Poll: Do you bring your clipboards with you to every room?

[NYgirl2]

Hmm...I thought I posted this but I can't find my post. I'm a newbie here, a third year med. student, and wondering what you all do with your clipboard when entering a patient's room. I always bring mine in with me (whether I'm doing a complete physical on my pt. or just stopping in to check on him/her). I has important info. on it, so I keep it with me at all times. (Also, I don't want to lose it!)

The other day, I was outside of a patient's room sitting at the hall desk writing notes, and another med. student from another school walked by me and sat his clipboard right next to me before walking into the patient's room. (Maybe he thought I'd guard it for him? Could he have left it there if no one was there? Who knows? I've never spoken to him before.) It didn't bother me or anything, and who knows if there was anything important on the top (I didn't look at it). If there was, would that be a hippa violation?)
After about several minutes of chatting with his patient, he came out of the room, slowly picked up his clipboard as though he was staring at me, and walked away. Weird stuff.

Anyway, fill me in on what you all do with your clipboards and if this is okay to do this.

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[Blade28]

Depends on what field you're in.

If you're in surgery, there's no way anyone would ever be caught dead holding a clipboard.

Now ER and IM, maybe...

 

[Pir8DeacDoc]

Depends on what field you're in.

If you're in surgery, there's no way anyone would ever be caught dead holding a clipboard.

Now ER and IM, maybe...

Agree with above.

 

[Blade28]

I should add that I was assuming you were wondering what interns did (as you posted your question in the Internship forum). If you're asking for general advice, most people either carry their clipboard everywhere, or leave it lying around from time to time - in the patient's room, at the nurses' station, in the call room, in clinic, etc. It doesn't really matter - it's the same as leaving a chart lying around somewhere. If you're worried about HIPAA regulations, get one of those clipboard "boxes" where all your papers can be hidden inside, so patient information isn't just lying around in plain sight.

 

[Bertelman]

Hmm...I thought I posted this but I can't find my post. I'm a newbie here, a third year med. student, and wondering what you all do with your clipboard when entering a patient's room. I always bring mine in with me (whether I'm doing a complete physical on my pt. or just stopping in to check on him/her). I has important info. on it, so I keep it with me at all times. (Also, I don't want to lose it!)

The other day, I was outside of a patient's room sitting at the hall desk writing notes, and another med. student from another school walked by me and sat his clipboard right next to me before walking into the patient's room. (Maybe he thought I'd guard it for him? Could he have left it there if no one was there? Who knows? I've never spoken to him before.) It didn't bother me or anything, and who knows if there was anything important on the top (I didn't look at it). If there was, would that be a hippa violation?)
After about several minutes of chatting with his patient, he came out of the room, slowly picked up his clipboard as though he was staring at me, and walked away. Weird stuff.

Anyway, fill me in on what you all do with your clipboards and if this is okay to do this.

I assume he was merely leaving it a the nurse's station because he didn't want to take it into the room. Has little to do with your presence or even HIPAA. I don't typically carry anything with me that cannot fit into a pocket, because I know I will lose it. Beyond that, I never really feel comfortable setting anything down in a patient's room. I'm not a germaphobe by any stretch, and I don't take the germ nazis too seriously, I just don't want to set my stuff down on the table where the nurse just had the dirty dressing change stuff, or the NG tube that was previously removed, or even the syrup off the waffle.

Repeat after me...Hospital rooms are D-I-S-G-U-S-T-I-N-G

 

[Winged Scapula]

Funny...I'm trying to think back to medical school and what I used. I don't think I ever used a clipboard; maybe just a small spiral notebook that would fit into my coat pocket. I guess I'm getting old...I can't remember that far back.

Anyway, what Blade said...no clipboards in Surgery.

(no crying either, but that's another story)

 

[Blade28]

Anyway, what Blade said...no clipboards in Surgery.

(no crying either, but that's another story)

Thought it was well-known, but maybe not?

Along with the above, no wearing your stethoscope around your neck in surgery!

And no wearing of scrubs without tucking in the top!

 

[OB1🤙]

I don't think I've ever strung the words "my" and "clipboard" together in the same sentence, let alone carry one around with me in the hospital, let alone contemplate the logistics of getting one from one room to another.

But hey, whatever works for you (and I don't mean that facetiously). Diff'rent strokes and such.

 

[Bertelman]

And no wearing of scrubs without tucking in the top!

Now, now, there are some larger folk that I would prefer leave it untucked.

