Staying home sick in 3rd-4th year

[Abilene85]

As an MS1, it's no problem to just study through a cold. As I was daydreaming in class, however, I wondered what happens when we get sick during 3rd or 4th year. I'm currently drugged up, and even though the medicine helps, I'm still coughing and stuffy.

In your clinical years, what would it take for you to stay home sick? A cold wouldn't prevent med students from doing their job, but how do you feel about seeing patients on the worst day? I know if I were a patient, I wouldn't particularly want to see my doc coughing and blowing into a tissue every few minutes. Have any of you gone to the hospital while sick and received dirty looks from patients or physicians?

Some people would probably claim the professional thing to do would be to work through it and tough it out. Others would say being professional means staying home and trying not to spread those germs to already sick people.

Any thoughts?

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[Napoleon1801]

I was sick last month on my medicine rotation. My philosophy was to keep coming until someone told me to go home. I was pretty noticeably sick and I had vomitted earlier in the morning before rounds. I mentioned it to the resident and he didn't bat an eye. Attending didn't even seem to notice at all.

 

[BillyWitchDoctr]

I didn't miss any days during MS3. It's usually not a big deal though unless you're on a rotation where you're absence will actually put more work on the other members of your team.

 

[smq123]

As an MS1, it's no problem to just study through a cold. As I was daydreaming in class, however, I wondered what happens when we get sick during 3rd or 4th year. I'm currently drugged up, and even though the medicine helps, I'm still coughing and stuffy.

In your clinical years, what would it take for you to stay home sick? A cold wouldn't prevent med students from doing their job, but how do you feel about seeing patients on the worst day? I know if I were a patient, I wouldn't particularly want to see my doc coughing and blowing into a tissue every few minutes. Have any of you gone to the hospital while sick and received dirty looks from patients or physicians?

Some people would probably claim the professional thing to do would be to work through it and tough it out. Others would say being professional means staying home and trying not to spread those germs to already sick people.

Any thoughts?

What we were told was, basically:
* If you're contagious, and it's something that could really make patients sick, stay home. (This can vary by rotation.)

* If you're delirious, stay home.

* Otherwise, suck it up.

There's a similar thread in the general residency forum. Some of the residents have come in and rounded while attached to an IV. That's quite a work ethic.

 

[futuremsf]

i had vomiting and diarrhea and stayed home for a day last rotation (surgery). called the intern that morning and told him. the chief the next day asked if i was really sick, and i said yes and that was that. and for those who are paranoid about your grade dropping, it was never mentioned in an eval and i got honors.

if you're really sick, stay home. if you have the sniffles, suck it up.

 

[humuhumu]

Some of the residents have come in and rounded while attached to an IV. That's quite a work ethic.

No, that's being a martyr. I'm not impressed. But as long as other people are impressed, it will keep happening. The system is in dire need of reform.

 

[lord_jeebus]

101.5 F or vomiting/diarrhea that would disrupt rounds

 

[anon-y-mouse]

If people have problems getting to class first and second year, will this turn into something huge for rotations? Did people just snap out of the whole 'sleeping in' thing? How do people get used to the abrupt "must go in or else" change in attitude?

 

[njbmd]

Think of your patients first and be guided by what is ultimately the safest thing for them. As a senior resident, I have sent medical students home that appeared contagious especially when I was on the transplant service. I just didn't want to risk the loss of a precious new organ because of someone who might be harboring a virus.

If you have a fever, stay home period. Your body needs the rest and again, people in hospitals do not need the added risk of being exposed to you. If you have a cold, you can wear a mask but flu, infectious diarrhea, etc. can be deadly to vulnerable populations. It isn't a matter of how tough you are, it's a matter of what's safe for the patients.

 

[TRAMD]

Maybe we had the same illness . . .

http://forums.studentdoctor.net/showthread.php?t=442060

 

[Law2Doc]

Before coming to med school, I worked for an attending who was a strong advocate of coming in if you were at all ambulatory. He stated that if doctors didn't come in sick, there would be very few doctors in the hospital (or at least in the ED or Peds) during the cold and flu season. You are exposed to sick people all day, every day, you are bound to catch some of it, at least in the first couple of years until your immune system had been exposed to the bulk of the usual suspects. Not saying his approach is the right one, but I suspect he is the type of person you could find yourself working under, and if so, a sick day is not acceptable.

 

[Law2Doc]

If people have problems getting to class first and second year, will this turn into something huge for rotations? Did people just snap out of the whole 'sleeping in' thing? How do people get used to the abrupt "must go in or else" change in attitude?

Folks quickly start to treat it like a job because it gets imparted to you that way. You aren't given the "option" of sleeping in. You are more often given the "we will round at 7, so you need to come in in the morning, see the patients, and have your write ups done before that".

