Bureaucracy: the medical student’s* constant companion

Or, a crazy stream-of-consciousness rant about my morning:

As a med school “super senior” who has done a fair share of away rotations, I have certainly seen a good amount of red tape, especially in my attempts to prove to away institutions that I am, in fact, vaccinated against mumps, OSHA-trained to safely dispose of needles, and insured against malpractice. But the bureaucracy I experienced this morning was, as my roommate put it, “a caricature of itself.” To briefly sum up the entertaining events of the morning: I started (rather, was supposed to start) a rotation today in toxicology at an unnamed hospital in the Midwest (I am applying for residency out here…can’t be too careful, ya know). After being unable to determine the exact date or time or location for anything this morning, despite multiple emails and calls to several people, I finally found a time and place to aim for. After waiting for ages in a boiling hot room of an ancient building with 40 other short white coats, we filled out some paperwork, then watched a video on proper needle-disposal and hand-washing practices (Really? Turn on the hot water? Ya don’t say), then attempted to get paperwork to get our ID’s (one of the only things I was told about the rotation I was starting was that I was not to show up without an ID). So I enter a very inefficient woman’s office (I already don’t like her…I recognize her name as one of the people who has never returned my phone calls), and am told to find my paperwork from a giant file cabinet, loaded with manila folders theoretically alphabetized by last name (welcome to 1954). She is flummoxed when I can’t find my paperwork. ‘What’s your last name? Are you sure you sent in your paperwork?’ Yes. Three weeks ago. ‘Are you sure it’s not in there?’ Yes. ‘What’s your last name?’ Rinse, repeat. She phones the administrator of my rotation, who…says she’s never heard of me. Despite the fact we’ve exchanged emails in the last week. Finally she admits she received my application. And although the papers themselves cannot be located, I have brought along an extra copy of all my immunization records. I am prepared! Yet I cannot get an ID because there is no list of all the negative TB tests I’ve had. I had a negative one in August (yay! No post-Africa TB for me) and records of one a year for the past 5 years (though with no listed results for the other ones). I explain that if my last one was negative, they’re all negative, because you can’t be positive and then negative. She says, “I know you’re trying to use logic, but I’m telling you I need this piece of paper.” Ah yes, silly me for using logic when I just need to produce a piece of paper. And here I thought the point of this was to show you I don’t have TB. Which I can do with this one paper I’m clutching in my clenched fist. But nevertheless, I understand it’s your job is to push paper, and you need this form. So the form gets faxed from my school’s student health department (good lord they are nice and helpful there), but all the while this is taking place, I am told to vacate my chair several times. Even when I’m not sitting in it (like when I’m in the hall pleading with the student health nurse to find my files, my bag and coat are still on it). But for some reason, this woman wants to have students lined up in a specific way: 1 at her desk, and 3 sitting in the chairs (which are not in a row) in her office. Nevermind that no students are actually lining up like this, they’re just entering her small office when the previous student leaves. And yet…she’s fixated on the fact that she needs her chair so students can sit in it while they’re lined up, even though no one is attempting to sit there. Eventually, just for entertainment purposes, I keep sneaking back in there and sitting in it while I’m waiting for my fax, just to see if she notices. Finally she accepts my vaccination sheet, and sends me off to get my ID. It’s OK that it’s 10:30 am and I was told to report to toxicology conference at 9am. Whatever. So I find my way to the ID badge office, and after telling the man working there I’m a student and handing over my paperwork, I am told, “A student? We’ve reached our quota for the day.” I look around. Quota? But there’s no one in here. There are three employees back there doing nothing. You’re telling me you can’t make me an ID? No, apparently there’s a “student quota” for ID’s which is usually met by 8:30am on a Monday. But, since an initial ‘no’ is rarely the final word, I am nice and persistent and smile and finally get my shiny new ID. (And I’m not even scowling in the photo). So, only two hours late, I start to make my way to toxicology conference. It’s in the Poison Control Center. I figure since no one answered my emails, I’ll just google the exact address and ask at the front desk. Seems simple, no? So I google it, it’s a block away, I go there and can’t find any doors where google maps tells me they’ll be (I know, I know, I should have learned by now not to trust google maps). So I call the administrator of the rotation to ask how to get there. “Oh, conference is at the poison control center downtown on Monday!” Of course, there are several poison control centers scattered around the city. Could NO ONE have mentioned this to me? Ok, deep breath. “And conference will be over soon anyway, so it’s not worth it to go over there.” Ok, that’s fine. I tell her I want to reach the program director to find out where and when I can meet her so I know what I should be doing for the rest of the day (since I can’t talk to her at conference like originally planned). I am told she’s in conference (duh) and won’t answer her phone, so I should send an email to this woman, who’ll forward it on (is anyone still following me here?? I’m confused just re-reading it, and I lived through it a few hours ago). I suggest I can just send the director an email directly, but the administrator would rather I send it to her, and she’ll forward it. Fine. So I hang up and send a one-line email about how to contact Dr. So-and-so. I wait. Five minutes later I get a response from the administrator (I am cutting and pasting this), “Did we speak or is this a recent e-mail. I thought we discussed that the conference was over at the poison control center downtown?” Um, what? I’m sending you an email because YOU TOLD ME TO SEND YOU AN EMAIL. And YES we just spoke it was 5 minutes ago!!! Ok, deep breath, calm response, saying I would like to reach the director I was supposed to be meeting at conference to see where I should go for the rest of the day. Five minutes later, another email, “They r done for the day. Conference is from 9:30 til 11:30. PLEASE CALL ME.” At this point I was beginning to think I was in some parallel universe TP'd in red tape, from which I was unable to escape.
Anyway, here’s hoping to a more efficient and well-organize day two…. ☺