 

[elwademd]

i'm in im... i used a clipboard until about the 3rd or 4th month of internship... after leaving it at various places, struggling to run to codes with it, etc., i downsized and put those things into my pockets... then downsized more as residency has gone on, and now i carry very little.

as a medical student, i suppose it's a sort of safety net or training wheels. after a while, hopefully you won't need it.

 

[Winged Scapula]

... then downsized more as residency has gone on, and now i carry very little.

Very true. I downsized during fellowship (largely because I didn't have to carry a lot of patient lists) and now I carry a couple of pens, my business cards in a small case and maybe a prescription pad.

 

[NotAProgDirector]

Anyway, what Blade said...no clipboards in Surgery

A bit of a surprise, given how useful a clipboard can be for smacking an incompetent med student/intern upside the head.

 

[Blade28]

A bit of a surprise, given how useful a clipboard can be for smacking an incompetent med student/intern upside the head.

The senior residents just use their hands for that.

 

[Bertelman]

A bit of a surprise, given how useful a clipboard can be for smacking an incompetent med student/intern upside the head.

Reminds me of a story as an MS3 scrubbed in on some kind of hemicolectomy. Attending thought he was Mr. Lap Chole, cursed, threatened nurses, never showed up for clinic, you know the type. Liked me only because I was entertaining. Senior resident was the one who shall not be named, basically hell on wheels for med students. Her reputation most certainly preceded her, but this was mere months prior to graduation, so she had mellowed. Note that this is a girl that could curse/berate with the best of them.

So, case is going well, until the attending closes the Kellys on the Sr's index finger. Ouch. With composure, she inhaled sharply, followed by "ouch, OUCH, OUCH!" at which point the attending realized his blunder.

I cannot tell you what exchange may have happened, including bodies thrown across the room, had it been anyone else misplacing that clamp.

 

[justwondering]

if ure not doing surgery, u can ignore all they naysayers above. lol.

im doing primary care, i think its a good idea to keep a clipboard or something w/u so u can keep ur scut sheets, h and p's, have something to write on, etc. i woudn't want to call a consult without having my h and p's around so i can answer the consultant's q's. plus, unlike surgery, primary care rotations often expect u to know a lot of little details and obscure things that u wouldnt think is relevant (but ur attending might ask about on hospital day #15), so its good to have everything on u. if ure worried about leaving it around, u can get one of those "med student" clip boards which actually fold in half so it fits in ur pocket ( http://www.amazon.com/Folding-Medical-Clipboard/dp/B000KK5FR8) . wouldnt use that as an intern tho.

i keep my stuff w/me unless the patient im going to see is on contact precautions.

 

[Winged Scapula]

A bit of a surprise, given how useful a clipboard can be for smacking an incompetent med student/intern upside the head.

True.

However, I prefer cutting remarks over flying fists of fury.

 

[Dr. V]

if ure not doing surgery, u can ignore all they naysayers above. lol.

unlike surgery, primary care rotations often expect u to know a lot of little details and obscure things that u wouldnt think is relevant (but ur attending might ask about on hospital day #15),

You would be wrong about surgery not needing to know those little details.

 

[filter07]

During my first week of surgical internship the chief asked me, "Who's that guy who carries a clipboard? You don't do that do you? I better not catch you doing that. That's embarrassing."

A week later, "Hey, what's that in your hand?"

"It's my textbook."

"Oh ok, you don't carry clipboards right?"

"No"

"Ok good."

 

[NYgirl2]

During my first week of surgical internship the chief asked me, "Who's that guy who carries a clipboard? You don't do that do you? I better not catch you doing that. That's embarrassing."

A week later, "Hey, what's that in your hand?"

"It's my textbook."

"Oh ok, you don't carry clipboards right?"

"No"

"Ok good."

Really several medical students do where I am. Why are those ones the dorks or something?

 

[Winged Scapula]

Really several medical students do where I am. Why are those ones the dorks or something?

Yes, if they are carrying clipboards on surgery rotations, they are dorks. Or maybe the Chiefs that allow it are dorks.

But go ahead if you want to...and while you're at it, wear a fanny pack, one of those scope holders, a flannel shirt over your scrub top and khakis and make sure you have your diagnostic kit available.

BTW, please DO worry about picky details on surgery. Its important (and was the subject of a previous thread in which I noted I could carry a whole month's worth of patient lists in my pocket, with all their labs, vitals, test results, etc.).

