Med Students and Resident's can't 'wear' stethoscopes?

[LoveBeingHuman:)]

I've heard this was a rule at the medical center I shadowed at. Anyone care to comment about their experiences?

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[NotASerialKiller]

I don't know what this means. Do you just wait until all murmurs are grade VI and hope the patient doesn't die before that, or does everyone share one common disgusting stethoscope?

 

[darkjedi]

sounds like you made that up

 

[The Knife & Gun Club]

You mean like, around your neck?

Where I go to school there’s no rule against stethoscopes around the neck, but you will be mercilessly mocked for it.

“Oh look it’s Dr. Grey, how’s McDreamy doing?”

Real doctors keep the stethoscope in their pocket, apparently.

 

[NotASerialKiller]

You mean like, around your neck?

Where I go to school there’s no rule against stethoscopes around the neck, but you will be mercilessly mocked for it.

“Oh look it’s Dr. Grey, how’s McDreamy doing?”

Real doctors keep the stethoscope in their pocket, apparently.

Who is doing the mocking, other med students who think they know things, or physicians? You'd have to be wearing your white coat at all times to have it in your pocket, which isn't always the case depending on what you're doing and the clinical setting. Maybe it's frowned on to "drape" it around your neck, but having the earpieces around your neck is convenient if you're using it repeatedly.

I feel like this is one of those things that has nothing to do with practicality, it's just an excuse to pick on newbies or dismiss something because they do it on TV. Do whatever you're comfortable with, I doubt the inside of my white coat is any more sanitary.

 

[The Knife & Gun Club]

Who is doing the mocking, other med students who think they know things, or physicians? You'd have to be wearing your white coat at all times to have it in your pocket, which isn't always the case depending on what you're doing and the clinical setting. Maybe it's frowned on to "drape" it around your neck, but having the earpieces around your neck is convenient if you're using it repeatedly.

I feel like this is one of those things that has nothing to do with practicality, it's just an excuse to pick on newbies or dismiss something because they do it on TV. Do whatever you're comfortable with, I doubt the inside of my white coat is any more sanitary.

Yea it’s just an opportunity to roast people, usually in good fun.

And yes, the white coat is literally just a giant fomite. Ties are even worse. I can foam my hands til they dry out and bleed, but my coat is still gonna be a giant C Diff sponge.

 

[Catalystik]

Med Students and Resident's can't 'wear' stethoscopes? I've heard this was a rule at the medical center I shadowed at. Anyone care to comment about their experiences?

Considering many healthcare workers consistently forget to sanitize their stethoscope between patients, this might not be a bad idea provided each patient has a dedicated institution-provided stethoscope kept at their bedside.

 

[Matthew9Thirtyfive]

Considering many healthcare workers consistently forget to sanitize their stethoscope between patients, this might not be a bad idea provided each patient has a dedicated institution-provided stethoscope kept at their bedside.

One of the hospitals I worked at put stethoscopes in each room so that the physicians didn't use theirs on multiple patients.

 

[Saifa]

When I was a nursing student I couldn't even get the thing to stay draped around my neck, so uncomfortable. I think I tried it for like a week (because everyone was doing it) until I just stuffed it in my scrub pockets.

 

[Catalystik]

One of the hospitals I worked at put stethoscopes in each room so that the physicians didn't use theirs on multiple patients.

So, I came up with this radical concept and someone went back in time and instituted it. Is that efficient, or what?

 

[21Rush12]

Residents*

One funny thing to add:

We have clinician lectures pretty often. The cardiologists, pulmonologists, EM physicians, and surgeons never being stethoscopes.

The Medical Geneticist MD on the other hand brings his stethoscope while lecturing to us about Fabry Disease.

 

[LizzyM]

Residents*

One funny thing to add:

We have clinician lectures pretty often. The cardiologists, pulmonologists, EM physicians, and surgeons never being stethoscopes.

The Medical Geneticist MD on the other hand brings his stethoscope while lecturing to us about Fabry Disease.

This makes me wonder if this isn't a symbol of the credential and thus is prohibited in some rule book, somewhere, for those who do not yet have the credential of "attending" yet carried by those who feel the need to exhibit the credential lest they be mistaken for someone who does not have the credential (medical geneticist MD not wanting to be mistaken for an MS or PhD in genetics). I bet sociologists and/or anthropologists have a word for this phenomenon.

 

[Saifa]

So, I came up with this radical concept and someone went back in time and instituted it. Is that efficient, or what?

This was at my hospital as well but they were only intended for isolated patients, and the stethoscopes were really cheap basically disposable units that were pretty unpleasant to use.

 

[Catalystik]

This was at my hospital as well but they were only intended for isolated patients, and the stethoscopes were really cheap basically disposable units that were pretty unpleasant to use.

Considering how often I (sadly, despite my opinionated comments to med students) observe clinicians listening to the chest wall through a patient's clothing, the lower quality of the stethoscope may not matter much, anyway.

 

[Matthew9Thirtyfive]

This was at my hospital as well but they were only intended for isolated patients, and the stethoscopes were really cheap basically disposable units that were pretty unpleasant to use.

Ours were okay. Nothing amazing, but not terrible.

 

[Matthew9Thirtyfive]

Considering how often I (sadly, despite my opinionated comments to med students) observe clinicians listening to the chest wall through a patient's clothing, the quality of the stethoscope may not matter much, anyway.

I see that a lot too.

 

[Catalystik]

I see that a lot too.

It kinda gripes my guts, honestly. How much harder is it to do the chest exam properly, after all.

/grumbling

 

[Matthew9Thirtyfive]

It kinda gripes my guts, honestly. How much harder is it to do the chest exam properly, after all.

