How do you stay hydrated and fed on rotations?

[enanareina]

Not to sound whiny, but I'm curious to see what solutions people have come up with to stay well fed on the more time intensive rotations. I'm on trauma surgery, so today we started collecting vitals at 0530, morning report at 0630 (I ate a granola bar), then I went to the OR, out at 1030 (energy bar), then we rounded for several hours. By the time I got home, I hadn't peed in 9 hours--isn't that oliguria in a patient?

I'm sure there are little tricks I need to learn. I also need to "toughen up", as one intern told me today, which is annoying but entirely true. Any advice on how to either sneak away, or carry enough food to keep me going?

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[pillowhead]

Not to sound whiny, but I'm curious to see what solutions people have come up with to stay well fed on the more time intensive rotations. I'm on trauma surgery, so today we started collecting vitals at 0530, morning report at 0630 (I ate a granola bar), then I went to the OR, out at 1030 (energy bar), then we rounded for several hours. By the time I got home, I hadn't peed in 9 hours--isn't that oliguria in a patient?

I'm sure there are little tricks I need to learn. I also need to "toughen up", as one intern told me today, which is annoying but entirely true. Any advice on how to either sneak away, or carry enough food to keep me going?

Surgery is probably the hardest rotation to stay fed and hydrated because the OR has no lunchtime. All you can do is what you're already doing--ALWAYS have an energy bar and a water bottle readily available so you can eat if you have five minutes of downtime. If you're pretty assured of 15-20 minutes of downtime between cases while the cafeteria is opened, then go and get lunch. Room turnover takes that long and while it's good to be in the room from the second the patient gets there until the second the patient leaves, sometimes you've got to take care of yourself too.

 

[loveumms]

I kept granola bars in my lab coat - snuck out for bathroom breaks whenever I could and then came home and totally gorged myself. It definitely sucks and at first you will think that you’ll never make it but, believe me … you do get used to it (especially the back and knee pain that comes with standing for countless hours) and eventually learn to deal with it. The interns are probably still getting “toughened” up since they all just started too. Best of luck.

 

[Caffeinated]

I basically kept myself volume-down for surgery so that I would not have to pee very often. Residents and attendings may ignore you when you are there, but if you have to leave in the middle of an 8-hour case to pee, they definitely notice that. If you don't do dehydration well, then I don't recommend this method. But it worked for me.

If your resident says "go to lunch" then do it. You don't know when you will be eating again, so make it worth it. Try to eat healthy, but indulge a little bit too, because you don't want to be hungry again in 90 minutes.

 

[vwhan]

Not to sound whiny, but I'm curious to see what solutions people have come up with to stay well fed on the more time intensive rotations. I'm on trauma surgery, so today we started collecting vitals at 0530, morning report at 0630 (I ate a granola bar), then I went to the OR, out at 1030 (energy bar), then we rounded for several hours. By the time I got home, I hadn't peed in 9 hours--isn't that oliguria in a patient?

I'm sure there are little tricks I need to learn. I also need to "toughen up", as one intern told me today, which is annoying but entirely true. Any advice on how to either sneak away, or carry enough food to keep me going?

I think I was dehydrated every day during 3rd year. So I don't really have any helpful hints there, but I always kept a protein bar (Genisoy) in a pocket. It came in real handy several times when I didn't have a chance to eat lunch. Maybe that's why I lost 25 lbs during 3rd year

 

[excalibur]

c'mon you don't have 90 seconds during your grueling days on your surgery rotation to take a piss? you can't pee from morning report to the OR, from OR to rounds? I understand holding it while you're in a case b/c you don't want to step out and look bad, but when you have more than one case, can you not find 90 seconds to piss? Do you really think that a surgeon is "tougher" or better for not having pissed while at work? I guess surgical residents don't pee while at work for 5 years

 

[excalibur]

I also need to "toughen up", as one intern told me today, which is annoying but entirely true. QUOTE]
You claim to have eaten two granola bars all day and not peed, and you're agreeing with your intern that you should toughen up???

What is our medical education coming to?

how can you complain about not eating or drinking enough, but then agree with the intern that you're being soft and need to toughen up?

The "if you eat, drink, or pee on the job, you're weak" mentality is such BS. The sad part is I know it's true in many places.

