The actual point of pre-rounding is that the patient gets a chance to tell the medstudent he wouldn‘t have allergies just to deny what he just said in front of all the doctors at great rounds.
My pre-round post spinal surgery was surgical resident and anesthesiologist coming in to tell me that I made them laugh hysterically when they were putting me under. Because allegedly, I stopped them while they were injecting me, and went "Is that propofol?" them "yes." "FYI, that feels like fire in the veins, probably why we don't use it in the vet clinic. Anyways, have fun with my intestines and spine boys!" and was out. ...I remember NONE OF THIS INTERACTION PRE SURGERY.
i had to be put under (for some reason) to get a surgery on a broken finger and get some pins put in to hold the bone in place, and when I came to my doctor told me I was singing before I went out, and they all had a laugh about it. doesn't surprise me, I'm a literal singer, but it was funny knowing that happened when I was basically unconsciou already and couldnt recall when I was awake again
why are hospitals so determined to deprive anyone and everyone of sleep? the staff is working 24 hour shifts, the patients are getting blood drawn at 2 am. it’s insane
@KRAZE should’ve stood up for yourselves. Also, you look at tik tok and see all the nurses bullshitting during their shifts? You get no sympathy lol. You do it to yourselves.
There are so many pts to be seen for vital signs, yep lab draws as very few venapuncturists for a vast number of AM routine & stat lab draws, portable chest trays which too few techs, etc., etc. Yep. It is hard on the pts....
Ideally, pre-round is for medical students to practice managing their assigned patients. Back in my school, med students are allowed to write orders in medical chart which will not be taken w/o attending physician /residents signature. Not getting ur orders erased is like one of med student's honorary badge.
This is exactly why pre-rounds is used. It’s not for the attendings. It’s for the medical students and junior residents. They need to independently come up with a plan rather than being told what to do. Attendings don’t pre-round. Sadly, med students think this is scut, and that pride at being able to come with a assessment and plan is gone.
I always wondered the point of pre-rounds. Having a rare syndrome and being in a teaching hospital, I talk to a lot of med students. I generally like pre-rounds because it gives me someone to discuss things that I want to discuss with the doctor since the final round tends to go rather quick and the med student can have my back if I forget anything I wanted to ask.
Pre-rounds are an exquisite excuse for us, poor, med students to take difficult histories that the patient isn’t willing to give. Also we wake up at extremely ungodly hours if we want to complete the ward. Then we get publicly ridiculed while “presenting the data” as the patient denies ever being diabetic.
@MsStarSword dude the best thing you can do is make a list of all the medications you take and what health conditions you have and bring it in to the hospital
@Larissa Gallo Only once a week?! Nurses get yelled & cussed daily. Eventually you develop a tolerance & can take it, but it also takes away you ability to give a f--k. Behold my field of f--ks, they lay barren and wasted. I am immune to the drama of immature and reactive adults who lack the ability to control their mouths when they are angry 😌
Practically, "continuous improvement" is impossible. Even after a major discovery or innovation, the process of "improvement" is only a refinement of what is already there as a foundation. New discoveries or breakthroughs are not always significant or actually helpful, and rushing into what we might immediately interpret as an "improvement" may turn out to be negative in the long run--this is why historical precedence matters. "Don't fix what isn't broken" is a fine phrase, though, of course, it's balancing act. Too much adherence and the field may stagnate; too much "innovation" and we fall into chaos, where nothing is true.
So I worked the night shift at a nursing home a while back, specifically, memory care. This hits a little too close to home. I had one resident who would throw her poop at us when we came in. I literally started carrying a cardboard shield with me when I went into her room and threw it away every day, made a new one, and so on. I know how this works on an emotional level.
LMAOOOOO! This is so spot on it makes me want to laugh and cry! As a "professional patient", all the checks and stuff they are always waking me up for is the bane of my existence when I get stuck in the hospital. The way you explain how the medical system really works, but with savage humor, is amazing. You are truly One Of A Kind, don't ever change! Ever!
In vet med, pre-rounds are secretly extra-time to cuddle with the new puppy/kitty litter that was delivered overnight. The length of the round is also directly proportionate to the cuteness of the patients. All need to be informed repeatedly they are the goodest of girls/boys. UPDATE: Wow, wasn't expecting this many likes. If you're reading this, please say a kind word to a veterinarian today. There is a dark side to this light banter - the DVM profession has one of the highest rates of suicides. This is due to being exposed to patients dying/performing eutanasia very often (compared to the majority of medical doctors), working under stress, being at the receiving end of angry/grieving owners. We're talking about highly empatic people, often with inadequate mental health care support, and having relatively easy access to medication that can be unfortunately used to end one's life. Thanks for reading.
At first I thought you meant Veteran medicine. People should more frequently take personal leave for mental health care. I was forced to do it once given the dire situation, but I so wish I had stopped that crazy 24/7 stress train before it got to that point. Prayers for you and your family and to all caregivers out there 🙏 ❤️
Surely the personality type and circumstances of the vets should be taken into consideration as well as the nature of the job. Many more classic over achieving females are becoming vets (in the UK at least). They may be more sensitive than their male counterparts and become prone to suicide ideation.
Thank you! I didn't know that statistic... Troubling for sure. Just know you are appreciated by this stranger. I wish you a happy New day every single day!
@Olivia Allen it was a god sent when I found a vet that would take payment plans- and would let me do much of my own vet care myself for the cats and dogs that tend to show up on my property (there’s legitimately a shelter in my town that suggest dumping animals down my road. I was livid.) I know how to do things like giving vaccines, IV fluids, blood draws, and I do my own fecals because no one treats goats, so it was skills I had to learn on my own. Finding someone that understands I have some basic knowledge but not a ton of money has made my life heaven, even if it’s an hour drive away from me. I’m not a pet owner, essentially, I’m the stop gap between the overfull shelters who will constantly put down animals because they’re over full, and finding someone to take this animal I helped off my hands as a permanent home. This last month alone I picked up 6 dogs and 13 cats. I obviously want to help them, but times are tough, and if I can’t do it myself with a little guidance, I can’t afford to do it at all. It’s hard, and very few people will help.
As a patient, I’m not appreciative of pre-rounds, they usually happen an hour after the last time my poor nurse takes my vitals before rounds, between 3-4am 🤣. I’m grateful to y’all regardless of the mild sleep deprivation 😎✊🏽🙏🏽
I always wondered what was the thinking behind so many sleep interruptions each time I had a surgery(9 of them so far). I really wish there was the option to recover at a recovery facility if home was not a good place to recover. It would have spead up my healing, in my opinion.
I kind of like when med students come meet me during their pre rounds because I’m what one med student called “medically interesting”, and it gives them time to ask a bunch of specific questions about my rare condition without the time constraints of the medical team.
