Starting to see patients not going well

[YellowTurtle]

I'm an MS2.

I recently started seeing real patients in the hospital on my own for the first time. The goal is for me to get comfortable with doing h/p's independently as I get ready for 3rd year. The first couple were kinda bumpy but the people were fairly friendly. However, I was supposed to see my 3rd one yesterday and it went much differently than I expected. Almost immediately after I started interviewing him he became upset and agitated because I was a student and I was asking him so many questions. The words he used to express his frustration left me feeling embarrassed because I'm "not a doctor" which he kept emphasizing and frustrated because in order for me to learn I have to impose on people in this uncomfortable way.

I'm hoping for some encouragement or hearing from anybody else's similar experiences. Anybody that has gone through this - how did you deal with it and become better at seeing patients as a student? Especially when some patients don't want to deal with us students ...

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[BurghStudent]

Own your space. They know they're coming to a teaching hospital or clinic. I introduce myself as the medical student working with Dr. XYZ. If they complain, I tell them the truth. "By speaking with me, you'll have to wait less, and the Dr. will be visiting you as well."

Own your space.

 

[ridethecliche]

I usually tell them that the doctor is with another patient so either they can hang out with me and I can listen to them and relay all the info to the doctor or they can speak to the doctor only for a rushed visit. If they tell me that they'd rather wait by themselves instead, I tell them that I'm awesome and that they're making a terrible mistake and start interviewing them anyway.

 

[stolen_biscuit]

Empathizing always helps: "I know it's frustrating to have so many students/doctors/residents coming in and out of your room often. The nice part about being one of the students here is that I typically get to spend a little more time with you to hear your concerns. Is there anything you want me to tell the attending in particular before he/she comes in later?" They will often soften; they are just frustrated.
I HATED doing that when I was an MS2, but I found it went more smoothly when I didn't let myself get flustered. And I tried to put myself in their place - if you have ever had to stay in a hospital, it is ridiculous: being woken up every few hours, answering the same Qs over and over....
3rd year is 50x better, so hang in there.

 

[madchemist89]

This happens at every level: student, resident, and attending. I would say that it occurs less as you go higher up the ladder though. As you become better with your history and physical, you will be able to more quickly and efficiently obtain the necessary information. By simply being more fluid and at ease with the conversation, these instances will occur less. This type of situation can happen to anyone because the patient or family is likely frustrated with someone other than you. The above advice can certainly help, but you have to quickly determine whether you can salvage the situation or not. Sometimes, it is best to leave and return at a later time when the patient is more receptive. Building a good rapport can sometimes take time, especially with some psychiatric patients. Most importantly, you can't take these things personally.

 

[YellowTurtle]

Empathizing always helps: "I know it's frustrating to have so many students/doctors/residents coming in and out of your room often. The nice part about being one of the students here is that I typically get to spend a little more time with you to hear your concerns. Is there anything you want me to tell the attending in particular before he/she comes in later?" They will often soften; they are just frustrated.
I HATED doing that when I was an MS2, but I found it went more smoothly when I didn't let myself get flustered. And I tried to put myself in their place - if you have ever had to stay in a hospital, it is ridiculous: being woken up every few hours, answering the same Qs over and over....
3rd year is 50x better, so hang in there.

The last couple pt's I saw I was able to empathize and also find something we had in common (sports team/tv show) to create some rapport with them. It seemed to work very well and made them more open to talking with me.

But with this pt yesterday I empathized with him, but the CC was respiratory. Breathing/talking was difficult for him and he kept telling me "just ask me your questions" AS I WAS ASKING THEM. Like he didn't understand why I needed more information from him other than "I couldn't breathe this morning" (he already received treatment and was resting) ... I didn't want him to get too agitated in his poor respiratory state, but how do you do a comprehensive history if the patient doesn't want to talk to you and it's difficult for them to breathe?

 

[Jabbed]

The last couple pt's I saw I was able to empathize and also find something we had in common (sports team/tv show) to create some rapport with them. It seemed to work very well and made them more open to talking with me.