 

[fuzzyerin]

You claim to have eaten two granola bars all day and not peed, and you're agreeing with your intern that you should toughen up???

What is our medical education coming to?

how can you complain about not eating or drinking enough, but then agree with the intern that you're being soft and need to toughen up?

The "if you eat, drink, or pee on the job, you're weak" mentality is such BS. The sad part is I know it's true in many places.

On the note of eating, the thing that pisses me off most about MSIIIs (I'm a PGY2) is when they ask me if they can go to lunch. Now, that's fine when we're not busy, but if I'm in the middle of admitting a patient and there's still 3 patients to be seen in triage, DO NOT ask me if you can go get lunch. Because there is still WORK to be done. We can all eat after.

Or, if you are going to be that stupid, ask me if I want anything, because I haven't had anything to eat all day.

 

[RustNeverSleeps]

On the note of eating, the thing that pisses me off most about MSIIIs (I'm a PGY2) is when they ask me if they can go to lunch. Now, that's fine when we're not busy, but if I'm in the middle of admitting a patient and there's still 3 patients to be seen in triage, DO NOT ask me if you can go get lunch. Because there is still WORK to be done. We can all eat after.

Or, if you are going to be that stupid, ask me if I want anything, because I haven't had anything to eat all day.

This is why I don't miss third year. This reminds me of the time I didn't get a day off for 4 weeks in my medicine rotation. We were supposed to get a day off every other week, but could only take it on a weekend. Of course the residents both wanted weekend days off, and neither wanted to handle the service without the other resident or the student, so I was left with no days off for 4 weeks. I understand that residents are often busy and overworked, but in most cases, so are students, and we are not protected by work hour regulations.

 

[mdphd2b]

Not to sound whiny, but I'm curious to see what solutions people have come up with to stay well fed on the more time intensive rotations. I'm on trauma surgery, so today we started collecting vitals at 0530, morning report at 0630 (I ate a granola bar), then I went to the OR, out at 1030 (energy bar), then we rounded for several hours. By the time I got home, I hadn't peed in 9 hours--isn't that oliguria in a patient?

I'm sure there are little tricks I need to learn. I also need to "toughen up", as one intern told me today, which is annoying but entirely true. Any advice on how to either sneak away, or carry enough food to keep me going?

Have not done surgery yet, so I can't advice you on the peeing part, but so far I've been using my inside pockets in my white coat. One has a small Aquafina bottle which I can refill, and the other has Kashi TLC bar, dried fruit, and nuts! If there are times in the future I can't where the white coat, I'm going to use a small belt bag

 

[NY Musicologist]

Go to an outdoor/sporting goods store, get a kiddie-size Nalgene bottle, and carry it in your pocket or use one of those mountain-climber clip-things (sorry, don't know what they're called, but there's probably a box of them right by the cash register!) to clip it to your belt loop. (kiddie-size so it weighs less and stays out of the way)

As for food, if you're eating dried fruit and granola bars all day, your dehydration situation can't possibly improve. What about substituting a baggie of baby carrots, celery sticks, radishes, apple slices, etc. for the granola bar in your pocket? (I'd keep the balance-bar-type thing, though.)

 

[Shodddy18]

How about a camel pak under the labcoat???

j/k

 

[Pox in a box]

On the note of eating, the thing that pisses me off most about MSIIIs (I'm a PGY2) is when they ask me if they can go to lunch. Now, that's fine when we're not busy, but if I'm in the middle of admitting a patient and there's still 3 patients to be seen in triage, DO NOT ask me if you can go get lunch. Because there is still WORK to be done. We can all eat after.

Or, if you are going to be that stupid, ask me if I want anything, because I haven't had anything to eat all day.

Chill out. First, where are you interns? Fourth years?

 

[Bubb Rubb]

Chill out. First, where are you interns? Fourth years?

he wrote that he's a PGY2, but if you meant to ask where are youR interns and fourth years then i have no answer. might be a small rotation: mine has just attendings and me, no one else.

as to the topic of this thread, the surgery lounge on my current rotation has sandwich ingredients, soda and oj in the fridge, and bagels/muffins out all day for doctors to snack on between cases (and presumably students! no one has carped yet). i'm often in the same OR for multiple cases, so the 20 minutes as the room is turned around is a perfect time to rehydrate and grab a bite.

