petty ? about med student

[hollyberry678]

I was working the other day, at the desk- couldn't leave, and a med student came up and asked me to 'get the nurse b/c so-and-so pt. needs to go to the bathroom'. The whole unit was tremendously busy, nurses running! around, our two understaffed aides behind with call lights, ect. The nurse for this pt was behind --tremendously busy. I felt like telling him to do it himself...I saiid, 'ok', and gave him a wary look b/c of that thought. What do you all think? Can they help pts to bathroom?

[PeachPie]

Regardless of whether or not this med student is a snob, PEOPLE ARE NOT PSYCHIC. A "look" or saying "All right, I'll do it," in an exasperated tone of voice doesn't cut it. All it does is portray anger. I deal with this all the time with my BPD aunt, who won't tell me why she's mad, rather getting passive aggressive and making me guess why she's mad. She is thoroughly allergic to asking for what she wants, she simply expects everybody to know what she's not telling you. It's infuriating and really lowers my opinion of her. IF YOU WANT SOMEONE TO KNOW HOW YOU FEEL, TELL THEM!!!! Yes, people sometimes think I'm a witch for asking or stating exactly what I want, but I'd rather be an articulate witch than a passive-aggressive, childish, unreasonable witch who can't communicate effectively.

Personally, I would say "I'll let the nurse know, but things are pretty crazy right now, if you could take the pt. to the bathroom, I know everyone would appreciate it."

This is an EXCELLENT response. It shows that you have acknowledged the situation, but you make it clear that he could be doing it.

[jojotoo, RN]

I am 3rd year medical student and was fortuitously directed to

this site from a medical student discussion board. I think your

discussion board is great and very respectful of each others'

views!

I know I am very green and feel completely lost half the time.

I don't know what I am doing but I am trying to learn. I want

to do what I can to help without being in the way, making

anyone else's job harder, or harming the patient. I see nurses who

are so good at patient care and want to feel as comfortable

as they do. When a patient has to go to the bathroom and they

have a lot of tubes, foleys, or wires connected, I'm lost on

what to do and worry about pulling on their foley, not

supporting them properly and them falling, or disconnecting

something crucial. Nurses and CNA's are so busy that we're

not sure the best way to ask for help without being in the way.

Thanks for your comments and insight! While a few med students

may think it is "beneath them" to aid a patient, most are

probably clueless as to what to do and would welcome some

instruction on how best to help a patient to the bathroom and

would love to help with IV's or wound care. Please teach us!

This is a very good attitude. The nurses that you will work with will appreciate it. And it's the nursing staff that will be the ones to save your butt (if it ever needs saving.) A little flexibility and kindness will take you a long way. Good luck!

[rn/writer, RN]

Most of the med students who come to our floor start out pretty much afraid of everyone, terrified they'll do something wrong, wired so they don't miss anything, and generally shaking in their loafers.

Imagine going into a patient's room, hoping you can project the tiniest ray of competence and not embarrass yourself by being unable to slience an IV alarm or change a dressing properly or answer a basic question.

In the beginning, coming onto a floor where everything is new and everyone else seems to know what they're doing must seem like walking onto a minefield.

I try to joke a little when they come to the desk and take extra time to not only answer specific questions, but to show them how to look certain things up in the chart or on the computer. I let them know where supplies are kept AND, in effect, give them permission to go into the supply room (while subtly informing them that they should not rely on the nursing staff to fetch and carry for them).

I don't like the adversarial atmosphere that can develop between the medical staff and the nurses, so whenever there is an opportunity to reinforce the idea that we are all colleagues equally worthy of respect, I like to establish that rapport.

Med students, interns, residents--they all need to be given the benefit of the doubt and welcomed to the floor. I want the ones I work with to feel invested and at ease--especially the first year residents, as these are the folks I'll be calling in the middle of noc shift over the next few years to help me deal with problems.

So back to the med students. They're in the very unpleasant position of knowing how much they don't know and fearing they could be put on the spot at any moment. They haven't been taught many of the basic patient care skills we nurses take for granted. They don't want to cause any harm. And they don't want to get yelled at. Is it any wonder they cut and run?

Be kind. Don't assume lack of involvement means arrogance when it could very well mean sheer terror. Even the arrogant ones are sometimes covering insecurity. The real clunkers will stand out after a bit. Don't withhold grace and mercy from the deserving because of a few dunderheads.

It occurs to me as I write this that some of the attendings who come across as high and might may at one time have been scared and lowly students who were not helped to become part of the team. Maybe they decided to insulate themselves from ever feeling that vulnerable and dependent again.

We nurses have a small but important part in helping to shape the future demeanor and practice of these young docs. It's in OUR best interest to connect with them and teach and nurture and guide whevever possible.

