Okay for premeds to perform vitals/triage?

[boba96]

Hello,

I recently joined a club named Flying Samaritans. They travel to Mexico once a month to provide free health care. However, during these clinic trips the undergrads are usually in charge of triaging the patients/ taking their vitals. I just wanted to know, would this raise eyebrows for adcoms if we aren't certified? I mean we are getting great clinical exposure, however I am worried that it is actually illegal as we aren't licensed/certified. Can anyone give input? Thank you!

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[medic86]

Hello,

I recently joined a club named Flying Samaritans. They travel to Mexico once a month to provide free health care. However, during these clinic trips the undergrads are usually in charge of triaging the patients/ taking their vitals. I just wanted to know, would this raise eyebrows for adcoms if we aren't certified? I mean we are getting great clinical exposure, however I am worried that it is actually illegal as we aren't licensed/certified. Can anyone give input? Thank you!

You're probably not -actually- triaging.

So just vital signs? Yeah, fine.

 

[boba96]

You're probably not -actually- triaging.

So just vital signs? Yeah, fine.

Sorry, yes I guess I meant vital signs only. It's cause emails keep mentioning triaging. Lol. Anyways, I am also confused as to whether or not it is okay because I remember when I volunteered at Kaiser back in high school, the Department Administrator of the Urgent Care clinic was not particularly happy when the nurses allowed volunteers to take vital signs. My local Kaiser proceeded to essentially ban volunteers from taking vital signs. Also, I've heard (I think from some sdn thread) that you should be wary about discussing the activities you partook in during clinic trips to places like Nicaragua, Costa Rica, etc. on those expensive one-week trips. I wasn't sure if those activities meant taking vital signs or actually performing medical/dental procedures like pulling someone's teeth out.

 

[Spinach Dip]

Sorry, yes I guess I meant vital signs only. It's cause emails keep mentioning triaging. Lol. Anyways, I am also confused as to whether or not it is okay because I remember when I volunteered at Kaiser back in high school, the Department Administrator of the Urgent Care clinic was not particularly happy when the nurses allowed volunteers to take vital signs. My local Kaiser proceeded to essentially ban volunteers from taking vital signs. Also, I've heard (I think from some sdn thread) that you should be wary about discussing the activities you partook in during clinic trips to places like Nicaragua, Costa Rica, etc. on those expensive one-week trips. I wasn't sure if those activities meant taking vital signs or actually performing medical/dental procedures like pulling someone's teeth out.

Some of these trips will actually allow the participants to place stitches and/or intubate anesthetized patients. That is a massive no-no.

Vitals should be fine.

(BTW, those are only 2 stories I have heard...)

 

[JessebenBenjamin]

I don't see how that would be an issue. If there are ONLY volunteers to do it and like 1 physician (With 100 patients waiting) who's going to do it then?
I have volunteered abroad before and they expected me to do a lot more than just re-stocking things.

 

[Winged Scapula]

Hello,

I recently joined a club named Flying Samaritans. They travel to Mexico once a month to provide free health care. However, during these clinic trips the undergrads are usually in charge of triaging the patients/ taking their vitals. I just wanted to know, would this raise eyebrows for adcoms if we aren't certified? I mean we are getting great clinical exposure, however I am worried that it is actually illegal as we aren't licensed/certified. Can anyone give input? Thank you!

There is no requirement to be licensed or certified to take vitals.

The person doing my disability insurance took my vitals and was a college student.

My medical assistants are trained to take vital signs but aren't licensed in any fashion.

 

[getdown]

I personally think all this hoopla is BS. This all stems from legal issues. If you're in America, yes it's a problem because people sue at a drop of a hate but if you're in a different country who cares. I mean what exactly differentiates an MS 3 and a volunteer in terms of capability? Sure the med student is allowed to be there for training and knows a little bit more about physiology but in terms of actual clinical skills ... no difference. As long as there is a supervising physician it's fine.

Today I was supervising an MS 4 trying to intubate. I mean you could have just given it to the volunteer and the suckage would probably be the same. That's why it's called training.

 

[GiveMeThatMD]

I personally think all this hoopla is BS. This all stems from legal issues. If you're in America, yes it's a problem because people sue at a drop of a hate but if you're in a different country who cares. I mean what exactly differentiates an MS 3 and a volunteer in terms of capability? Sure the med student is allowed to be there for training and knows a little bit more about physiology but in terms of actual clinical skills ... no difference. As long as there is a supervising physician it's fine.

Today I was supervising an MS 4 trying to intubate. I mean you could have just given it to the volunteer and the suckage would probably be the same. That's why it's called training.

Yeah, no.