 

[justwondering]

You would be wrong about surgery not needing to know those little details.

i didnt mean that as an insult or something. its just that, quite often on medicine rounds our attending would ask somehting about the h and p (ie who does this pt live with? what does he do for a living? what color fur does his cat have? lol) after theyve been there for like 3 wks. in those cases, its helpful to have the h and p since its not a detail that u would normally remember 21 days out (especially if it wasnt seemingly relevant for the first 20 days of their hospitalizations). maybe surgery rounds are different 4 u guys than they were at our med schl but our rounds lasted like 1 hr and medicine rounds were like for 3-4 hrs (thus giving them a lot more time to ask about those details while contemplating zebras). i

btw, OP, i dont think u mentioned what type of rotation u are on...surg or not?

 

[NYgirl2]

Yes, if they are carrying clipboards on surgery rotations, they are dorks. Or maybe the Chiefs that allow it are dorks.

But go ahead if you want to...and while you're at it, wear a fanny pack, one of those scope holders, a flannel shirt over your scrub top and khakis and make sure you have your diagnostic kit available.

BTW, please DO worry about picky details on surgery. Its important (and was the subject of a previous thread in which I noted I could carry a whole month's worth of patient lists in my pocket, with all their labs, vitals, test results, etc.).

Um...thanks for the tip. Really? Is surgery really filled with pompous and egotistical Jacka$$es that have nothing better to do than to critique incoming med. students and what they do or do not carry? Not meaning to start an argument, just wondering...

 

[Dr. V]

i didnt mean that as an insult or something. its just that, quite often on medicine rounds our attending would ask somehting about the h and p (ie who does this pt live with? what does he do for a living? what color fur does his cat have? lol) after theyve been there for like 3 wks. in those cases, its helpful to have the h and p since its not a detail that u would normally remember 21 days out (especially if it wasnt seemingly relevant for the first 20 days of their hospitalizations). maybe surgery rounds are different 4 u guys than they were at our med schl but our rounds lasted like 1 hr and medicine rounds were like for 3-4 hrs (thus giving them a lot more time to ask about those details while contemplating zebras). i

btw, OP, i dont think u mentioned what type of rotation u are on...surg or not?

I know you didn't mean it as an insult, if I had thought you did I may have responded more than I did.

It's a popular misconception that's all and I noticed Dr. Cox was quick to point out that we have to know lots of small details as well. Our rounds are shorter but we are still expected to know all that stuff and if not, well it's not good. Post op day? Abx day? I's and O's? Drain outputs, IFV, lab values, wound CX, bowel fx? past medical and surgical hx, home meds, film results (not radiology reads but radiology reads PLUS what we read and you better dang well read it long before a radiologist gets to it) it's not pimped on much because it's expected that we know. The only time we are asked about it is if the attending is considering changing something etc and then it is very quiet if you have to say "no sir, I don't remember which abx the patient is on."

 

[Winged Scapula]

Um...thanks for the tip. Really? Is surgery really filled with pompous and egotistical Jacka$$es that have nothing better to do than to critique incoming med. students and what they do or do not carry? Not meaning to start an argument, just wondering...

I was joking.

But I am sure you are well aware that certain modes of dress, behavior, etc. are in in style in certain specialties. What flies on medicine does not necessarily fly on surgery and vice versa.

Frankly, I don't care if you carry a clipboard but it will be noticed because its pretty uncommon on surgery. That's all I meant since that's what the OP asked. I have far better things to do than critique medical students.

 

[Winged Scapula]

i didnt mean that as an insult or something. its just that, quite often on medicine rounds our attending would ask somehting about the h and p (ie who does this pt live with? what does he do for a living? what color fur does his cat have? lol) after theyve been there for like 3 wks. in those cases, its helpful to have the h and p since its not a detail that u would normally remember 21 days out (especially if it wasnt seemingly relevant for the first 20 days of their hospitalizations). maybe surgery rounds are different 4 u guys than they were at our med schl but our rounds lasted like 1 hr and medicine rounds were like for 3-4 hrs (thus giving them a lot more time to ask about those details while contemplating zebras).

I don't think anyone was insulted, just as Dr. V says, its a common misconception that surgeons don't want to know details about their patients and we just wanted to clear that up.

Some details are extremely important. For example, surgeons DO want to know what the patient's home situation is...if I'm doing a big whack on someone and they live alone I need to know because they may be more likely to need Rehab postop than someone who has a active and helpful SO or family member around to help.

I don't really care about the color of their cat's fur unless the patient has a bezoar and I see cat fur.

 

[elwademd]

Very true. I downsized during fellowship (largely because I didn't have to carry a lot of patient lists) and now I carry a couple of pens, my business cards in a small case and maybe a prescription pad.

hopefully i'll be there someday, lol.

