Making the Most of Clinical Experience

[Ajroy03]

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[apumic]

See if you can get in and things. The ER staff isn't going to ask you to help with medical activities, but they might let you do simple things like check on pts (just don't comment on their condition if you're not qualified to do so -- and as a premed you're not), assist in restraining a nonviolent/nonpsych pt (e.g., helping keep staff safe while a catheter is placed), etc. (not sure what your hospital will allow but some here will let students doing an internship do those things). You should talk w/ the volunteer coordinator and find out what you can be allowed to do and then see what the ER staff will allow.

 

[JJMrK]

Yeah, this is pretty much how it goes, and also the reason I did as little ER volunteering as possible.

 

[DrYoda]

3) See more procedures/doctor related interactions.

For seeing procedures you're better off setting up some shadowing with a surgeon or procedure heavy speciality. That way you'll know you'll see something (the procedure will be scheduled ahead of time). Because in the ER it's basically luck of the draw if you're in the right place at the right time to see X procedure done.

 

[apumic]

For seeing procedures you're better off setting up some shadowing with a surgeon or procedure heavy speciality. That way you'll know you'll see something (the procedure will be scheduled ahead of time). Because in the ER it's basically luck of the draw if you're in the right place at the right time to see X procedure done.

I'd agree, although it also depends on what kind of hospital this ER is at. A burn center or level 1/2 trauma center is going to get far more interesting cases than a small community hospital's ER or a hospital branch's ER (or even a level 3/4 trauma center) that choppers anything of interest out the moment the pt has been minimally stabilized.

 

[usaf88233]

Find either a nurse or preferably a doctor who you think you can approach and tell them your situation. Ask if you can tag along for a bit, or if they remember when they are doing something interesting to come grab you. Where you really want to get to is asking to follow them during an entire shift (not as a volunteer). Here you will get a full picture of how EM is practiced. As an ED Tech for 2 years in a level-1, people like assertive personalities so don't be afraid to approach and talk to people! You'd be surprised how open and willing they all are to help/teach. It's just easy to forget you're there. Hope this helps!

 

[wanderer]

As a volunteer you can probably get more patient interaction on a patient floor than in the ED. EDs are often crowded and hectic and most HCPs will want you out of their way. The ED is also a lot more "anonymous" so if you aren't acquainted with any HCPs you will likely never get to do anything, much less have some patient interaction. Basically, you can either make your presence known, or you should switch to another department, such as an inpatient floor.

 

[Disinence2]

Don't be afraid to ask to observe. Of course you are there to volunteer so you should try to help out as much as possible, but when your not doing something i'm sure there is at least one resident in the ER who would let you follow them around.

Also don't be afraid to approach any med students you see. We still remember what its like to be pre med. I've been approached be a few pre-meds in the ER and usually we know who a good person to ask would be.

 

[ahmcadams]

Be assertive and ask someone specific - a nurse, med student, maybe a resident - if you can shadow them specifically. If you familiarize yourself with one or two people, they'll be more likely to let you assist with something or at least be willing to answer your questions and show you how stuff is done (even if they don't let you actually do it). Stay out of their way when something important is happening and save your questions for the right time (often in b/w patient encounters while in the hallway, etc.).

Just make your voice heard and keep asking until someone lets you tag along. The worst that can happen is you'll hear 'No' a lot. It'll be a rare MD or student who will actively come get you while you're hanging around in the hall looking for something to do.

 

[Wildebeest]

Since you are already a volunteer there, see if you can contact one of the ER docs (email/phone/in person) and tell them you are pre-med and that you volunteer there and see if you can shadow them.

 

[tennisball80]

Being an EMT is also an advantage. It provides you with great clinical experience.

 

[JoshUNCW]

I do all my volunteering at my hospitals ER. I actually help facilitating the ER, which means I'm the first person people see when coming. I take all their information including problems before they go to registration, or if its a slow day I call the charge nurse and find a room for them and take them straight back (bedside registration). But yeah, aside from walking patients around and taking information I don't do a lot. But it's given me the chance to find doctors to shadow where I get to see a lot of stuff up close. So just talk to some of the doctors during your volunteering and maybe find one to shadow.

 

[Ajroy03]

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[vcfor3]

I remember when I had to do my hospital time in the ER during EMT school, I was so scared to ask anyone anything, so it ended up being a waste of time in general since it was a small hospital and ER and nothing exciting happened. I was just people-watching most of the time, but the highlights were seeing a patient whose name was Michael Jordan (not the real one) and EMT's bringing in patients (highlight because the EMT's looked like they should have been the ones being wheeled in because they were easily pushing 90 or 100 years lol no joke)

I would try to contact the hospital and see if you can come and see grand rounds. I know a hospital near me that is encouraging people to call them so they can arrange people to see them (mostly EMS people that is), so you can find that a good time to ask and find other shadowing opportunities.