*I realize that bad bureaucracy happens to good people everywhere. I have just experienced 95% of my life's red tape in the past four years.

I AM ACTUALLY ALIVE: Life updates, Musings, etc

So, I haven't lost the URL of this blog, nor forgotten it exists, I've just...I dunno...been lazy. There, I said it. No feeble excuses about being "busy," cause I've found time since the last post to watch 3 seasons of Alias and 30 rock. I have been doing real rotations for the last 4 months, like M-F 9-5 (or 8-6) ones, except this month, which is more hours and days per week than I care to count up. I wrote some posts in the last couple months but never actually edited them and posted them, so maybe I'll do that eventually. Now, though, many exciting things are happening! It is, of course, the vernal equinox, which would be easier to understand if it weren't 40 degrees out and 30 in my apartment. And yesterday was Match Day! NECN was at our school, and you can watch the clip here if you weren't lucky enough to be there. :) People have matched to all sorts of exciting places, and my classmates will soon be (gasp!) residents. And as if welcoming all the fourth-year-med-students-and-soon-to-be-interns back to the hospital today (we had yesterday off...it's kind of a national holiday in the world of medical education), my resident greeted me looking like this:
It's like she was saying, "Congratulations on the Match! Soon you will look like this. Make sure your scrub pants are tied real tight." (In case you're wondering, L-R: personal [hospital] pager, stroke pager [stroke intern off today], code pager, pre-pre call [i.e. back-up admission] pager, PDA.) Oy. I'm glad I'm putting of graduation and internship for another year. :)

Day 1 in la emergencia

Ok this has been quite an interesting day. I was supposed to spend part of the day in surgery, but I never ran into a surgeon (nothing is too pre-planned here), so I just spent the day in the emergency room. By 10 am I had seen an arma blanca wound to the buttocks (side note: it was not explained to me what an arma blanca is. It was just stated to me as the mechanism of injury, as if I was supposed to know what it was. I was foiled in googling it because it´s also the name of a Spanish rap group. I finally had to inquire around the house, and it turns out it´s a long piercing knife-like thing. I guess everyone in the ER knows what this is, and people come in with these wounds all the time, like everyone in the UMass ED knows what a switchblade is.), a cockroach-from-the-ear extraction, and two amputated fingers (on the same person). And I seriously got to put my rusty suturing skills to good use today. And every time I sutured I was surrounded by 3-8 students, who I gather were the Guatemalan equivalent of pre-med (they said they were in high school but were wearing matching uniforms...they were probably 17 years old). At one point the (only) doctor said, "I´m going to a meeting. You can finish suturing this cut then sew up that head wound over there?", and before I could process the fact that she had just annouced she was leaving, I was on my own. (HELLO?!? Imagine leaving a fourth-year in charge of the UMass ED. Disaster couldn´t be far behind.) At the time I felt ok, I could definitely suture these people up in a vaguely competent fashion. But of course in short order there were trauma victims coming in, and paramedics (we´ll call them that...I mean the people that bring patients in on stretchers) were telling me about car and motorcycle accidents, and nurses were coming up to me saying, "Doctora, (something in Spanish I barely understood and even if I understood the question I didn´t know the answer)." One of the nurses located the doctor´s stamp, which she had left behind (with her name; it´s what you need to write orders), so I could write xray orders (hey, it takes hardly any Spanish to elicit C-spine tenderness). And of course, everywhere I went there was a gaggle of white-uniformed students following me, who may or may not have been under the impression that I had any idea what was going on. FUN TIMES. Everyone lived though, and everyone eventually stopped bleeding. (i.e. no harm came to anyone, in case there´s some liability lawyer or med school administrator that´s eventually going to read this.) More later. I took some pretty (I hope, I haven´t seen them yet) pictures yesterday that I want to upload. Besos a todos. :)