Patient POV: My daughter has a condition that has led us to be in the hospital way too much. Anyway, when it's about your kid who's sick and you're happy they made it through the night, pre-rounds are something you set your alarm for, you schedule your poops around, you live for those things so the doctor can give you hope for the remainder of the day. Rounds are where you get an idea of where the entire team is at and what the goals for the day are. Pre-rounds usually feel more intimate, Rounds feel more like a couple coaches coming together to come up for a game plan . That's just me though
That's a good POV to have. It's nice to have a more of an informal round and then a formal round. I feel like they would see you more as a human during pre round than an object as well
In nursing school we would spend hours the night before clinicals researching our patient and writing up their med list, nursing goals, etc. Half the time we would get there in the morning and they would be discharged and we had to write up everything on a different patient 😬 don't miss those days at all
@Mel Cat this just seems so silly to me now because the average floor nurse definitely does not have the opportunity to study their patient the night ahead. Even the newgrad ones. More the so you should also be capable of switching assignments on the fly and receiving report. Relying on written report forms is also not ideal, in the real world you use up to date EMR when presenting a patient and any foreseeable goals for the day.
Gosh. In nursing school we had to know everything for us to get a good patient history because we need it for case presentation. Because if there are missing clinical info, the clinical instructor would skin us alive. Nope. Not missing that at all.
I remember those days… ugh. One time, I had a patient with pancreatitis and I didn’t read up on it enough the night before. I got chewed up by my instructor :( I just remember being deliriously tired at that point. I was doing my best!!!
God I remember that. I remember how much time it took up to formulate a Nanda care goal and then when I hit the field it was like "there literally isnt time to waste like this"
I will say that when having a loved one in the hospital, pre-rounds gave me comfort that they were being taken care of & that the med team actually cared. I’m sure it’s cumbersome on your side, but thank you so much for doing them.
💞Asi con toy y sus mañas no se la loveme.Uno/uchi Megan: "Hotter" Hopi: "Sweeter" Joonie: "Cooler" Yoongi: "Butter" Son unos de los mejores conciertos , no puede ir pero de tan solo verlos desde pantalla, se que estuvo sorprendente. ...
Yes. Hospitals are a great place to stay if your condition is dangerous, or you need urgent or emergency care. They are a terrible place to stay if you need rest and convalescence.
Omg yes! Especially if you share your room with 3 other patients and all of them were diabetic. Seriously, nurses coming and going from our room all day and night. It was terrible. And I had to stay there for 43 days 😭
As a chronic illness patient, I don't even question it anymore lol I love talking to the student. I was able to calm a nervous student down once and was so happy!
THIS!! I’m an MA and every time we had a student go to see a patient first it was just take twice as long to get the patient in and out. Of course it’s important for them to get this experience while on clinical rotations, but there’s gotta be a more efficient way of doing things 😩
As someone who isn’t into medicine this seems like a perfectly reasonable thing for med students to do. It’s kinda like reading through a chapter before attending class
I feel this on a spiritual level, especially rounding on surgical wards. I genuinely don't understand how this isn't seen as a barrier to better pt recovery. Ok now your elderly post-op is sleeping until 11 because you woke them at 6, and they're too tired for morning physio which means they might get left until tomorrow. Make it make sense.
@Catherine Bills you replied to the wrong person Karen LOLOL. I made no medical statements other than IV’s feel good when you are dehydrated. FROM PERSONAL EXPERIENCE. Get a grip lady
In my twenties I tried really hard to be a doctor...I couldn't afford a thing, panicked, and dropped out. So this channel, in a very hilarious way, makes me wanna try again...just to meet this guy 🤣🤣
As a parent of a child that is frequently hospitalized, I actually liked the pre-rounds. Those students were very thoughtful and inquisitive and made sure to ask the team any questions I may have. Being surrounded by a whole team would sometimes feel intimidating.
I remember having my appendectomy last year and afterwards being told to get lots of rest to help me recover faster only to be woken up every few hours for the next 4 days.
Oh my gosh the sleep deprivation I went through when I was having surgeries to reconstruct my leg, it was so excruciating. They also wake you around 4am for blood draws.
I was hospitalized for COVID for 15 days, my husband for 2 months before passing away from COVID, and I totally understand this video. You even made me laugh 😂
When I was in the hospital recently, the rounds were completely useless from the patient's perspective. The docs would barely talk to the patients about their conditions or let them share about their symptoms or ask questions. So I would have appreciated the pre-rounds because it sounds like an opportunity to actually talk to someone and not just be treated like a piece of furniture.
I loved pre-rounds 🙄 5 yrs living mostly in hospital with my daughter; every 3 hr vitals followed by pre-rounds. I was so deprived of sleep for years; my lucky kid would sleep through all of it. I drew the line at them doing a physical during pre-rounds because that would wake her, and then I’m stuck with a grumpy baby/toddler lol
Asi con toy y sus malas no se la loveme.Uno/PROZEN 💕 Megan: "Hotter" Hopi: "Sweeter" Joonie: "Cooler" Yoongi: "Butter" Son unos de los mejores conciertos , no puede ir pero de tan solo verlos desde pantalla, se que estuvo sorprendente .
Asi con toy y sus malas no se la loveme.Uno/PROZEN 💕 Megan: "Hotter" Hopi: "Sweeter" Joonie: "Cooler" Yoongi: "Butter" Son unos de los mejores conciertos , no puede ir pero de tan solo verlos desde pantalla, se que estuvo sorprendente .
You missed the best part of pre-rounds -- none of the blood work has come back (or hasn't even been drawn) and last vitals were at 2 am, so absolutely nothing relevant to present to the team other than patient cursed at me for waking them up early. Good times.
That (the patient) was me, granted you managed to wake me up (no easy task). I’m not a morning person so there’s a -1000% chance of me being nice before 8AM. Quadruple that if I’m in pain. Double on top for every digit above 6 and hour from last pain med dose. I would say sorry but I’m not.
That was me!!!! (Not directly me in your case) They took their last vitals at 11:30pm, gave me the Demerol and it was night night time… then 4am I heard the door jiggling open and I immediately got annoyed
@Abby The Duck Lord I've been given the needle several times to help with difficult sticks. No complaints -- always happy to help expedite, if needed. And I have no issue with the time it takes to do the draws. My criticism is on our medical team for scheduling decision-making rounds (and pre-rounds) before all the information is back. Either do the draws at 5 am (as scheduled) and wait until 10-11am to round, OR, round at 8 am with 'conditional' plans for blood to be drawn at a reasonable hour. My issue is with sequencing the data inputs with insight generation, not with the speed it takes to generate the data.
@Bald Kiwi trending is important but there are so many docs that put in orders in between the trending draws. Ive had patients tell me that they would've never told their nurse/doc about chest pain if they knew how many times it would make them get poked. There's also times where the large amount of blood draws has caused them to go towards the comfort care route instead because they get so sick of everything. Trendings are important but so many doctors don't realize how draining (literally and figuratively) it can be on a patient. When the pt has had 4 normal, non-increasing trop levels in a row, odds are, they don't need to keep getting poked for that unless new chestpain arises or it may just need to be checked once a day with morning labs. There are way to many docs out there that say "I want just a few more."
