I was once told by a patient (as a radiographer), “to you I must be another chest X-ray, but to me, this is the scariest day of my life, so thank you for being so kind”. And that really hit a nerve, you really do become desensitised towards the procedures you do. A CxR is the most common and (boring) projection to perform in my opinion, but after hearing a patients feedback on my work, and how it relates to them. Never again do I look at a CxR request form and get annoyed that I have to do it. So important to treat your patient like a person.
That is so true wow! I am a PCT and if course we go a lot for the pts but forgot how they feel. For example peri care when pts have foleys and we forgot how they must feel if that position. Definitely need to come back to reality sometimes instead of being so un sensitive
I was told by my family MD to go to the ER. Anorexia is a lifelong problem. Anyway, I had a standard film taken of my chest in my bed. I was told there's a spot the size of a nickel on your lung. This was about 7 months after my husband had died of lung cancer. I'm younger than he was, and never smoked, but it still made my hands shake after I had CT scans for a minute or two. After what seemed like an eternity to me, I was told it was a bone spur... then it clicked, I must have broken a rib when I was in the bottom of a hockey pile. I've never played coed since. I'm half the weight of some male players. The point of the story is, yes patients are thrilled to get to the machine, then sre often on tenterhooks until they receive the report. We are very grateful that people are there to scan and interpret our data.
@@jellyfishattack WOW! Yes, very good explanation why you would get shakes about it! And the hospital personnel around you, would not know anything that valid reason.
As a retired nurse, I loved the last video where you said to treat each patient as a family member. I always tried to do this! It helped me give better care for sure.
The lack of pens around nurses is on purpose - we keep them in our pockets, lockers, or purses exclusively so that we do not lose them, especially if we've just bought or found a new fresh box for ourselves.
this, also we simply do not have time to waste looking around for a pen. gotta be prepared at all times. even now, working as a circulator in surgery, i still make sure i put a pen in my pocket at the beginning of my shift every single day.
If I lend a pen, I will hang around until ypu give it back. The amount of drs who have tried to walk off with my pens is insanely high, then they look upset when you ask for it back
I guess I’m Dr King Pen? I’ve never had that issue. I did have my senior resident one year that would swipe them when lent. So I’d lend and just 7:53 leave my hand out until she gave it back, 😂. I usually wear a nice polo shirt anymore (relaxed dress is nice) and I keep two pens in my collar. I’ve never lost both in the same shift. Well a couple times when I gave one to a Patient that wanted one so they could write letters. Duh, they cost less than a buck for decent ones so it’s a simple decision to hand one over if a Patient requests it. I can buy more. If that makes an elderly woman’s day, I count that as high of a win as getting them healthy. I’m getting older but it’s good to see younger people that have a brain and motivation. Thank You for these videos. I doubt they help me a lot but there are some things that are stated that are absolute fact in any hospital. First I love that you are creating a team environment. I’m old and shaky. Some 22 year old nurse can do some things better than me due to this. However I’m still a strong male so I don’t mind helping them with heavy tasks. I actually will get on them if they do heavy things and don’t ask for my help. I’ve lifted my entire life so I’m a lot stronger than I look, and at 175# or so I can bench 2x+ my weight and I don’t squat for weight anymore but I got 660# up back in 2019. So I’m not weak. So the only real chewing I give are when my staff of almost 100% female nurses don’t ask me to help with something heavy. If I have a couple traveling male nurses for the shift, yeah they can handle all that stuff. I’m not saying the ladies can’t. They do. I’m just so much stronger than they are it’s silly to not ask for my help. They all know if I can I will. Has to be teamwork.
Several of us nurses got those pens with our names printed on them. The docs would borrow them and insist they were theirs. Then we would show them the name on the pen. Good for a laugh but not particularly helpful. Docs continue to never had their own pens. What is up with that? How hard can it be? We nurses have mastered the skill long ago!
I'm only in the health-care system as a patient, but I have the best doctors who, I'm convinced, have internalized these rules. And as a retired teacher, I can say that most of these rules apply to us as well. Great content!
As a nursing student, I was taught to NEVER apologize for calling a provider...even if it's in the middle of the night. That's their job. You are doing yours and they should be doing theirs. No apologies needed. Also....the "S" word (slow) is also frowned upon in the ED. 😉
More unwritten rules of the hospital: Listen, listen and listen to us nurses. We are here for the pts 24/7, and know them best. When nurses share that a pt is transgender, please use their chosen name and pronouns. So very important! I always carry many pens, and only lend those that I am prepared to not get back. Do not type notes on your laptop as you are reviewing a pt. Very rude and disrespectful. Do not steal anyone's lunch/dinner/food in the staff fridge. If you didn't bring it to work, then it's not yours to eat. Please ask if you can eat the hospital provided food in the fridge. We might be saving it for a pt. Also ask if we have snacks. I know where the Tim Tams are, and keep them hidden! Thanks for a great video!
I'm an ER housekeeper and can attest to the chaos after someone said the "Q" word. I have lost count on how many "death glares" I got from the ER staff for saying "quiet".
Psych nurse here... the dagger stares that get thrown your way if you say the Q word are looks to kill. Luckily, the stares won't last long because 3 Code Grays WILL be called within a minute.
Unwritten rule: as a med student, hide your stethoscope so that the interns / residents won't ask for it to save their face infront of the attending. (I lived in constant dread of losing my stethoscope like half 3 or 4 times when i lent it to them)
I want to add this here in case it'll help someone, in some brands like Littmann you can get your name written on the sthetescope by the company. Either on the bell or on the tube part.
Oh if you said that in America people would want to fight you. I cut my patients off if I think that is what they are going to say. I tell them I would rather you cuss me out then say the Q word. Also, full moons = crazy nights. I used to have all the full moons on my calendar so when I was putting in my schedule I would avoid as many as possible. And Friday the 13 are bad luck days here.
Rule #3 is very important because without a pen you can’t document anything and of course that leads to lawsuits. I recommend taking numerous pictures to prove the hospital had no pens for you to use just in case you have to go to trial.
Before I became an EMT, I was a Correctional Officer in a prison. Inmates in custody of Dept of Corrections prisons are given a "DOC number" used as identification. My prison was large. Every male that was sentenced to prison first arrived to my prison to be processed. When my prison received inmates (refered as reception), assigned them into cells (refered as housed), and transferred them to other prisons (refered as shipped), it was vital to associate inmates with their DOC #. I'm currently an EMT and work for a non emergency patient (refered as passenger) stretcher transport company, I provide nurses the patient's name first then room number. Sometimes the room number my dispatch provided me doesn't match the room the patient is in. I agree not to refer to patients by their room number because they are humans. Secondly because the room numbers aren't always accurate.
One more. Sometime nurses have to call a Doc at night. We don't want too, it is not our favorite thing to do. We get yelled at, our sanity questioned and worst of all, hung up on. I allow the Doc to express his frustration, because I know he has probably been called 3 times before my call. I then take my turn with all the information Doc needs to make a decision on the phone. As for the hangup, I immediately call back say politely, "I'm sorry, we got disconected." It never fails, God is completely different. So nice! After a while Docs get to know me and the calls are incredible!
I had a CT scan this past year where the radiologist noted that my gallbladder was unremarkable. My gallbladder was removed 3 years ago. I hate cut and paste. Chart mistakes happen when providers hurry through notes. Read what you check ✔ and don't cut and paste.
One of the things I learned, and this goes along with your teaching others what you are doing like "advanced procedures". The rule is, "WATCH one, DO one, TEACH one". So you don't know how to do "it", watch someone do "it", next chance you get do "it" yourself (usually with someone watching you), then teach someone else who doesn't know how to do "it"!
