What to do if resident tells you to go home?

[HMSBeagle]

As I was reading all of these posts, this is the one post that resonates exactly what I was thinking. I think warning signs should be blaring if you are being sent home. A good student can make an intern's call a lot easier if the student is trusted. Wound checks, void checks, post-op checks are not scut work and if the intern/resident can trust the student to do these things then the student is obviously valuable.

I was on a rotation where other students would be sent home early or made to spend the night in the hospital without being called for anything (worse in my opinion than being sent home), whereas when I was taking call I would be up pretty much the whole night because I would be doing the aforementioned "scut" until late with the intern and be up for any consult/procedure that needed to be done because I made it very clear that I was competent and interested in being involved.

If you're being sent home while other students are being kept on their call nights I would do a self-evaluation or talk to your intern to see how you can improve...

Well thanks for the advice but I just got my eval back and I got 100 so I must be doing something right. I got great comments also from the attendings, not only the residents and people here are not known for handing out good grades you have to do things right in order to earn good grades. I guess residents just want you to go home and do whatever we need to do.

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[Feynmann]

I was on call last week and 2 hours into it the resident told me to go home because it was a slow night. I told her I'd stay but she insisted that I leave. I left but I didn't feel comfortable doing so. Any advice for this situation if it presents in the future? Am I defrauding someone (ie: clerkship director)This is a very confusing situation!!!!

Next time you should do the opposite of whatever she tells you. If she tells you to stay, go home. And she tells you to go home, stay.


Is English your 10th language? Go home means go home! gosh...how did you get this far?

 

[beavis]

As I was reading all of these posts, this is the one post that resonates exactly what I was thinking. I think warning signs should be blaring if you are being sent home. A good student can make an intern's call a lot easier if the student is trusted. Wound checks, void checks, post-op checks are not scut work and if the intern/resident can trust the student to do these things then the student is obviously valuable.

I was on a rotation where other students would be sent home early or made to spend the night in the hospital without being called for anything (worse in my opinion than being sent home), whereas when I was taking call I would be up pretty much the whole night because I would be doing the aforementioned "scut" until late with the intern and be up for any consult/procedure that needed to be done because I made it very clear that I was competent and interested in being involved.

If you're being sent home while other students are being kept on their call nights I would do a self-evaluation or talk to your intern to see how you can improve...

This is crap. Just because you get told to "go home" doesn't mean you are not helpful.

All this awful Type-A-ness kills me....when life throws you a break, TAKE IT (especially in this field).

beav

 

[Acherona]

Some residents are very good at managing people and delegating tasks, while others are too overwhelmed to even think about how to get you involved. I think with the latter types it really helps to offer to do specific things. You learn by doing these things, and they get their work done faster. I don't see the problem and it has nothing to do with sucking up. Also I feel really bad for my residents when they are overworked and I do actually want to help.

 

[QuikClot]

And by the way, "Is there anything else I can do to help" is not always a suck up way of getting the hell out of there. Sometimes it's because you're bored and would like something to do. Other times it's because you're very interested and want to help. All enthusiasm is not necessarily fake.

Or because you are not psychic and don't know if your resident is sitting there wishing you would pitch in. Or because the student is a normal type-A doctor type, and they won't be able to relax off-shift unless they can check off the mental box that says "Did everything I could to help my resident."

Or sometimes we really want to help. Corny as it may sound, I'm in a helping profession because I like to help. Also, I came out of EMS and the fire service and in that ethos the team sticks together and everybody works hard if anybody is working hard.

I personally have been impressed with the extent to which my education has taken priority over scutwork. Hustling to do everybody's least-favorite tasks is a near-universal feature of on-the-job professional training. It's nice there's some protection for our learning. If I had my wish -- which of course I don't, being the MS-3 -- residents would focus on learning when things were chill, and slam me with scutwork or anything else when they are up the creek.

 

[QuikClot]

Some residents are very good at managing people and delegating tasks, while others are too overwhelmed to even think about how to get you involved.

That's the bottom line. There's no way a reasonably intelligent 3rd-year can't be an asset to someone willing to put a little thought into home to use them. But people get pressured and they put their heads down and focus on their task.