 

[Spinach Dip]

I personally think all this hoopla is BS. This all stems from legal issues. If you're in America, yes it's a problem because people sue at a drop of a hate but if you're in a different country who cares. I mean what exactly differentiates an MS 3 and a volunteer in terms of capability? Sure the med student is allowed to be there for training and knows a little bit more about physiology but in terms of actual clinical skills ... no difference. As long as there is a supervising physician it's fine.

Today I was supervising an MS 4 trying to intubate. I mean you could have just given it to the volunteer and the suckage would probably be the same. That's why it's called training.

Yeah, no.

The skill level may be the same, but there is some more protection/recourse against one of those two when they inevitably break off a couple teeth.

 

[getdown]

The skill level may be the same, but there is some more protection/recourse against one of those two when they inevitably break off a couple teeth.

And that's my point. The only reason we don't let volunteers do it is because of legal issues. Back in the day medicine was practiced by an apprenticeship. How is that any different than an unlicensed person doing it today? You think they had certificates when the first surgeons did their thing?

Yeah, no.

Yeah, actually it is. You don't suddenly get amazing technical skills just by getting the coveted med student title.

 

[boba96]

You're probably not -actually- triaging.

So just vital signs? Yeah, fine.

Just had a meeting today and the presentation was on triaging and EMR. So I think they are requiring us to triage of the clinic trip. They said we had to do the HPI (History of Patient Illness) on the EMR app of the iPad. Also, we are expected to write the chief complaint. Do these things sound like triage? And you need to be licensed to triage? Please help! I'm worried now if Flying Samaritans is a good organization to be a part of...

 

[boba96]

I personally think all this hoopla is BS. This all stems from legal issues. If you're in America, yes it's a problem because people sue at a drop of a hate but if you're in a different country who cares.

I thought med school adcoms would view it as: "if it's not legal in the U.S., then you shouldn't be doing it out of the country" (from what I have heard). Is that true or false?

 

[deleted407021]

Our clinic calls it "triage", as well. I'll confirm that it is cool, so long as all you're doing is taking vitals, doing finger sticks (with training), figuring out which meds the pt need refilled and recording symptoms and CC info.

 

[mimelim]

Just had a meeting today and the presentation was on triaging and EMR. So I think they are requiring us to triage of the clinic trip. They said we had to do the HPI (History of Patient Illness) on the EMR app of the iPad. Also, we are expected to write the chief complaint. Do these things sound like triage? And you need to be licensed to triage? Please help! I'm worried now if Flying Samaritans is a good organization to be a part of...

#1 HPI is History of Present Illness. Not patient illness.

#2 Chief complaints are what brings the patient to see a physician, many would say, "in the patient's own words." Anyone can do this. There is no training or licensing.

#3 It takes years of practice to take a good HPI. Maybe a couple of weeks or months to be competent, but I have been in clinical medicine for 6 years now and I'm still refining how I go about obtaining an HPI. Should a volunteer be solely responsible for obtaining the HPI for a patient. Absolutely not. Do MS3s obtain HPIs, absolutely, but they are never the only one doing it, there is always someone else who is double checking the important points and verifying with the patient.

#4 I imagine based on your description that you will be functioning similar to the triage staff in a community ER or MAs in physician offices. Someone comes in, you take their vitals and you ask them, "Why are you here?" They give you an answer, and then you ask a couple of regimented follow up questions to fill in the EMR. From there, someone else will look at what you've entered and then start the actual patient encounter. This is perfectly fine to do. MAs do this in most physician offices. There is no licencing for any of it.

 

[MarylandMatt]

There is no requirement to be licensed or certified to take vitals.

My medical assistants are trained to take vital signs but aren't licensed in any fashion.

Do they give the vitals back after they take them?

 

[boba96]

#4 I imagine based on your description that you will be functioning similar to the triage staff in a community ER or MAs in physician offices. Someone comes in, you take their vitals and you ask them, "Why are you here?" They give you an answer, and then you ask a couple of regimented follow up questions to fill in the EMR. From there, someone else will look at what you've entered and then start the actual patient encounter. This is perfectly fine to do. MAs do this in most physician offices. There is no licencing for any of it.

I think the only time someone else will look at what we've entered in the EMR is when we give the EMR to the doctor to evaluate the patients. After that, the EMR is signed by us and saved into the system. Does that seem okay?

 

[mimelim]

I think the only time someone else will look at what we've entered in the EMR is when we give the EMR to the doctor to evaluate the patients. After that, the EMR is signed by us and saved into the system. Does that seem okay?

It isn't so much about who will see it, it is more what you are documenting. If you are attesting to vital signs being correct and the chief complaint/basic HPI being correct, that is perfectly fine. Even if the doc is the only one seeing it, I I don't think it is okay to put in much more than that.