Watch one, do one, teach one especially for adavanced procedures is a sure way inadequate teaching. Advanced procedures require many observations - proper background teaching of A & P - potential complications etc etc etc - it's an outmoded and dangerous system. Do I want someone who has seen one Lumbar Puncture doing one on me - not on your life. As a PICC nurse I have them watch several after extensive training - scrub in and they are not teaching till they hit the 100 mark or so
@@zeldaron1 As you very well know when you wrote this ridiculous reply, that advanced procedures were NOT what was being talked about. Some people's children!
Next time I want to give a 'thank you' gift to anyone at a hospital, I'm including a pack of pens. I've heard about the pen thing from SO many nurses and doctors, I feel like a big pack of decent pens (especially if you happened to know their brand/color preference) would be super welcome, lol. Love the part about teaching everyone, that's an excellent rule for ANY line of work!
The pen thing drives me insane. I’m a pharmacist, I usually have 5 pens and a sharpie on me but I HATE when people ask to borrow a pen. Get your own pens!!
I appreciate your medical etiquette and ethics so much! So true, you never know when you’ll need “that one person” for something some day. Goes with life in general, right?
Finishing clin’l rotations (us tech). Been to 6 hospitals; trauma 1 to micro. Size didn’t matter though. Culture did. A couple were Dr Cellini style and just outstanding places to learn. A couple others seemed a culture of indifference. The other two I can barely speak about. But whatever the culture, it ran through the facility like a great vessel. Probably from the top down. Good rules 👍
One that i'm reading a lot on the med school reddit is that its wise to never tell your school that you missed / need to miss a day of clinical rotations -- just professionally inform your resident/attending and arrange for a make-up date with them, since getting the school involved with cause a giant headache. something i'll be thinking about as i start my 3rd year this summer!
More generalized as a hospital rule. Keep problems on your level and in your group. Managers or people in other work-groups will usually make things worse. Usually. Patient safety or anybody else's safety are sometimes the exception.
I noticed this the other day about the pens too. You seriously can’t find one! I’m a hospital chaplain resident and we as chaplains when we are on call doing rounds tell the staff (or on-call chaplains if we are fortunate enough to go home) that “I hope you have a boring night.”
Sure you can find a pen ... in your pocket 😉. In fact, there should be at least three. (It contributes to the whole bit in being the "non-anxious presence.") One of my prized possessions is a pen that I received one night while on-call. I had my pen, but commented how clever it was that the pen the deputy coroner was using was three-sided. He gave it to me ❤ .
I’m not sure why you popped up on my feed... but I needed to hear from you tonight. I have been in a hospital since last Thursday and it is now Monday evening and have had some awful experiences by two nurses here. I am so grateful for the professional other’s that have been here for me as a person. I often times wonder why some people pick their professions. These are young and relatively new to their careers. Within the last couple of years to grow so very hard and disrespectful. Already! 🥰🙏💕
The call bell is not the "room service remote" You use that thing too much, you will notice that your wait time gets much longer! If possible, consolidate your needs into one call bell press because no staff has time to be bringing you samples of all our juices and crackers every 20 min.
Love the pen advice. But, I am always held responsible for required signatures from Doctors. (Apparently, my potty training for my children has now been substituted for for training doctors to do their job and sign their stuff). Therefore, when I hand them something to sign, I give them a pen and then stand there, waiting to get my paper and my pen returned😜
I worked I'm dialysis for 4.5 years and I refused to treat my patients like patients. They're people that needed dialysis, so they get treated like people. We'd joke and talk and I was always honest with them about everything. I never had a problem with any of them and even had patients asking me to come take care of them when they had an issue occur with another employee because they trusted me. Treat your patients like people and joke with them and educate them and they're infinitely more comfortable... I even had one patient calling me Dr josh because she heard me always teaching new patients about the monitors so they wouldn't be uncomfortable
BWHAHAHAAHH!!! I was in Rehab yesterday and said..."man it's quiet down here"...The THREE Nurses behind the desk collectively yelled: "DON'T!!!!" I almost jumped out of my skin and tiptoed down the hall afterwards. LOL!!!!
Hi I’m a med school dropout (hated it) but I did learn one hospital rule: besides never saying anything bad about a fellow provider, also never say anything good about a fellow provider. I saw my supervisor make this error and the patient thought he was bragging and the provider whom he had said the good thing about was very put out. Also it can backfire if the patient doesn’t like the one you are praising. The best thing to say to a patient about anyone else in the hospital, as far as I could tell, is nothing at all. If the patient complains about another provider, ask the patient to describe the problem in as much detail as possible. That usually seemed safe. And now that I am (unhappily) often a patient (Parkinson’s and long-term after efforts of cancer surgery) I see docs respond this way - with questions- whenever I say anything about another provider.
ALWAYS restock your supply carts after using them. I work in an ICU and it is common practice for us (and I'm assuming in many hospitals) to keep supplies stocked in carts that are in each patient room or in each unit. In our ICU and in the ED, we have carts of supplies with syringes, blunt tip needles, saline flushes, gauze, angiocatheters, etc. and procedure-specific carts that the providers use such as our "line cart" which is used for inserting central lines or chest tubes. I cannot emphasize enough how EMBARRASSING it is to bring our line cart into a patient's room because the physician is getting ready to insert a central line into a patient and we can't find ANYTHING we need stocked in the line cart. If you use it, restock it!
The worst place I worked at was a new modern hospital. The plan was to have everything the patient needed in his room . I was there in the pm. I spent a lot of time finding the things I needed..
As a patient when I was in the medical unit after breakthrough seizures in the mental health unit I kept hearing different codes. I had no clue what the codes meant. I feel it is important that the patients know what the different codes mean. The only one I somewhat knew was code red was because every time it was called the door to the room was closed. Yet, that was all I knew about that code. I didn’t know what any of the other codes meant though. The only one that was really easy to understand was rapid response team to a location or room number.
Hi Dr. Cellini, hope you are doing well. Loving this new content. Love from FL Hahaha the pen one 😂 so true! As a previous scribe you can’t imagine the amount of times I laid in bed thinking, did I chart that last set of vitals on pt x in room 24?!? The struggle was real
As a scribe I can relate. I would be in the shower after I got home from a shift and all of a sudden think to myself... oh man I forgot to "...blank..."
Hi Dr Cellini! great video! I'm pretty sure I commented on your first unwritten rules video because I agreed so much with your rules. These also were right on the money. I worked in rehab and it was always hard not to refer to our patients as the knee/hip replacement in room___. I also giggled about the pen thing. So true! I thought when all our notes went electronic it wouldn't be as much of an issue. Boy was I wrong! Really loved this topic. Stay well! (-:
I’ve had patients ask me about doctors if they were any good or knew what they were doing. I was very careful how I answered! All the cardiologists I worked with were very good at what they did. I liked the Q word advice! You’ll learn not to say or have this in your thoughts. Another thing not to say is, I’ve seen it all. No, no you haven’t. I worked in the medical field for 24 years, and even up to the time I left was surprised by something new.
Just a nomination from a patiant: never make bad jokes to the patient or jell at them for there vital funktions. I have a cuple of problems so I'm at hospital at least once a year for at least a week. Last time the surgen told me BEVOR my fist heart surgery (performed just with lokal anesthesia) I was the first person he operate on without a superviser. Later the same one jelled at me because I've got aterial fiblilation and he wanted me to stop it. It was over a year ago but I still have nightmares about that day.
Ive been in the hospital over 500 days since 2016. I leaned quickly to bring pics… makes you very humanized to your health care providers. I have kids. I am a daughter. I am a granddaughter. And when they see pics, they treat you VERY differently, not just a number
I totally agree. A couple years ago I was hospitalized for a long time. In total my stay was 3 months and 11 days. During that time I was transferred between different units and because of the constant moving I never had a chance to display any humanizing items. One of the results was I was treated as a number and not a human. At day 17 of my stay I was transferred to my last ward. It was a rehabilitation ward in the hospital. One of my friends brought in some of my pictures, many get well cards and some art from neighborhood children. The change in the way I was greated, the interactions with medical staff and housekeeping and food services was remarkable.
