The Orientation Blues

The BBQ Pit
1

I really fucking hate the beginning of the semester. Today, however, was not just the beginning of the semester, but the beginning of the Clinical Years, so it was everything I hated about the last two years of orientation–and so much more!

My day:

8:00 AM–I arrive at the first meeting of the Medicine/Surgery Clerkship, dressed in full doctor regalia (shirt and tie, white coat, etc.). We are given the syllabus for the Surgery half, after which the course director gets up and–just like EVERY FUCKING CLASS I have ever taken-- spends 30 minutes reading the syllabus to us. If I ever teach at this level, and I hope I do, please shoot me if I do that. I will hand out the syllabus and say, “Read over this, and let me know if you have any questions.”

8:30 AM–The Medicine course director, they tell us, is on vacation in Florida. Hot Damn! No read-along hour! I would be so lucky. No, Dr. Griffith was kind enough to make a VIDEOTAPE of himself going over the syllabus for 45 minutes. I contempate death.

9:15 AM–We’re done. “Oh, you’re not actually seeing patients or meeting your residents and attendings until Wednesday”, they tell us. “Why did all of you get so dressed up?” someone asks. Someone slaps the person who said that, at least in my fantasy. Fortunately, I’m only a 20-minute stroll from home, so I can go change before our full afternoon of Third Year Orientation in the crowded lecture hall begins at 1:00.

1:00–We fill out paperwork. I correct my personal information yet again, hoping that this time they figure out that I’m not married. I understand this set of rules. I understand that policy. I agree with this nomination. On and on and on…

1:45-3:30–Various lectures on Professionalism. Don’t get me wrong, professionalism is important, and I am one of the biggest advocates of a patient-centered approach. I don’t, however, think that lectures about professionalism have any effect–those who would be professional would be anyway, and those who would not will not be despite the lecture. A fine example of a 2-hour lecture when a “here, read this policy” would have sufficed.

Four different people lectured, and all of their talks could be summed up as “Put the patient first, and don’t be an asshole.” I begged the person sitting next to me to kill me.

3:30-4:15–a lecture on how to write in charts. Somebody alert the media–it’s actual useful information! This can’t be!

4:15-5:00–an unintentionally humorous lecture on How To Maintain Your Health And Well-Being During The Clinical Years. His bottom line–1.)get plenty of sleep, 2.)eat right, 3.)spend time with your friends and family, and 4.)take time out for yourself. “Of course, we don’t give you nearly enough time to do any of that, between the late call and the 6:45AM M&M conferences, but we just like you to know what you’re missing,” he didn’t say.

Tomorrow, starting at 8:00 AM, we do it all again! Two hours on blood-borne pathogens! Yay! Not only have we all passed a rather tough microbiology course, not only have we sat through the same two-hour lecture before each of the last two years, but we are required to carry a card with us with all the pertinent information on it at all times. Yes, two fun-filled hours that boil down to, “Don’t stick yourself with a needle.”

Yes, I realize that all this is important information and that we need to have it. I’m just bitching–that’s what the pit is for, right? I do think that today could have lasted about two hours, total, but no one asked me.

Dr. J

PS: I’ll probably write/rant about school more as the year goes on. I want to write about it, and I’m more inclined to write to the SDMB than my journal for some reason.

2

And the worst part of it is, you volunteered for this.

Oy.

3

I’d have had you spend 15 minutes writing “I will wash my hands before and after EVERY patient contact”, and given you the morning off. And that’s all the card would say, too. :wink:

Oh, and don’t forget:
1)Always blame the lab, when possible (and give it a stab even if it seems unlikely to fly)
2)Never blame the pharmacy
3)Obligatory Opal third entry

Shaky Jake

4

Well, it sounds like you have been fully orientated!
::ducks dictionaries thrown by participants in this thread::

5

Ok, why do so many not wash their hands before and after patient contacts? Some seem to think it is ok to wash before or after, as long as they washed once between each patient. One doc sees a patient, enters data on the pc just outside the room, goes washed his hands. Another doc washes her hands, enters data and then goes sees the patient. Ack!!

And why does no one seem to care about how dirty computers might be? Once when i worked at the UoCHs one of the path lab teminals broke. They wanted me to take it back to our repair facility and have it fixed. There was still blood on the keyboard. I beeged off that one and before I could find an authority to disallow this, another tech had done as requested. Seems unsanitary to me.

6

Volunteered, hell! I’m paying $11 grand a year for the privilege!

Dr. J

7

I’m a student X-ray tech, and I have to follow the same Universal Precautions that docs and nurses follow.

First off, washing hands before AND after each patient is counterproductive, especially given that I will probably do films five minutes apart. This translates to washing my hands four times in a ten-minute period. If I wash before AND after, my hands will be so dry and chapped that anything can get in there, and make ME sick.

Second, most nurses (and I as well) will not wash in the patient’s room because it’s not particularly clean in there. There’s a sink in one of the staff areas that’s much cleaner, and Hibiclens soap versus the cheap stuff they put in the patient bathrooms. You may not be able to see us wash our hands, but believe me, we do it.

Robin

8

Believe me, I had opportunity to see far too many health care professionals not wash hands when they should. Some are very careful, others are not. No they were not washing their hands in an area just out of sight, some simply did not wash hands when they should. Sitting at the nurses station trying to fix BHIS terminals, or printers, or the PCs or the other systems and devices that i had to fix I got plenty or time just to observe. Running scandisk and defragging the damn hard drives gives you plenty of just sit and watch time.

And yes your hands tend to be dry from all that washing. If you wash properly you are removing the grease patches on your hands that keep in the moisture and where colonies of bacteria cling to.

I hated the labs the most. There were green marked areas that were supposed to be clean. I watched supposed profesionals turn on the taps with gloved hands. ICK. Great big signs saying not to do that and they still do that.