But with this pt yesterday I empathized with him, but the CC was respiratory. Breathing/talking was difficult for him and he kept telling me "just ask me your questions" AS I WAS ASKING THEM. Like he didn't understand why I needed more information from him other than "I couldn't breathe this morning" (he already received treatment and was resting) ... I didn't want him to get too agitated in his poor respiratory state, but how do you do a comprehensive history if the patient doesn't want to talk to you and it's difficult for them to breathe?

Respiratory distress is something of a contraindication for taking a comprehensive history.

 

[username456789]

In your situation, it may help to set expectations early on with him. Tell him that you plan on asking several questions related to his chief complaint of breathing problems, and that you're hoping to get a better idea of what led to them and how you can best treat his condition and prevent these symptoms in the future. Let him know that you understand he is likely tired or not feeling well, but that you very much appreciate his help in answering your questions.

 

[stepone2015]

I just introduce myself as the med student working with Dr. X. As long as your confident and make it apparent that this isn't your first ever patient visit, you'll be fine. You just need some more practice. I don't even mention that Dr. X will be coming in to see them until the end of the visit, unless they ask, which is rare.

 

[stolen_biscuit]

The last couple pt's I saw I was able to empathize and also find something we had in common (sports team/tv show) to create some rapport with them. It seemed to work very well and made them more open to talking with me.

But with this pt yesterday I empathized with him, but the CC was respiratory. Breathing/talking was difficult for him and he kept telling me "just ask me your questions" AS I WAS ASKING THEM. Like he didn't understand why I needed more information from him other than "I couldn't breathe this morning" (he already received treatment and was resting) ... I didn't want him to get too agitated in his poor respiratory state, but how do you do a comprehensive history if the patient doesn't want to talk to you and it's difficult for them to breathe?

Can you clarify what you need to do with your director? I'm with Jabbed on this one. I'd be really surprised if someone expected you to do a complete h&p on a pt like that. Typically you just want to know how he did overnight, so a few focused questions should be enough. The he just has to lay there for most of the exam, so you could take more time with that. (For a more willing pt, I'd definitely practice the whole deal for the experience.)

 

[YellowTurtle]

Can you clarify what you need to do with your director? I'm with Jabbed on this one. I'd be really surprised if someone expected you to do a complete h&p on a pt like that. Typically you just want to know how he did overnight, so a few focused questions should be enough. The he just has to lay there for most of the exam, so you could take more time with that. (For a more willing pt, I'd definitely practice the whole deal for the experience.)

Since I'm still in preclinical years I'm expected to do a fully comprehensive h/p to show competence before I can begin doing more focused. It's supposed to be like a "pretend nobody has seen this pt yet" even though many times they've already been in the hospital for a few days. I'm not allowed to see any test results. I do the h/p and then write a SOAP note. This particular pt was admitted in the early morning, treated, and I saw him in the afternoon. I really don't think that before I walked in the room he was in any respiratory distress. It was more that his agitation with me being a student and the yelling that ensued that stressed his respiration. After trying to calm him down and express empathy, I could tell he was stressing himself (starting to sweat) and I decided it wasn't worth it and left.

 

[stolen_biscuit]

I really don't think that before I walked in the room he was in any respiratory distress. It was more that his agitation with me being a student and the yelling that ensued that stressed his respiration. After trying to calm him down and express empathy, I could tell he was stressing himself (starting to sweat) and I decided it wasn't worth it and left.

Ha! We had to do a similar thing. If you aren't required to see that pt in particular, sometimes you can just return to the nurse's station and ask for a different pt, in particular a chatty/friendly one.

 

[Tenk]

If he was old he was probably delirious. If not then he was just a jerk. Don't sweat it.