Best golden and unspoken rules ,Great advise - keep your comments positive & encouraging about your staff and departments in the hospital Be always a team player. You are so on point with your advise. 👍Thank you
Re: No 4 " if you didn't chart it, it didn't happen ". I was thinking about this recently. I think that is a potential loophole clinicians can exploit that we radiologists cannot. Say if a clinical finding was missed on examination and therefore isn't documented then, the assumption is that it must not have been present. However for us, our work is always available for someone else to critique retrospectively which opens us more to litigation.
I actually knew a few people that worked in the hospital that had side gigs that required some sales or marketing (like their own RUclips channel, But I retired more than 10 years ago so RUclips channels were not so popular, yet), somebody got the smart idea to get marketing pens printed up for their side gig and intentionally leave them in the nursing stations and anywhere else people are always looking for pens. Win-win all the way around.
We did that 15 yrs agonwith the new ability to order pens with your name on it. So when we searched Dr's or made them empty their pockets we'd find all these pens with our names on them the MD borrowed just for a moment! Lol the labcoats have so many pockets, plus the scrubs or suit underneath. Everyone laughed but the MDs got better at searching themselves for pens!
A twist on the pen rule: medical students should always carry an extra cheap pen to ‘give’ to attendings/residents when they need them😅😂 Source: I’m a 3rd year
I am never afraid to say ‘quiet’. I dont believe in magic because I am a grown up. I think people just tend to focus on the bad stuff and blame things like superstitions to make themselves feel better. I have had plenty of quiet nights and days where I had commented on how quiet it was with no issues. I have also had days where I never mentioned the word and things went to sh’t. It is the same thinking of ‘clouds’. It all equalizes in the end, the result is just based on what your mind wants to focus on.
My mom is an RN and moved to a different hospital a few months ago. Two of her managers just got fired because they got into a shouting match in the hallway in the middle of A main hallway between their women’s services units and pediatrics😬😬
Two of our anesthesiologists routinely hit nurses! This was late 70's early 80's. One gyn MD was an alcoholic. The other MD's covered for him. Oh, the memories!
I don't mind being referred to as a room number. lol What I dislike: 1) patients are viewed as body parts rather than a whole person; 2) health and fitness aren't promoted to patients and med providers; and 3) direct drug advertising to the public. A couple months ago, Dr Mark Williams wrote an article on Medscape about a new patient who was taking 43 prescribed meds and almost as many OTC drugs. I've never crossed paths with anyone that extreme but have with many who were diagnosed with two or three dozen conditions directly related to my three dislikes.
Idk how it's over there but in my country especially elderly patients you give them 1 medicine to use for a week, they keep using it after that. I don't know if it's because doctors don't tell them to stop using the medicine after a certain amount of time or some other reason but It's crazy to me.
Pens disappear in any kind of care setting. I worked in group homes and we could never find pens either. Next time my son goes into the hospital though; I'll remember to bring a box of pens. (He's got chronic medical issues so he's in and out of hospitals frequently.) And here's another "unspoken rule" doctors should be aware of. DO NOT ASSUME your patient or their family does not know anything about their medical condition(s). Especially someone who has a chronic long term health issue like epilepsy. And particularly parents of sick children. I have a young adult son now who's had epilepsy since he was a baby. I have access to the same Internet the doctor does. Except if I'm not a university student and I want to read a study; I have to pay for access to it. And after 17 years of trying to solve the mystery of my son's form of epilepsy; yes, I can pick out a "spike wave discharges" from "movement artifact" on an EEG. So don't you dare lie to me and tell me a test is "normal" when I know it's not. Due to "mychart" type online records; I also can read the reports and the test results. And if there's something on the report that I don't know what it means; I'll go look it up. I know most people don't do that. But I also know that if my son is going to have the best shot at the highest level of independence that he's capable of attaining. Patient education is very important. Doctors aren't the only ones "putting time into" trying to solve complicated medical issues. Your patient, or their family member may actually be right!
I was in the Army for 6 years, our doctors are notoriously bad. One almost killed me by sending me home. That night I had to walk to the ER, had a fever of 104, and ended up spending 2 weeks in a Korean hospital. Nobody spoke English, the medics had to leave to go back to man the ER. They kept wanting me to sign things in Korean. I flipped out so much they gave me a private room and all the morphine I could want. But also put my IV in my right hand so I had a hell of a time showering or brushing my hair. Army doctors...
I have had two doctors come to blows over me and a sugical intervention. My Dad was a doctor. So of course I was shocked. I was prepped and on the gurney almost in the surgery suite. Luckily I got out of surgery and healed on my own.
How about never acknowledge to a patient that another doctor screwed up. I was admitted six hours after discharge following a surgery, the first doctor told me it was due to a reaction to the pain meds. When admitted (to ICU on IV antibiotics) the first doctor brought in a colleague to back up their story. A few months later I was facing another surgery and that Doctor was telling me he was going to be using the same pain med, I asked if he seen in my record that I had reacted to that, he checked the record and labs and said no “looks like an infection, no mention of a reaction”. This was the same hospital.
Your rule about the pens is sooooo on target. I used to swear that people were eating them as snacks. You open up a new box of pens take one and put the rest in a drawer, you go back an hour later because someone used and walked away with the pen you got an hour ago, and the box of pens is totally empty. My nurse manager did a really cool thing one year. She had a bring back the pens work day, where you were supposed to bring back all the pens, scissors, hemostats, carpujets/and the ones that replaced them, and/or anything else you accidentally took home. There were prizes for each shift for the people who brought back the most items. It made for a "fun day" and for at least a week we had pen galore. I suggested we might need to do this monthly, LOL. I was accused of not writing a discharge note, which eventually led to my dismissal from that particular hospital. My best friend/coworker said that they eventually found the discharge note. There was some kind of a computer glitch, and that part of the record went to cyber HELL for a time period of time. You talk about not being afraid to ask questions. When I started right out of nursing school, there was an aid (I honestly don't think she was even a CNA) who had worked at this hospital since they put the plumbing into the original hospital and we had long since been in the new building and the old had been torn down. Anyway, she almost always knew the answers to questions and was fun to work with. She also had horror stories to tell about things that had happened over the years and how things have changed! LOADING THE BOAT...I was so afraid of codes that I was always the 1st or 2nd person on the scene because they were the people who go relieved and became the runners and fetchers for things that were needed or went out to help on the floor during the code. Anyway, I wanted to know about pushing the code drugs and how fast they could be pushed. One of my coworkers gave a "flippant" answer, BUT because it was flippant I never forgot it. She said, "David, push those drugs as fast as you can, they are already dead you can't kill them again!" The first time I said the "Q" word I thought my colleagues were going to kill me. They said the only time we were allowed to say that was at the final report before leaving, LOL!
As a Neonatal ICU nurse, the Q word is looked upon as if you were summoning the devil himself! I can honestly say that anytime I’ve been on shift and the Q word was used, all hell would break loose. And I mean every single time. Over the years I’ve even noticed that I will not even use that word outside of work either. 😂
From a patient, watch your speech around patients. Just because it’s 3:00 AM and you’re in the hall, don’t assume the patient in bed A is asleep and can’t hear you. I woke up following emergency surgery and three CNAs were just outside the door, mocking my surgeon for his lack of sexual prowess and small private parts--the guy who’d just had his hands in my abdominal cavity four hours earlier. Their choice of adjectives was lewd and mean-spirited. When I filled out the patient satisfaction form at discharge, the CNA’s lack of professionalism was the only seriously negative thing I had to say except that the creamed beef looked unappealing. (Nothing served in a hospital should resemble vomit. I couldn’t eat it because it looked like someone already had!)