You can't make this stuff up...

Patient (looking at me intently): You look like Amy.
Me: Who's Amy?
Patient: My cat.

A night out in Worcester

So as part of my Emergency Medicine rotation, I have to do two ride-alongs with Worcester EMS. I had kind of a crazy and interesting night, which I feel like sharing parts of semi-publicly. We had quite a few calls tonight, which usually came in right as we were nearing a coffee shop (did the dispatcher know what we were doing and where we were going? perhaps). There were a couple non-interesting calls, so I'll leave those out. But even amid the mundane, the two paramedics I was with were quite a duo. They were hilarious and inappropriate, and just as I was on the brink of rolling my eyes at their adolescent humor, they quickly and smoothly sedated and intubated an old woman in respiratory distress. I mean, I had barely opened the bag with the equipment and I looked up and the tube was in her mouth (paramedic: "When you look in and see their teeth come out, you know you're golden"). Preceding her florid respiratory failure, she had just been having some difficulty breathing. Her rapid decline (this was the most serious gasping for breath I have ever witnessed) while we were on our way to the hospital forced me to poke my head up toward the driver and ask, in a polite and high-pitched voice, "um, excuse me? could you please pull over?" and as soon as we stopped she was intubated and we were on our way again. And the medics were nothing but patient with me as I fumbled with IV tubing and squirted saline on them (and on me) (Medical Students: Always Cool Under Pressure). Actually the scene wasn't as frantic as I would have imagined an emergency intubation on the side of the road to be. (End result: we brought her to the hospital, and I have no idea what eventually happened to her.) (Unsatisfying, I know.) What's also interesting about this lady is that she kept saying over and over she didn't want a breathing tube (known in medicalspeak as being DNI: Do Not Intubate), but then when she actually started gasping for breath and frothing at the mouth, she said she wanted the tube. This is not the first time I have seen this happen, where people swear up and down they want no "heroic" measures, then when it comes down to it, they want everything. I guess your feelings are different when you're thinking about what may potentially happen in the future and experiencing what is actually happening. I can't imagine the terror of knowing you're about to die, even if you're very old and very sick and have thought about it a lot. But this is a discussion for a whole other post.
Anyways, we had this other call which was to a "man down" in downtown Worcester. He ended up being a drunk guy with new and old cuts, scrapes, and bruises all over him, and large switchblade hanging out of his back pocket (which, upon noticing it, the paramedic and police officer quickly took). At first I was thinking, this guy's totally drunk, he was stumbling around and fell and hit his head, he's refusing to go to the hospital, why are we here? Then I got more of an idea of what was going on, and it turned out he was well-known to all parties on the scene, he's a sometimes-resident of the PIP shelter, he's pretty skinny and pathetic and gets jumped all the time, and had been beaten up today because he had $20 that someone else wanted. He carries the blade for protection. The officer told him he understood it was for protection, because there were some dangerous characters out there (I'm cleaning up his language in paraphrasing here), and then told him, after seeing a bottle of gatorade in his bag, to "pound that shit." I was kind of surprised (and then felt guilty that I was surprised) at how patient and respectful and just plain nice everyone was being to him. The man eventually decided to come to the hospital, and as we were getting out, the medic reminded him to please be polite and treat people with respect, and that's how he would get treated by the doctors and nurses. I'd like to think that's true, but I'm not sure the bleeding drunks sleeping in hall stretchers get treated the same as other patients. I know if there were a choice of two patients to go see, I probably wouldn't choose the drunk man in the hall. (I wish that wasn't true and I didn't think like that, but I'm being totally honest). But it was nice to see this man from a different angle; fine, he's an alcoholic (who am I to judge), but he's also just trying to survive (and has probably had a pretty bad life so far), and ends up bleeding on the sidewalk every couple of weeks because Worcester's Finest want to mug him for his $3.50 bottle of vodka. Life's a bitch for some people...so who am I to judge them and not treat them with respect??
[Side note: talking about this man brought up one of UMass' family physicians who works at the PIP shelter, Worcester's only (I think) wet shelter, and an all-around rough place. We quickly concluded that this particular doctor is a bald, male version of Mother Theresa, in that he is compassionate and respectful and patiently treats everyone, even if they walk out the door and start shooting heroin into their eyeballs; then they come back the next day and he treats them again. We are certain that he has an express, speed-of-light ticket to heaven. He's the kind of doctor that before medical school we all wanted to be like, treating everyone, being kind, being non-judgmental. Now most of us are just in awe that someone like that exists, and we mull over his saintliness as we elbow each other out of the way for the few open derm slots.]
And just when I thought I'd seen enough for one night, we got a "FDGB" (fall down go boom) call. We walked into the house, and it was (I'm not making this up) a family of deaf people. Most people that know me know that I love sign language and that learning it has been a hobby since college. It's not really a handy life skill (even though ASL is the third most common language in the country, after English and Spanish), and I don't think I've ever been called upon to actually use it. Needless to say, the paramedics were kind of stunned that I could communicate with this family and figure out what happened, and then talk to the patient on the way to the hospital. I ended up waiting there until the interpreter got there, leaving my ambulance to go out and take more calls, cause I felt bad leaving this poor person in a cervical collar strapped to a backboard staring at the ceiling and unable to communicate with anyone. I'd imagine that would be a pretty scary situation for a deaf person, only able to look up, not really able to move at all. At the end of the night I was pretty pleased that I hadn't totally forgotten all my ASL, though certainly it could use some work.
I feel like I packed a bunch of crazy experiences into one short shift. Thanks for reading this very long post (if you even did...and didn't skip right to the last sentence...I have a short attention span too, I know how it works). I don't think my next ride-along will be quite as adventure-packed, but we'll see... :)