Reminds me of an old saying. "The light on top of the tower is for planes so that they see it and don't crash. And the point of the tower is to hold up the light."
no joke, i was the most tired i've ever been in my life after spending 4 days at the hospital, which was after they admitted me because my hemaglobin was lower than 5. so basically i was more tired from the hospital stay than from having no blood lol
Lol as someone with severe medical conditions who has spent years in and out of the hospital, the amount of times someone comes in to ask you a question by the time rounds comes around… 🤣
to clear up some confusion, rounds are where your examination skills are evaluated by the attendings. its not about efficiency, it's about education. non education hospitals dont need this, attendings will just go over all 30 patients in like 1 hour. med students need longer time to examine the patients because : 1. we are performing tests not routinely done by attendings 2. we may have to look up how to perform some tests as we go 3. we are way less experienced, meaning we may be digging up some unnecessary data or letting the patient ramble pointlessly. a good physician knows when and how to cut off the patient
I'm convinced it's all just a tactic to make sure the sick patient gets as little sleep as humanely possible😉 I'm kidding lol but ahhh, I swear it's not possible to get more than 2 hours of sleep uninterrupted while in the hospital. Between the meds, the blood pressure checks, 6am blood draw, 7am shift change, and then the begining of what I call the doctor parade around 8am🤣 I generally come home from lengthy hospital stays and sleep a ton just to catch up(I know, I am there to get better and I totally appreciate all my nurses and doctors lol I'm just teasing)
Watching these medical shorts always informs me of how little actual care I have received during my medical needs. Saying, they’re showing me how things are supposed to be done.
When I was a long term patient at one point in my life, sleep was impossible. 2am blood draw 4am xray 6am vitals 8am breakfast 10am family visit/doctor rounds 1pm lunch 3pm Physical Therapy/misc treatment 4pm Vitals 5pm family visit 6pm dinner 8pm misc treatment 10 pm lights out And I've had chronic insomnia ever since.
Lmao, this is so true! The patients always hate being awakened at ungodly hours especially after they were already awakened at 2am for vitals. Noone ever really sleeps.
I remember when I went to my dream job for a week (to check out if it was what I wanted) we started work at 6 and then we had to say good morning to all the patients, and we chilled. It was so peaceful. I can imagine how ER is. Or any other place. Rehabilitation for injuries is better in that place imo
I remember when I spent the night in ICU-like room and the doctor and his minions had a "round." The one on my left side was a burn victim, the one across was in a car accident, while me got a severed artery resulted from a gunshot on the leg. The doctor and his minions did their Q&As in front of the patients but they just completely ignored me when it was my turn. 😅 I was like, "what? My case is not interesting enough?" The suck part was I also got shot on the left forearm, the bullet actually created a hairline fracture on my radial. The nurse only noticed my forearm injury when she cleaned up the rest of my dried up wound in the morning. I did not feel it since I was still numbed from the post surgery.
When I left hospital I was EXHAUSTED, getting home I was able to actually recover & begin to feel better. Although I did have a nurse come in for 2 hours every day. But she came to me last every day. She could hook up my PICC to IV antibiotics. They take hour n half to run through. So she did her notes, we watched TV, had chats (I know she was "sneakily" getting more info about my recovery. It was middle of July & hot as balls. So when the ice-cream truck came outside, my brother (he lurked around our house until my husband got home from work) would head to the ice-cream van and get us all frozen yummies. But I was so much better rested after I left hospital...
god bless the "pre-rounders" mom had secondary pulmonary hypertension. i made it a point to be bedside when they came to see her. an M1 took it upon herself to call me every afternoon with any updates. i am sure she and the intern she worked with knew mom inside out and were able to provide detailed info to the team resulting in the excellent care mom received.
I love this. I think that this is some of the best way medical students can add value to the care. Often residents or attendings may be too busy to call family unless absolutely necessary. Medical students also have more time to take a more thorough history and to bond with the patient. When I would pre-round on a call day (when rounds are in the afternoon), I would sometimes spend 45 minutes talking to the patient about their health, habits, motivations, and just life. Also in clinic students would call patients to help remind them/check in about medications including insulin titration/blood sugar logs and check to see how therapy was working. Anyway, rambled just to say that there are important things that medical students can do that are beneficial to the patient. Ultimately medical students are going to be doctors and they need to learn and practice - best way to do that is see real patients - but I can see that you know that. :)
This reminds me about a policy where my dad worked. 2 VPs had to sign a document rather than 1. My dad asked why. The response was, "Because it's policy." "Why is it policy?" "Because we get audited on it." "Why are we audited on it?" "Because it's policy." "Why is it policy?" "Because we get audited on it." The convo kept going like that until my dad gave up and hunted down another VP and explained the same thing to him with a diagram.
As a person who has spent a great deal of time as a hospital patient, watching all these shorts and tiktoks made by doctors and nurses, I find it so interesting seeing how so many of these hospital practices or as confusing for the staff as they are for the patients.
As a recent patient in the hospital, I was ALWAYS asleep when the med student would come in at 5am. They will wake you up and smile in your face while talking loud as you glare at them. I finally asked one of them to come back after they visited the other patients since I was just plain exhausted. They weren't the only ones that never let me sleep. You don't get any rest while in the hospital.
Say it louder for the people in the back!!! I know when I stayed in a teaching hospital that had this kind of system,we won't even get into the disaster that was that stay and how unorganized everyone was,us patients were waken up throughout the night for vitals,blood draw at somewhere from 1-3 a.m,i.v pole going off or my roommate's,her vitals didn't get done the same time as mine so the lights got turned on by each other's nurses,then pre round comes in between 5-6 then the group came in around 7ish. And again my roommate had a different team then me so this was done twice essentially. But then they get mad and wonder why you're trying to sleep during the day. 🤦♀️😧 all my other stays weren't at a teaching hospital but the other stuff like vitals,blood draws and what not ring true regardless of where ya stay. Along with the why are you sleeping it's not night.
Actually I read a study once where pre-rounds was a concept specifically to help train med students so that way they had good bedside manner there was something else too but I'm struggling to remember lol
It's a great chance to have all the patients wake up, and use their call lights just before just shift change. It's a wonderful way to lower Nelson Denney scores, because they've been woken up AND neglected by nursing staff who are stressed to the max 😌👍🏾
Pre-rounding is done to gather subjective data from the patient, and objective data from your physical exam, and then for you as a provider to form a plan to present during rounds. Whether that plan is accepted or not by the attending is another matter, but the idea is that the attending will not be spending more than a fraction of the time you as the primary “responding clinician” does with your patients (attendings will be overseeing an order of 2-4x more patients than residents/NPs/PAs/etc.) The practice of multi-hour walking rounds is meant to teach students/residents in teaching hospitals, but IMO is too cumbersome for many specialties. It works well for ICUs, not sure about other types of units where the number of patients is higher. In my experience pre-rounding combined with sit-down rounds (in a conference/meeting room) is much better for patient and staff quality of life. I usually let my patients “sleep” until 8am, but they have usually already been awoken for vital signs and labs at or before 6am, because we want/need those lab values to help formulate that plan we present at rounds.