One of my favorite doctors is the one that says I don’t know to my question In the same breath he says I will find out or let me look this up So much better than bullshit
I work at the front desk at a hospital, and now that I've heard so many things about missing pens, I'm just going to take a handful of pens to the nurse stations at the start of my shift
Really appreciate your content. The ultimate aim for me is interventional neuroradiology. Would you happen to know if its more advisable to apply for it after a neurology residency or an diagnostic radiology residency? Thank you
I don't know where you are, but in Canada, you can do neuroIR only after diagnostic radiology or neurosurgery residency. Of course, you need additional training on top of either residency (full fledged fellowship or a mini one). There is no path into neuroIR from neurology residency.
Omg u hit those rt on! I'd like to add never ignore a spouse that tries 3 times to alert the discharge doc her concerns of husband's mental status decline. He was called down 3 xs 1st 2 times with out going near him YELLED for me to go get discharge meds. At which point nurse agreed with me refused to take out his 3 IVs so he then yelled get his damn DC meds or we will put him on shuttle and your fault no pain pills. I asked nurse make sure u have forms for me to dispute DC. I get back 30 min later my husband cut be Roused.. they call the idiot down again . He starts yelling I yell back I refuse the DC and wth? U DC him on meds that are in ALLERGY SHEET! HE again was angry IVs still in. Nurse quickly reported it all to charge nurse head if team came down in seconds took 1 look at pt said he's not going anywhere! Listened to my concerns the meds gave 2 doses of narcan he started to wake up then had a seizure and crashed rushed to ICU for a week. All my concerns were rt. RULE LISTEN TO SPOUSE OR FAMILY! YES your rt I will never forget him
As a nurse I will have no less than 2 ink pens in the right pocket and 2 sharpies in the left. Also I will unknowingly collect unattended pens throughout the day and empty my pockets before leaving my shift:)
If its not charted it didn't happen.... first thing my mom taught me when I first started working in a hospital. I document every thing. Its called cover your axx. Also true about finding a pen. Gossip at the unit secretarys desk is another no no. Big problem some have. Talking about a problem patient or family member.
Ok so like if there's an orthopedic surgeon who is a butcher with a great bedside manner and his patients love him and you're recovering the patient on their 4th ORIF redo, and you start hinting that maybe that many redos isn't normal, aren't you kinda taking care of the patient?
Bravo!! I haven’t worked in a hospital in a while. I see things haven’t changed one bit!! I have one though, I had a dream about a week ago that I was back working in the hospital and I came home with 17 pens in my pocket😂😂😂😂😂
Hahah that last rule is hilarious! As a doctor in Jamaica… we also do NOT say the “Q” word… if anything when wishing our colleagues well as we leave and they come on for the night shift… we will spell out the word but NEVER say it lol
with stuff like the Q-word superstition: having an influx of patients after someone says the Q-word probably just feels subjectively worse than if the influx was not preceded by that, so even if a staff member knows that the word doesn't affect the chance of an influx, it's still plenty irritating when the word is said because it primes them for disappointment.
Right along side of, "If you didn't chart it, it never happened" is the MUST REMEMBER rule of thumb- C.Y.A. COVER YOUR ASSES, LADIES AND GENTLEMAN!! This rule is the twin guideline to the 1st rule of documentation, especially when charting anything to do with Medicare and/or Medicade. So many things in a long, hectic 12 or 16 hour shift seem inconsequential at the time or you put off documenting small details that you end up forgetting. Some small occurrence perhaps happens to one of your patients, something so minor that even the patient themselves blows off the importance of following everything up with proper documentation and records. Then, two days later, in the middle of your days off, you recieve an extremely frustrated and annoyed phone call from your D.O.N. wanting to know why there's no record or incident report of patient so-and-so falling while she was walking with a C.N.A. during your last shift on?? You feel that little tickle of panic in the bottom if your stomach because you know there's no way you would be getting a call unless something bad has happened.. THAT little tickle? It's the OPPOSITE of what C.Y.A. feels like. You quickly try to explain that even Mrs. So-And-So swore the fall was nothing, no big deal, and that shift was terribly busy and you did the best you could do and.. and...The patient is what? With a brain bleeding where?! The family is threatening to do- Damn. Just DAMN. Y'all, twenty-three years of experience here. MAKE the time to C.Y.A. Protect yourselves today so that you're completely prepared to answer any question tomorrow. I hope everyone has a wonderful evening!
What happened-- before the pandemic the hospitals were trying for better food--some even had chefs--BRING that back anything is better than hospital food the way it is. After all what they charge for a hospital stay should include decent food choices
Everytime there’s a code and the residents come running and asks me for a pen and then I never see it again 😩 so I start bringing extra pens everyday to work now.
Dr. Cellini- Does a patient have the right to personally view the film taken during their CT angiogram? I understand that they might not have a clear - - or even foggy - - idea what they are looking at. Prospectively, however, when viewed in context with the IR doctor's report, the report itself might make better sense. I look forward to your earliest response. Thank you.
As a person who has spent my whole life as a patient I appreciate the not treating somebody like a number. I have been treated poorly and I have been treated like a family member… I will say mayo clinic is the biggest offender of this rule… Just saying
I was once told by a patient (as a radiographer), “to you I must be another chest X-ray, but to me, this is the scariest day of my life, so thank you for being so kind”. And that really hit a nerve, you really do become desensitised towards the procedures you do. A CxR is the most common and (boring) projection to perform in my opinion, but after hearing a patients feedback on my work, and how it relates to them. Never again do I look at a CxR request form and get annoyed that I have to do it.
So important to treat your patient like a person.
That is so true wow! I am a PCT and if course we go a lot for the pts but forgot how they feel. For example peri care when pts have foleys and we forgot how they must feel if that position. Definitely need to come back to reality sometimes instead of being so un sensitive
I was told by my family MD to go to the ER. Anorexia is a lifelong problem. Anyway, I had a standard film taken of my chest in my bed.
I was told there's a spot the size of a nickel on your lung. This was about 7 months after my husband had died of lung cancer. I'm younger than he was, and never smoked, but it still made my hands shake after I had CT scans for a minute or two.
After what seemed like an eternity to me, I was told it was a bone spur... then it clicked, I must have broken a rib when I was in the bottom of a hockey pile. I've never played coed since. I'm half the weight of some male players.
The point of the story is, yes patients are thrilled to get to the machine, then sre often on tenterhooks until they receive the report. We are very grateful that people are there to scan and interpret our data.
dangg bro, it really changes perspective
@@jellyfishattack WOW! Yes, very good explanation why you would get shakes about it! And the hospital personnel around you, would not know anything that valid reason.
That is wonderful! Good for you😍😍😍
As a retired nurse, I loved the last video where you said to treat each patient as a family member. I always tried to do this! It helped me give better care for sure.
The lack of pens around nurses is on purpose - we keep them in our pockets, lockers, or purses exclusively so that we do not lose them, especially if we've just bought or found a new fresh box for ourselves.
this, also we simply do not have time to waste looking around for a pen. gotta be prepared at all times. even now, working as a circulator in surgery, i still make sure i put a pen in my pocket at the beginning of my shift every single day.
If I lend a pen, I will hang around until ypu give it back. The amount of drs who have tried to walk off with my pens is insanely high, then they look upset when you ask for it back
I guess I’m Dr King Pen? I’ve never had that issue. I did have my senior resident one year that would swipe them when lent. So I’d lend and just 7:53 leave my hand out until she gave it back, 😂. I usually wear a nice polo shirt anymore (relaxed dress is nice) and I keep two pens in my collar. I’ve never lost both in the same shift. Well a couple times when I gave one to a Patient that wanted one so they could write letters. Duh, they cost less than a buck for decent ones so it’s a simple decision to hand one over if a Patient requests it. I can buy more. If that makes an elderly woman’s day, I count that as high of a win as getting them healthy. I’m getting older but it’s good to see younger people that have a brain and motivation. Thank You for these videos. I doubt they help me a lot but there are some things that are stated that are absolute fact in any hospital.
