How to do well on wards (covid 19)?

[Lawpy]

I realize there's several threads with tips on how to do well in clinical years. But covid 19 led to a lot of significant changes/disruptions and for those currently in clinical years and especially for MS2s starting rotations soon, any advice would be helpful.

MS3s and MS4s and residents/attendings please feel free to share your experiences and what you think can be improved

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[PipetteDreams]

Do everything in those threads and always bring your PPE.

Be the person on rounds who knows the patient's COVID status (especially if they're being admitted, it may have not resulted yet).

Ask if the patient needs a new COVID test for discharge (SAR/SNFs require these, often within a certain time frame).

Know the hospital's current policy for allowing family to visit (these change often and depend on the level of care).

Don't try to start Barbra Walters-style interviews with residents/attendings about their time during the peak. Sometimes it comes up and there are some truly incredible stories, but I have seen medical students ask during painfully inappropriate times.

 

[Reckoner]

Get used to shouting so your team can hear you through the N95

 

[ciestar]

KNOW YOUR PATIENTS.
this seems stupid to say, but seriously, this is essential. Developing decent plans comes with time, but this is a basic starting point. Act interested, offer to help without being overbearing. If you’re told to leave, go.

 

[Osteosaur]

.

 

[Espressso]

In regards to COVID I definitely second the knowing the covid status of the patients. But often times you won't know that. I would probably keep in the back of your mind that everyone could potentially be positive or carrying it. Especially in the ER for random complaints, I assume patients have it until a negative test tells me they don't.

In general though, knowing your patients is obviously huge. Really try to own your patients, know every detail about them. The cliche "be willing to learn" is still true. I think a big thing too is to learn to try and anticipate what people will need. Both your residents and attendings, as well as other staff in the hospital. If you go on rounds and you start to catch on that for cardiac complaints the attendings likes to have the ekg ready to go, try and get that ready right before the resident is presenting. Also carry an extra pen with you for a similar reason. Anticipate when someone will need it and have it ready. It sounds so ridiculous but seriously I've found that it gives off a good impression to those you're working under/with.

It's also great to never be late, obviously. But also trust when they tell you that you can go home. They mean it. Leave lol

 

[longhaul3]

Keep yourself out of harm's way as much as possible. Before covid it was great when med students showed initiative to independently see patients, round multiple times per day, etc. Now I don't want my med students seeing any patients they won't learn anything from, and I don't have them see any covid patients, no matter what. For interesting non-urgent consults, I have them wait until the covid test is negative.

Be smart, and don't be tempted to see patients without proper PPE. If you're on rounds and the team is seeing a covid patient, don't go in unless you have to. They shouldn't be putting you in that position anyway. And if you realize you forgot your N95 when you go to the ED, don't be a cowboy and go in with the rest of the team. Excuse yourself, go get it, and come back.

 

[ekmf27050]

Get used to shouting so your team can hear you through the N95

Y'all are getting N95s? 😂😭

Seriously though, I second all the PPE comments.

1. 1. Figure out what is comfortable and workable early. Otherwise, you end up in warm exam rooms trying to see through a crappy fogged-up face shield. For me, the best combo was:
   1. Headbands with buttons for the masks (you would not believe how much a blister on the back of your ear hurts). If you're not a headband person, consider one of the plastic "ear saver" bands or masks that tie around the head.
   2. "Glasses" face shield. These are on amazon for like $10. It's a plastic glasses frame that attaches to a face shield. Much easer to get on and off, more air circulation to breathe because the top is open, and no headaches from a shield band tight around your skull.
2. Shove some kind of de-fogging wipes in your bag. Between taking the shield on and off, adjusting it, hitting it with coffee, whatever, it gets dirty. Also always, always have extra masks. There is nothing more awkward than ending up on the floor, realizing you don't have a mask, and not being able to find one.

 

[Matthew9Thirtyfive]

Y'all are getting N95s? 😂😭

lol for real. We're using surgical masks. (though I think there are studies with coronaviruses and influenza showing that they are noninferior to n95s in nonaerosolizing situations).

 

[ekmf27050]

lol for real. We're using surgical masks. (though I think there are studies with coronaviruses and influenza showing that they are noninferior to n95s in nonaerosolizing situations).

If we go through the right hallways we can get the "procedural" masks that aren't even allowed in the OR

 

[aldol16]

The role of the medical student hasn't changed with COVID. There may be some changes but the overall theme is the same - be enthusiastic, try to learn, be humble, and remember that we're all there for the patient. I realize that it's hard to keep all these in mind while constantly being evaluated but if you prioritize patient care, the rest will fall in place.