"So pre-rounding is when you find out what happened overnight?" "Well, actually we hear about overnight events during sign-out." "Signout? what's that?"
I was awake in the middle of the night looking for sleep meditation, and ended up here on this video. So i watched several of your videos. Of course, I love them. Now to find that sleep meditation.
I had a nursing student that came in and asked me questions. She said she was a student and this was required. I did my best to be helpful. She was sweet and being trained to be an awesome nurse. I wish the best for her. 😀
Never was I so annoyed when, in all my post-partem glory, a med student cane in at 6am and started talking at my sleeping body, awakening me in the middle of whatever it was she was saying to me.
Prerounds to me if they're kept to trainees are a great way for some hands on training yes its repetitive but that works when it comes to learn how to read charts and questioning patients
I was in the icu for 5 days 2 years ago, I never slept. Eother the monitor of mine or someone else's was going off, or them taking blood,blood pressure, docs and nurses coming in asking how I'm doing! Honestly loved it! I loved the attention, and I was so exhausted that I would fall back asleep over and over again.
Every time I’ve experienced this as a patient, the pre-rounder asks me questions to get all my info, then the doctor comes in and asks all the same questions lol
In vet med, pre-rounds are secretly extra-time to cuddle with the new puppy/kitty litter that was delivered overnight. The length of the round is also directly proportionate to the cuteness of the patients. All need to be informed repeatedly they are the goodest of girls/boys.
For my non-med friends, pre-rounds is also a way for med students or interns to learn, talking to the patient and getting additional info like fluids, urine output, pain and discomfort etc, which would take longer during rounds. It's so students gain experience and one-on-one time seeing the patient before the consultant or senior resident, otherwise they won't learn. Consultants also check the students knowledge about the case during rounds so it's better they are more prepared beforehand. It's more encouraging for me to teach and explain the information to the residents and students if they are aware of the patient's condition. If you don't, then I'm assuming you're not making an effort to know your patient. They appreciate it when the people taking care of them do that.
@not disappointed or surprised my understanding is that this only happens in public hospitals here. If you are rich enough to pay for private hospital care, you won't be helping train any new doctors or woken up at ungodly hours. Money is the differenciating factor.
@panic! Short answer: Is that extra 1-2h worth $2,600 to you because that's the average cost per day. Pushing all our 10-40+ patients off an hour would increase your likelihood of that occurring. Long answer: Hospitals aren't the same type of businesses as hotels. We order labs to trend and assess your stability to leave. We would all rather be with our families or come in later, but our subspecialists are human too and will need to see you. Delays run the risk of having you be at the bottom of the list and unseen? The same goes with other needed treatments/ services. The point of pre-rounding in the US is to identify emergent interventions and allow for a reasonable plan to be made when you can assess them the same day. It can help you get out the hospital ASAP and minimize your chance of catching an infection from the hospitalization or from getting injured while hospitalized. Lastly, we have to chart and act on recommendations from consultants to expedite your care. Charting is important because the most dangerous time for patients is during transfers of care, so there is a ton that goes on for every patient. Again, multiply it all by 10-40 times. it isn't practical to push it off when staff already get there at 4-5 AM to review the chart and might be driving home at 10 PM (I've done that many times). Contrary to how that may sound, we really do want our patients to have a rejuvenating stay and to see them improve and happy.
@they walking up to you and in a poor third would country in Asia. That's it. Don't worry you probably don't live there, you'll be fine. We have a few karens but generally our countrymen are nice to the people trying to save their lives.
Y'know, it's nice to know why I was woken up so frickin early everyday during my week stay in ICU. I swear I fell back to sleep on multiple days while my nurse was talking. I cannot wake up that early and function enough to give detailed answers 😂
This is the absolute most frustrating thing as a patient. They keep telling you how important your rest is yet wake you up every single hour through the night by checking on you then wake you up when it’s still dark outside for rapid fire questions.
when my mom was in the hospital for a surgery and i was there to take care of her. it was very early morning and i barely slept a blink when the med students came to do pre rounds, but when i thought it was over and i can finally sleep in peace, the nurses and doctors came next to do the rounds ☠️ i felt more tired than my mom tbh lol
My friend took me with her to the hospital when she had fluid collecting in her lungs and needed it drained. She had to answer like 15 questions to get processed into a room in the er, then the same questions again before they moved her to a room in the actual hospital. Then another round of the same questions in the hospital room by her nurse, before getting those same questions again from a group of doctors, and one last time from her actual assigned doctor. All before they decided they weren't going to drain her lungs until the next day. It was insane.
I was in hospital for ten days over Christmas and New Year with a broken tibia and fibula. I would fall asleep around midnight, have at least one or two nurse visits during the night, then get woken up about 5am. Sometimes I'd nap in short bursts during the day, but I never understood why patients are woken up during the night. Surely a good block of sleep helps them feel better?
I still remember my experience staying at hospitals for about 2 weeks. I had trouble sleeping cause of my illness and 4am-6am is like the golden time for me..it's the time i was in deep sleep..but the nurse, med student & the sanitary staff kept coming & doing their activities, asked me to wake up, to move around so they can change the bed-sheet, checked on me, took my blood, intvwd me..and it's already 7am when they finally gone..then it's time for quick bath & breakfast. I got pretty annoyed at that time. 😁 I feel like screaming "I need my sleep! Please let me sleep!" But i said nothing cause i don't have any energy. 😂 Once i got out of hospital, i slept through the day to payback my sleep deprive. 😂
This is so funny. I recently spent about 3 weeks in the hospital, kidney issue. I saw the hospitalist maybe a total of 3 times. So about once a week. But they changed my meds every day. We’d finally find a routine that controlled the pain, the very next day, the doctor I hadn’t seen, goes in and changes them. It was INFURIATING, for myself and the nurses.
The whole sleep part.. as a nurse I always say.. you didn’t come to the hospital to rest 😂 the sleep is minimal for patients cause nurses do vitals over night as well
Omg- I remember I was visiting my Dr for a checkup on my medication and she had student with her who came to see me before and it was weird and awkward cause with was like "New person- Not okay" and then I had the Exact same conversation when the Dr came in but this time with my Dr. Idk, I guess it's a good learning experience? The student was really nice and asked me if I was in school and how school was going and was super shocked when I told her I was still in high school after asking me what I was studying for. 😅 I often get the reaction of people thinking I'm much younger or much older so- she legit double checked my paper and was like "Oh, right, you're sixteen I'm sorry!" In her defense I was there for medication for a stress headache disorder so I would also assume myself an overworked college student ¯\_(ツ)_/¯ but nah, I'm just a mentally ill student with a stress disorder an anxiety disorder and a stressful family 😌 Fucking amazing when your body realizes you're not doing well and so makes your head feel like it's being hit with a damned hammer
I'm never going to understand why the medical community seems so hellbent on busy work that takes up valuable time that could be used on sleep or not being at work. The sheer amount of time that they expect you to spend at work horrifies me.