An Ode to Inpatient Medicine

This morning, I decided to channel my energy away from thoughts of strangling my attending (or at least re-doing her hair) and into more creative places. Hence, a poem for you:

O inpatient medicine, please listen to me
I can't take too much more of ACS and PE
Of blows to my ego, of sickness, of death
Of five-to-five admits, and of course M.Ed.'s

O inpatient medicine, send me a sign
You take over my life, and up all my free time
I used to have friends, and hobbies, and fun
Now my guitar gathers dust, and I can't hold my wine

O inpatient medicine, what can I do?
Your lights are fluorescent, your halls smell like poo
I'm ensnared by your monster, caught in its grasp
It will haunt me forever, till I'm old and sick too

O inpatient medicine, do you see those blue skies?
While I'm locked in this labyrinth, a part of me dies
I'm dreaming of summer, of drinks with umbrellas
But you're immune to my pain, and deaf to my cries

O inpatient medicine, I'm doing my best
Help me through these last days, through third year's last tests
Give me strength to come in, and motivation to learn
And - oh, fuck it, I've got just two weeks left

Why didn't I become an I banker??

I'm pretty sure that inpatient internal medicine is going to get the best of me. I am 2 (two) weeks in out of 7 (seven!!!) and I'm already ready to throw in the towel. I'm not entirely sure how/why anyone actually goes into internal medicine, and ends up alive with cognitive and emotional function intact at the end. As my resident put it (he's only a PGY-2), "When I was in medical school I wanted to save the world. Now I just want to make it through each day alive." This is seriously the most draining rotation I've done this year. Thoughts about that? Other opinions on the most exhausting one? I'm not even sure the hours in surgery were worse, given that you had post-call days off q4. As an example of my morning: We worked up a new patient (obviously I'm not revealing/changing the details...I know you're reading this, HIPAA) for new-onset weakness, and she ended up having f***ing mets all over her brain from an as-yet-unknown-but-probably-lung cancer. That was real fun. And my patient from last week with ten zillion medical problems that we managed to stabilize was just discharged back to her nursing home. She's 45 years old. How can people do this day after day?? Maybe one day it'll make me so numb that it won't depress me anymore. But then that in itself might depress me. Oy. I leave you with the eternal wisdom of Scrubs:

Dr. Cox: You see Dr. Wen in there? He's explaining to that family that something went wrong, and that patient died. He's gonna tell them what happened, he's gonna say he's sorry - and then he's going back to work. Do you think anybody else in that room's going back to work today? That is why we distance ourselves; that's why we make jokes. We don't do it because it's fun. We do it so we can get by. And... sometimes because it's fun. But mostly it's the getting by thing.