In the future as a med student, instead of taking the time to introduce yourself as med student working for X attending collecting information and why that saves the patient time, etc. Just introduce yourself by your saying Hi, I'm Jack. How are you today? Then just talk to the person about their day for a minute or whatever else they chose to talk about. This will establish rapport with the patient and they won't even know that you are using Jedi mind tricks to get them to talk about themselves. It's been scientifically proven that when you get a person to talk about themselves or about something they enjoy they will think the conversation went better/longer/smoother/etc. Then you just transition that to talking about their illness.

Also, try to never wear your short white coat. Ever.

 

[cbrons]

Since I'm still in preclinical years I'm expected to do a fully comprehensive h/p to show competence before I can begin doing more focused. It's supposed to be like a "pretend nobody has seen this pt yet" even though many times they've already been in the hospital for a few days. I'm not allowed to see any test results. I do the h/p and then write a SOAP note. This particular pt was admitted in the early morning, treated, and I saw him in the afternoon. I really don't think that before I walked in the room he was in any respiratory distress. It was more that his agitation with me being a student and the yelling that ensued that stressed his respiration. After trying to calm him down and express empathy, I could tell he was stressing himself (starting to sweat) and I decided it wasn't worth it and left.

I did a little experimenting with an introduction technique that I think gives you more legitimacy in the patients eyes, enough to where they wont think you are playing doctor or wasting their time.

I never say "im a medical student working WITH so and so."

Instead I always say, "Im an M.D. student working FOR dr so and so."

Now you might say, wait a minute, how is that really any different/why does it matter?

Because sadly a lot of people dont know what a "medical student" is. Lots of people today think they are "med students" and go to "medical school." I know a pharmacy technician who would tell people she goes to a "small medical school" nearby. She didnt do it on purpose to misrepreset herself, she just didnt know any better.

So by saying M.D. student, you are highlighting the fact that you are a student who is specifically in school to be a doctor (because most people know doctors are MDs). For whatever reason, that seems to make the average joe look at you kind of like the real thing even though we all know that youre not.

Other thing is that when you say, "I'm working WITH Dr. So and so" theres a subtlety there that can suggest equality of relationship. Kind of like the uneducated Nurse Practitioners who say, "I collaborate with so and so" to temper the fact that they arent independently practicing at least according to the law. Patient dont like this, makes it seem like they werent important enough for the doctor or that theyre time is gunna be wasted.

When you say "I work FOR Dr. X" it makes it seem like you are a member of an entire team led by Dr. So and so. It makes the patient feel important enough that theyre being taken care of by an entire group of people and makes your attending look important and gives the patient the idea that they better give you all the detailed info because dr X isnt going to be doing the low level history taking.

 

[Gambler 101]

This happens third year too. I state my name and refer to myself as a doctor-in-training and tell them I'm working with your medical team to expedite the process (they like to hear that you're helping move things along). Then I'll start my HPI. I like to integrate my ROS with the HPI and PMH so it doesn't feel so rapid fire. If they're getting tired during the history, I'll start the physical and throw in my last few questions. It helps to be personable and get to know them as people. Finding out who they live with, where they live, what they like to do, etc all helps with discharge planning

 

[sloop]

I just say "Hello, I'm Sloop and I'm part of your primary medical team. Would you mind if I talk to you for a bit?" Most people won't ask for more qualification on who you are and will answer your questions. I know some people have qualms about this, ethically, but you're there to learn and need to do what's necessary to make sure you learn.

On first encounters, I always end with "I'll be in and out over the course of your stay. Is there anything you need? Okay, well if there's anything you need or you have any concerns let me know." This last part shows that you're willing to do stuff to help them out and I find it goes a long way. Usually if they need anything it only amounts to getting them some ice water or a blanket. Anything more than that and you can just let the nurse know about it. Either way, it usually makes people like you and tolerate your presence.

