There's a lot of standing in one place that happens during med school third year clerkships. Some of it is understandable, like on surgery rotations, but for the life of me, I can understand why I had to stand for 4-5 hours straight during my medicine rotations.
At the university hospital, rounds would start at 8AM, and we'd walk down the hall over the next four hours, discussing each patient. Some teams would round for six hours. Six hours of essentially standing in place, discussing patients.
I'm sure there's some educational reason why this would be done, but by the end of it, all I could focus on was how much my feet hurt.
And then there's me, kicking those 3rd years off my computer and out of my chair so I can sit down to chart.
ReplyDeleteI made a med student stand up yesterday and felt bad. But she was at my freakin desk and I had work to do.
DeleteI am a first year, and have "preceptor" clinic one half day per week. I expected that I had to stand the whole time. My preceptor has told me several times to sit in the second chair that is next to the patient. I am so grateful to him for that.
DeleteMed students were required to use the computer to put in orders and complete other tasks on several rotations. If we didn't do them fast enough the residents would yell at us. You sound like one of those people who thinks med students exist solely to be in your way.
DeletePerhaps it's because the team can't physically see the patients without going into their rooms? As a senior medicine resident responsible for a ward of 35 patients, I couldn't provide decent care without walking around to all of my patients and seeing whether they matched the descriptions provided by my (sometimes inept) team members. I've called code blues on morning rounds on patients who were described to me as "stable and in no distress" by my team members.
ReplyDeleteMaybe they were "stable" and "in no distress" when the intern pre-rounded on them at 7AM, but by the time you actually saw them at 1PM they had deteriorated. A lot can happen in 6 hours.
DeleteOf course that can always happen...it's happened to me. But early trainees also can't necessarily recognize when a patient is showing early signs of distress, and that's the value of also having a more experienced eye round on the patients.
DeleteHaving more experienced people on the team is basically the whole point of the residency training system. It's so comforting to know that you refer to them as "inept."
DeleteYou could also just see the patients before rounds and round together to compare notes with the rest of the team? Or physically round on the worrisome patients than sit down for the rest of them? I've had teams use both those strategies and it made all the difference to the students.
DeleteMed student here, I've passed out twice on rounds because of all the standing and because we aren't allowed to carry snacks or drinks with us. And the patient rooms are so dang warm.
ReplyDeletethe rooms don't get less warm and the shifts don't get less long when you're doing it for real. you DO get to carry snacks though.
DeleteAt least the attending gets to sit on the patient's bed or in a chair next to them. Everyone else has to stand. To be fair, 4 hours isn't that bad, it's when it goes to 2 p.m. that it gets awful. Honestly, it's cruel!
DeleteRecently started a new job on 12 hour orientation shifts. My preceptor insisted on standing for charting...this is while everyone else was sitting down using the computers to chart, with a wealth of open workstations (without Dragon even! Open game, imo!) for our choosing. Nope...we either walked or stood for 12 hours, minus lunch/dinner, during my entire floor orientation.
ReplyDeleteAt my last rotation, the attendings would frequently review the charts or write notes by standing next to the workstation right over a perfectly good chair. I never understood this. Of course I couldn't reach over and grab the chair because no one else was sitting. Sometimes there were 2-3 empty chairs and still no one used them. I kept thinking, do attendings just not like sitting or something? The time they save by standing is negligible, and it's not like we were ever in a hurry.
ReplyDeleteAnother time, I sat in a chair next to a workstation when the attending and one of the residents went into a patient room. The room had contact precautions so it made sense to limit the number of people who went in the room, and I didn't have anything else to do. A few minutes later, a resident needed to use the workstation to write a note, so I stood up so she could sit while writing. She insisted I keep sitting and she just moved the chair over and continued charting while standing. I felt so guilty taking the chair, and I still don't understand why no one ever sits.
Ugh… I hate standing in one place for a long time!! I always feel like I have the body of an 80 year old after! I've requested that my fiancé buy me a new pair of Danskos for my birthday this year so I'll have them next year for clerkships. I'm hoping they make my lowly medical student existence a little more bearable when everyone else has chairs.
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