I sold a piece of my soul, but the wine sure was good

I finally went to my first drug company dinner last week. I really just wanted to get a free dinner at a yummy-sounding restaurant in town, as I always feel pretty guilty taking anything from drug reps (normally I don't even take pens or anything, just on principle). But the prospect of a free dinner got the better of me, and I justified it to my conscience by saying that they're selling a drug I'm never going to prescribe (it's for osteoporosis...and EM people don't really treat that chronically), and I could write about it here to sort of make up for it. (right??) It was pretty interesting, and overall pretty bizarre. The main speaker was (I think) an endocrinologist, and she told some made-up story about how her own mother was thrilled to learn about this new osteoporosis drug (which obviously I'm not naming here...I'm not doing free name-advertising for them). The whole thing made me pretty uncomfortable, what with the knowledge that drug companies spend almost 30 billion dollars (I can't even get my brain around that) a year on advertising, most of it directly to doctors (i.e. not direct-to-consumer advertising like on TV). And rising drug costs are at least partly responsible for the rising cost of health care and insurance, leading to fewer insured people, etc etc etc. But I digress. I enjoyed the dinner (it was actually pretty yummy, and had lots of free-flowing wine), but with every bite I could taste a little bit of guilt. It sucks that a for-profit industry is so entrenched in (and in a big way driving) what should be an essentially non-profit, for-the-greater-good industry and profession. If sales tactics didn't result in increased use and prescription of drugs, companies wouldn't take entire offices out to dinner or give stethoscope tags or free pens. The office where I had outpatient medicine had free lunch every single day sponsored by drug reps. One day I walked into the kitchen and the rep was holding up a big brochure and describing the effects of her new lipid-lowering medication, while trays of (literally, I am not making this up) KFC fried chicken and mac and cheese sat on the table. I guess she was trying to create future customers?? I'm going to stop here, before thoughts of the current state of health care in this country cause me to become apoplectic in public. I hope everyone is doing well!!

Would you want a computer program deciding your fate?

Well, it's that time of year again. No, not the first day of spring (though that it is), but Match Day. Match Day is quite the event in the world of medical education, though it is possible that people who don't have a friend or loved one going through the process (or will go though it soon themselves) have never really heard of it. (What? How could you have not woken up this morning with a start, already feeling the excitement in the air?) Anyhoodle, what is this 'match,' you may be asking yourself. Well, basically at 12pm eastern time on the third Thursday in March, all the soon-to-be-graduating medical students gather at their school, get an envelope handed to them, and find out where in the country a giant computer program has placed them for the next 3-7 years of their life. Fun, right?? Lest you think that the computer can send you anywhere, all the applicants rank which programs they want to get matched to, in order. For example, if you want to go to BU, Harvard, and NYU (as your 1st, 2nd, and 3rd choices), the computer will first look and see if BU ranked you on their list; if BU didn't rank you, then it looks to see if Harvard ranked you (it probably didn't). Then they go to the next one on the list, Tufts, and if Tufts has ranked you then that's where you're Matched. Get it? I don't either really, but that's the story they give us of how the system works, anyway.
So instead of spending the afternoon diligently caring for my patients (my friend Rachel: "If one starts bleeding, they'll page you"), I instead pored over UMass' match list. Some interesting tidbits:
-It appears that the majority of MGH's pediatrics program will be comprised of UMass grads, many of whom seem to be going there
-A whopping 19 people out of 104 are going into pediatrics. I think it'll be even higher next year (at least partly because of that wacky and charismatic peds attending we all know and love).
-Zero people are going into dermatology, which is kind of surprising, considering derm is so popular (though it is competitive).
-About half of the grads are staying to do residency in MA. Surprising or not? I dunno, but it's interesting to think about since all the students are from here. Perhaps this cold and snowy winter has pushed people further south and west than in other years, like when the third snowstorm in a week hit right in the middle of interview season. (The pediatrics residents told of interviewees who got stranded in Worcester and couldn't get back to Logan on more than one occasion: applicants from California who likely ended their interview day curled up in the fetal position in a snow drift on Route 9.)
I thought that going to the Handing Out Of The Envelopes today was pretty fun (my senior resident: "Come on, team, we're going on a field trip!"), but seeing it all made me wish I were going through it next year, instead of in two years. Hey, even though I made the choice to extend and graduate in 2010 doesn't mean I'm not allowed to whine about it sometimes. :)

addendum: Our very own soon-to-be-Dr. Brant has matched at Tulane in internal medicine, her first choice! Yay!! :) Though we in the north will certainly miss her.