 

[Zoom-Zoom]

I did some volunteering in the ER during undergrad and I know exactly what you're talking about. You end up assisting nurses and nurse assistants, and you can get sidelined. In retrospect I think what you should do is introduce yourself to the doctor(s) in the beginning and just say you're willing to learn and would like to help with whatever you can. I got pretty good at running EKG's which is pretty helpful in the ER as they are given to almost everybody. If you run around plugging them in to charge and wheeling them around everyone will be grateful and you'll learn how to do the leads, which is a big help. You can print them and show them to the doctor. You can learn about the waves and try to read them. You'll probably also see some lumbar punctures and a bunch of venipuncture. The nurses like it when you get the blood drawing kits, bringing stuff to the lab, etc. Echos are given to lots of trauma patients and are fun to watch, depending on the size of your ER. The doctors are the technicians in the ER so try to get as close to them as possible so you can see the cool stuff. You will also be asked more about your interactions with doctors during interviews than many other things, so it's good for the resume, but there's plenty of other ways to kill time if they're not super friendly.

 

[riverjib]

Alright, so...

I have been volunteering at a local hospital in the ER. Its always VERY hectic in there, and it seems like people usually do their own thing. I had been having a little trouble remembering people's names which had me being kind of reserved to ask for help or anything really. However, I am now becoming more and more comfortable with the staff and the nurses who work there so I feel like its time for me to try to improve MY experience there.

I really would like some suggestions on what to try to do to make this the most positive experience for me. The majority of the time I will come in and say hello and ask if anyone needs any help with anything. To this, they all reply "more blood-draw kits!!!" They probably go through 100 per shift, so much of my time is spent making these and bagging them up. I was wondering what other people have done to make the best use of their time in the ER/ED. Its not really a situation where you can ask a doctor to observe a surgery or anything so it is somewhat a unique area.

My goals:

1) Be more productive. In gaining experience for myself and for the rest of the staff.
2) Involve myself in more hands on involvement and patient interaction. Currently, I sometimes take patients to different places around the hospital, get them blankets or sometimes food, and that is on limited occasions.
3) See more procedures/doctor related interactions.

Actually, in writing this I have kind of come up with an Idea myself. I think I may talk to one of the more friendly nurses and tell her that I am a pre-med student, and that it is a goal of mine to observe, at least once, all the procedures that are performed routinely in the ER. Maybe she can help me out. The only problem is getting time with these nurses can be difficult because they are always so busy. Another problem is that I feel as a volunteer, I am more of an employee so asking to do something seems out of place. It may just be me though.

Sorry for the long post, but I have a few more topics I'd like some input on. I will also be shadowing some doctors coming up and would really like to know what others have done to have the BEST possible shadowing experience. What are the best things to get out of shadowing an MD? What are some actions to take in order to achieve this?

(Oh and there is a short, somewhat decent thread on ^ this already so... if you have already posted on the subject feel free to disregard)

Thanks everyone!!

-AJ

If you want to do formal shadowing, you should formally ask a physician for the opportunity. That's your best chance of getting know what they do, and for getting a personal letter of recommendation.

However, having volunteered in a busy ED, I can tell you this: if the nurses like you and the residents and attendings get to know you, they'll invite you into patients' rooms, including critical care. The only thing that bothered me was that I was part of a group of research interns who were desperately seeking opportunities to see "cool cases." They'd brag about watching someone code, and even seeing a patient die. It turned my stomach. It was like the "Lord of the Flies" in the sense that they were so determined to "see something" that they became so desensitized, and they tuned out the aftermath.

Before I went back to school, I was a surgical technologist assisting in trauma cases. When we lost a patient, we all felt we'd failed somehow. I was just the one retracting and passing instruments, and I still felt like I should have been able to do more. Everyone feels that way, though you just learn not to convey your emotions. It was disheartening to me to see (some of) the interns misconstruing this as permission not to feel anything, and to take pleasure in what was essentially voyeurism.

I'm sure you're nothing like that, but I think so many doctors and nurses (at least in the hospitals I've worked) have seen so much of that attitude that they're not really interested in teaching anyone who isn't there for formal education. In fact, that happens to be true for many of the health care workers I know.

If you formally shadow someone, he/she will get to know you better than a constantly rotating staff will. Someone who's willing to do that will treat you like a (less skilled) medical student, and will have the patience to explain the cases you've seen. They'll respect you as part of the future of medicine, rather than another hopeful pre-med who's there to see all the excitement.