Thursday, February 3, 2011

Pre Op Checklist

Dear Cowboy Classmate, 

I listened respectfully to you describe all the pharmacokinetics of bisphosphonates, which was super. Can I make a suggestion though for next class? Maybe you can put your arrogant ego aside for one minute and think: hey, my classmate might have some important insights to offer the group too, especially if the topic is...pre-op checklists...since that classmate has probably done a thousand pre-op checklists, on real patients in a real hospital. Maybe you'd listen, because you see, pre-op checklists have to be done right. This isn't some hypothetical situation that will never arise once they unleash you from the PBL room and onto the wards in 6 months.

If it was me, I'd be happy to have a nurse mention that height, weight, and last-meal time are actually crucial pieces of information to gather as well as 'abc's and maybe an echo' . Oh and that forgetting to ascertain said information might result in a pissy post-op encounter with an anesthetist, or surgeon. Just trying to save you from the mistakes I've made, pal.

Go ahead and roll your eyes. Enjoy the new asshole you'll be given come ward-time.

Yours truly,

Someone Who Has Actually Worked in a Hospital

P.S The sooner you make friends with the nurses, the better your life will be.


Cara said...

LOL. Love it.

Yah, they really don't like it if you send the kid down for surgery and don't mention that he had "just a few bites of muffin" (she forgot to double check and the parents apparently really didn't understand what "NOTHING BY MOUTH" actually means) 1.5 hours before. Ooops. Happened to my poor nursing group mate on clinical.
Everybody makes mistakes. Really smart people try to learn from the people who've already been there, done that...

Anonymous said...

Another major failing of the problem based learning system: sometimes, what the problem is has little to do with reality.

I look forward to seeing this guy get smacked around by the OR nurses.

Grumpy, M.D. said...

Let him fail. He deserves it. It will be the only way he learns.

Heather said...

"The sooner you make friends with the nurses, the better your life will be."

This is a universal truth, similar to the dictum about not pissing off the librarian(s). I know it now and will do my damndest to remember it in the future.

MDToBe said...

So the one thing that's been reverberating in my mind from all the reading I did about being a doctor both before and after I decided to go for it is: be nice to the nurses.

I really, really want to do that once I get on the wards. Partly for my own well-being, partly because I don't like being disliked, but mostly because I want to be nice to these people who put so much work into caring for others.

The thing is, no one's given too many specifics about how to do it - and I'm worried I'll screw it up once I'm there. Could you please write a post about how to do that, please?


Albinoblackbear said...

Cara--Exactly. Or when a kid doesn't have a weight on the chart but is already on the table in the O.R.

I agree--smart people learn from others' mistakes.

IANH--Haha, yeah exactly. The problem with PBL for me now is that it has been going on for a year and a half (after an entire nursing degree in PBL as well) and I am about ready to poke my eyes out before every session.

Grump--Yep. I just pray I am not on placement with certain people in my'd make for a long 18 week placement!!!

M/H--YES! I agree with the librarian one as well--I made friends with one of the librarians last year and she has helped me out LOADS.

MD2B--Definitely, great idea. I will do that, prob this weekend.

OMDG said...

I'm confused. What actually happened here?

Albinoblackbear said...

Oh just during one of our PBL sessions this arrogant classmate of mine was making all sorts of eye-rolling gestures and sighing when I elucidated on his report-back to the group about pre-op checklists.

I try and not drop too many of the 'one time at band camp' stories from the hospital but he left out height, weight, and last meal in his list of things to be ascertained...which are important. And I gently tried to add that to his contribution (telling about my getting chewed out in the hospital for leaving things out in the past) which resulted in typical crossed arms, eye rolling, and sighing.

Whatever. I don't mention that shit for my sake.

Anonymous said...

It's funny you say you try not to talk about your previous experience, because with our system, if anyone got word you were a nurse in a past life, irrespective if your scope of practice had nothing to do with with the topic at hand, you were automatically the epistemic authority on "clinical experience".

I recall one group where a former OR nurse was repeatedly quizzed on the nuances of diagnosis and treatment of bipolar disorder by the rest of our group, much to her confusion.

I'm also impressed you made it to a year and a half before reaching the 'eye gouging stage'; I only lasted about 5 months.

OMDG said...

What a dipshit. I'm sure he'll get his comeuppance once you hit the floors. Wait, that's less than 6 months away!!

Robert said...

Preach it sister!

Anonymous said...

The sooner you make friends with the nurses, the better your life will be.

Seriously not sure how this isn't self-evident to pre-meds or medical students, let alone residents and asshat attendings.

Grumpy, M.D. said...

It's not an issue of it being self-evident. It's an issue of congenitally having your head up your ass.

Estelle said...

Glad to see I am not the only one with a complete know-it-all asshole for a classmate.
Good luck, doll. :)

Maha said...

Well done! I'd much rather be learning in the classroom than getting my ass handed to me on a platter during an actual rotation. Whatevs - his deal to lose.

Albinoblackbear said...

IANH--Oh the eye gouging started long ago, it has sort of morphed into a "pbl has now broken my spirit as well as making me want to gouge out my eyes" at this point.

I dunno, I suppose I feel that anecdotes are slightly frowned upon as they can spiral into "one time, when my uncle went to the doctor..." stories. So I try to only pipe up with that when it is VERY relevant (or when it was a mistake I made that I think others can learn from). After all, this is *technically* the basic sciences part of the course, not the clinical medicine part.

Sigh. Clinical medicine, the elusive mistress...

OMDG--Exactly! Can't wait! (For the 6 months part, not the comeuppance part--heheh)

NXY--Amen. =)

MSO--I know, right?

Grump--Yes that and having a bizarre delusion of self-importance.

ED--Haha, are you referring to him or me? :P It's true, those types abound.

Maha--I suppose getting spanked in clinical is part of the education, so I wouldn't want to rob him of that opportunity! :)

Anonymous said...

that fella is gunnning for ortho, right?

also, the worst kind of doctor is the one who doesn't recognize the smarts (experience, resourcefulness) of the people around them. I'm lucky I'm a young idiot - it makes it easy to look to others for help and wisdom. I hope I really practice what I preach - that guy could definitely stand to listen to a few of your ass-saving tips.

Albinoblackbear said...

DO--I honestly don't know what he is gunning for (other than being a giant Asshat)

I agree that those people become the worst doctors (also frightening ones because they never admit to not knowing something or needing help).

Today in class he was appalled to discover that our lecturer yesterday for "management of backpain" was a MEDICAL student. He snorted something about them getting students to teach us.

Yeah, well--she was also a PHYSIOTHERAPIST with a MASTERS specializing in CHRONIC BACK PAIN. Idiot.

I'm with you, I love being a student because it gives an all-access-pass to curiosity and legitimizes seeking the wisdom of others.