Me, a hospital security officer: "Who called the code gray? (Combative patient)" Doc: "It was me, he just got combative out of nowhere!" Me: "Are you sure nothing lead up to this?" Doc: "Well the nurse woke up him every hour between midnight at 5 AM for meds and he kept telling her to leave him alone so he can sleep but that probably doesn't have anything to do with it". Me: (attempts to not facepalm in front of the doctor so I don't get fired)
I’ve had them come in at like 4 am for my daughter. I get a “Mom, I’m Dr. So and So. Just checking on your daughter and see how things are going.” 😴 I jump up because they scared the shit out of me. Lol
I remember not getting much sleep when I was hospitalized , but only cause they were terrified of the noises the machine would make every time I drifted to sleep 😅 My O2 sat would drop like a rock, and they just wanted to make sure I wasn’t dead or dying. I was fine. Turns out I just have congenital PAH, diagnosed in 2014 👍 thanks docs
As someone who had a heart transplant… Doctors constantly checking in was the bane of my existence. And on top of it UCLA is a learning hospital so add a whole bunch more to whatever is “normal“. I can count on one hand the amount of time I got more than four hours of sleep entire time I was there. I am fairly sure that my recovery would have been drastically improved if I had been able to sleep!
As a caregiver who spent years trying to hold down a full time job (average 60-70 hour weeks) while sleeping on the little hospital couches...yeah that extra hour of sleep would've really helped.
Based on my (unfortunately) extensive experience as an admitted patient, the med student also has to have this conversation w the majority of the patients they’ve woken. Along with, “we really have to do this again?” and, “you and the vampire phlebotomist! Why is it always when I’m asleep?!”
As patient, I once talked to medstudent during pre-round but forgot to mention certain details. During round, the doctors talked to me and scolded the medstudent for not getting all details. She almost burst into tears. I felt really bad for her and feeling guilty.
I always thought pre rounds is where the med students make their analysis as if they were the doctors and then in the rounds they confirm or deny if they got things right, it's like their practice
I love the contradictory orders i get to deal with - "delirium precautions" and "routine neuro/cms checks every 4 hours" cannot both be followed. That 4am check is gonna be closer to 6 when phlebotomy, the pre-round med student/ortho intern, or the scheduled Tylenol is due.
LOL 😂 I just got out of a two month stay in the hospital and this literally drove me nuts!!! 6am they would wake me.... eventually I put a note on my door saying "NO 6am visits!! Patient sleeping".
![Ed Sheeran - 2step ft Antytila [Official Video]](http://i.ytimg.com/vi/OJ2B4Fb7xQQ/mqdefault.jpg)
The actual point of pre-rounding is that the patient gets a chance to tell the medstudent he wouldn‘t have allergies just to deny what he just said in front of all the doctors at great rounds.
Lmao 🤣🤣🤣🤣🤣🤣🤣
@Rosemary Lindop so true 🥴
Many patients purposefully change stories….think it’s funny…..
Oh this HITS hardd 😭
My pre-round post spinal surgery was surgical resident and anesthesiologist coming in to tell me that I made them laugh hysterically when they were putting me under. Because allegedly, I stopped them while they were injecting me, and went "Is that propofol?" them "yes." "FYI, that feels like fire in the veins, probably why we don't use it in the vet clinic. Anyways, have fun with my intestines and spine boys!" and was out.
...I remember NONE OF THIS INTERACTION PRE SURGERY.
😂😂😂
@delphie23 you still kinda feel it just not as much
i had to be put under (for some reason) to get a surgery on a broken finger and get some pins put in to hold the bone in place, and when I came to my doctor told me I was singing before I went out, and they all had a laugh about it. doesn't surprise me, I'm a literal singer, but it was funny knowing that happened when I was basically unconsciou already and couldnt recall when I was awake again
@Nightraven26 thanks
@blucantrell2 you can mix propofol with lidocaine
why are hospitals so determined to deprive anyone and everyone of sleep? the staff is working 24 hour shifts, the patients are getting blood drawn at 2 am. it’s insane
@KRAZE should’ve stood up for yourselves.
Also, you look at tik tok and see all the nurses bullshitting during their shifts? You get no sympathy lol. You do it to yourselves.
There are so many pts to be seen for vital signs, yep lab draws as very few venapuncturists for a vast number of AM routine & stat lab draws, portable chest trays which too few techs, etc., etc. Yep. It is hard on the pts....
Actually sleep deprivation in patients at hospitals is a serious problem and contributes to worse outcomes.
Ideally, pre-round is for medical students to practice managing their assigned patients.
Back in my school, med students are allowed to write orders in medical chart which will not be taken w/o attending physician /residents signature. Not getting ur orders erased is like one of med student's honorary badge.
This is exactly why pre-rounds is used. It’s not for the attendings. It’s for the medical students and junior residents. They need to independently come up with a plan rather than being told what to do. Attendings don’t pre-round. Sadly, med students think this is scut, and that pride at being able to come with a assessment and plan is gone.
Dude I love that
I always wondered the point of pre-rounds. Having a rare syndrome and being in a teaching hospital, I talk to a lot of med students. I generally like pre-rounds because it gives me someone to discuss things that I want to discuss with the doctor since the final round tends to go rather quick and the med student can have my back if I forget anything I wanted to ask.
@? exactly. No one likes that timing
Cool but like can they not do it at 5:30am while I'm severely depressed and sleep deprived
Pre-rounds sounds like one of those things that an overachiever kept doing that quickly became the standard.
@BacklTrack Totally.
@Just Me that explains a lot. Seems like we need to give all doctors unlimited drugs
@Daan change bayud and especialy in academic -_-
lol
Pre-rounds are an exquisite excuse for us, poor, med students to take difficult histories that the patient isn’t willing to give. Also we wake up at extremely ungodly hours if we want to complete the ward. Then we get publicly ridiculed while “presenting the data” as the patient denies ever being diabetic.
@MsStarSword dude the best thing you can do is make a list of all the medications you take and what health conditions you have and bring it in to the hospital
@Larissa Gallo
Only once a week?!
Nurses get yelled & cussed daily. Eventually you develop a tolerance & can take it, but it also takes away you ability to give a f--k.
Behold my field of f--ks, they lay barren and wasted.
I am immune to the drama of immature and reactive adults who lack the ability to control their mouths when they are angry 😌
#truth. I would take 1/4 of a Xanax everyorning just to get thru rounds. Got yelled at at least once a week.
@NoalFarstrider someone just woke him up for pre rounds, dont mind him. The tantrum will pass
“Because that’s how we’ve always done it.” Is one of the biggest inhibitors of continuous improvement.
Practically, "continuous improvement" is impossible. Even after a major discovery or innovation, the process of "improvement" is only a refinement of what is already there as a foundation.
New discoveries or breakthroughs are not always significant or actually helpful, and rushing into what we might immediately interpret as an "improvement" may turn out to be negative in the long run--this is why historical precedence matters.
"Don't fix what isn't broken" is a fine phrase, though, of course, it's balancing act. Too much adherence and the field may stagnate; too much "innovation" and we fall into chaos, where nothing is true.
