On the wards, what do you carry in your pocket?

[The Angriest Bird]

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Just want to get an idea about what are the must-have's for one's lab coat pockets.

By the way, someone said putting the stethoscope around one's neck is bad etiquette. Is this true?

 

[nicko18]

I carry a pencil

 

[Hayden2102]

By the way, someone said putting the stethoscope around one's neck is bad etiquette. Is this true?

Yes, the polite way is to fasten it tightly around your left ankle.

 

[GodoShingo]

Since I am in the second year, when I do my summer internship, I use to bring with me:

Stethoscope - To measure blood pressure (keep it in my pocket to not confuse patients with me being a real doctor. I only have them around my neck if we are assigned to take bloodpressure from many patients)

Dictionary - Since I do my practice in Poland and that I don't know soe words

Pen and notebook - Just in case I need to memorize stuff (like once a doctor spoke about hydrocephele, of which we watched a surgery about later in the day).

Condoms - Makes good toys to cheer the nurses up.

Water - You will stand up for several hours, following the doctor, so you'll get thirsty.

Cigarettes and lighter - In case we get a 5 min break, I haven't got time to go get them from my bag. Yes, I know smoking is bad. I am currently trying to smoke less to be able to quit.

Gloves - Makes good toys for the kids when they are crying in the pediatrics.

Since I do my practice in a teaching hospital, we are allowed to request anything we want to do.

 

[MadameLULU]

Moving to clinical rotations. Also please see this thread.

 

[Law2Doc]

Just want to get an idea about what are the must-have's for one's lab coat pockets.

By the way, someone said putting the stethoscope around one's neck is bad etiquette. Is this true?

What you need in your pockets is going to depend on your rotation. But in general, you want to have (1) lots of pens (never pencils -- the medical records are legal documents and so writing notes in pencil is inappropriate because it can be altered), (2) your stethoscope (a few attendings consider around your neck to be bad form, but if you aren't working with one of those, free up the pocket). (3) a small notepad, (4) a PDA or other pharmaceutical reference, (5) maxwells or other medicine references -- there are different useful ones for most rotations, (6) assorted model progress soap notes/history forms you have had positive feedback on so you needn't reinvent the wheel, (6) a pen light, (7) reflex hammer, (8) alcohol wipes -- to clean off instruments, (9) a granola/power bar - in case you don't get time to eat. On some rotations you will also want an otoscope/ophthalmoscope, tongue depressors, eye chart, pregnancy calculation wheels, etc. Needless to say, the 5 small pockets on most white coats will have difficulty containing these. But the attendings, who carry none of this stuff, will expect med students to have them at the ready.

 

[Droopy Snoopy]

My setup includes a Maxwell's (with eye chart included), pda, 2 pens, small spiral notebook, and stethoscope. One pocket is left free for patient lists and such, and I keep my wallet and ID badge on me all the time. Lots of my classmates walk around like pack mules, but when your stethoscope can double as a reflex hammer, snacks can be stored in a locker or team room, and alcohol wipes are readily available at every nurses' station I just don't bother carrying all that extra crap around.

 

[domer621]

My setup includes a Maxwell's (with eye chart included), pda, 2 pens, small spiral notebook, and stethoscope. One pocket is left free for patient lists and such, and I keep my wallet and ID badge on me all the time. Lots of my classmates walk around like pack mules, but when your stethoscope can double as a reflex hammer, snacks can be stored in a locker or team room, and alcohol wipes are readily available at every nurses' station I just don't bother carrying all that extra crap around.

👍

I also carry the Pocket Medicine book.

 

[smq123]

Just want to get an idea about what are the must-have's for one's lab coat pockets.

By the way, someone said putting the stethoscope around one's neck is bad etiquette. Is this true?

Must haves:

• Pen
• Penlight
• Maxwell's
• Small notebook/blank paper
• Patient lists (if inpatient)
• Granola bars
• PDA/palm
• ID badge
• Wallet

Specialty specific must-haves:

• Pager (if you're on an in-patient team)
• OB wheel (for some reason these were hard to come by at my school)
• Small bandage scissors
• Practice sutures
• Small toy for children (while on peds)
• Otoscope/ophthalmoscope

Things that are nice, but not necessary:

• Cell phone (as long as you leave it on silent.) I would loan my cell phone to my resident when she got paged but we weren't near a phone. This is a moot point if your cell phone IS your pda (i.e. a treo or a blackberry).
• If I had room, I sometimes carry stuff to study whenever I have some down time. What was even better was when someone gave me old excel files that they had made as study guides - I just put them on my pda and I studied from that. It frees up some room.