Residents are in the process of learning how to be team leaders. Some are better at it than others. I hope most people realize that their goal should be to be able to see the whole board, and work efficiently while simultaneously making the best use of others on your team.

 

[Firebird]

Thanks. I'm worried that if the coordinator finds out he'll chew my ass but I just did as told.

That might very well happen. More than once someone will yell at you and you will honestly say "I was just doing what I was told," and the person will not care in the least. It's not fair, but that's how things go.

 

[yeasterbunny]

Some residents are very good at managing people and delegating tasks, while others are too overwhelmed to even think about how to get you involved. I think with the latter types it really helps to offer to do specific things. You learn by doing these things, and they get their work done faster. I don't see the problem and it has nothing to do with sucking up. Also I feel really bad for my residents when they are overworked and I do actually want to help.

And then there are some residents who know that the only thing they can really delegate to you is the most worthless of the scut and they have vowed not to do that to their students unlike the residents by whom they were themselves crapped upon.

Honestly, I don't know about the "overwhelmed" part so much as the fact that it is usually simply easier for you both if the resident just does the job his/herself. In my opinion, students are there to learn about disease primarily, how to manage time secondarily, and how to do random logistical crap like 67th. Going home and resting or possibly even reading (I know that doesn't usually happen) is almost always more beneficial.

 

[45408]

or possibly even reading (I know that doesn't usually happen) is almost always more beneficial.

hey, I actually did go home and read for several hours yesterday when the rest of the team was post-call.


But right now I'm gonna take a nap in a few minutes.

 

[Acherona]

And then there are some residents who know that the only thing they can really delegate to you is the most worthless of the scut and they have vowed not to do that to their students unlike the residents by whom they were themselves crapped upon.

Honestly, I don't know about the "overwhelmed" part so much as the fact that it is usually simply easier for you both if the resident just does the job his/herself. In my opinion, students are there to learn about disease primarily, how to manage time secondarily, and how to do random logistical crap like 67th. Going home and resting or possibly even reading (I know that doesn't usually happen) is almost always more beneficial.

What is the most worthless of scut? I feel there is very little scut that has no educational value, with the exception of making appointments or social/discharge issues.

 

[MattD]

What is the most worthless of scut? I feel there is very little scut that has no educational value, with the exception of making appointments or social/discharge issues.

I agree. For instance I'm rotating at the local 'indigent care' hospital right now, and we had a patient come in who wound up having a massive ICH. I was asked at one point to go get copies of the CT made, walk to the local academic hospital (it's not that far...) and take it to one of the neurosurgeons to see if they thought there was anything they could do for her. Yes, this is 'scut' in the purest sense of the word, but for a.) if I hadn't done it, the intern would have, and her time is worth more than mine, but more importantly b.) even in this 'scutty' task I wound up learning a lot, as I was able to go over the CT with the NSx and discuss it with him, someone who knew much more about that issue than my internal medicine team, he wound up walking back to the hospital with me to eval the patient, so I got to go through a brain death sort of evaluation with someone very good at it, and I made a contact with someone who was willing to teach and help with my education. So despite it being a 3 hour scut job for me, I learned a TON, and the intern who was 'spared' this job later stated she wished she'd been able to hear the pointers I got.

Long example, but the point is that what you think is scut may not really be that bad of a deal.


And another thing, I've been lucky enough to have a series of residents and interns who believe in the 'no scut' policy. I am very grateful for this. However, it often leads to the situation where I'm being completely unutilized because the resident deems ALL of the work that needs to be done, 'scut'. Never mind that he and the interns are having to do it. Often when I DO get assigned 'scut' they apologize profusely for asking me to do whatever it is they need, and it drives me crazy. I appreciate their efforts to be fair, but they don't seem to realize that the alternative at that moment to doing their scut is often standing there WATCHING them do the scut themselves. Which is boring beyond belief. I honestly can't recall a single job I've been asked to do which I didn't either feel was a.) educational or at LEAST b.) helpful to the team.