Fun on the wards

So I started inpatient pediatrics this week, and while traipsing around 5 East listening to stuffed animals' hearts and lungs and placing bets on which pregnant resident is gonna pop first, I've started playing a little game (in my own head...yes, I'm easily amused) I like to call, "Pediatrics and Surgery: same or different?"

For example, our senior resident was gone yesterday, but left us a paper to fill out about newborns as "homework." She came back today (she's very cheery and blond...just painting a picture of the peds residents for you) and said, "So, guys, did you do your homework?" and we said, "Why, yes we did," and she said, "Great! We'll go over it during ice cream tomorrow." Because, you see, Friday is Ice Cream Day on 5 East. So for this one the answer to my game is: different. There is no Ice Cream Day in surgery. Instead, sometimes if you're really lucky you can swipe Lorna Dunes while you're doing a consult in the ER.

Round two: My (blond, cheery) intern seems to have something of a policy of doling out no less than 18 warm fuzzies every minute. Like, I retrieve one piece of paper (that I probably should have had in the first place), and she'll say, "You're doing such a great job!" or the other student and I might, you know, see our own patients for 5 minutes, and she'll say, "Oh my goodness, you two are just so fantastic!" I think you can guess the answer to this one: that's right, different. The surgery residents don't have time for warm fuzzies. Maybe inside they think we're doing a great job, but their outside is too busy saying, "This is a lap pad!! I wanted a four-by-four!!!!" or, "Cut! I said cut here!!!!" to really tell us out loud.

I actually had to phone a friend today to ask for a same one. She said (and she's right): Pee remains very important. I continue to monitor the urine output of my patients at near-OCD levels, and pediatrics adds the added twist of forcing me to calculate everything in cc/kilogram, exposing my horrendous math skills for all the world to see (sorry, mom). Actually, I never knew I was so bad at mental arithmetic until I had to calculate stuff like: how many teaspoons of tylenol should a 23-pound child get if the tylenol suspension has 160cc/mL and the dosage is 15mg/kg? Oy vey. (Usually I end up scratching my head and blindly pressing buttons on my calculator, until I eventually admit defeat and start rummaging around in the drawers for the acetaminophen dosing chart.)

Anyhoo, all in all this has been a fun game for me. I'll definitely try to keep playing as I'm enjoying a sundae tomorrow, while making sure to keep the caramel sauce off the expensive end of my stethoscope.

Fun in the ER

I was asked a question by a parent yesterday that caught me off guard: "Is this one of the first lumbar punctures you've ever done?" And I answered honestly (though sorta lied by omission): Yes. She certainly didn't have to know that her son was the recipient of my very first LP. Sure, I tried to make it look like I'd inserted thousands of long needles into young kids' spines before, but I don't usually hide my panic well. When I had explained to her why her kid needed one an hour earlier, part of my explanation was something along the lines of, "Don't worry! Dr. Attending has done millions of these before!" even though I knew full well I was going to be the one doing it. I couldn't very well have said, "Actually I'm going to practice my first one on your eleven-year-old. Don't be alarmed! I passed my anatomy of the back exam."
[side note: When she asked me that question I had a flashback to the very first Kaplan SAT class I taught, in which one girl asked me if it was in fact the first class I had ever taught. I went with honesty and told her yes: bad idea. I lost them. I might as well have written on my forehead: DON'T RESPECT ME, I'M NEW HERE.]
I mean, parents have a right to know when semi-competent medical students are learning how to do invasive procedures on their loved ones. However, if they truly knew, no one would ever consent to that. Right? I feel like if it were my kid I would have said, "No way! Dr. Attending will be performing this procedure, thankyouverymuch." It's been pretty well-documented that patients receive better care at teaching hospitals (ones with residents and students), but that piece of information seems quite abstract and theoretical when you're in a place like the one I found myself in yesterday. I do feel kind of guilty that I didn't come clean from the beginning and make sure she knew I'd be the one doing the procedure, but I also am pretty sure she would have said no. So what to do??
(p.s. Tap went well. Kid lived. Clear fluid. Discharged home.)