I never wear a stethoscope around my neck. I've never heard of anyone saying that it's "bad form," but I have heard that the oils from your skin interact with the tubing so that it can crack easily. I know, I know - just buy a new one, but I'm saving my money for Step II CS. 😳

 

[71263]

I keep the steth around my neck, so I have room in my pockets for my notebook on one side, and 'Boards and Wards' on the other side. Anytime I seem to have a free minute or 2, I pull it out and start reading, or at least keep it in front of my face and blank out so I dont at least look like a slacker. When the attending starts talking to students again, they have my undivided attention.

 

[Jason110]

I never wear a stethoscope around my neck. I've never heard of anyone saying that it's "bad form," but I have heard that the oils from your skin interact with the tubing so that it can crack easily. I know, I know - just buy a new one, but I'm saving my money for Step II CS. 😳

Forget the oils!

Just so you know, I'm a third year student and a friend of mine developed a MRSA abscess around his neck from his stethoscope (it followed the outline of the 'scope). He probably picked it up from a peds patient (he was on peds at the time), and I think it's partially his fault for not frequently using the stethoscope wipes, but just so you know.

I would recommend wiping down the scope frequently and wrapping it around your white coat, and make sure it doesn't come in contact directly with skin.

You have been forewarned.

Jason

 

[TexasTriathlete]

I had a gigantic MRSA abscess on my ass from cycling. It was disgusting.

 

[marooner]

i only carry small notebook, pen and pda.

 

[Cuteasaurus]

I agree with most of the above. One I'd add: Trauma Shears. They are more multipurpose than suture scissors and come in handy for additional purposes as well.

 

[RockfordWF]

Just want to get an idea about what are the must-have's for one's lab coat pockets.

By the way, someone said putting the stethoscope around one's neck is bad etiquette. Is this true?

First of all, everyone I see wears it around their neck, so who cares?

In my lab coat pockets I carry the following:

1. Trauma shears
2. Latex gloves
3. Stride gum
4. Blistex chapstick
5. Card with codes and passwords
6. Dictation H&P Card
7. Car keys
8. Neuro hammer
9. Stethoscope
10. Pens
11. Penlight

I don't carry any books because ePocrates is on my phone and that's all I need. If I can't find it there, I'll just Google it....

 

[RockfordWF]

Must haves:

• Pen
• Penlight
• Maxwell's
• Small notebook/blank paper
• Patient lists (if inpatient)
• Granola bars
• PDA/palm
• ID badge
• Wallet

Specialty specific must-haves:

• Pager (if you're on an in-patient team)
• OB wheel (for some reason these were hard to come by at my school)
• Small bandage scissors
• Practice sutures
• Small toy for children (while on peds)
• Otoscope/ophthalmoscope

Things that are nice, but not necessary:

• Cell phone (as long as you leave it on silent.) I would loan my cell phone to my resident when she got paged but we weren't near a phone. This is a moot point if your cell phone IS your pda (i.e. a treo or a blackberry).
• If I had room, I sometimes carry stuff to study whenever I have some down time. What was even better was when someone gave me old excel files that they had made as study guides - I just put them on my pda and I studied from that. It frees up some room.

I never wear a stethoscope around my neck. I've never heard of anyone saying that it's "bad form," but I have heard that the oils from your skin interact with the tubing so that it can crack easily. I know, I know - just buy a new one, but I'm saving my money for Step II CS. 😳

Why on earth would you carry an otoscope/opthalmoscope?

What hospitals don't have these?

 

[smq123]

Why on earth would you carry an otoscope/opthalmoscope?

What hospitals don't have these?

I'm on my ophtho rotation. None of the clinic rooms in the eye hospital have an ophthalmoscope, because ALL of the residents inspect the optic disc with a slit lamp and a lens (i.e. the "indirect" scope). I can't use a slit lamp to save my life, so if I want to see anything, I need to carry my own ophthalmoscope (i.e. the "direct" scope).