First I love that you are creating a team environment. I’m old and shaky. Some 22 year old nurse can do some things better than me due to this. However I’m still a strong male so I don’t mind helping them with heavy tasks. I actually will get on them if they do heavy things and don’t ask for my help. I’ve lifted my entire life so I’m a lot stronger than I look, and at 175# or so I can bench 2x+ my weight and I don’t squat for weight anymore but I got 660# up back in 2019. So I’m not weak.
So the only real chewing I give are when my staff of almost 100% female nurses don’t ask me to help with something heavy. If I have a couple traveling male nurses for the shift, yeah they can handle all that stuff. I’m not saying the ladies can’t. They do. I’m just so much stronger than they are it’s silly to not ask for my help. They all know if I can I will.
Has to be teamwork.
Several of us nurses got those pens with our names printed on them. The docs would borrow them and insist they were theirs. Then we would show them the name on the pen. Good for a laugh but not particularly helpful. Docs continue to never had their own pens. What is up with that? How hard can it be? We nurses have mastered the skill long ago!
I'm only in the health-care system as a patient, but I have the best doctors who, I'm convinced, have internalized these rules. And as a retired teacher, I can say that most of these rules apply to us as well. Great content!
As a nursing student, I was taught to NEVER apologize for calling a provider...even if it's in the middle of the night. That's their job. You are doing yours and they should be doing theirs. No apologies needed. Also....the "S" word (slow) is also frowned upon in the ED. 😉
More unwritten rules of the hospital:
Listen, listen and listen to us nurses. We are here for the pts 24/7, and know them best.
When nurses share that a pt is transgender, please use their chosen name and pronouns. So very important!
I always carry many pens, and only lend those that I am prepared to not get back.
Do not type notes on your laptop as you are reviewing a pt. Very rude and disrespectful.
Do not steal anyone's lunch/dinner/food in the staff fridge. If you didn't bring it to work, then it's not yours to eat.
Please ask if you can eat the hospital provided food in the fridge. We might be saving it for a pt.
Also ask if we have snacks. I know where the Tim Tams are, and keep them hidden!
Thanks for a great video!
I'm an ER housekeeper and can attest to the chaos after someone said the "Q" word. I have lost count on how many "death glares" I got from the ER staff for saying "quiet".
Psych nurse here... the dagger stares that get thrown your way if you say the Q word are looks to kill. Luckily, the stares won't last long because 3 Code Grays WILL be called within a minute.
I flinch even if I hear the 'Q' word OUTSIDE the hospital
I’m a nurse! We put our pens in our pockets to avoid all of the doctors stealing them haha
😂😂😂😂😂
Unwritten rule: as a med student, hide your stethoscope so that the interns / residents won't ask for it to save their face infront of the attending. (I lived in constant dread of losing my stethoscope like half 3 or 4 times when i lent it to them)
100% agree with this
I was going to add the rule. I must have lost ten expensive stethoscopes from residents and attending after letting them borrow them
This!!
Would you suggest hiding it on your persons or somewhere else?
I want to add this here in case it'll help someone, in some brands like Littmann you can get your name written on the sthetescope by the company. Either on the bell or on the tube part.
That last rule is kinda funny. Here in Germany we wish each other a "quiet shift" ("ruhige Schicht") when you arrive to or have finished your shift.
Oh if you said that in America people would want to fight you. I cut my patients off if I think that is what they are going to say. I tell them I would rather you cuss me out then say the Q word.
Also, full moons = crazy nights. I used to have all the full moons on my calendar so when I was putting in my schedule I would avoid as many as possible. And Friday the 13 are bad luck days here.
Ausgezeichnet! Ich mag dass.
Rule #3 is very important because without a pen you can’t document anything and of course that leads to lawsuits. I recommend taking numerous pictures to prove the hospital had no pens for you to use just in case you have to go to trial.
Pens; bring your own AND an extra. If someone needs one give it to them. I've done that, and actually have seen them returned occasionally.
Having pens is each individual provider's responsibility. Be an adult and be responsible.
We started taping our names on them, then making MDs empty pockets before they leave the unit....wow we'd find pen treaure!
Before I became an EMT, I was a Correctional Officer in a prison. Inmates in custody of Dept of Corrections prisons are given a "DOC number" used as identification. My prison was large. Every male that was sentenced to prison first arrived to my prison to be processed. When my prison received inmates (refered as reception), assigned them into cells (refered as housed), and transferred them to other prisons (refered as shipped), it was vital to associate inmates with their DOC #. I'm currently an EMT and work for a non emergency patient (refered as passenger) stretcher transport company, I provide nurses the patient's name first then room number. Sometimes the room number my dispatch provided me doesn't match the room the patient is in. I agree not to refer to patients by their room number because they are humans. Secondly because the room numbers aren't always accurate.
One more. Sometime nurses have to call a Doc at night. We don't want too, it is not our favorite thing to do. We get yelled at, our sanity questioned and worst of all, hung up on. I allow the Doc to express his frustration, because I know he has probably been called 3 times before my call. I then take my turn with all the information Doc needs to make a decision on the phone. As for the hangup, I immediately call back say politely, "I'm sorry, we got disconected." It never fails, God is completely different. So nice! After a while Docs get to know me and the calls are incredible!
I had a CT scan this past year where the radiologist noted that my gallbladder was unremarkable. My gallbladder was removed 3 years ago.
I hate cut and paste. Chart mistakes happen when providers hurry through notes. Read what you check ✔ and don't cut and paste.
An unwritten rule should always be...listen to what the patient is telling you! Simple theory but few follow that truly smart rule. 🥰🙏💕
One of the things I learned, and this goes along with your teaching others what you are doing like "advanced procedures". The rule is, "WATCH one, DO one, TEACH one". So you don't know how to do "it", watch someone do "it", next chance you get do "it" yourself (usually with someone watching you), then teach someone else who doesn't know how to do "it"!
Watch one, do one, teach one especially for adavanced procedures is a sure way inadequate teaching. Advanced procedures require many observations - proper background teaching of A & P - potential complications etc etc etc - it's an outmoded and dangerous system. Do I want someone who has seen one Lumbar Puncture doing one on me - not on your life. As a PICC nurse I have them watch several after extensive training - scrub in and they are not teaching till they hit the 100 mark or so
@@zeldaron1 As you very well know when you wrote this ridiculous reply, that advanced procedures were NOT what was being talked about. Some people's children!
Next time I want to give a 'thank you' gift to anyone at a hospital, I'm including a pack of pens. I've heard about the pen thing from SO many nurses and doctors, I feel like a big pack of decent pens (especially if you happened to know their brand/color preference) would be super welcome, lol. Love the part about teaching everyone, that's an excellent rule for ANY line of work!
😍😍😍
Black ink please!
Or good coffee
Unwritten rule: turn on notifications for Dr Cellini’s channel
Facts
Like that rule!
good 👍 one!
The pen thing drives me insane. I’m a pharmacist, I usually have 5 pens and a sharpie on me but I HATE when people ask to borrow a pen. Get your own pens!!
I appreciate your medical etiquette and ethics so much!
So true, you never know when you’ll need “that one person” for something some day. Goes with life in general, right?
Finishing clin’l rotations (us tech). Been to 6 hospitals; trauma 1 to micro. Size didn’t matter though. Culture did.
A couple were Dr Cellini style and just outstanding places to learn. A couple others seemed a culture of indifference. The other two I can barely speak about.