 

[fuzzyerin]

Chill out. First, where are you interns? Fourth years?

My interns are still learning what to do, plus I cover them when they are at clinic. My fourth years are helping the PGY3 run a very busy antepartum service. And I was the intern all last year and this happened more than once from MSIIIs. I'm all for letting MSIIIs eat - heck, I want to eat too - but there's a time and a place to ask. It's just a matter of assessing the situation and knowing if it's appropriate to ask a question.

 

[Caffeinated]

Have not done surgery yet, so I can't advice you on the peeing part, but so far I've been using my inside pockets in my white coat.

When I first read this I thought you were saying that you were peeing into the pockets in your white coat!

 

[lexrageorge]

If you have to pee, or take care of any other bodily function, then go to the rest room and do it. There are a lot of urban legends floating around, and not be allowed to go pee is one of them. You will not fail your surgery rotation because you had to scrub out on a case.

As for lunches, etc., keep those granola bars handy.

 

[mdphd2b]

When I first read this I thought you were saying that you were peeing into the pockets in your white coat!

LOL...didn't even see that coming

 

[OSUdoc08]

Not to sound whiny, but I'm curious to see what solutions people have come up with to stay well fed on the more time intensive rotations. I'm on trauma surgery, so today we started collecting vitals at 0530, morning report at 0630 (I ate a granola bar), then I went to the OR, out at 1030 (energy bar), then we rounded for several hours. By the time I got home, I hadn't peed in 9 hours--isn't that oliguria in a patient?

I'm sure there are little tricks I need to learn. I also need to "toughen up", as one intern told me today, which is annoying but entirely true. Any advice on how to either sneak away, or carry enough food to keep me going?

Why don't you just carry a bottle of water with you on rounds. Youve got plenty of pockets in your white coat for it.

I've always got a bottle of water with me, unless I need to be in a sterile field (altough you can use one of those camel packs.)

 

[YouDontKnowJack]

has anyone tried hanging a plastic piss bag from their crotch?
You can let it hang down the side of a leg, and then empty it out during breaks.
of course you'll be turning heads when the piss hits the plastic, but maybe it won't be noticeable if the music is turned on in the OR.

 

[Caffeinated]

has anyone tried hanging a plastic piss bag from their crotch?
You can let it hang down the side of a leg, and then empty it out during breaks.
of course you'll be turning heads when the piss hits the plastic, but maybe it won't be noticeable if the music is turned on in the OR.

Or just go straight to the Foley. Among the mess of tubes, wires, and sterile drapes, nobody is likely to notice your Foley bag and tubing.

 

[OSUdoc08]

Or just go straight to the Foley. Among the mess of tubes, wires, and sterile drapes, nobody is likely to notice your Foley bag and tubing.

This is exactly why I'm not going into surgery......

 

[DadofDr2B]

I basically kept myself volume-down for surgery so that I would not have to pee very often. Residents and attendings may ignore you when you are there, but if you have to leave in the middle of an 8-hour case to pee, they definitely notice that. If you don't do dehydration well, then I don't recommend this method. But it worked for me.

If your resident says "go to lunch" then do it. You don't know when you will be eating again, so make it worth it. Try to eat healthy, but indulge a little bit too, because you don't want to be hungry again in 90 minutes.

====================================

What would you do with a resident that is a Type 1 diabetic resident? Admit them when they go into a coma.

 

[group_theory]

For food - just do what your residents are doing. They have to eat sometime ... eat with them (or follow their schedule). Just learn how to eat as quickly as they do.

For surgery ... unless you are in a rare complicated case, most surgeries won't last longer than 6 hours. Use the bathroom while changing in the lockerroom. If the OR suite have bathroom inside the "scrubs/hats/boots required" area, take advantage of that in between cases.

If you really have to go during a case ... then wait for a good time (NOT when the surgeon is trying to tie off a bleeding artery or the patient is in SVT and the anesthesiologist is yelling at the surgeon to hurry up) and just tell the surgeon that you have to scub out and use the restroom. Chances are, as a MS3, you're just observing or holding the retractor (or suctioning).