I know you didn't mean it as an insult, if I had thought you did I may have responded more than I did.

It's a popular misconception that's all and I noticed Dr. Cox was quick to point out that we have to know lots of small details as well. Our rounds are shorter but we are still expected to know all that stuff and if not, well it's not good. Post op day? Abx day? I's and O's? Drain outputs, IFV, lab values, wound CX, bowel fx? past medical and surgical hx, home meds, film results (not radiology reads but radiology reads PLUS what we read and you better dang well read it long before a radiologist gets to it) it's not pimped on much because it's expected that we know. The only time we are asked about it is if the attending is considering changing something etc and then it is very quiet if you have to say "no sir, I don't remember which abx the patient is on."

you don't necessarily need a clipboard for that... you can put things in a spreadsheet format, and have that in your pocket...

Um...thanks for the tip. Really? Is surgery really filled with pompous and egotistical Jacka$$es that have nothing better to do than to critique incoming med. students and what they do or do not carry? Not meaning to start an argument, just wondering...

as you get on in your training, you should learn and retain more and more... and hopefully over time, you won't really need a clipboard after some period of time.

 

[gutonc]

Um...thanks for the tip. Really? Is surgery really filled with pompous and egotistical Jacka$$es that have nothing better to do than to critique incoming med. students and what they do or do not carry? Not meaning to start an argument, just wondering...

In a word, yes.

Of course there are also a lot of those people in other fields as well.

 

[Blade28]

i didnt mean that as an insult or something. its just that, quite often on medicine rounds our attending would ask somehting about the h and p (ie who does this pt live with? what does he do for a living?

Uh, we know all that stuff too. We just don't have to write it down to remember it.

as you get on in your training, you should learn and retain more and more... and hopefully over time, you won't really need a clipboard after some period of time.

This is the other amazing thing during training - is that even as your life gets more hectic, somehow your memory improves. It's amazing how quickly you can start remembering lab values, vitals, etc.

 

[Winged Scapula]

This is the other amazing thing during training - is that even as your life gets more hectic, somehow your memory improves. It's amazing how quickly you can start remembering lab values, vitals, etc.

Really is strange isn't it?

 

[Blade28]

Really is strange isn't it?

Yes, it is.

Early on during internship, it's tough enough just to remember the diagnosis of every patient on your service. Six months later, you're reeling off post-op day #s, yesterday morning's K values, antibiotic day #s, etc. effortlessly!

 

[justwondering]

yeah, it does become easier especially since u become responsible for all of it (like remembering yesterday's K because u wrote the orders for the kcl and rpt chem 7).

 

[Faebinder]

mm.. a story comes to mind... about one attending that uses the mini milk cartons vs. solid hospital wall to relieve anger.

NO CLIPBOARD IN SURGERY THANK YOU!! THEY DON'T NEED ANY MORE IDEAS!!!!

 

[Coastie]

In the ICU/IM setting, where patients are >>>> complicated than surgical ones, carrying a notebook to stay organized with the scut is key. I'll write upwards of 30+ ICU notes in a day, and a notebook is key to keep it all straight and efficient.

Silly surgeons. Always consulting, never treating...

Yes, if they are carrying clipboards on surgery rotations, they are dorks. Or maybe the Chiefs that allow it are dorks.

But go ahead if you want to...and while you're at it, wear a fanny pack, one of those scope holders, a flannel shirt over your scrub top and khakis and make sure you have your diagnostic kit available.

BTW, please DO worry about picky details on surgery. Its important (and was the subject of a previous thread in which I noted I could carry a whole month's worth of patient lists in my pocket, with all their labs, vitals, test results, etc.).

 

[gasnewby]

In the ICU/IM setting, where patients are >>>> complicated than surgical ones

oh REALLY???

when's the last time you were in a 30 bed trauma/surgical icu?

 

[Coastie]

I just like messing with surgeons.

 

[Coastie]

P.S. I do carry a notebook. It really makes the wards efficient...

 

[Dr. V]

Actually, in my experience Medicine is always consulting never touching a patient.

Surgery is always treating the patients.

We see the ICU and the floor with no notebooks needed, only the current day's list.

You don't need a notebook if you have a good memory.

i heh

 

[Coastie]

Where I'm doing my internship, medicine rarely consults, and MICU never consults. It's always the other services consulting us...

The notebook is more for management of scut paperwork, not for reading off notes or needing an information crutch.

Actually, in my experience Medicine is always consulting never touching a patient.

Surgery is always treating the patients.

We see the ICU and the floor with no notebooks needed, only the current day's list.