 

[Winged Scapula]

No, that's being a martyr. I'm not impressed. But as long as other people are impressed, it will keep happening. The system is in dire need of reform.

No, its doing what is expected. I, nor none of the others were asking anyone to be impressed. My belief is that you should come in and stay until someone more senior tells you to go. As I head into the real world of practicing medicine, it is with the expectation that I cannot simply call in sick and ask the office staff to cancel 40 patients for the day or to cancel surgeries which already have had the patient waiting several weeks for the procedure. This is the way things work most of the time in the real world.

In the case of rounding with an IV, post-op hour 36 (I had no pain and except for being a little dehydrated, really did feel fine and wasn't infectious), I was sent home by the attending. I have sent others home for the same. There are plenty of things/learning experiences that can be done without exposing patients to your cold.

Unfortunately, IMHO, the number of people who aren't really sick but claim to be and don't come in, far exceeds the number who are actually sick.

 

[Blade28]

Maybe we had the same illness . . .

http://forums.studentdoctor.net/showthread.php?t=442060

Was just going to provide a link to our interesting (heated) discussion over there.

 

[Tired]

If you have a fever, stay home period. Your body needs the rest and again, people in hospitals do not need the added risk of being exposed to you. If you have a cold, you can wear a mask but flu, infectious diarrhea, etc. can be deadly to vulnerable populations. It isn't a matter of how tough you are, it's a matter of what's safe for the patients.

Neat. So what exactly are you afraid of transmitting? Please, be specific, doctor.

 

[Blade28]

BTW, while it may be gross to pre-meds and med students (and even those not in General Surgery, due to its scope), if you were to tell your fellow residents that you're calling in sick because you have some diarrhea?

 

[deucerp]

To me, big difference between 3rd and 4th. 3rd year, surgery attending said "if you're not being admitted you'd better be here." 4th year, as long as its not an AI, if I stub my toe I may call in...

 

[Blade28]

Enjoy 4th year - will be the most relaxing, enjoyable, leisure-time-packed year for a LONG time.

 

[AmoryBlaine]

I had a pretty nasty URI during my FM rotation. The AM clinic had a ton of babies so I pretty much wore a mask all day. The nurses were looking at me like I was crazy.

As far as staying home goes, I wouldn't do it unless you are a danger to patients. The stories about surgery residents getting a quick liter bolus after rounds are not urban myths.

 

[UnderdogMD]

I am sick at the moment so this thread came to mind. I don't get sick often (2 to 3 times per year) but when i do it is bad. For some reason sickness affects me worse then others. My nose becomes red and chaffed from blowing it so much. Normal people get a runny nose I get a faucet. I literally look down and start dripping. My eyes become bloodshot to pinkeye levels and people think I am high (I am-NyQuil). My throat becomes so sore it is hard to swallow and my voice becomes like chocolate rain. I measure time by how many times I have coughed (4 per minute). It is as if I am speaking into hollow pipe. Basically I am miserable for about 3 days. Would they still expect me to come in like this? Isn't it dangerous for the patients. I hate being sick but being sick with another medical condition like a broken leg etc would be even worse.

 

[Llenroc]

It's not a matter of how sick you are, it's a matter of how badly they screw you over.

Some schools give you up to 5 sick days per rotation. I hear students use up these days even if they aren't sick. If that's the policy, then why wouldn't you take a day off for being sick? That said, most schools (mine included) aren't as nice.

On some rotations, if you're sick, perhaps you can speak with your team and they'll let you stay at home. When I was on Pediatrics, one student had a terrible attack of diarrhea during rounds, and they let him go home for the day without penalty.

On other rotations (like Surgery and OB-GYN at my institution), they give you two extra nights of call for each day of work you miss whether they are excused or unexcused. Have fun with that.

3rd year of medical school is for suckers. I'm so glad to be done with that rat race.

 

[PeepshowJohnny]

If people have problems getting to class first and second year, will this turn into something huge for rotations? Did people just snap out of the whole 'sleeping in' thing? How do people get used to the abrupt "must go in or else" change in attitude?

It hasn't for me and I think the majority of other people. I think the difference is in the style of learning.

Second year I wake up, I've got a sore throat and headache I think to myself "Okay, I can either suffer through hours of boring pathology lectures which I can learn myself if I read the textbook (which I'll have to do anything because I won't be able to focus when I'm sick) and risk not getting better or take a personal day and maybe try for the afternoon"

Third year, it's not so much about learning as "being there". If I show up sick, I may do a crap job interviewing my patients and my note, I may not be able to respond to any pimping questions, but I was physically THERE and sometimes that's enough.