Wednesday, March 9, 2011

Shadowing Part 3 : What to do when shadowing

As I mentioned in one of my previous entries, my shadowing advice was so long, I needed to divide it up for ease of use. This is part three, what to do when shadowing. Since some things are OR specific, I am going to divide this into sections.

Part 3a : What to do when shadowing (general)

1) Make sure you are wearing the correct outfit you are supposed to wear.

If you don't know what the doctor wants you to wear, ask.

Business casual is pretty standard if you are going to be seeing awake patients. Think button-down collar shirt with a tie for men, equivalent for women. Nice pants, decent shoes.

No white coat unless you are asked to wear one. I've only had one doctor ask me to wear the white coat. I felt like an idiot. And yes, when someone says white blazer, they mean white coat. You can get one from Scrubs & Beyond.

Only wear scrubs if you are going to spend the day in the OR AND your attending okays this and doesn't want you to just change before you go in. On days I am shadowing in the OR, I just show up to the hospital in scrubs of the appropriate colour (light blue is typical at that hospital). I don't get a locker so I don't have anywhere to put my clothing anyway. I've been allowed to round in scrubs, but I felt out of place. I once heard from the neurologist I shadowed to never wear scrubs outside of an OR because it's disrespectful to the patients. I can kinda see that.

In the OR, you will be wearing scrubs along with a mask, hat, shoe coverings, and eye protection.

2) Be careful of who you listen to.

In the OR, listen to the nurse. When in doubt, ask the nurse. Apparently attending surgeons will do things that will get you as a premed into trouble if you listen to them.

In a private practice, you can probably trust the attending's word. It's still amazing how many of them double check with the nurse. As one of my doctors said about his nurse "She's the one that's really in charge!"

3) Don't ask questions in front of the patients

It could be considered rude.

4) Don't even write notes in front of the patients unless your attending is ok with this.

Also, probably rude. Here is a time when it would probably be ok to write notes, such as when your attending says : "Hey FA, you might want to read up on XYZ." You can probably write XYZ down on the note pad you brought.... you DID remember to bring a notepad right? Just in case you didn't think to do it, I will add it on the checklist just for you.

5) Bring a notepad

Just in case you didn't think about it. By the way, it's faster than typing on an ipod touch, which yes I've had to do that too. That's why I use the notepad now. A neurologist used to call my ipod touch, "my auxiliary temporal lobe." Very funny.

6) Know how to use any medical apps that you have on your ipod/iphone

This of course if only relevant if you have the ipod/iphone/BB or whatever and you have the apps like epocrates. I cannot tell you how many times I had to use epocrates when I shadowed.

7) Put your cell phone on vibrate.

I sometimes forget this one, luckily I'm not that popular so no one calls me.

Part 3b : What to do when shadowing in an OR

1) Don't touch anything blue.

Dark blue generally means it's sterile. Try to avoid that. A decent rule is to stand at least a foot or two away from anything you shouldn't touch.

2) If an attending asks you to come closer, do it even if you are scared to.

The OR is a crazy place and the people have the weirdest sense of humour. If they threaten to throw blood on you if you don't come closer, the best response is to just go closer, not say "You can't hit me from here." Now, they can hit you, they probably won't try though because then the nurse will get upset. But do you really want to take that chance?

3) Don't ask a surgeon why their name is on supplies

Just don't.

4) Do not show fear.

The more scared you act, the more the OR staff will mess with you. It takes a special type of person to do their work and when they decide to be weird, the weirdness really comes out. I could never be a surgeon but I have respect for anyone who can do that type of work. I'm convinced they eat their young.

5) Try to resist comparing the OR to what you've seen in M*A*S*H or Scrubs.

It's hard not to do. First time I saw my attending in a doo-rag, I nearly cracked up. When he started playing music through his ipod, I was biting my lip to keep from laughing. I almost couldn't take him seriously anymore. I was really, really hoping the theme to Scrubs was on his ipod and that it would play.

6) Make sure there is always a place to sit

This is more just in case you feel faint. It can get warm in an OR, plus it's pretty bloody.

7) Ask your doctors (your actual doctors, not the person you are shadowing) if it would be wise to take prophylactic medication if you know you are a queasy person.

My doctors knew I was very queasy and said I was going to be fine and gave me some suggestions on how to avoid fainting and avoid vomiting. I was on so much medication the first time I shadowed in the OR, that there was no way I could have passed out or vomited even if I wanted to.

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