when do you start to do procedures?

[doctr1]

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hello,

do they usually ask you to do some procedures? to draw blood, to insert IV lines, or to insert a foly catheter??

if not, then when do you they ask you to do such procedures?

 

[tbone0705]

From my experience over the last 8 months, I found that most docs won't ask unless you make an effort to let them know you are interested in doing the procedure. Even then they still might be hesitant. However, I noticed that the old school docs tend to ask more often. It really all depends on the doc and you're own comfort level.

 

[Dirt]

Depends on the resident/attending.

I have been places where I was not allowed to see patients on my own as a third year, and I have started a-lines and central lines with the resident on the other side of the bed giving directions.

Probably the majority of people start doing more stuff as a sub-I and really learn early in intern year.

 

[MedLover25]

I started doing procedures right when I started my 2nd rotation (surgery). No femoral sticks or a-lines - they pushed me right through to chest tubes, central lines, etc. Definitely depends on the place you rotate at.

 

[1nycdoc8]

totally depends on the hospital/residents.

that being said our teaching hospital is pretty hands on through all the rotations... my first one was obgyn and I started doing IVs, suturing, delivering etc. from week 1. in IM our nurses aren't supposed to draw blood cx so we basically do them. our RTs don't do ABGs so students and residents do them etc.

 

[Law2Doc]

hello,

do they usually ask you to do some procedures? to draw blood, to insert IV lines, or to insert a foly catheter??

if not, then when do you they ask you to do such procedures?

Totally depends on the rotation/hospital, and somewhat on your interest level. At some places you have to be a bit proactive -- if you come in saying "if the opportunity arises, can I try" some resident probably will make sure you get a shot. I definitely tried to get med students as involved as they wanted during my intern year. You absolutely should be asking to put in foleys in the OR, NG tubes, etc. As a med student I got to do I&Ds, paracentesis, joint aspirations, LPs, lots of suturing. Some places shy away from med students doing much, so I've seen med students pair up and put IVs and even NG tubes into each other. To a large extent on some rotations there will be a disconnect, where your rotation coordinator will tell you you absolutely need to do X, Y and Z, but then if you sit and wait for it to happen, it won't -- you often won't be "asked" to do the procedures. You will have to be proactive. You may even have to tell the nurses, if there's an NG or Foley to put in, page me, or else you may come up short on your procedure checklist.

Also bear in mind that first year residents start in late June/early July of each year, and so for the first month or two there will be lots of people fighting to do procedures. If you hold off on the procedural rotations until the fall, you will have a better chance to do stuff once the novelty has worn off.

It's a good idea to be proactive and do as much of this as you can during med school, because otherwise you may be learning on the job on very tough patients at 3am while on call. The nurses won't call you for the easy ones, so if you have some experience under your belt, you are much better off. If you find you aren't getting as much procedures in, an ED elective during 4th year is a good idea (although more work than many folks like to do during 4th year). Sign up for as many overnight shifts as allowed, because that's when the residents/attendings are more likely going to let you do stuff as a "reward" for being there.

 

[IHeartNerds]

You absolutely should be asking to put in foleys in the OR, NG tubes, etc.

NG tubes may be useful depending on your specialty. Learning to put in Foleys is worthless. I have never seen someone with MD attached to their name toss a Foley in. Although admittedly I never rotated on urology.

Sign up for as many overnight shifts as allowed, because that's when the residents/attendings are more likely going to let you do stuff as a "reward" for being there.

In the half dozen hospitals I've rotated in, this has never been the case. Nobody at 2am wants the guy who's going to take half an hour to do a procedure when there's someone who can do it in five minutes.

 

[Law2Doc]

NG tubes may be useful depending on your specialty. Learning to put in Foleys is worthless. I have never seen someone with MD attached to their name toss a Foley in. Although admittedly I never rotated on urology.

In the half dozen hospitals I've rotated in, this has never been the case. Nobody at 2am wants the guy who's going to take half an hour to do a procedure when there's someone who can do it in five minutes.

I don't know what to tell you -- I'm writing from first hand experience on both these.

First, at many hospitals you absolutely will be called as an intern when the nurse cannot get a Foley in. If you haven't ever put in a Foley on a healthy person, it's even more tough to get a Foley or coude in on someone with a non-healthy urethra, or a morbidly obese person, etc. Lots of hospitals require the primary team to try to put in the Foley before you are allowed to call urology. So yeah, in my experience most folks on here could be called to do one.

Second, my experience at the several hospitals I've rotated through was that you absolutely will get more hands on experience at night, particularly in the ED or trauma bay. The ED staff are on shift work and don't get to go to a call room, so they don't really care if it takes you 5 minutes or a half hour. On the wards it's different, because someone on call gets to sleep if nothing is happening -- I was talking about the ED in my prior post.