Rotation mistakes

I called one of my attendings a nerd. It was towards the end of the rotation, so I knew her pretty well. She thought it was funny, but that's still a bit over the line. I guess I learned that...uh...I shouldn't do that.

 

Thanks to a classmate that was rotating with me

"Always check with the nurse to see if the patient's baby is alive before walking in & asking how the baby is doing"

In his defense, new hospital, new patient.
Found out later that while red flower on door = girl, blue = boy, green = dead baby

 

lol. who doesn't love a good dead baby joke.

 

the parents?

 

1) Not all bovies have the same configuration for cut and coag. (Or I just forgot which direction was which). Oops.

2) It's not the surgeon's responsbility to avoid sticking you with a needle when closing; it's your responsibility to make sure your hand is out of the way (despite retracting for him to allow his closure)

3) Don't wear a watch you like to a precipitous delivery on a multiparous woman

4) Don't do anything you learned on OB/Gyn while on General Surgery

5) Don't do an elective in forensic pathology because you think NCIS is a cool show; it's actually a very horrible and traumatic experience

6) If your gut knows what your mind doubts, go with your gut

 

If you're curious about a patient's accent or ethnic background, inquire using a very polite, very vague open-ended question ("So where are you from?"). Don't probe further if they dodge the intention of your question ("I'm from this town!"). I'm an armchair geography and language nerd who celebrates diversity and is genuinely curious about people's backgrounds. However, many people assume less benign intentions when they get questions like this, or are of the opinion it's none of my business or irrelevant.

The above goes doubly for residents and attendings of foreign origin. If you're really curious, ask someone else where that person is from.

If you're the kind of person, like me, who learns by asking lots of questions and having informal discussions, wait until you've heard a new resident or attending's responses to other students before you start firing questions or comments at them. Some get an inquisitive student like me and think, "Here's an enthusiastic, motivated learner." Some think, "What's this showoff trying to accomplish by opening his mouth about things he knows so little about? He must really like getting pimped and assigned extra presentation topics!"

 

Don't go to a patient's room to get their baby when the baby is already in the nursery.

 

I was on labor in delivery at a small community hospital at 1 am with an attending I was shadowing for a few weeks in OB/GYN. A young woman was being evaluated for labor in triage and the nurses had no idea where anything was. My doctor needed a light to help visualize the cervix and the nurse ran out of the room for quite a while. At some point I thought of the stellar idea to "help out" by turning on the flash light app on my iphone for the doctor. The woman freaked out because she thought I was taking a picture of her vagina with my phone...

The doctor thought it was hilarious and the woman didn't care once she understood, but it was that day I learned the obvious lesson to not point your phone's camera at your patients vagina for any reason... (I face palmed so hard after this)

 

On a psych rotation, I was doing an MMSE on an elderly woman whose son was present in the room. She struggled with serial sevens, and was apparently discouraged by her inability to do this. In an attempt to make her feel better, I said, "That's okay, I think this would even be challenging for most normal people."

To this her son quickly responded, "What, are you saying she's abnormal? Gee, thanks!"

Lesson learned: Do not compare your patients to "normal people".

 

I'd say my worst was walking into the (peds cardio outpatient clinic) room of a 13 year old male. He was sitting on the table, and his dad/mom were sitting in the chairs next to him.

I introduced myself to the patient, then turned to dad to shake his hand and he said "Hi I'm his father". Then I went to Dad's right and said "Hi Mom" going to shake her hand.

The father started cracking up and said "That's not his mother, that's his little sister."



Dad thought it was funny, but boy was the girl pissed

 

If the patient tells you on the way to the OR that she needs to go to the bathroom, don't assume the foley will just take care of things...

 

Has anybody made it through MS3, or MS3 and part of MS4, without getting ANY negative criticism? I get negative criticism every rotation. It's usually not damning, usually something like I need to work on expanding my knowledge base (well, yes, of course) or making my notes shorter and more to the point, but at times I have had comments like "is rough around the edges" or "needs to find better timing for her questions." Just now a fellow MS4 commented casually that he didn't get ANY negative comments written on his 3rd year evals, and for some reason that made me feel awful, remembering that after a while I just stopped reading my comments because they usually weren't helpful. Is his experience common? I had thought that people usually, when asked, could find something "constructive" to say about a student and so most people got some negative comments. Is this not so?