 

[cbrons]

This happens third year too. I state my name and refer to myself as a doctor-in-training and tell them I'm working with your medical team to expedite the process (they like to hear that you're helping move things along). Then I'll start my HPI. I like to integrate my ROS with the HPI and PMH so it doesn't feel so rapid fire. If they're getting tired during the history, I'll start the physical and throw in my last few questions. It helps to be personable and get to know them as people. Finding out who they live with, where they live, what they like to do, etc all helps with discharge planning

For presenting, always mix hpi ros fh/sh and pmh/psh into 1 if you can, only noting whats relevant. Course they may want it different but its a good default.

 

[cbrons]

Also, try to never wear your short white coat. Ever.

Yeah i agree, if you can get away with it, never wear it. Some clueless students think it makes them look professional. It doesn't.

 

[YellowTurtle]

Yeah I've come to realize that it just puts a sign on my back saying "clueless med student over here"
Alas, it's required for me to wear mine.

 

[eye love lamp]

Part of the fun of medical school is getting kicked out of patient rooms. Just wait until your OB/GYN rotation (assuming you're a male). My personal record was getting refused or kicked out of 8 straight rooms.

It's not personal, it's just the garbage that's required to get you to residency where you're not so worthless.

 

[Ismet]

Since I'm still in preclinical years I'm expected to do a fully comprehensive h/p to show competence before I can begin doing more focused. It's supposed to be like a "pretend nobody has seen this pt yet" even though many times they've already been in the hospital for a few days. I'm not allowed to see any test results. I do the h/p and then write a SOAP note. This particular pt was admitted in the early morning, treated, and I saw him in the afternoon. I really don't think that before I walked in the room he was in any respiratory distress. It was more that his agitation with me being a student and the yelling that ensued that stressed his respiration. After trying to calm him down and express empathy, I could tell he was stressing himself (starting to sweat) and I decided it wasn't worth it and left.

Who told you to see this particular patient?? When we did this in MS1/MS2, the resident or attending we were with always got the patient's permission first. Sometimes they would still get bored/annoyed with us because they didn't realize how many questions/how long a full physical was, but they at least played along for the majority of it. You're going to deal with difficult patients, and you're going to have to learn to handle them, but if you're just starting out, you really need agreeable patients.

 

[YellowTurtle]

Part of the fun of medical school is getting kicked out of patient rooms. Just wait until your OB/GYN rotation (assuming you're a male). My personal record was getting refused or kicked out of 8 straight rooms.

It's not personal, it's just the garbage that's required to get you to residency where you're not so worthless.

I'm definitely a woman. But it's funny you mention that because OB/gyn is actually on my potential list of what to apply to (along with many others). I've seen many pelvic exams (ER scribe pre-med school and extensively shadowed an Ob/gyn M1-M2 summer) and I have definitely been kicked out of rooms before. But none were as abrasive as this particular pt. I wasn't going to leave the room unless he clearly expressed that he wanted me to (trying to hold my own). When he kept cutting me off to say how "they send me med students and won't let me rest" I politely asked if he would prefer for me to leave so he can rest he responded with "you keep asking that but I don't see you walking out the door" and "if I tell you to leave you'll go tell someone I made you leave and make me look bad." When after being in his room for 30 seconds and getting 2 questions out about his current episode he would have no reason to have that suspicion of me.

I feel like I'm ranting now. I don't know what it is about this guy. I'm usually confident with walking into people's room and talking to them. I just couldn't figure out if it was my fault or if he was just downright rude. I'm starting to think he was just a rude person.

 

[YellowTurtle]

Who told you to see this particular patient?? When we did this in MS1/MS2, the resident or attending we were with always got the patient's permission first. Sometimes they would still get bored/annoyed with us because they didn't realize how many questions/how long a full physical was, but they at least played along for the majority of it. You're going to deal with difficult patients, and you're going to have to learn to handle them, but if you're just starting out, you really need agreeable patients.

I only interact with the one attending I'm assigned to. I was told he had verbally consented to it earlier in the day. I think he misunderstood what that meant when he agreed to it, though ...