But whatever the culture, it ran through the facility like a great vessel. Probably from the top down.
Good rules 👍
Yep! So many hospitals are SO diffferent
One that i'm reading a lot on the med school reddit is that its wise to never tell your school that you missed / need to miss a day of clinical rotations -- just professionally inform your resident/attending and arrange for a make-up date with them, since getting the school involved with cause a giant headache. something i'll be thinking about as i start my 3rd year this summer!
More generalized as a hospital rule. Keep problems on your level and in your group. Managers or people in other work-groups will usually make things worse. Usually. Patient safety or anybody else's safety are sometimes the exception.
I noticed this the other day about the pens too. You seriously can’t find one! I’m a hospital chaplain resident and we as chaplains when we are on call doing rounds tell the staff (or on-call chaplains if we are fortunate enough to go home) that “I hope you have a boring night.”
Sure you can find a pen ... in your pocket 😉. In fact, there should be at least three. (It contributes to the whole bit in being the "non-anxious presence.")
One of my prized possessions is a pen that I received one night while on-call. I had my pen, but commented how clever it was that the pen the deputy coroner was using was three-sided. He gave it to me ❤ .
I’m not sure why you popped up on my feed... but I needed to hear from you tonight. I have been in a hospital since last Thursday and it is now Monday evening and have had some awful experiences by two nurses here. I am so grateful for the professional other’s that have been here for me as a person. I often times wonder why some people pick their professions. These are young and relatively new to their careers. Within the last couple of years to grow so very hard and disrespectful. Already! 🥰🙏💕
Can you do unwritten rules in the hospital for patients? Thanks!
I wish patients...wouldn''t cough in our faces when we are drawing their blood, etc.
The call bell is not the "room service remote" You use that thing too much, you will notice that your wait time gets much longer! If possible, consolidate your needs into one call bell press because no staff has time to be bringing you samples of all our juices and crackers every 20 min.
Please don’t leave urgent requests for the last 15 minutes of my shift! I’m happy to help you, but please ask earlier if you can.
Be POLITE. use your manners, your nurses and drs are people. Don't verbally, physically or sexually abuse your medical team.
Love the pen advice. But, I am always held responsible for required signatures from Doctors. (Apparently, my potty training for my children has now been substituted for for training doctors to do their job and sign their stuff). Therefore, when I hand them something to sign, I give them a pen and then stand there, waiting to get my paper and my pen returned😜
Many of the concepts you speak of translate well to most work environments. Love your vids and attitude!
I worked I'm dialysis for 4.5 years and I refused to treat my patients like patients. They're people that needed dialysis, so they get treated like people. We'd joke and talk and I was always honest with them about everything. I never had a problem with any of them and even had patients asking me to come take care of them when they had an issue occur with another employee because they trusted me. Treat your patients like people and joke with them and educate them and they're infinitely more comfortable... I even had one patient calling me Dr josh because she heard me always teaching new patients about the monitors so they wouldn't be uncomfortable
BWHAHAHAAHH!!! I was in Rehab yesterday and said..."man it's quiet down here"...The THREE Nurses behind the desk collectively yelled: "DON'T!!!!" I almost jumped out of my skin and tiptoed down the hall afterwards. LOL!!!!
So as a patient what happens if I say it? I feel like just going to a hospital and just say it just to see what happens
I use pens as currency in my hospital.
Haha good idea
LMAOOO
These rules are fantastic Doc, I think your care for patients really shone through in the first few! Also the pen rule made me giggle 😂😂
Hi I’m a med school dropout (hated it) but I did learn one hospital rule: besides never saying anything bad about a fellow provider, also never say anything good about a fellow provider. I saw my supervisor make this error and the patient thought he was bragging and the provider whom he had said the good thing about was very put out. Also it can backfire if the patient doesn’t like the one you are praising. The best thing to say to a patient about anyone else in the hospital, as far as I could tell, is nothing at all. If the patient complains about another provider, ask the patient to describe the problem in as much detail as possible. That usually seemed safe. And now that I am (unhappily) often a patient (Parkinson’s and long-term after efforts of cancer surgery) I see docs respond this way - with questions- whenever I say anything about another provider.
ALWAYS restock your supply carts after using them.
I work in an ICU and it is common practice for us (and I'm assuming in many hospitals) to keep supplies stocked in carts that are in each patient room or in each unit. In our ICU and in the ED, we have carts of supplies with syringes, blunt tip needles, saline flushes, gauze, angiocatheters, etc. and procedure-specific carts that the providers use such as our "line cart" which is used for inserting central lines or chest tubes.
I cannot emphasize enough how EMBARRASSING it is to bring our line cart into a patient's room because the physician is getting ready to insert a central line into a patient and we can't find ANYTHING we need stocked in the line cart. If you use it, restock it!
The worst place I worked at was a new modern hospital. The plan was to have everything the patient needed in his room . I was there in the pm. I spent a lot of time finding the things I needed..
As a patient when I was in the medical unit after breakthrough seizures in the mental health unit I kept hearing different codes. I had no clue what the codes meant. I feel it is important that the patients know what the different codes mean. The only one I somewhat knew was code red was because every time it was called the door to the room was closed. Yet, that was all I knew about that code. I didn’t know what any of the other codes meant though. The only one that was really easy to understand was rapid response team to a location or room number.
Why do you need to know? Do don't work there.
The pen rule goes for stethoscope also. Don't ask. I had a Bragg lifted during a code😢
Can you do a video on hardships that you had to overcome in order to get through medical school and become a doctor?
Hi Dr. Cellini, hope you are doing well. Loving this new content. Love from FL
Hahaha the pen one 😂 so true!
As a previous scribe you can’t imagine the amount of times I laid in bed thinking, did I chart that last set of vitals on pt x in room 24?!? The struggle was real
Haha I can imagine
As a scribe I can relate. I would be in the shower after I got home from a shift and all of a sudden think to myself... oh man I forgot to "...blank..."
@@stangy007 yess!! hahah but let me tell you being a scribe really does prepare you well for everything else
Hi Dr Cellini! great video! I'm pretty sure I commented on your first unwritten rules video because I agreed so much with your rules. These also were right on the money. I worked in rehab and it was always hard not to refer to our patients as the knee/hip replacement in room___. I also giggled about the pen thing. So true! I thought when all our notes went electronic it wouldn't be as much of an issue. Boy was I wrong! Really loved this topic. Stay well! (-:
I’ve had patients ask me about doctors if they were any good or knew what they were doing. I was very careful how I answered! All the cardiologists I worked with were very good at what they did.
I liked the Q word advice! You’ll learn not to say or have this in your thoughts. Another thing not to say is, I’ve seen it all. No, no you haven’t. I worked in the medical field for 24 years, and even up to the time I left was surprised by something new.
Just a nomination from a patiant: never make bad jokes to the patient or jell at them for there vital funktions.
I have a cuple of problems so I'm at hospital at least once a year for at least a week. Last time the surgen told me BEVOR my fist heart surgery (performed just with lokal anesthesia) I was the first person he operate on without a superviser. Later the same one jelled at me because I've got aterial fiblilation and he wanted me to stop it.
It was over a year ago but I still have nightmares about that day.
Ive been in the hospital over 500 days since 2016. I leaned quickly to bring pics… makes you very humanized to your health care providers. I have kids. I am a daughter. I am a granddaughter. And when they see pics, they treat you VERY differently, not just a number
I totally agree. A couple years ago I was hospitalized for a long time. In total my stay was 3 months and 11 days. During that time I was transferred between different units and because of the constant moving I never had a chance to display any humanizing items. One of the results was I was treated as a number and not a human.
At day 17 of my stay I was transferred to my last ward. It was a rehabilitation ward in the hospital. One of my friends brought in some of my pictures, many get well cards and some art from neighborhood children. The change in the way I was greated, the interactions with medical staff and housekeeping and food services was remarkable.