Just don't make a habbit of doing it every case or having to scrub out every day.

The key also is to be friends with the scrub and circulating nurses. If they like you, then they won't get annoyed when you have to scrub out to use the restroom.

 

[Mr. McDuck]

I never really had a problem with staying hydrated and fed during the day. I drink a bottle of water over the course of the day, sometimes two, and I eat lunch whenever I get the chance. I have a smoothie and a banana for breakfast on the way to the hospital, and when I get home, I just eat until I go to sleep. If it's REALLY busy, I'll keep a bag of skittles or something and a bottle of water in my pocket so I can get something. Also, I always keep money with me in case there is suddenly 10 mins to eat or something.

 

[Caffeinated]

====================================

What would you do with a resident that is a Type 1 diabetic resident? Admit them when they go into a coma.

I am just speaking from my own personal experience as a medical student. I have no experience as a resident or supervising residents.

 

[JayZee]

If the cafeteria is open I'll go there right after I park my car, carry it to the lounge and stuff it in the fridge. Between cases, I'll scarf a bite or two...

One time, I did that and my attending came out of the locker room and I popped up and closed the box...he said "what are you doing?" and I was like, "putting my food away" ...he said "SIDDOWN and EAT your food there's plenty of time!!"

hehe...i hope all my attendings are like that!

 

[Sammich81]

On the note of eating, the thing that pisses me off most about MSIIIs (I'm a PGY2) is when they ask me if they can go to lunch. Now, that's fine when we're not busy, but if I'm in the middle of admitting a patient and there's still 3 patients to be seen in triage, DO NOT ask me if you can go get lunch. Because there is still WORK to be done. We can all eat after.

Or, if you are going to be that stupid, ask me if I want anything, because I haven't had anything to eat all day.

This post brings back a terrible memory of my 3rd year OBGYN rotation. Certainly a student shouldn't ask to go to lunch when their resident is busting their butt, but if the student is sitting there holding up the wall and they can't be helpful in any way, a kind resident would send them off. Give them your ID and tell them to pick up something for you if you want, but there's no reason to spread your pain and misery. Maybe your student is useful to you. If so, I can understand why you'd be put off by a request to eat when you obviously can't.

Students give as good as they get. If you're as harsh on them as the post makes you sound, it's no wonder they're trying to get away.

 

[supercut]

One of the things you learn as you gain some experience is that the pockets of your coat are for food and drink, not for books!

Seriously, though...long OR turnover times are a blessing for us surgery residents (that's when I eat, hydrate, and pee). I find a protein shake in the am before I leave (or sometimes in the car) helps me get through the morning. Often you can use MAFAT (mandatory anesthesia f&#$ around time) to pee or hydrate.

 

[enanareina]

For clarification, I'm on a trauma surgery rotation, which is a little different from general surgery. When I'm scrubbing into cases, I actually have found time to eat and go to the bathroom. The problem has come when we round. On this service, we round all damn day. When on bedside rounds, we are not supposed to eat or drink, which I understand because we're entering patients' rooms and such. It just gets really really long and dull, especially since the med students on this team are not allowed to be responsible for patients, so during rounds we're utterly useless.

Coat pockets: I am carrying enough pre-packaged food to open a convenience store. Unfortunately, there is no room for a bottle of water. For some reason, water fountains are few and far between in this hospital.

I appreciate all the suggestions so far!

 

[DrWuStar]

i find that a cliff bar and one of those yogurt/smoothie type drinks fit in the pocket nicely, provide enough calories and fat to make it through the afternoon, and takes only 1.5 minutes or so to eat. my resident and attending don't eat lunch, but i can't live like that, so that's my best solution.

the dehydration thing is rough. i just try to find water fountains and live with it.

 

[littlepurplepil]

For clarification, I'm on a trauma surgery rotation, which is a little different from general surgery. When I'm scrubbing into cases, I actually have found time to eat and go to the bathroom. The problem has come when we round. On this service, we round all damn day. When on bedside rounds, we are not supposed to eat or drink, which I understand because we're entering patients' rooms and such. It just gets really really long and dull, especially since the med students on this team are not allowed to be responsible for patients, so during rounds we're utterly useless.