Otherwise, I wouldn't carry it.

2. Latex gloves

By that token, why do you carry latex gloves? What hospitals don't have those?

 

[Blade28]

By the way, someone said putting the stethoscope around one's neck is bad etiquette. Is this true?

Depends on the field. You'll never catch surgeons doing that. 🙂

It's also dangerous in Psych, when patients can use it to grab you.

By that token, why do you carry latex gloves? What hospitals don't have those?

Sometimes there are none nearby, or at least none in your size.

 

[RockfordWF]

I'm on my ophtho rotation. None of the clinic rooms in the eye hospital have an ophthalmoscope, because ALL of the residents inspect the optic disc with a slit lamp and a lens (i.e. the "indirect" scope). I can't use a slit lamp to save my life, so if I want to see anything, I need to carry my own ophthalmoscope (i.e. the "direct" scope).

Otherwise, I wouldn't carry it.



By that token, why do you carry latex gloves? What hospitals don't have those?

Working in an emergency room, if a patient crashes, I don't want to be fumbling for gloves. I would never do an eye exam in a coding patient.

 

[RockfordWF]

Depends on the field. You'll never catch surgeons doing that. 🙂

It's also dangerous in Psych, when patients can use it to grab you.



Sometimes there are none nearby, or at least none in your size.

Likely because surgeons don't know how to use a stethoscope....

 

[smq123]

Working in an emergency room, if a patient crashes, I don't want to be fumbling for gloves. I would never do an eye exam in a coding patient.

Fair enough. But, again, on the ophtho rotation, it's almost exclusively outpatient stuff, and very little of it is of an urgent nature. So I carry the ophthalmoscope with that kind of out-patient stuff in mind. And if I don't act fast, and jump in and say "I have my ophthlamoscope right here, is it okay if I take a look?" I'd never see anything. The residents sometimes forget that I'm standing there, so they sometimes forget to show me on the slit lamp. 😳

 

[RockfordWF]

Fair enough. But, again, on the ophtho rotation, it's almost exclusively outpatient stuff, and very little of it is of an urgent nature. So I carry the ophthalmoscope with that kind of out-patient stuff in mind. And if I don't act fast, and jump in and say "I have my ophthlamoscope right here, is it okay if I take a look?" I'd never see anything. The residents sometimes forget that I'm standing there, so they sometimes forget to show me on the slit lamp. 😳

It sounds to me like you should probably remind them to allow you to look in the slit lamp, instead of busting out with an opthalmoscope.

 

[Blade28]

Likely because surgeons don't know how to use a stethoscope....

...or we just don't like them around our necks. 🙂

 

[smq123]

It sounds to me like you should probably remind them to allow you to look in the slit lamp, instead of busting out with an opthalmoscope.

Probably. And I do, although not always with the actual hand-held lens that they also use.

And part of the point of the ophtho rotation (particularly if you're not going to go into ophtho) is to learn how to use the ophthalmoscope correctly. Since every patient is dilated, why not take advantage of it? Does every ER have a slit lamp, and is every ER physician trained how to use it? I know that not every family med clinic has a slit lamp, but almost all have an ophthalmoscope.

 

[Aures]

> On the wards, wht do you carry in your pocket?

My PSP.

 

[RockfordWF]

Probably. And I do, although not always with the actual hand-held lens that they also use.

And part of the point of the ophtho rotation (particularly if you're not going to go into ophtho) is to learn how to use the ophthalmoscope correctly. Since every patient is dilated, why not take advantage of it? Does every ER have a slit lamp, and is every ER physician trained how to use it? I know that not every family med clinic has a slit lamp, but almost all have an ophthalmoscope.

It sounds like you picked the wrong eye rotation, if they don't eve use the tool you wanted to learn to use. I hope to God that every ER physician is trained to use a slit lamp. It is a LIABILITY to not use one on eye patients.

 

[AmoryBlaine]

I'm going to second the call for GLOVES. I keep a pair in my inside white coat pocket at all times.

Try it for a week, if you never pull them out then stop. If you are doing a rotation anywhere involving sick patients I think you are stupid not to have gloves on your person.

Also, do a little "audit" on yourself after a few weeks on a new rotation. If you are NEVER using that thing in your left pocket leave it at home or in your bag. Nothing says "rookie" like a short white coat crammed with patient lists from your last sub-i.