@@nitahill202 wow, so sorry. I get it’s a mill of people for them but we are humans and that often gets put to the side
Best golden and unspoken rules ,Great advise - keep your comments positive & encouraging about your staff and departments in the hospital Be always a team player. You are so on point with your advise. 👍Thank you
Re: No 4 " if you didn't chart it, it didn't happen ".
I was thinking about this recently. I think that is a potential loophole clinicians can exploit that we radiologists cannot. Say if a clinical finding was missed on examination and therefore isn't documented then, the assumption is that it must not have been present. However for us, our work is always available for someone else to critique retrospectively which opens us more to litigation.
I actually knew a few people that worked in the hospital that had side gigs that required some sales or marketing (like their own RUclips channel, But I retired more than 10 years ago so RUclips channels were not so popular, yet), somebody got the smart idea to get marketing pens printed up for their side gig and intentionally leave them in the nursing stations and anywhere else people are always looking for pens. Win-win all the way around.
We did that 15 yrs agonwith the new ability to order pens with your name on it. So when we searched Dr's or made them empty their pockets we'd find all these pens with our names on them the MD borrowed just for a moment! Lol the labcoats have so many pockets, plus the scrubs or suit underneath. Everyone laughed but the MDs got better at searching themselves for pens!
A twist on the pen rule: medical students should always carry an extra cheap pen to ‘give’ to attendings/residents when they need them😅😂
Source: I’m a 3rd year
What's the difference between medical students and residents?
I have spent my share of money supplying pens to coworkers. . I would come to work with two or three pens and go home with one..
I am never afraid to say ‘quiet’. I dont believe in magic because I am a grown up. I think people just tend to focus on the bad stuff and blame things like superstitions to make themselves feel better. I have had plenty of quiet nights and days where I had commented on how quiet it was with no issues. I have also had days where I never mentioned the word and things went to sh’t. It is the same thinking of ‘clouds’. It all equalizes in the end, the result is just based on what your mind wants to focus on.
😮
My mom is an RN and moved to a different hospital a few months ago. Two of her managers just got fired because they got into a shouting match in the hallway in the middle of A main hallway between their women’s services units and pediatrics😬😬
My mother, may G_D rest her soul, was a RN, once witnessed 2 doctors fight over a patient in the parking lot of the hospital!
OMG!
Two of our anesthesiologists routinely hit nurses! This was late 70's early 80's. One gyn MD was an alcoholic. The other MD's covered for him. Oh, the memories!
I don't mind being referred to as a room number. lol What I dislike: 1) patients are viewed as body parts rather than a whole person; 2) health and fitness aren't promoted to patients and med providers; and 3) direct drug advertising to the public.
A couple months ago, Dr Mark Williams wrote an article on Medscape about a new patient who was taking 43 prescribed meds and almost as many OTC drugs. I've never crossed paths with anyone that extreme but have with many who were diagnosed with two or three dozen conditions directly related to my three dislikes.
Idk how it's over there but in my country especially elderly patients you give them 1 medicine to use for a week, they keep using it after that. I don't know if it's because doctors don't tell them to stop using the medicine after a certain amount of time or some other reason but It's crazy to me.
Pens disappear in any kind of care setting. I worked in group homes and we could never find pens either. Next time my son goes into the hospital though; I'll remember to bring a box of pens. (He's got chronic medical issues so he's in and out of hospitals frequently.)
And here's another "unspoken rule" doctors should be aware of. DO NOT ASSUME your patient or their family does not know anything about their medical condition(s). Especially someone who has a chronic long term health issue like epilepsy. And particularly parents of sick children. I have a young adult son now who's had epilepsy since he was a baby. I have access to the same Internet the doctor does. Except if I'm not a university student and I want to read a study; I have to pay for access to it. And after 17 years of trying to solve the mystery of my son's form of epilepsy; yes, I can pick out a "spike wave discharges" from "movement artifact" on an EEG. So don't you dare lie to me and tell me a test is "normal" when I know it's not. Due to "mychart" type online records; I also can read the reports and the test results. And if there's something on the report that I don't know what it means; I'll go look it up. I know most people don't do that. But I also know that if my son is going to have the best shot at the highest level of independence that he's capable of attaining. Patient education is very important. Doctors aren't the only ones "putting time into" trying to solve complicated medical issues. Your patient, or their family member may actually be right!
I was in the Army for 6 years, our doctors are notoriously bad. One almost killed me by sending me home. That night I had to walk to the ER, had a fever of 104, and ended up spending 2 weeks in a Korean hospital. Nobody spoke English, the medics had to leave to go back to man the ER. They kept wanting me to sign things in Korean. I flipped out so much they gave me a private room and all the morphine I could want. But also put my IV in my right hand so I had a hell of a time showering or brushing my hair. Army doctors...
The quiet word is very real and people really truly dislike people who say that word. Especially on nights. Lol
🙏🏻Thank you for the video which allows me to relax before my great immunology exam tomorrow . .
I have had two doctors come to blows over me and a sugical intervention. My Dad was a doctor. So of course I was shocked. I was prepped and on the gurney almost in the surgery suite. Luckily I got out of surgery and healed on my own.
This is a great video series. Good job.
RN’s never let docs borrow their stethoscope! Like pens, they grow legs and walk away
How about never acknowledge to a patient that another doctor screwed up. I was admitted six hours after discharge following a surgery, the first doctor told me it was due to a reaction to the pain meds. When admitted (to ICU on IV antibiotics) the first doctor brought in a colleague to back up their story. A few months later I was facing another surgery and that Doctor was telling me he was going to be using the same pain med, I asked if he seen in my record that I had reacted to that, he checked the record and labs and said no “looks like an infection, no mention of a reaction”. This was the same hospital.
Loved 🥰 this!! I think some of these rules could apply elsewhere. Thank you 🙏🏼.
Excessive documentation demands including multiple unneeded fields and slowed internet does effect direct patient care.
Your rule about the pens is sooooo on target. I used to swear that people were eating them as snacks. You open up a new box of pens take one and put the rest in a drawer, you go back an hour later because someone used and walked away with the pen you got an hour ago, and the box of pens is totally empty. My nurse manager did a really cool thing one year. She had a bring back the pens work day, where you were supposed to bring back all the pens, scissors, hemostats, carpujets/and the ones that replaced them, and/or anything else you accidentally took home. There were prizes for each shift for the people who brought back the most items. It made for a "fun day" and for at least a week we had pen galore. I suggested we might need to do this monthly, LOL. I was accused of not writing a discharge note, which eventually led to my dismissal from that particular hospital. My best friend/coworker said that they eventually found the discharge note. There was some kind of a computer glitch, and that part of the record went to cyber HELL for a time period of time. You talk about not being afraid to ask questions. When I started right out of nursing school, there was an aid (I honestly don't think she was even a CNA) who had worked at this hospital since they put the plumbing into the original hospital and we had long since been in the new building and the old had been torn down. Anyway, she almost always knew the answers to questions and was fun to work with. She also had horror stories to tell about things that had happened over the years and how things have changed! LOADING THE BOAT...I was so afraid of codes that I was always the 1st or 2nd person on the scene because they were the people who go relieved and became the runners and fetchers for things that were needed or went out to help on the floor during the code. Anyway, I wanted to know about pushing the code drugs and how fast they could be pushed. One of my coworkers gave a "flippant" answer, BUT because it was flippant I never forgot it. She said, "David, push those drugs as fast as you can, they are already dead you can't kill them again!" The first time I said the "Q" word I thought my colleagues were going to kill me. They said the only time we were allowed to say that was at the final report before leaving, LOL!