My opinion is that all the med students who whine about scut are people who've never had to work before, and just aren't used to being in the workforce yet. But that's just n=me.

 

[45408]

What is the most worthless of scut? I feel there is very little scut that has no educational value, with the exception of making appointments or social/discharge issues.

Depends. If you're given a fair amount of latitude and asked to go follow up on a study, see how it fits in with the most recent set of labs, and talk to the attending and then get back to the resident, then you've got a pretty good chance to learn and pick up some useful information. If you're just going through a list of 20 patients and copying down all their labs, that's pretty useless on its own.

I'd rather my intern told me to go see a patient, write a note, and see what the consult recs were and if any of them had results back, than if she were to give me a little to-do list of unconnected items.

 

[JaSam]

Don't get me wrong, I could get med students to help me out, but I'm not allowed to ask them to do "scut". And scut is anything the student in question interprets as scut. So, if I ask the med student to write down lab values so we can replete electrolytes, or update the meds section of our list, or preround on a few patients, I can get in trouble for it. So why would I? Instead, I'm only supposed to involve them in "educational" activities -- like seeing a new consult. Which is great. If they say that's my job, then I'll do it. But it takes more time to let the student see the consult, have the student present to me, go see the consult myself, discuss the patient again with the student so we can go over any differences in our exam, etc. than it does to just bang it out myself.

I remember being a student... it was only a few months ago. One of the things I loved about my surgery clerkship was that I was definately part of the team -- getting numbers, checking labs, prerounding, taking out staples, whatever. I learned by doing that stuff, too. My most miserable experiences were the ones in which I was marginalized as a member of the team. I feel bad that I can't pass on to students what I liked so much... but I can't. If a student decides I've "scutted them out", I'll get in trouble for it.

Anka

Just judging from your posts I know I would love to have you as my resident/intern/attending. You're one of those people that actually remember what its like and are probably easy to work with on every lvl. Best of luck to you and I hope you continue to get good med students working under you.

 

[JaSam]

I tell you what. You feel free to hold MS3s to that standard, IF and ONLY IF, as an intern/resident you manage to have the presence of mind to think to yourself every day, "Hey, there's nothing going on, let me go personally find the med students and tell them to go home!" Because you know very well what happens if the students don't go ask the resident "Is there anything else I can do to help?" They completely zone in on what they're doing, and if there's nothing they need the student to do, they ignore them. So the student stands there with his thumb up his ass for hours with nothing to do. So I think that that question is a perfectly acceptable, polite way to prod the resident to either give you some work to do or dismiss you.

And by the way, "Is there anything else I can do to help" is not always a suck up way of getting the hell out of there. Sometimes it's because you're bored and would like something to do. Other times it's because you're very interested and want to help. All enthusiasm is not necessarily fake.

well yes its definitely true that it can be a very sincere question. I'm not saying I think its fake all the time, but I'm pretty good at telling when someone's being fake and just trying to look good. I mean after a couple days working with someone , you generally can get the flow and figure out how that individual approaches things.

Honestly, don't worry is all i'm saying. when i get to be a senior resident I'll make sure my students don't stay longer in the hospital than they need to if they're not learning/helping and i won't put them in a position where they "stands there with his thumb up his ass for hours with nothing to do." as u suggested. Why? because I've been a student myself and I've been in that position and I know how it feels so its a personal goal of mine to teach my students and treat them better than any of the other residents. I know how a student's mind functions. I've worked with students who were completely unhelpful all day long and were lazy and then when it gets near the end of the work day they go up to the head resident with this fake ass smile on their face and innocently ask , "Is there anything else I can do?" and when I'm a resident, these types of students stay longer in my books. I'm nice to my students until they give me good reason not to. Its the way it goes in the world. Innocent until proven guilty.

 

[DD214_DOC]

My first rotation, I always asked as a courtesy when told to go home. About to enter my fourth rotation, I usually just say, "See ya, have a good night".

On an unrelated note, I thank my preceptor at the end of every day when told to leave. I'm actually thanking them for devoting their time to teach me, but I think they believe it's just for letting me actually leave at some point