 

[Ismet]

I'm definitely a woman. But it's funny you mention that because OB/gyn is actually on my potential list of what to apply to (along with many others). I've seen many pelvic exams (ER scribe pre-med school and extensively shadowed an Ob/gyn M1-M2 summer) and I have definitely been kicked out of rooms before. But none were as abrasive as this particular pt. I wasn't going to leave the room unless he clearly expressed that he wanted me to (trying to hold my own). When he kept cutting me off to say how "they send me med students and won't let me rest" I politely asked if he would prefer for me to leave so he can rest he responded with "you keep asking that but I don't see you walking out the door" and "if I tell you to leave you'll go tell someone I made you leave and make me look bad." When after being in his room for 30 seconds and getting 2 questions out about his current episode he would have no reason to have that suspicion of me.

I feel like I'm ranting now. I don't know what it is about this guy. I'm usually confident with walking into people's room and talking to them. I just couldn't figure out if it was my fault or if he was just downright rude. I'm starting to think he was just a rude person.

It's not your fault. He may just be a rude person, but he may also be frustrated with how things are going and he's just tired and cranky. The hospital is a scary, lonely, frustrating place. Some people let that affect how they interact with others. Don't take it personally.

 

[VisionaryTics]

1. Never try to hide or be oblique about your role. "I'm part of your medical team" sounds vague and stupid. I introduce M3s and M4s as "senior medical students". And wear your white coat if appropriate. You can't knock NPs for turning their badge around or hiding behind alphabet soup, and then not wear your short white coat and introduce yourself in way that is deliberately vague and confusing. Think of it as practice for when you have to tell a parent you're an intern when you're about to suture their daughter's facial laceration. Own your role.

2. When a patient refuses to see a student or resident, see that as a blessing. They are nearly all on the axis.

 

[SDN]

2. When a patient refuses to see a student or resident, see that as a blessing. They are nearly all on the axis.

Fact.

 

[penguinism]

This sounds similar to what first- and second-year students at my school do, which is see a patient on the wards just to practice H&Ps. They are not involved at all in their care otherwise, and do not interact with the primary team caring for the patient (you instead have a different facilitator who will discuss patients with the students in the small group at the conclusion of the session). The facilitator finds students patients that are willing to be seen by them, although sometimes patients don't understand that the student will be performing a complete history and physical. Every once in awhile you'll get a patient like this one. If the patient is not cooperative, you can certainly try to reason with him/her, but it is understandable to go back to your facilitator and request a new patient (time permitting). Alternatively, skip the part(s) the the patient refuses. It happened to me a couple times as an MS1/2 and no one faulted me for doing so.

 

[jhamaican]

walk in like you own the place. Let them know they are in an academically affiliated hospital and this is part of the game.Be the boss

 

[italiancowgirl]

Also I will point out that as a person terrified and probably (assumption here) medically illiterate, this man probably didn't understand what was going on at all. He sounds like he may have been elderly and I have met more than a few cranky old men. Imagine being terrified, not understanding and feeling like no one really cared about you. He may have felt you were asking him the same questions as someone else had because you didn't trust him or he may have just been exhausted because he didn't sleep or eat well. It is important to know that we sometimes get people at their absolute worst. Let it roll off and learn to react with confidence! Explain clearly why you are an important part of the team and maybe directly ask him why he feels you would say bad things about him. It could give you valuable insight into either his mental status or his bias. I find that if they are complaining I directly ask them why, and then I try to calmly address their worries. Ambiguity makes patients more lost and worried, just be clear that you are doing the best you can to help them but you can only do that if they work with you.

 

[hamstergang]

I wasn't going to leave the room unless he clearly expressed that he wanted me to (trying to hold my own).

I don't get this part. You don't prove anything by torturing the guy. When it was clear he didn't want you there, you could have left. No need for the two of you to play this passive aggressive game.

 

[Mad Jack]

Just don't take it personally. The hospital makes most people miserable in ways they normally would not be, and they can snap because of the environment and situation. Being sick isn't easy, so when someone is miserable and ill, just remember that it isn't you, nor is it really even them, they're just going through a lot.