Coat pockets: I am carrying enough pre-packaged food to open a convenience store. Unfortunately, there is no room for a bottle of water. For some reason, water fountains are few and far between in this hospital.

I appreciate all the suggestions so far!

Make use of the styrofoam cups they use for pts...there's ALWAYS a water & ice dispenser on each floor (usually more than one per unit) and the most you may have to do is find out the code to the door (from a nurse or knowledgable MS-IV) to get into the food room where they keep the cups, lids, straws, and yummy graham crackers. Depending on the hospital the nurses will either kindly look the other way when you get a big cup of water or you may have to be a little subtile and not parade your partaking of "pt food." The benefit is you can rehydrate right before/betwen rounds and if the attending walks up, it's easy to blend the evidence into the rest of the junk hanging around nurses' stations.

I've often made a nice meal out of one of those lil cranberry juices, some ginger ale, and three packages of graham crackers...my resident and I once had an impromptu picnic of sorts between work rounds and attending rounds on a particularly busy day

 

[Bobblehead]

i find that a cliff bar and one of those yogurt/smoothie type drinks fit in the pocket nicely, provide enough calories and fat to make it through the afternoon, and takes only 1.5 minutes or so to eat. my resident and attending don't eat lunch, but i can't live like that, so that's my best solution.

the dehydration thing is rough. i just try to find water fountains and live with it.

I've eaten many clif bars but while I think they're great for running they wear off too quickly. I find protein bars will last a little longer than ones that have primarily carbs as their calorie source.

 

[PlasticMan]

I've eaten many clif bars but while I think they're great for running they wear off too quickly. I find protein bars will last a little longer than ones that have primarily carbs as their calorie source.

Enter Clif builder bars

 

[TBforme]

On the note of eating, the thing that pisses me off most about MSIIIs (I'm a PGY2) is when they ask me if they can go to lunch. Now, that's fine when we're not busy, but if I'm in the middle of admitting a patient and there's still 3 patients to be seen in triage, DO NOT ask me if you can go get lunch. Because there is still WORK to be done. We can all eat after.

Or, if you are going to be that stupid, ask me if I want anything, because I haven't had anything to eat all day.

luckily over the course of 3rd year, you will have enough residents like fuzzyerin that you will get use to being in prerenal ARF with starvation ketosis. it use to really bother me at the beginning of the year, but after a while, you really get used to it. i always figured if i had a syncopal episode i would at least get to go home.

 

[lizmid152]

We used the buddy system on surgery. Partner up with a couple of your fellow third years. When someone had down time, they would go eat lunch, run to the bathroom, and then check to see if any of the other students needed to break scrub to take a quick lunch break, especially on CVT service, since those surgeries can be 10+ hours.

It works pretty well, since there is still a student present to do the slave work. None of our attendings or residents had a problem with this, since you were usually only gone 15-20 minutes max. I have been scrubbed into a surgery where the attending and/or residents broke scrub for some reason or another. As long as someone can cover you for a few minutes, you shouldn't have a problem.

 

[lvspro]

Hey all
I read about people having issues taking care of functions at work, but I have yet to meet anyone that is reasonably organized that can't find time to pee, or scarf down some food. Also, I've noticed that virtually every hospital I've worked in ihas a water/ice dispenser in the pacu. I always managed to find some time to eat in between cases, and was always well hydrated because I had a route planned for myself that would take about 8 minutes to run. I'd run down to the cafeteria, grab a handy food like a sandwich, or fruit or something, jog back up to the floor, scarf down said food, wash it down with some water, and get back to my cases. I may have to hold on peeing until after the next case, but I managed.
Another thing, you should carry granola bars for when you're on floor-style surgery like trauma, or consults at night.
Now that I think about it, it may be more of a problem with efficiency with writing notes. If you get good a system of note-writing, you should save a few minutes on each side, ultimately giving you enough time to eat and drink.
Good luck

 

[Nerdoscience]

I got used to teating whatever food was available in the nutrition rooms in the hospitals. That meant lots of boullion with saltines, peanut-butter and graham crackers, and water. I kept some Crystal Lite packet with me, too. I On peds, it was shortbread cookies and Ensure. I don't necessarily recommend that, but it did keep me from getting presyncopal...