So I worked the night shift at a nursing home a while back, specifically, memory care. This hits a little too close to home. I had one resident who would throw her poop at us when we came in. I literally started carrying a cardboard shield with me when I went into her room and threw it away every day, made a new one, and so on. I know how this works on an emotional level.
Hospital RN here, took me a sec to switch definitions of "resident" :'D though my first thought might not be out of the question after 27 hr call ....
Bruh
LMAOOOOO! This is so spot on it makes me want to laugh and cry! As a "professional patient", all the checks and stuff they are always waking me up for is the bane of my existence when I get stuck in the hospital. The way you explain how the medical system really works, but with savage humor, is amazing. You are truly One Of A Kind, don't ever change! Ever!
Professional patient... I assure you everytime those nurses see your name on the check on screen they say "fml"
Haha. Professional patient. Love that term. What makes you "professional". Over 7 hospital admittance in a year?
In vet med, pre-rounds are secretly extra-time to cuddle with the new puppy/kitty litter that was delivered overnight. The length of the round is also directly proportionate to the cuteness of the patients. All need to be informed repeatedly they are the goodest of girls/boys.
UPDATE: Wow, wasn't expecting this many likes. If you're reading this, please say a kind word to a veterinarian today. There is a dark side to this light banter - the DVM profession has one of the highest rates of suicides. This is due to being exposed to patients dying/performing eutanasia very often (compared to the majority of medical doctors), working under stress, being at the receiving end of angry/grieving owners. We're talking about highly empatic people, often with inadequate mental health care support, and having relatively easy access to medication that can be unfortunately used to end one's life. Thanks for reading.
Ok new plan, we’re going into vet now
At first I thought you meant Veteran medicine. People should more frequently take personal leave for mental health care. I was forced to do it once given the dire situation, but I so wish I had stopped that crazy 24/7 stress train before it got to that point. Prayers for you and your family and to all caregivers out there 🙏 ❤️
Surely the personality type and circumstances of the vets should be taken into consideration as well as the nature of the job. Many more classic over achieving females are becoming vets (in the UK at least). They may be more sensitive than their male counterparts and become prone to suicide ideation.
Thank you! I didn't know that statistic... Troubling for sure. Just know you are appreciated by this stranger. I wish you a happy New day every single day!
@Olivia Allen it was a god sent when I found a vet that would take payment plans- and would let me do much of my own vet care myself for the cats and dogs that tend to show up on my property (there’s legitimately a shelter in my town that suggest dumping animals down my road. I was livid.) I know how to do things like giving vaccines, IV fluids, blood draws, and I do my own fecals because no one treats goats, so it was skills I had to learn on my own. Finding someone that understands I have some basic knowledge but not a ton of money has made my life heaven, even if it’s an hour drive away from me. I’m not a pet owner, essentially, I’m the stop gap between the overfull shelters who will constantly put down animals because they’re over full, and finding someone to take this animal I helped off my hands as a permanent home. This last month alone I picked up 6 dogs and 13 cats. I obviously want to help them, but times are tough, and if I can’t do it myself with a little guidance, I can’t afford to do it at all. It’s hard, and very few people will help.
As a patient, I’m not appreciative of pre-rounds, they usually happen an hour after the last time my poor nurse takes my vitals before rounds, between 3-4am 🤣. I’m grateful to y’all regardless of the mild sleep deprivation 😎✊🏽🙏🏽
Oh no :'D hope you're getting better sleep these days ✨
I always wondered what was the thinking behind so many sleep interruptions each time I had a surgery(9 of them so far). I really wish there was the option to recover at a recovery facility if home was not a good place to recover. It would have spead up my healing, in my opinion.
I kind of like when med students come meet me during their pre rounds because I’m what one med student called “medically interesting”, and it gives them time to ask a bunch of specific questions about my rare condition without the time constraints of the medical team.
It's a precious moment of autonomy, when med students can safely develop the social skills required to interact with patients one-on-one.
Patient POV: My daughter has a condition that has led us to be in the hospital way too much. Anyway, when it's about your kid who's sick and you're happy they made it through the night, pre-rounds are something you set your alarm for, you schedule your poops around, you live for those things so the doctor can give you hope for the remainder of the day. Rounds are where you get an idea of where the entire team is at and what the goals for the day are. Pre-rounds usually feel more intimate, Rounds feel more like a couple coaches coming together to come up for a game plan . That's just me though
That's a good POV to have. It's nice to have a more of an informal round and then a formal round. I feel like they would see you more as a human during pre round than an object as well
In nursing school we would spend hours the night before clinicals researching our patient and writing up their med list, nursing goals, etc. Half the time we would get there in the morning and they would be discharged and we had to write up everything on a different patient 😬 don't miss those days at all
@Mel Cat this just seems so silly to me now because the average floor nurse definitely does not have the opportunity to study their patient the night ahead. Even the newgrad ones.
More the so you should also be capable of switching assignments on the fly and receiving report.
Relying on written report forms is also not ideal, in the real world you use up to date EMR when presenting a patient and any foreseeable goals for the day.
Gosh. In nursing school we had to know everything for us to get a good patient history because we need it for case presentation. Because if there are missing clinical info, the clinical instructor would skin us alive. Nope. Not missing that at all.
I remember those days… ugh. One time, I had a patient with pancreatitis and I didn’t read up on it enough the night before. I got chewed up by my instructor :( I just remember being deliriously tired at that point. I was doing my best!!!
God I remember that. I remember how much time it took up to formulate a Nanda care goal and then when I hit the field it was like "there literally isnt time to waste like this"
I will say that when having a loved one in the hospital, pre-rounds gave me comfort that they were being taken care of & that the med team actually cared. I’m sure it’s cumbersome on your side, but thank you so much for doing them.
💞Asi con toy y sus mañas no se la loveme.Uno/uchi
Megan: "Hotter"
Hopi: "Sweeter"
Joonie: "Cooler"
Yoongi: "Butter"
Son unos de los mejores conciertos
, no puede ir pero de tan solo verlos desde pantalla, se que estuvo sorprendente. ...
Yes. Hospitals are a great place to stay if your condition is dangerous, or you need urgent or emergency care. They are a terrible place to stay if you need rest and convalescence.
Exactly
Omg yes! Especially if you share your room with 3 other patients and all of them were diabetic. Seriously, nurses coming and going from our room all day and night. It was terrible. And I had to stay there for 43 days 😭
So true. I was in hospital for two weeks and there was constantly sth going on...
Tragically, rest and convalescence are absolutely critical to recovering from almost any ailment, a point often lost on doctors.
As a chronic illness patient, I don't even question it anymore lol I love talking to the student. I was able to calm a nervous student down once and was so happy!
THIS!! I’m an MA and every time we had a student go to see a patient first it was just take twice as long to get the patient in and out. Of course it’s important for them to get this experience while on clinical rotations, but there’s gotta be a more efficient way of doing things 😩
As someone who isn’t into medicine this seems like a perfectly reasonable thing for med students to do. It’s kinda like reading through a chapter before attending class
Idk if there’s extra stuff that I’m missing but I just recently went to the hospital and it makes zero sense there tbh…
The chapter is a human being that is in pain and healing and you’re disturbing their sleep for information that could easily have waited for rounds …?