If a student/intern/new res told me so-and-so needed a new dressing, I'd ask if they knew how to do it and where the supplies were. If they knew both, I'd probably say, "Then what do you need me for?" A negative answer would have me telling them, "Come with me and I'll show you."

Most of the docs-in-progress on my floor have been exceedingly grateful for any help received.

[Tweety, BSN, RN]

Well, I know how I feel when I ask a CNA to take a patient to the bathroom and I get the old "why don't you do it yourself can't you see I'm busy.....", so I'm going to give the med-student a break.

[RN and Mommy]

I think the med student did the right thing by telling someone to let the nurse know. He probably wasn't sure about things and thought it was just best to let the nurse know. On a side note, there was an orthopedic surgeon on our unit the other day and was in making rounds while breakfast trays were being passed. The CNA put the tray outside the room and the doctor brought the tray to the patient when he was done. A simple thing, but he could have left it there because it "wasn't his job".

[Ruby Vee, BSN]

if we've chosen to work in a teaching hospital, we should be well aware that part of our job as nurses is to teach. not just student nurses, although that's a big part of our job, but student respiratory therapists, student physical therapists, pharmacy students, radiology students and even medical students, interns and residents. it's a great opportunity to start a good working relationship with mds from the ground up! and since their education is different from ours, there are many things we can teach them (and vice versa.)

[Sunny99]

I am 3rd year medical student and was fortuitously directed to

this site from a medical student discussion board. I think your

discussion board is great and very respectful of each others'

views!

I know I am very green and feel completely lost half the time.

I don't know what I am doing but I am trying to learn. I want

to do what I can to help without being in the way, making

anyone else's job harder, or harming the patient. I see nurses who

are so good at patient care and want to feel as comfortable

as they do. When a patient has to go to the bathroom and they

have a lot of tubes, foleys, or wires connected, I'm lost on

what to do and worry about pulling on their foley, not

supporting them properly and them falling, or disconnecting

something crucial. Nurses and CNA's are so busy that we're

not sure the best way to ask for help without being in the way.

Thanks for your comments and insight! While a few med students

may think it is "beneath them" to aid a patient, most are

probably clueless as to what to do and would welcome some

instruction on how best to help a patient to the bathroom and

would love to help with IV's or wound care. Please teach us!

Yes, great attitude.

I think a lot of people don't realize that, while med students are getting well-educated in diagnosing and treating disease, they often have less training in basic, direct patient care than nurse aides do. Heck, I was shaking in my shoes the first several times I had to take a wobbly patient to the bathroom, and I had been trained exactly how to do it. Imagine how scared the med students feel.

Trainingwheels, I hope many of your colleagues share your attitude.

[nursesaideBen]

One of the Med schools in my area actually had a contract with my nursing school to put their 1st year students through a CNA course for experience in patient care, I thought it was a great idea. My heart goes out to the Med students I see in my clinicals they're really just overwhelmed. I had this one girl come up and ask me "Where can I find some gloves?" I just wanted to give her a big hug! :icon_hug:

[rn/writer, RN]

One of the Med schools in my area actually had a contract with my nursing school to put their 1st year students through a CNA course for experience in patient care, I thought it was a great idea. My heart goes out to the Med students I see in my clinicals they're really just overwhelmed. I had this one girl come up and ask me "Where can I find some gloves?" I just wanted to give her a big hug! :icon_hug:

This is a fantastic idea--both in the sense that it's great and in the sense that it's unlikely that this will ever be the norm. But we can dream.

[mydesygn]

I was working the other day, at the desk- couldn't leave, and a med student came up and asked me to 'get the nurse b/c so-and-so pt. needs to go to the bathroom'. The whole unit was tremendously busy, nurses running! around, our two understaffed aides behind with call lights, ect. The nurse for this pt was behind --tremendously busy. I felt like telling him to do it himself...I saiid, 'ok', and gave him a wary look b/c of that thought. What do you all think? Can they help pts to bathroom?

Truth be told, I would rather not have "untrained personnel" assisting a patient to the bathroom. I don't want the med students (or nursing students) for that matter assisting patients to the bathroom without trained personnel present.

[IndySkies]

Early in my career I remember an Orthopedic attending that if he happened to be on the floor while we were totally lifting patients or log rolling patients would pitch in and have any and all residents and/or med students that were trolling behind him pitch in.

These would be any patients wheter they were his or not.

[Batman24]

Personally, I would say "I'll let the nurse know, but things are pretty crazy right now, if you could take the pt. to the bathroom, I know everyone would appreciate it."

That's what I would have done. It's honest and it gives him a new way of looking at things. If he had questions as to what to do you could also teach him at that time.