Student Expectations
DO:
Send me an eval at the start of shift
LET ME OR STAFF KNOW IMMEDIATELY IF SOMEONE LOOKS LIKE THEY'RE "SICK"/ ACUTELY DYING. Students have caught strokes, heart attacks, severe sepsis, hemorrhagic shock, and near-death DKA in the "low acuity" area while working with me - and were the first outside of triage to see the patient. 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, perform my own exam; 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 play doctor in a safe(ish) environment!
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, staff, myself, other students
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
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.
ASK when picking up a patient in the last hour. Grab the wrong one and you may have a hard time signing out smoothly, safely, or on time - bad for you, bad for patients, bad for me and the attending staff.
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.
CARRY MORE THAN 3 PATIENTS AT A TIME WITHOUT TALKING TO ME FIRST
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