And sometimes they'll have frontotemporal dementia, so there's that lol...

 

[YellowTurtle]

I don't get this part. You don't prove anything by torturing the guy. When it was clear he didn't want you there, you could have left. No need for the two of you to play this passive aggressive game.

What I mean by trying to hold my own is that I was trying to be confident in my patient interaction and not walk out the door and give up as soon as it became clear it wasn't going as smoothly as my previous two. As BurghStudent pointed out above I was just trying to "own my space" and not tuck tail and run. I definitely do not mean I was trying to hold my own in any sort of fight against him or by any means trying to do anything that would make him more uncomfortable. In fact, that was my primary concern - how do I continue to talk to him when it seems that our interaction is stressing him? With such little patient experience on my own I don't think I have learned yet how to apply all the great advice that has been given so far. But I have definitely received many great pointers from this post and will try to incorporate them more into my future patient interactions.

But by no means was I being passive aggressive or playing a "game" in order to torture him.

 

[Amygdarya]

That's quite a positive post there ^

 

[YellowTurtle]

u keep defending urself but the fact is u could have left the dude alone and gotten ur "comprehensive hx" on someone else... and the world would have kept spinning.. it wasnt a big deal and idk why you had to chase after a clearly exasperated patient. shame on u

Shame on you for not reading. Because "leaving the dude alone and getting my comp hx on someone else" is exactly what I did. And yes, the world is still spinning.

Thanks for your constructive input.

 

[sloop]

1. Never try to hide or be oblique about your role. "I'm part of your medical team" sounds vague and stupid. I introduce M3s and M4s as "senior medical students". And wear your white coat if appropriate. You can't knock NPs for turning their badge around or hiding behind alphabet soup, and then not wear your short white coat and introduce yourself in way that is deliberately vague and confusing. Think of it as practice for when you have to tell a parent you're an intern when you're about to suture their daughter's facial laceration. Own your role.

I don't think it sounds stupid. It's worked for me. People are more cooperative and I can do my job more effectively. You can think it sounds stupid if you want, but I'd rather have people on the internet think I'm saying stupid things than deal with people hassling me about being a med student at 6 in the morning. I also introduce myself as a doctor when talking to medical records departments so they don't give me a hard time (and have been explicitly told to do this by residents and attendings). This latter part is actually far more deceptive than the first thing, but whatever. It allows me to do my work and focus on learning rather than arguing with people about social roles.

Here's the deal. I report to the medical team, not the nursing team. I'm not lying. Most patients don't question it and probably don't really care. Eventually, most patients will get clarification of my role (I do not lie about it) after I've been in to visit a couple mornings. By that time, I've helped them get various comforts and shown enough confidence and competence that they don't really care who I am. Ultimately, they're at a teaching hospital and I'm a medical student. I'm entitled to learn medicine.

I know what I'm saying contradicts every first year medical ethics course in the U.S., but whatever. Patients who benefit from the care of educated medical professionals have an ethical responsibility and social duty to contribute to the education of those they benefited from. The harm to patient transparency in introducing yourself as part of the medical team or something similarly evasive with regard to student status (I.e. Student doctor, doctor in training, etc.) needs to be balanced against the harm to medical education in requiring students introduce themselves with their meek subordinate titles which lead substantial numbers of patients to deny them experiences that are necessary for their training.

Let the backlash begin. I'm ready for it.

 

[seminoma]

I'm an MS2.

I recently started seeing real patients in the hospital on my own for the first time. The goal is for me to get comfortable with doing h/p's independently as I get ready for 3rd year. The first couple were kinda bumpy but the people were fairly friendly. However, I was supposed to see my 3rd one yesterday and it went much differently than I expected. Almost immediately after I started interviewing him he became upset and agitated because I was a student and I was asking him so many questions. The words he used to express his frustration left me feeling embarrassed because I'm "not a doctor" which he kept emphasizing and frustrated because in order for me to learn I have to impose on people in this uncomfortable way.

