Not just that clerk anymore… Reflections on learning/working in the hospital.

Clerkship is officially over.

I am both thrilled and terrified that this part of life is over.  I am done being “just that clerk.”  But, it means that I am starting classroom stuff for a few weeks (ick), then the LMCC, and then I will be a resident.  Terrifying and thrilling (it seemed worth repeating).

Clerkship has brought along some valuable learning, embarrassment, laughter and heartache.  Definitely a worthwhile experience.   Somehow, along the way, without really noticing, I learned stuff.  Lots of stuff.  I still feel stunned, but I know I learned at least a bit.  The funny thing is, in medicine, the more you know, the more you know you don’t know.  So, I guess that is a good thing that  I still feel stunned.

A festivity like this calls for a top ten list of unusual and interesting things I have learned in clerkship.  Some of them are more about myself and others are more about the system and others are kind of Murphy’s laws of working in a hospital.

  1. Every woman… Especially young woman in a hospital is a nurse until proven otherwise.  This used to drive me crazy when I was in Nuc Med.  But, in med school it is worse because its not even like we wear scrubs most of the time.  I am not saying there is anything wrong with being considered a nurse.  But, it is sometimes frustrating and confusing when people start asking for their pills or to get up or expect me to fix their beeping IV when technically I can’t really help much with any of the above.  I try, because that is what one should do, but  I can’t give meds, I am not able to help some people to get up, especially if they need special equipment or more people than one for an assist and those bloody IV things are all different.
  2. I am terrible at staying up all night.  I get migraines and cranky and am just plain miserable.  The next day.  Then night of, I somehow manage to be my usually sunny self and confuse people as to how I can be so chipper at 4 in the morning.  30 hour shifts are bad ideas.  All around bad ideas.  We don’t let pilots do them.  We don’t let anyone else do them.  People need sleep.  Doctors are people.  Let them sleep.  Thankfully, there is change leaning towards this direction in some parts of Canada.
  3. Everything looks delicious at 3am.  But, everything is not delicious at 3am.  In fact, even if it tastes good going down, it will not want to stay down by the time 4am rolls around.  This also begs the question as to why you can’t get anything except vending machine food at 4am… A salad or fruit would be safer, but unless you have the foresight to know you are going to be starving at 3am, you won’t bring that with you.  Hospitals are like big cities… People never sleep.  But for some reason, the cafeteria does.
  4. The medical system has a lot of its own terminology.  Most people have no idea what you mean when you say that you are a clerk.  Senior medical student, yes… Clerk no.  So, sometimes, my go to “I’m just a clerk,” response is just not adequate to explain why I look young or can’t give a prescription.  Also, sometimes this leads people to try to give me paperwork for the ward clerk.  Or just plain confusion.  The same thing happens (but somewhat differently) with the whole resident versus intern debate.  Oh boy.
  5. Once you lock yourself out of the online health information system, you feel like your life is over.  And it kind of is… That is where everything you need to know can be found and you can’t get to it.  So, you waste half your day on hold with the tech support people.  And get yelled at by staff.  It is just proof that we are now that dependent on computers, even when the system isn’t that good.
  6. My ability to write has always been lacking.  One of my friends diagnosed me with dysgraphia… A learning disorder where a person has significant challenges in writing neatly.  I try… Really, really hard.  And I am okay in the morning, but it worsens as the day goes on.  The thing is… Compared to many, my handwriting isn’t that bad… Because at least I try.  Some people’s notes require a decoder or some sort of magic to decipher.  I think this is an indication that computer based technology for orders should be in place at all hospitals.
  7. Whatever supplies you need are not going to be right there.  I am a firm believer in being prepared.  Always having gloves and tape in your pockets.  If you are going to a procedure gather the materials ahead of time.  Learn where the supply stashes are.  Whenever you are in the OR or on the floor, it seems like there is always something you need that gets forgotten or something comes up.  Thus, knowing where things are is a big asset.  Stuff seems to grow legs and walk away, especially in a pinch.  Like extra tape when removing a chest tube (I have been burned here… A few pieces stuck to your gloves and suddenly, you have gauze, an open wound and nothing to hold it closed).  Or gloves when the patient starts hurling everywhere (also been here… Not so much a time).
  8. I am really, really scared of pagers.  They always go off when you least expect them to.  They always go off at awkward times.  They don’t always work.  Why have a paging system if there are dead zones in your own hospital?  I mean, nothing is better than being issued the NICU pager and being told that you can’t receive pages from the library, student lounge or parts of the cafeteria.  Translation: Don’t go anywhere!  Some people think pagers are cool, but they are not (see this post for more).
  9. Most hospitals do not seem to be designed with people in mind.  I spent 20 minutes yesterday looking for an office.  The email I received said “Learning and Development Center” with no room number, but indicated it was on level 1.  Level 1 is huge.  And a maze.  It took 4 tries before I got to the right room.  I had to ask three times before I found someone who knew what I was talking to.  At one point, our hospital’s orthopedic clinic was in the basement near an elevator most people did not know existed.  Way to go… Make the broken people wander. That has since been changed.  Thank goodness.
  10. Hospital fire alarm systems are perpetually under repair.  Everywhere I have gone, I seem to recall at least one day where there are announcements that the fire alarms are down, or that something was a false alarm.  At some hospitals, this happens more often than not.  I get that they are big buildings, but really, is it necessary?  There are sick people.  They need their rest.  At least we know the alarms work.  Or at least they should.
  11. Bonus: If medicine is a caring profession, then why do we round on really sick post-operative patients at 6:30 am and wake them from a dead sleep?  On a related note, why do I have to awaken from a dead sleep to go to work to wake up said patients?  I know there is logic to this and the OR schedule, but it still boggles my mind.

What random things have you learned from working in a hospital about yourself or the system?

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7 thoughts on “Not just that clerk anymore… Reflections on learning/working in the hospital.

    • I am glad you like them. I hope they are helpful when you get on the floors!
      That is so exciting! I found second year flew by compared to first year. You’re almost there!

  1. Ah this is so true! When I was on rural meds, every male was called doctor (and there were many male nurses) and every female was called nurse… and it was a little annoying, but whatevs, nurses are pretty amazing (most of the time, when they aren’t busy making politics of the wards).

    I dig all of the other points too, especially about supplies not being there… very true in SA public health. Whenever I find a box of small gloves, it’s like I hit the end of the rainbow!

    • Its true, thought its annoying, they are great professionals to get mistaken for!

      I love what you say about the gloves being the end of the rainbow. Here, we are so blessed to have so much and yet it still seems that gloves are few and far between… Well, we have tonnes, just not in opportune spots… And people steal them when they are (possibly for their personal stashes… guilty).

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