 

[Blade28]

Also, do a little "audit" on yourself after a few weeks on a new rotation. If you are NEVER using that thing in your left pocket leave it at home or in your bag.

BTW, similar advice works for your closet - anything you haven't worn in over a year should be thrown out or donated.

 

[smq123]

It sounds like you picked the wrong eye rotation, if they don't eve use the tool you wanted to learn to use. I hope to God that every ER physician is trained to use a slit lamp. It is a LIABILITY to not use one on eye patients.

- ER physicians may be trained to use the slit lamp to evaluate the cornea and the conjunctiva. But how many of them can use the slit lamp to evaluate the optic disc and macula? Unless your ER program gives you your own set of indirect lenses, that is.

- On your ophtho rotation, how many of the residents used the direct scope to look at the optic disc? And how many just used the slit lamp and indirect lenses to look at the optic disc? I can't imagine that there are that many ophthalmologists nowadays who use the direct scope more often than they do the indirect scope.

- It makes MORE sense that the residents never use a direct scope. With the indirect scope, you can see much more of the retina than you can with the direct scope.

- The point of carrying the ophthalmoscope is to LEARN how to use it. You can't always guarantee that there will be one in the room - even in a large hospital like Wills Eye. (Especially since every resident carries their own set of indirect lenses.) But if you carry it around you have it available to practice on patients. And I use it a lot. (That's probably why the hospital gave each student an ophthalmoscope to use on the rotation.)

Also, do a little "audit" on yourself after a few weeks on a new rotation. If you are NEVER using that thing in your left pocket leave it at home or in your bag.

If this rule holds then I should be carrying my ophthalmoscope every day of the rotation, because I have been using it pretty much every day. The only exception has been retina and the OR.

 

[AwesomO]

My Personal list

-Maxwells: Only really used for a checklist for writing admission orders.

-Pocket Medicine: Also rarely used, but residents are always impressed that I have it

-Pens

-Blank index cards: Good for checklists and writing down quick notes.

-Daily Patient list: Obvious use, plus I wind up writing down lab results on them. I found this method a whole lot more organized than carrying around a handful of the medfools pt sheets.

-*Blank progress note forms*-For some reason pt charts seem to always be out of blank forms when I get there 🙄 So instead of spending 5-10 minutes searching for the forms (cause they can never be in the same place in all the departments) I keep them in my pocket and just slap them in there. Seriously cuts down my rounding time by 20 minutes.

-Protein bar: For when evening rounds that go until 8 pm.

 

[RockfordWF]

- ER physicians may be trained to use the slit lamp to evaluate the cornea and the conjunctiva. But how many of them can use the slit lamp to evaluate the optic disc and macula? Unless your ER program gives you your own set of indirect lenses, that is.

- On your ophtho rotation, how many of the residents used the direct scope to look at the optic disc? And how many just used the slit lamp and indirect lenses to look at the optic disc? I can't imagine that there are that many ophthalmologists nowadays who use the direct scope more often than they do the indirect scope.

- It makes MORE sense that the residents never use a direct scope. With the indirect scope, you can see much more of the retina than you can with the direct scope.

- The point of carrying the ophthalmoscope is to LEARN how to use it. You can't always guarantee that there will be one in the room - even in a large hospital like Wills Eye. (Especially since every resident carries their own set of indirect lenses.) But if you carry it around you have it available to practice on patients. And I use it a lot. (That's probably why the hospital gave each student an ophthalmoscope to use on the rotation.)



If this rule holds then I should be carrying my ophthalmoscope every day of the rotation, because I have been using it pretty much every day. The only exception has been retina and the OR.

1. I never did an eye rotation. I did something more fun like anesthesia.

2. Ophthalmoscopes are in every room in the ER.

 

[Droopy Snoopy]

1. I never did an eye rotation. I did something more fun like anesthesia.

Ooooooh, pwnd! 🙄

 

[smq123]

1. I never did an eye rotation.

🙄

 

[RockfordWF]

🙄

Apparently people are annoyed by the fact I didn't do an eye rotation.

Is it apparently commonplace for people to do this?

I spend most of my 4th year working in the ER. I didn't want to do a boring clinic rotation. So what?