I feel this on a spiritual level, especially rounding on surgical wards. I genuinely don't understand how this isn't seen as a barrier to better pt recovery. Ok now your elderly post-op is sleeping until 11 because you woke them at 6, and they're too tired for morning physio which means they might get left until tomorrow. Make it make sense.
The point of pre-rounds is to avoid getting destroyed during the rounds.
Yup!
@Catherine Bills you replied to the wrong person Karen LOLOL. I made no medical statements other than IV’s feel good when you are dehydrated. FROM PERSONAL EXPERIENCE. Get a grip lady
@Impossiblemusic55 you have a lot to learn about medicine
You can still get destroyed during rounds trust me
In my twenties I tried really hard to be a doctor...I couldn't afford a thing, panicked, and dropped out. So this channel, in a very hilarious way, makes me wanna try again...just to meet this guy 🤣🤣
"The bureaucracy is expanding to meet the needs of the growing bureaucracy"
As a parent of a child that is frequently hospitalized, I actually liked the pre-rounds. Those students were very thoughtful and inquisitive and made sure to ask the team any questions I may have. Being surrounded by a whole team would sometimes feel intimidating.
I remember having my appendectomy last year and afterwards being told to get lots of rest to help me recover faster only to be woken up every few hours for the next 4 days.
Oh my gosh the sleep deprivation I went through when I was having surgeries to reconstruct my leg, it was so excruciating. They also wake you around 4am for blood draws.
I was hospitalized for COVID for 15 days, my husband for 2 months before passing away from COVID, and I totally understand this video. You even made me laugh 😂
So basically pre rounds are unnecessary except for when the med student gets to be scolded about something they did or didn't do 🤣
When I was in the hospital recently, the rounds were completely useless from the patient's perspective. The docs would barely talk to the patients about their conditions or let them share about their symptoms or ask questions. So I would have appreciated the pre-rounds because it sounds like an opportunity to actually talk to someone and not just be treated like a piece of furniture.
I loved pre-rounds 🙄 5 yrs living mostly in hospital with my daughter; every 3 hr vitals followed by pre-rounds. I was so deprived of sleep for years; my lucky kid would sleep through all of it. I drew the line at them doing a physical during pre-rounds because that would wake her, and then I’m stuck with a grumpy baby/toddler lol
Someone give this man a trophy. He speaks straight facts!
Asi con toy y sus malas no se la loveme.Uno/PROZEN 💕
Megan: "Hotter"
Hopi: "Sweeter"
Joonie: "Cooler"
Yoongi: "Butter"
Son unos de los mejores conciertos
, no puede ir pero de tan solo verlos desde pantalla, se que estuvo sorprendente .
Asi con toy y sus malas no se la loveme.Uno/PROZEN 💕
Megan: "Hotter"
Hopi: "Sweeter"
Joonie: "Cooler"
Yoongi: "Butter"
Son unos de los mejores conciertos
, no puede ir pero de tan solo verlos desde pantalla, se que estuvo sorprendente .
You missed the best part of pre-rounds -- none of the blood work has come back (or hasn't even been drawn) and last vitals were at 2 am, so absolutely nothing relevant to present to the team other than patient cursed at me for waking them up early. Good times.
Accurate.
That (the patient) was me, granted you managed to wake me up (no easy task). I’m not a morning person so there’s a -1000% chance of me being nice before 8AM. Quadruple that if I’m in pain. Double on top for every digit above 6 and hour from last pain med dose. I would say sorry but I’m not.
That was me!!!! (Not directly me in your case)
They took their last vitals at 11:30pm, gave me the Demerol and it was night night time… then 4am I heard the door jiggling open and I immediately got annoyed
@Abby The Duck Lord I've been given the needle several times to help with difficult sticks. No complaints -- always happy to help expedite, if needed. And I have no issue with the time it takes to do the draws. My criticism is on our medical team for scheduling decision-making rounds (and pre-rounds) before all the information is back. Either do the draws at 5 am (as scheduled) and wait until 10-11am to round, OR, round at 8 am with 'conditional' plans for blood to be drawn at a reasonable hour. My issue is with sequencing the data inputs with insight generation, not with the speed it takes to generate the data.
@Bald Kiwi trending is important but there are so many docs that put in orders in between the trending draws. Ive had patients tell me that they would've never told their nurse/doc about chest pain if they knew how many times it would make them get poked. There's also times where the large amount of blood draws has caused them to go towards the comfort care route instead because they get so sick of everything. Trendings are important but so many doctors don't realize how draining (literally and figuratively) it can be on a patient. When the pt has had 4 normal, non-increasing trop levels in a row, odds are, they don't need to keep getting poked for that unless new chestpain arises or it may just need to be checked once a day with morning labs. There are way to many docs out there that say "I want just a few more."
Reminds me of an old saying. "The light on top of the tower is for planes so that they see it and don't crash. And the point of the tower is to hold up the light."
no joke, i was the most tired i've ever been in my life after spending 4 days at the hospital, which was after they admitted me because my hemaglobin was lower than 5. so basically i was more tired from the hospital stay than from having no blood lol
Lol as someone with severe medical conditions who has spent years in and out of the hospital, the amount of times someone comes in to ask you a question by the time rounds comes around… 🤣
to clear up some confusion, rounds are where your examination skills are evaluated by the attendings. its not about efficiency, it's about education. non education hospitals dont need this, attendings will just go over all 30 patients in like 1 hour.
med students need longer time to examine the patients because :
1. we are performing tests not routinely done by attendings
2. we may have to look up how to perform some tests as we go
3. we are way less experienced, meaning we may be digging up some unnecessary data or letting the patient ramble pointlessly. a good physician knows when and how to cut off the patient
I'm convinced it's all just a tactic to make sure the sick patient gets as little sleep as humanely possible😉 I'm kidding lol but ahhh, I swear it's not possible to get more than 2 hours of sleep uninterrupted while in the hospital. Between the meds, the blood pressure checks, 6am blood draw, 7am shift change, and then the begining of what I call the doctor parade around 8am🤣 I generally come home from lengthy hospital stays and sleep a ton just to catch up(I know, I am there to get better and I totally appreciate all my nurses and doctors lol I'm just teasing)
Watching these medical shorts always informs me of how little actual care I have received during my medical needs. Saying, they’re showing me how things are supposed to be done.
When I was a long term patient at one point in my life, sleep was impossible.
2am blood draw
4am xray
6am vitals
8am breakfast
10am family visit/doctor rounds
1pm lunch
3pm Physical Therapy/misc treatment
4pm Vitals
5pm family visit
6pm dinner
8pm misc treatment
10 pm lights out
And I've had chronic insomnia ever since.
Lmao, this is so true! The patients always hate being awakened at ungodly hours especially after they were already awakened at 2am for vitals. Noone ever really sleeps.
I remember when I went to my dream job for a week (to check out if it was what I wanted) we started work at 6 and then we had to say good morning to all the patients, and we chilled. It was so peaceful.