You don't need a notebook if you have a good memory.

i heh

 

[Faebinder]

Oh here we go with the medicine vs surgery..

Where do you hide a $100 bill from an internal medicine doc?
(Under a dressing.)

Where do you hide a $100 bill from a surgeon?
(In the chart, at the progress notes.)

 

[SoCuteMD]

In the ICU/IM setting, where patients are >>>> complicated than surgical ones,

As much as I am displeased with my surgery rotation, I have to say that I thoroughly disagree with this statement. Our SICU patients are ridiculously complicated, and a lot of the attendings like to avoid CC consults (all the CC attendings are medicine-trained). As a result, the residents manage some very complicated patients with minimal attending input (depending on the patient's surgical attending).

 

[gasnewby]

As much as I am displeased with my surgery rotation, I have to say that I thoroughly disagree with this statement. Our SICU patients are ridiculously complicated, and a lot of the attendings like to avoid CC consults (all the CC attendings are medicine-trained). As a result, the residents manage some very complicated patients with minimal attending input (depending on the patient's surgical attending).

hate it when we rotate at community hospitals (where patients aren't even that sick, mind you) and those guys can't/don't want to take care of them when they hit the icu...do you really want a medical guy taking care of your postop patient and throwing his 2 cents about if the pt needs to go back to the OR? i think it's a referral thing- you consult everybody and their mother at these community places...so hopefully the favor gets returned. you used an inhaler once when you were 13? let me consult pulmonary. you have a one time blood pressure reading of 141/91? better get somebody on board for medical management!

you don't have any anesthesia or surgery critical care guys where you are? painful.

 

[Coastie]

I'd have to say my experience in the SICU and MICU is that the MICU has far more complicated patients. N of..what...1 month SICU, 4 mos MICU.

As much as I am displeased with my surgery rotation, I have to say that I thoroughly disagree with this statement. Our SICU patients are ridiculously complicated, and a lot of the attendings like to avoid CC consults (all the CC attendings are medicine-trained). As a result, the residents manage some very complicated patients with minimal attending input (depending on the patient's surgical attending).

 

[Dr Serenity]

Oh here we go with the medicine vs surgery..

Where do you hide a $100 bill from an internal medicine doc?
(Under a dressing.)

Where do you hide a $100 bill from a surgeon?
(In the chart, at the progress notes.)

Where do you hide a $100 bill from a plastic surgeon?
(you can't)

 

[GoodMonkey]

Where I'm doing my internship, medicine rarely consults, and MICU never consults. It's always the other services consulting us...

exact opposite where i'm training. complete, 180-degree opposite.

and my surgical icu patients were all kept straight by supersmall-font, multi-page spreadsheet lists. no notebooks needed. i could keep everything i needed to know - and yes, minutae on top of minutae down to the occupations of the patient's family members - in my pockets or in my head, between that spreadsheet and my rapidly expanding memory (haha or my memory that is pushing out all other "minor" details, like the password to my verizon wireless online account, which i can't remember for the life of me.)

 

[Apollyon]

(haha or my memory that is pushing out all other "minor" details, like the password to my verizon wireless online account, which i can't remember for the life of me.)

You mean it's NOT "Möxy Früvous"?

 

[Blade28]

exact opposite where i'm training. complete, 180-degree opposite.

and my surgical icu patients were all kept straight by supersmall-font, multi-page spreadsheet lists. no notebooks needed. i could keep everything i needed to know - and yes, minutae on top of minutae down to the occupations of the patient's family members - in my pockets or in my head, between that spreadsheet and my rapidly expanding memory

That's exactly how it is here, as well. The patient census is always formatted to fit one side of a 8.5x11" piece of paper, via Microsoft Excel. Sometimes that makes for a VERY small font.

 

[Coastie]

How many ICU patients, on average, do you fellow interns carry on a daily basis?

 

[angel80]

I'm an IM resident and I was never into the whole clipboard thing. I think that may be because my first rotation as an MS3 was surgery, and I witness the resident take a clipboard out of a fellow student's hands and throw it on the floor, and tell him never to bring it again. I just got used to doing without one. On my IM rotations and during intern year, I would just keep folded up pieces of paper or index cards in my pockets.

 

[Blade28]

We didn't do an ICU rotation until our PGY-2 year.

On each SICU month, depending on the time of year (trauma is busiest around holidays and the summer), we'd have anywhere from 25-45 patients on our service.

 

[gasnewby]

How many ICU patients, on average, do you fellow interns carry on a daily basis?

micu interns usually take buddy call. they're not doing much on their own.