em...You're gonna be a doctor for cryin' out loud!

 

[Al Pacino]

Originally posted by Whisker Barrel Cortex
Not true. I read many medical student notes as a medicine intern when cross covering on a patient and when the resident note was too short or incomplete.

Also, I've noticed that the notes written by fellow medical students are always so much more legible and understandable. Most students want to impress their residents, hence the neat handwriting. Meanwhile, I've noticed that 80% of attending notes are basically illegible...it's almost a show of power as if to say, "Look I'm so important that I can get away by scribbling crap...and I'm gonna force you to waste your time trying to decipher it"

 

[Kalel]

I've heard horror stories about PA students at my school too. One story came from a classmate in ob/gyn who said that this PA student would pre-round on every patient in the service and have a note written for every patient (including other student's patients) before most people even showed up. I worked with a PA student who was a complete slacker though, I guess that it was early in her rotations, but she showed no interest in learning anything and "signed off" on patients she wasn't interested in anymore, so I guess that it's just one of those things that's student dependent too.

 

[shag]

Originally posted by Whisker Barrel Cortex
Not true. I read many medical student notes as a medicine intern when cross covering on a patient and when the resident note was too short or incomplete. The worst cross cover cases were always the one when no one bothered to write a good progress note during the entire stay and I had to dig through orders, etc in order to figure out what the heck they were doing for the this patient and why. Quite a pain in the butt.

It warms my heart to hear that someone with MD after their name actually reads student notes. I got the impression that my notes were of little use at best, and were usually an annoyance to busy residents if they were forced to read/co-sign them by attendings.

I recall one incident where an intern was actually called in on his off day by the chief on the general medicine service because he forgot to put his H&P on the chart. When I asked why he didn't just read my note, he answered by saying "I don't have time to read through all that crap." My "crap" was a 2 page complete H&P that I felt addressed important points and avoided fluff. Anyway, that put into perspective just how important my efforts at documentation were.

 

[trex92499]

I recall one incident where an intern was actually called in on his off day by the chief on the general medicine service because he forgot to put his H&P on the chart. When I asked why he didn't just read my note, he answered by saying "I don't have time to read through all that crap." My "crap" was a 2 page complete H&P that I felt addressed important points and avoided fluff. Anyway, that put into perspective just how important my efforts at documentation were.

I've had something similar happen with a surgical attending. After spending 30 minutes doing an extensive pre-op with a patient in clinic and addressing all of the guys medical problems, getting his pre-op appointments/labs/studies, the attending drops my pre-op form in the HIPPA box and says "We need someone with letters after their name to see the patient"

I just wanted to laugh, because the resident pre-op workup consisted of him putting a big X through the review of systems even though the guy had reported hemoptysis. Way to go, letters after name.

 

[DOtobe]

Originally posted by Kalel
I've heard horror stories about PA students at my school too. One story came from a classmate in ob/gyn who said that this PA student would pre-round on every patient in the service and have a note written for every patient (including other student's patients) before most people even showed up.

Yikes!!!

I worked with 2 PA students during my surgery rotation, and they were both great. Not gunners, not slackers. We never raced for the 4X4's or staple removers either... 🙂

On the subject of surgery rounds, the only thing I hated was that they started so damn early. I hated doing rounds and looking out the window at nothing but darkness. And waking patients up asking about bowel movemements at 5:30 am was not my idea of fun.

I actually had a fairly decent surgery rotation, but I'm glad that it's over...