As a Neonatal ICU nurse, the Q word is looked upon as if you were summoning the devil himself! I can honestly say that anytime I’ve been on shift and the Q word was used, all hell would break loose. And I mean every single time. Over the years I’ve even noticed that I will not even use that word outside of work either. 😂
Very nice video amigo !!!!!! Stay Safe all ! ER doc here :)
Love the one about the pen! So true
Thanks. Please do a part 3.
This is great information even for my job as a teacher . Thank you 👍
Never mention the name of an ER frequent flyer patient…it will surely bring them in the door 😂
Gonna be starting my work as a scribe soon so this video came at a great time for me!
From a patient, watch your speech around patients. Just because it’s 3:00 AM and you’re in the hall, don’t assume the patient in bed A is asleep and can’t hear you. I woke up following emergency surgery and three CNAs were just outside the door, mocking my surgeon for his lack of sexual prowess and small private parts--the guy who’d just had his hands in my abdominal cavity four hours earlier. Their choice of adjectives was lewd and mean-spirited. When I filled out the patient satisfaction form at discharge, the CNA’s lack of professionalism was the only seriously negative thing I had to say except that the creamed beef looked unappealing. (Nothing served in a hospital should resemble vomit. I couldn’t eat it because it looked like someone already had!)
This part is better than part 1. One of your best videos!
Wow! AMAZING!
Great Video as always! Are there any news about the Podcast? Really looking forward to that
Yep! Filmed a test run last night actually 😎. Coming soon!
@@DrCellini nice 🤩 that's what I wanted to hear
This man out here dropin Q's all over the place as i'm about to head to the hospital. Thanks Dre. Cellini, this is on you lol.
That pen rule speaks on another level!
Truth on the pen stuff man! It's crazy😅
One of my favorite doctors is the one that says I don’t know to my question In the same breath he says I will find out or let me look this up So much better than bullshit
I work at the front desk at a hospital, and now that I've heard so many things about missing pens, I'm just going to take a handful of pens to the nurse stations at the start of my shift
Good advice.
Really appreciate your content.
The ultimate aim for me is interventional neuroradiology.
Would you happen to know if its more advisable to apply for it after a neurology residency or an diagnostic radiology residency?
Thank you
I don't know where you are, but in Canada, you can do neuroIR only after diagnostic radiology or neurosurgery residency. Of course, you need additional training on top of either residency (full fledged fellowship or a mini one). There is no path into neuroIR from neurology residency.
Omg u hit those rt on! I'd like to add never ignore a spouse that tries 3 times to alert the discharge doc her concerns of husband's mental status decline. He was called down 3 xs 1st 2 times with out going near him YELLED for me to go get discharge meds. At which point nurse agreed with me refused to take out his 3 IVs so he then yelled get his damn DC meds or we will put him on shuttle and your fault no pain pills. I asked nurse make sure u have forms for me to dispute DC. I get back 30 min later my husband cut be Roused.. they call the idiot down again . He starts yelling I yell back I refuse the DC and wth? U DC him on meds that are in ALLERGY SHEET! HE again was angry IVs still in. Nurse quickly reported it all to charge nurse head if team came down in seconds took 1 look at pt said he's not going anywhere! Listened to my concerns the meds gave 2 doses of narcan he started to wake up then had a seizure and crashed rushed to ICU for a week. All my concerns were rt. RULE LISTEN TO SPOUSE OR FAMILY! YES your rt I will never forget him
As a nurse I will have no less than 2 ink pens in the right pocket and 2 sharpies in the left. Also I will unknowingly collect unattended pens throughout the day and empty my pockets before leaving my shift:)
Great tips! Have you thought of doing a video on teleradiology?
What is there to do a video about?
@@DrCellini Pros/cons, maybe your thoughts of rads choosing to exclusively do teleradiology
Happened to go onto RUclips after 19 seconds of posting, but I’m sure it’s a good one
Haha good timing!
If its not charted it didn't happen.... first thing my mom taught me when I first started working in a hospital. I document every thing. Its called cover your axx. Also true about finding a pen.
Gossip at the unit secretarys desk is another no no. Big problem some have. Talking about a problem patient or family member.
Ok so like if there's an orthopedic surgeon who is a butcher with a great bedside manner and his patients love him and you're recovering the patient on their 4th ORIF redo, and you start hinting that maybe that many redos isn't normal, aren't you kinda taking care of the patient?
Bravo!! I haven’t worked in a hospital in a while. I see things haven’t changed one bit!! I have one though, I had a dream about a week ago that I was back working in the hospital and I came home with 17 pens in my pocket😂😂😂😂😂
Agree, and you should do a third video
Hahah that last rule is hilarious! As a doctor in Jamaica… we also do NOT say the “Q” word… if anything when wishing our colleagues well as we leave and they come on for the night shift… we will spell out the word but NEVER say it lol
As a younger x-ray tech, I would run to the ER nurses station on 3rd shift and say " It sure in quiet". I would then run away as fast as I could.
The word it’s Quiet is a no no in the hospital.
GREAT VID! Don't forget to try to est, very important, but you are the doctor LOL. THIS IS WHY THEY SAY DOCTOR ARE THE WORST PATIENTS!
Oh wow..the pen thing is so true!!
As a nurse for many years, I’ve gone home with 4 or 5 pens in my ponytail. Just a habit, lol.
Do you have to sign off on your dictation notes to ensure accuracy
Yep. Every single one
The “Q” even happens in Venezuelan hospital too!!
with stuff like the Q-word superstition:
having an influx of patients after someone says the Q-word probably just feels subjectively worse than if the influx was not preceded by that, so even if a staff member knows that the word doesn't affect the chance of an influx, it's still plenty irritating when the word is said because it primes them for disappointment.
Right along side of, "If you didn't chart it, it never happened" is the MUST REMEMBER rule of thumb- C.Y.A. COVER YOUR ASSES, LADIES AND GENTLEMAN!! This rule is the twin guideline to the 1st rule of documentation, especially when charting anything to do with Medicare and/or Medicade. So many things in a long, hectic 12 or 16 hour shift seem inconsequential at the time or you put off documenting small details that you end up forgetting. Some small occurrence perhaps happens to one of your patients, something so minor that even the patient themselves blows off the importance of following everything up with proper documentation and records. Then, two days later, in the middle of your days off, you recieve an extremely frustrated and annoyed phone call from your D.O.N. wanting to know why there's no record or incident report of patient so-and-so falling while she was walking with a C.N.A. during your last shift on?? You feel that little tickle of panic in the bottom if your stomach because you know there's no way you would be getting a call unless something bad has happened.. THAT little tickle? It's the OPPOSITE of what C.Y.A. feels like. You quickly try to explain that even Mrs. So-And-So swore the fall was nothing, no big deal, and that shift was terribly busy and you did the best you could do and.. and...The patient is what? With a brain bleeding where?! The family is threatening to do- Damn. Just DAMN. Y'all, twenty-three years of experience here. MAKE the time to C.Y.A. Protect yourselves today so that you're completely prepared to answer any question tomorrow. I hope everyone has a wonderful evening!
What happened-- before the pandemic the hospitals were trying for better food--some even had chefs--BRING that back anything is better than hospital food the way it is. After all what they charge for a hospital stay should include decent food choices
Everytime there’s a code and the residents come running and asks me for a pen and then I never see it again 😩 so I start bringing extra pens everyday to work now.
Dr. Cellini- Does a patient have the right to personally view the film taken during their CT angiogram? I understand that they might not have a clear - - or even foggy - - idea what they are looking at. Prospectively, however, when viewed in context with the IR doctor's report, the report itself might make better sense. I look forward to your earliest response. Thank you.
As a person who has spent my whole life as a patient I appreciate the not treating somebody like a number. I have been treated poorly and I have been treated like a family member… I will say mayo clinic is the biggest offender of this rule… Just saying