 

[Mr. McDuck]

I'm jealous of you guys that can "scarf down food". I eat slow as hell, and I really can't speed it up any. I've gotten used to just eating my lunch slowly between cases hours at a time.

 

[DORoe]

As for the urinating why don't you try THIS for the problem?

 

[Quix]

This works, too.

 

[Paws]

Well, I just started on surgery today and I was told that 'we don't eat lunch' at all. So that was weird especially since the day lasted 13 hours. So I had a small bowl of cereal when I got up and then nothing until just about now.

It seems insane to me, epsecially since you are basically completely ignored except to be given some sharp comments. I don't think I want to go into surgery, and tonight I am thinking I don't even really want to be doing medicine anymore. This is the first day of my third year rotation and I sort of wish I had become an English teacher or something.

 

[OSUdoc08]

Well, I just started on surgery today and I was told that 'we don't eat lunch' at all. So that was weird especially since the day lasted 13 hours. So I had a small bowl of cereal when I got up and then nothing until just about now.

It seems insane to me, epsecially since you are basically completely ignored except to be given some sharp comments. I don't think I want to go into surgery, and tonight I am thinking I don't even really want to be doing medicine anymore. This is the first day of my third year rotation and I sort of wish I had become an English teacher or something.

I run into all of the surgeons and all of the students on surgery every day in the cafeteria. An overweight chief of surgery will ensure that meals are eaten.

 

[DrMom]

I run into all of the surgeons and all of the students on surgery every day in the cafeteria. An overweight chief of surgery will ensure that meals are eaten.

It all depends on the schedule on surgery and how long the hospital cafeteria stays open. There were multiple days on my surgery rotation where I missed meals...and so did the residents and attendings. I learned to carry crackers/snack food in my pockets. I also tag-teamed with a classmate so that if I was scrubbed in over a mealtime she'd grab food for me to eat later & I'd do the same for her.

 

[deleted87716]

An overweight chief of surgery will ensure that meals are eaten.

That, or he can afford to skip a lot of meals.

 

[OSUdoc08]

It all depends on the schedule on surgery and how long the hospital cafeteria stays open. There were multiple days on my surgery rotation where I missed meals...and so did the residents and attendings. I learned to carry crackers/snack food in my pockets. I also tag-teamed with a classmate so that if I was scrubbed in over a mealtime she'd grab food for me to eat later & I'd do the same for her.

That or you could pack a sack lunch. The food in the cafeteria isn't that good anyway....

 

[Paws]

Today I found the OR lounge and the motherlode of crackers and coffee. Well, stale coffee but it's free and it sure tased good. I also had a big package of sunflower seeds with me and those were great. Salted too, so that acted to sort of absorb any potential need to pee frequently. Today went a little better over all.

 

[mlw03]

i find that a cliff bar and one of those yogurt/smoothie type drinks fit in the pocket nicely, provide enough calories and fat to make it through the afternoon, and takes only 1.5 minutes or so to eat. my resident and attending don't eat lunch, but i can't live like that, so that's my best solution.

the dehydration thing is rough. i just try to find water fountains and live with it.

i too find that a cliff bar can go a long way for only 250 calories. i find most of the flavors pretty tasty, and at about a dollar a piece, they're not too expensive.

 

[Brown429]

so...for those of you that worked out pumpin weights in the gym throughout undergrad and perhaps preclincial years...you let your muscles deteriorate and become scrawny??? im on my way to medical school and am asking myself why even workout if you a. do not have time to in med school and b. cannot find time to eat to properly nutrition yourself....

this is why I am considering derm., I WANT TO LIVE HAPPILY!

 

[OSUdoc08]

so...for those of you that worked out pumpin weights in the gym throughout undergrad and perhaps preclincial years...you let your muscles deteriorate and become scrawny??? im on my way to medical school and am asking myself why even workout if you a. do not have time to in med school and b. cannot find time to eat to properly nutrition yourself....

this is why I am considering derm., I WANT TO LIVE HAPPILY!

I work out 2-3 days a week. I have time to work out more days of the week, but I don't need to. I am currently an MS-III.

I also have a very good diet. Eating nutritiously has nothing to do with time. You can have a salad at the hospital cafeteria much more quickly than wait for them to cook you a burger.