Student Expectations

DO:

• LET ME KNOW IMMEDIATELY IF SOMEONE LOOKS LIKE THEY'RE "SICK"/ ACUTELY DYING.  Triage is an imperfect process.

• SHORT presentations, <30 seconds. I really don't want to know review of systems, family history, surgery they had ten years ago that has nothing to do with today, bland vitals, normal exam findings, or about the patient's dog waiting at home - unless you think something is relevant to ED management or just especially fun to share, you don't need to present it. Please, please, please stick to pertinent positives and negatives. I take my own history and perform my own exam. I am not relying on yours.

• State a DIFFERENTIAL, PLAN, and ORDERS when you present. Better yet, put in your best guess at orders prior to presenting. This is your chance to do it in a safe(ish) environment before you're on your own!

• ESCALATE situations you don't know how to handle

• ASK QUESTIONS, whole point is for you to learn on the job

• Consistent, thoughtful, and kind communication with everyone - nursing, patients, families, registration, custodial staff, the unpleasant homeless person in the lobby

• Be PROACTIVE - confirming orders are placed, following up why studies haven't been done, reassessing patients after interventions and updating them on plans of care.  I should not be reminding you of tasks.

• LISTEN to feedback and GIVE feedback. It's often uncomfortable on both ends, may or may not seem justified, and tough not to take personally or give unintentional offense when our jobs are such a huge part of our lives. The feedback process is also the most critical part of your growth (and mine) into an amazing physician.

• SIGN ALL NOTES BEFORE LEAVING

• LEAVE ON TIME

• HAVE FUN

DON'T:

• PICK UP new patients if the ones you have aren't completely caught up.  Orders in and cosigned, all possible consults placed, available studies reviewed, note finished, patient updated, plan for determining a disposition in place, and a discharge written up with cosigned prescriptions, referrals, and specific patient instructions including return precautions if a discharge is anticipated.

• DISHONESTY in any form

  • Patients may get hurt

  • Odds are that it will be discovered

DOESN'T MATTER:

• Number of patients you see (but I will push you if I think you can handle it)

Expectations from McDonald:

• Meet you wherever you're at

• Screen out patients that are poor learning opportunities

• Snipe patients that are great learning opportunities

• Have you put in your own orders (only if you want)

• Take you to see any interesting shock/arrest patients

• Guide your performance of all procedures on your own patients; your patient means your procedures

• Teach you something on most patients, unless they're exceptionally boring cases

• Get you out on time

• Evals done within 24 hours