I'm hoping for some encouragement or hearing from anybody else's similar experiences. Anybody that has gone through this - how did you deal with it and become better at seeing patients as a student? Especially when some patients don't want to deal with us students ...

You haven't yet finished M2 so your primary issue going to be lacking the knowledge base necessary to do a focused interview.

Imaging going to get a flat tire fixed only to have the mechanic start asking you when you last had your oil changed, filters changed, if your seatbelt still works, if any of your signal lights are out, etc. You went for a simple reason and now some guy is asking you a million questions and wasting your time.

The last couple pt's I saw I was able to empathize and also find something we had in common (sports team/tv show) to create some rapport with them. It seemed to work very well and made them more open to talking with me.

But with this pt yesterday I empathized with him, but the CC was respiratory. Breathing/talking was difficult for him and he kept telling me "just ask me your questions" AS I WAS ASKING THEM. Like he didn't understand why I needed more information from him other than "I couldn't breathe this morning" (he already received treatment and was resting) ... I didn't want him to get too agitated in his poor respiratory state, but how do you do a comprehensive history if the patient doesn't want to talk to you and it's difficult for them to breathe?

You don't need a comprehensive history right away. You need enough of a history to rule out emergencies. You ask yes/no questions with dyspneic patients so they don't have to work so hard to talk.

Also you're probably right, he probably didn't know why you needed more info. Most patients aren't doctors.

2. When a patient refuses to see a student or resident, see that as a blessing. They are nearly all on the axis.

Top 3 things that can happen to me on any given day:

1. Get to go home early.
2. Patient refuses to see me.
3. Free food at conference.

Regarding all the @sloop hate, I do the same thing. "Hi I'm seminoma with neurology".. or whatever clerkship I happen to be on. If the patient asks, then I say I'm a med student.

Most patients have no idea what the coat length means, at least not in my experience. I would happily never wear my white coat, but wearing it around patients is an unspoken rule at the rotation sites around here.

 

[W19]

One has to go thru a lot of BS before becoming an attending... It's part of the game. Don't take it too personal!

I have seen, on multiple occasion, patients refused to be evaluated/seen by PA/NP... At least you won't have to deal with that once you become an attending.

 

[Psai]

"Hi I'm Psai, I'm a 3rd year medical student working with the whatever doctors." I've only had a problem two times; once with a guy who was obviously antisocial and once with a girl whose gastric bypass surgery didn't seem to have worked. The parents I met on peds surgery were also a little wary but never had them say no.

 

[TBV]

"Hi I'm TBV and the series House was loosely based on my career in medicine"

 

[675R]

The rule of thumb I always had when working in the hospital was this- Do your job to the best of your abilities and with complete honesty. This sounds silly, but you would be amazed how many people cut corners, are dishonest, or get lazy with time. You are going to deal with people (patients and family) who no matter what, they will not be happy. It could be something you're doing, they could be extremely unhappy people, it could just be (and usually is) really bad timing and something sets them off. If a patient isn't receptive to your volunteering or doing something that isn't your job or HAS to get done, then thank them and do something else. If it is your job or it HAS to get done, then you don't have to be super nice to them, but just do it politely, efficiently, and thank them and leave. You can't please everyone and you won't. That's all there is to it.

So when you're doing this interviewing, tell them who you are and why you're there and what you would like to do. Tell them it's strictly voluntary and for education. Most people won't turn around and change their mind after agreeing to that stuff.

 

[YellowTurtle]

Update -- I was able to talk with my attending today about this pt. I asked if there was anything I could have done differently and she said "no, you did nothing wrong. He was a jerk."

Apparently he was nice initially and when he told her I could see him, but then rude with me, and then later he was rude with her. She said everybody was happy when she discharged him. I also asked her if it could be a psych thing and she said that no, he was just rude.

TL;DR. Some people are just rude. Can't make everybody happy.

 

[Señor S]

I wish I got turned away a little more. Damn Southern manners.