 

[smq123]

Apparently people are annoyed by the fact I didn't do an eye rotation.

No - just unsure why someone who never did an ophtho rotation would think that he would know what a person should or should not carry in her pockets while on that rotation.

I don't tell you what to carry around with you in the ER (because I haven't done an ER rotation yet) - so why tell someone what to carry around with her on a rotation that you haven't done yet?

 

[RockfordWF]

No - just unsure why someone who never did an ophtho rotation would think that he would know what a person should or should not carry in her pockets while on that rotation.

I don't tell you what to carry around with you in the ER (because I haven't done an ER rotation yet) - so why tell someone what to carry around with her on a rotation that you haven't done yet?

You shouldn't take things so personally.

 

[deleted29780]

😴 boring

 

[DrQuinn]

I never did an eye rotation in residency (did one in my EM residency, however). And I am well versed in how to use a slit lamp.

In medical school: I would, at minimum, carry a pocket pharmacopeia, Maxwell's, Sanford's, stethoscope, occult stool cards, KY jelly, occult p00p juice, tongue depressor, reflex hammer, ID badge, and a few bucks on me (if I wore scrubs).

As a resident in EM, it was Sanford's, pharmacopeia, Tarascon's Adult EM pockebtook and IM/ICU pocketbook, stethoscope, poop cards/jelly/juice.

As an attending, pharmacopeia, poop cards/jelly/juice, stethoscope.

If I were a 3rd year medical student, I would look into a general medicine book, depending on the rotation. I found Saint Frances to be good during FP rotations. I never like Wash Manual or Scutmonkey. Which is why I wrote my book "PIMP Protector" for medical students, which covers most things you'll need in 3rd and 4th year.

Also notice I almost always have fecal occult cards on me. Surgery, medicine, cardiology, GI, you're always gonna need those bad boys.

Q

 

[inked_caduceus]

As someone who carries an otoscope/opthalmoscope on her person, there's a few reasons:

You know that dive-and-duck-while-attempting-to-not-rupture-an eardrum maneuver you did in peds? MUCH easier when the otoscope is not tethered to the wall.

Or how about on inpatient, when the scopes aren't in the room. (Or if they are, they're across the room from your patient?)

I'd rather give up the pocketspace to my wee 100 dollar set instead of hunting down a scope or playing strangle the patient every time I wanted to look in an ear, eye, nose or throat.

 

[Terpskins99]

Boards and Wards (now Surgical Recall for surg rotation)
Minispiral notebook
Pens
Highlighter
more pens
Maxwells
Stethoscope
Reflex hammer
PDA phone with epocrates
Crumpled up napkins from the cafeteria
Notecards with micro DOC's (picked up from the clinical pharmacist)

 

[Feli]

What I like to carry:

-Pens and small spiral notebook
-Mini Lister scissors with clip
-Maxwell's Pocket Med
-Tarascon Pharm book
-Alcohol wipes
-Paper rulers
-Specialty book du jour for rotation (Tarascon IM, Lubin EKG, Sanford, Pocket Surg, etc)
(usually stopwatch for vitals, keys, wallet, phone, etc in pockets of slacks or scrub pants)

When I'm on podiatry rotations, I always carry Pocket Podiatrics book, goniometer, and a monofilament (diabetic protective threshold). I guess those are obviously not real useful for most other specialties, though. Come to think of it, I carry those all the time even on external rotations because attendings still ask pod questions frequently.

A lot of great suggestions on coat pocket essentials from everyone...
One thing that I'm surprised never comes up are those disposable paper rulers, though...
http://www.vendian.org/mncharity/dir3/paper_rulers/UnstableURL/rulers_combo.pdf

I carry those everywhere for measuring, charting, or photographing ulcers, lacerations, rashes, erythema, edema, etc. I probably go through at least 5-10 every week. Sure, Maxwell or the Tarascon books have a centimeter scale on the back page, but do you want to keep sticking the edge of your book in and around wounds, rashes, lesions, etc?

I have a nice PDA but mised well sell it on eBay. PDA just seems to bulky and expensive. I'd much rather lose a $5-10 pocket book, and they never run out of batteries or freeze up when you need them most. Since I've gotten good at navigating my books, I can usually find the dosing info I need even faster than most other students can power on their PDA.

...Good thread and discussion 👍