 

"Needs to work on technical skills" - after avulsing a placental cord

All of those "negative" comments just sound like they're constructive. You're getting your money's worth

 

he probably got lucky in the residents/attendings who filled out his evals--I think it's usually a personality thing on the part of the evaluator, a lot of people just feel the need to write something negative, or "constructive".

 

One time, I was told to take out a central line in ICU because pt is getting downgraded to regular floor. With all the confidence and the intention to impress the attending, I took out the line in a matter of a few min. Little did I know the pt still has her last abx dose running through the same line and she has no good peripheral line. Thank god, I was able to put in a quick IV line while trying to explain to the not-so-happy screaming ICU nurse.

Moral of the story: Don't forget to check what's running before you take out any lines. Make sure there are other working IV lines.

 

Did that on peds with a patient and his VERY pregnant girlfriend.

She wasn't too happy.

I got to do the 1 week exam on baby just a few weeks later. Girlfriend (now mom) still wasn't happy with me.

 

I was doing a pre-op neuro assessment on a patient in the holding area with my attending. After questioning me (and getting the "strong work" nod of approval), we started walking back to the OR.

Him: "Hey, one more question."
Me: "Shoot."
Him: "Notice anything else about her?"
Me: "Like what?" (starts rattling off miniscule findings)
Him: "Anything about her neuro exam?"
Me: "Other than the CNIII palsy I told you about? No, I don't think so..."
Him: "Think hard. What color was her left eye?"
Me: (shrugs shoulders)
Him: "Dude, you're gonna be a crappy neurosurgeon... Maybe she doesn't have a CNIII palsy because SHE DOESN'T HAVE A LEFT EYE."

Made for a few weeks worth of chuckles at my expense, but nothing more than that. Glad he likes me, and it definitely made me look really carefully before answering anything again.

 

lol, you talk to your attendings that casually? that's pretty cool.

 

Only my mentors... Other attendings are on a very strict professional level.

 

I totally would have done the same thing.

 

Kind of random, but I definitely just realized that my favorite attending (from above) speaks and sounds exactly like the WINNING Charlie Sheen. I'm gonna see if I can get him to say "tigerblood" to the parents of the next kid who does well.

Regardless of whether it works or not, I'm sure it'll end up on this forum soon enough.

 

During clinic my attending was busy in another room for quite a while and there were no seats left so I decided to sit in his favorite seat till he came back. In my rush to get up when he got back I bumped the chair backwards and almost accidentally did the "pull the chair" trick on him and he almost busted his ass on the floor. Thankfully he didn't but damn I felt stupid.

Lessons learned - Never sit in an attendings favorite chair for any reason and don't be nervous around attendings (this was early on in my very 1st rotation - surgery)

 

There was an emergency in endoscopy room (patient was moving) and I was asked to find doctor "M" to help. He was in the patient waiting room. I said 'excuse me' and he interrupted and said 'one minute' it was an emergency and i said 'there is an emergency in the endoscopy room' and i felt how patients got scared the hell out.

Another time i was taking history of a patient that could not go to toilet for 12 days with anal bleeding. I asked is there blood in your stool and he said yes and to my embrrassement i laughed. so bad. i was afraid i would be reported by the patient but it was all grand.

 

This is so funny, and i would be so ashamed if i did that

 

Doing a breast exam and saying "everything feels good" instead of "'normal"

 

Lol. I love this thread

 

Asked a very nice, older woman if she had any children after the birth of her now fully grown son.

Failed to do crude math in my head -- his age, her surgical hx -- and ended up asking her if she'd had any more kids since the hysterectomy.

 

I 2nd-degreed a G6 delivering a 3.5kg baby. Haven't lived it down since, though everyone reassures me that you never know who's going to get a lac.

 

1st and 2nd degree tears are pretty common. I don't think it was a "mistake" at all unless you were purposely not protecting the perineum and controlling the speed of delivery...

 

One of my medical students months ago laughed at a 320 lb Samoan man who was tip-toeing around the psych room because he thought he was a fairy.

I didn't care, but you don't laugh at a 6'3" 320 lb Samoan man.

 

That reminds me of the fairy and little rabbit foo foo. I guess the student hasn't heard the story.