/grumbling

Yeah. It also grinds my gears when clinicians do things based on anecdotes or personal preference despite there being evidence that it is at best not beneficial and potentially harmful at worst (I see this more in mid-levels, but it happens with physicians too).

 

[Saifa]

Considering how often I (sadly, despite my opinionated comments to med students) observe clinicians listening to the chest wall through a patient's clothing, the lower quality of the stethoscope may not matter much, anyway.

This is funny considering I felt like the only person in this hospital-based RN diploma program not parading around with a master cardiology/cardiology III or something similar. These kids were decked out.

 

[21Rush12]

@LizzyM I am sure you’re right. I just see a sort of humor in the fact that the doctor least likely to need a stethoscope is the only one who carries one.

 

[LizzyM]

Considering how often I (sadly, despite my opinionated comments to med students) observe clinicians listening to the chest wall through a patient's clothing, the lower quality of the stethoscope may not matter much, anyway.

Again, the listening may be only symbolic as they are going to order a chest film, CT, MRI, Ultrasound or all of the above, as soon as the exam is over. 😉

 

[Matthew9Thirtyfive]

Again, the listening may be only symbolic as they are going to order a chest film, CT, MRI, Ultrasound or all of the above, as soon as the exam is over. 😉

It’s still usually a good idea to actually listen to the lungs lol.

 

[Catalystik]

Again, the listening may be only symbolic as they are going to order a chest film, CT, MRI, Ultrasound or all of the above, as soon as the exam is over. 😉

Sad to say, such studies are often ordered as soon as patients arrive, per department protocol, on the basis of their chief complaint, before any exam is done at all.

 

[Mad Jack]

As a former respiratory therapist, it's hard for me to put it anywhere other tl than around the neck out of habit. I'm used to wearing just scrubs and having no other place to put it, plus scopes much more easily fall out of pockets than off of necks

 

[Matthew9Thirtyfive]

As a former respiratory therapist, it's hard for me to put it anywhere other tl than around the neck out of habit. I'm used to wearing just scrubs and having no other place to put it, plus scopes much more easily fall out of pockets than off of necks

We had hooks on the bulkhead in medical that we hung them on.

 

[Mad Jack]

We had hooks on the bulkhead in medical that we hung them on.

See, if we hung then anywhere other than on out person, they tended to get stolen at Big Medical Center. Stethoscopes we're notorious for growing legs and walking

 

[Mad Jack]

Considering how often I (sadly, despite my opinionated comments to med students) observe clinicians listening to the chest wall through a patient's clothing, the lower quality of the stethoscope may not matter much, anyway.

A trained ear isn't really deterred by a millimeter of fabric

 

[Matthew9Thirtyfive]

See, if we hung then anywhere other than on out person, they tended to get stolen at Big Medical Center. Stethoscopes we're notorious for growing legs and walking

Our medical was the size of a few bathrooms, and we locked the door when we left. Not many places for them to go. There were also only four of us lol.

 

[Matthew9Thirtyfive]

A trained ear isn't really deterred by a millimeter of fabric

It’s the principle of the thing.

 

[Melchizedek]

I've heard this was a rule at the medical center I shadowed at. Anyone care to comment about their experiences?

Who is doing the mocking, other med students who think they know things, or physicians? You'd have to be wearing your white coat at all times to have it in your pocket, which isn't always the case depending on what you're doing and the clinical setting. Maybe it's frowned on to "drape" it around your neck, but having the earpieces around your neck is convenient if you're using it repeatedly.

I feel like this is one of those things that has nothing to do with practicality, it's just an excuse to pick on newbies or dismiss something because they do it on TV. Do whatever you're comfortable with, I doubt the inside of my white coat is any more sanitary.

I'm not sure about the sanitary/mocking/fashion aspect of it, but we frequently had altered/combative patients on our floor so we were highly encouraged not to have steths, necklaces, ID badges etc around our necks so patients can't grab on to them and yank us into swinging range.

 

[TypeADissection]

Not sure why there's an incessant "need" to wear the stethoscope around one's neck. They slide around a lot. Cumbersome. And can sometimes get you confused with a nursing student.

 

[libertyyne]

Its because you keep one of these bad boys in your pocket instead.

 

[libertyyne]

But in all actuality it is probably a social norm to distinguish physicians from the nurses and other folks. The docs probably did it, then the nurses and then the docs abandoned it. A similar game happened with whitecoats.

 

[Catalystik]

A trained ear isn't really deterred by a millimeter of fabric

:roll eyes:🙄

 

[getdown]

you can hear plenty through clothing, what you can't hear through is 2 feet of fat.

 

[CherryRedDracul]

you can hear plenty through clothing, what you can't hear through is 2 feet of fat.

Fat and edema were bigger factors for me than clothing. Plus, I'm trying to think of a situation where the presence of clothing greatly altered my management. I could already pick up those subtle murmurs with my Cardio III that others couldn't, a few millimeters of clothing be damned.

If there was something significant anyway, we went onto echocardiography or CXR/CT chest. With a few notable exceptions, much of the physical examination as we know it has quite poor predictive value, and we do it more or less as a formality (and for billing). However, inspection is perhaps the most important element of it that should not be forgotten.

As an aside, check out The Rational Clinical Examination: Evidence-Based Clinical Diagnosis by Simel and Rennie to take a look at the statistics behind each physical examination maneuver.

 

[frosted2]

One of the hospitals I worked at put stethoscopes in each room so that the physicians didn't use theirs on multiple patients.

They do that in the ICU, NICU, and PICU where I work.