I can imagine how ER is. Or any other place. Rehabilitation for injuries is better in that place imo
I remember when I spent the night in ICU-like room and the doctor and his minions had a "round." The one on my left side was a burn victim, the one across was in a car accident, while me got a severed artery resulted from a gunshot on the leg. The doctor and his minions did their Q&As in front of the patients but they just completely ignored me when it was my turn. 😅 I was like, "what? My case is not interesting enough?"
The suck part was I also got shot on the left forearm, the bullet actually created a hairline fracture on my radial. The nurse only noticed my forearm injury when she cleaned up the rest of my dried up wound in the morning. I did not feel it since I was still numbed from the post surgery.
If you're here watching This and feeling inspired then keep going grinding away! keep up the good work and Never Give Up!
When I left hospital I was EXHAUSTED, getting home I was able to actually recover & begin to feel better.
Although I did have a nurse come in for 2 hours every day. But she came to me last every day. She could hook up my PICC to IV antibiotics. They take hour n half to run through.
So she did her notes, we watched TV, had chats (I know she was "sneakily" getting more info about my recovery.
It was middle of July & hot as balls. So when the ice-cream truck came outside, my brother (he lurked around our house until my husband got home from work) would head to the ice-cream van and get us all frozen yummies.
But I was so much better rested after I left hospital...
god bless the "pre-rounders"
mom had secondary pulmonary hypertension. i made it a point to be bedside when they came to see her. an M1 took it upon herself to call me every afternoon with any updates. i am sure she and the intern she worked with knew mom inside out and were able to provide detailed info to the team resulting in the excellent care mom received.
I love this. I think that this is some of the best way medical students can add value to the care. Often residents or attendings may be too busy to call family unless absolutely necessary. Medical students also have more time to take a more thorough history and to bond with the patient. When I would pre-round on a call day (when rounds are in the afternoon), I would sometimes spend 45 minutes talking to the patient about their health, habits, motivations, and just life. Also in clinic students would call patients to help remind them/check in about medications including insulin titration/blood sugar logs and check to see how therapy was working. Anyway, rambled just to say that there are important things that medical students can do that are beneficial to the patient. Ultimately medical students are going to be doctors and they need to learn and practice - best way to do that is see real patients - but I can see that you know that. :)
That final line really got me giggling the way he said it 😂
This reminds me about a policy where my dad worked. 2 VPs had to sign a document rather than 1. My dad asked why. The response was, "Because it's policy."
"Why is it policy?"
"Because we get audited on it."
"Why are we audited on it?"
"Because it's policy."
"Why is it policy?"
"Because we get audited on it."
The convo kept going like that until my dad gave up and hunted down another VP and explained the same thing to him with a diagram.
As a person who has spent a great deal of time as a hospital patient, watching all these shorts and tiktoks made by doctors and nurses, I find it so interesting seeing how so many of these hospital practices or as confusing for the staff as they are for the patients.
As a recent patient in the hospital, I was ALWAYS asleep when the med student would come in at 5am. They will wake you up and smile in your face while talking loud as you glare at them. I finally asked one of them to come back after they visited the other patients since I was just plain exhausted. They weren't the only ones that never let me sleep. You don't get any rest while in the hospital.
Say it louder for the people in the back!!! I know when I stayed in a teaching hospital that had this kind of system,we won't even get into the disaster that was that stay and how unorganized everyone was,us patients were waken up throughout the night for vitals,blood draw at somewhere from 1-3 a.m,i.v pole going off or my roommate's,her vitals didn't get done the same time as mine so the lights got turned on by each other's nurses,then pre round comes in between 5-6 then the group came in around 7ish. And again my roommate had a different team then me so this was done twice essentially. But then they get mad and wonder why you're trying to sleep during the day. 🤦♀️😧 all my other stays weren't at a teaching hospital but the other stuff like vitals,blood draws and what not ring true regardless of where ya stay. Along with the why are you sleeping it's not night.
I love this guy! One time my attending asked why I didnt wake up a completely stable getting outpatient workup inpatient patient....lols.
Actually I read a study once where pre-rounds was a concept specifically to help train med students so that way they had good bedside manner there was something else too but I'm struggling to remember lol
I love how doctor's are all "rest and recover" and you're awoken at 12am, 3 am, 5am, etc.
"Yeah doc, rest is NOT happening." 😒
It's a great chance to have all the patients wake up, and use their call lights just before just shift change. It's a wonderful way to lower Nelson Denney scores, because they've been woken up AND neglected by nursing staff who are stressed to the max 😌👍🏾
Pre-rounding is done to gather subjective data from the patient, and objective data from your physical exam, and then for you as a provider to form a plan to present during rounds. Whether that plan is accepted or not by the attending is another matter, but the idea is that the attending will not be spending more than a fraction of the time you as the primary “responding clinician” does with your patients (attendings will be overseeing an order of 2-4x more patients than residents/NPs/PAs/etc.) The practice of multi-hour walking rounds is meant to teach students/residents in teaching hospitals, but IMO is too cumbersome for many specialties. It works well for ICUs, not sure about other types of units where the number of patients is higher. In my experience pre-rounding combined with sit-down rounds (in a conference/meeting room) is much better for patient and staff quality of life. I usually let my patients “sleep” until 8am, but they have usually already been awoken for vital signs and labs at or before 6am, because we want/need those lab values to help formulate that plan we present at rounds.
"So pre-rounding is when you find out what happened overnight?" "Well, actually we hear about overnight events during sign-out." "Signout? what's that?"
If I had a dime for all times I’ve had this exact conversation my student loans would be paid off 😂
As a patient I fully appreciate the awareness that they keep waking me up
I was awake in the middle of the night looking for sleep meditation, and ended up here on this video. So i watched several of your videos. Of course, I love them. Now to find that sleep meditation.
I had a nursing student that came in and asked me questions. She said she was a student and this was required. I did my best to be helpful. She was sweet and being trained to be an awesome nurse. I wish the best for her. 😀
Never was I so annoyed when, in all my post-partem glory, a med student cane in at 6am and started talking at my sleeping body, awakening me in the middle of whatever it was she was saying to me.
Trust me we don’t want to do it either but unfortunately we’re being evaluated and must 😂😂😂
Last time I was in the hospital they started rounds with me and it was super early and I ended up falling back asleep while they were talking to me
Prerounds to me if they're kept to trainees are a great way for some hands on training yes its repetitive but that works when it comes to learn how to read charts and questioning patients
I was in the icu for 5 days 2 years ago, I never slept. Eother the monitor of mine or someone else's was going off, or them taking blood,blood pressure, docs and nurses coming in asking how I'm doing!
Honestly loved it! I loved the attention, and I was so exhausted that I would fall back asleep over and over again.
Every time I’ve experienced this as a patient, the pre-rounder asks me questions to get all my info, then the doctor comes in and asks all the same questions lol
In vet med, pre-rounds are secretly extra-time to cuddle with the new puppy/kitty litter that was delivered overnight. The length of the round is also directly proportionate to the cuteness of the patients. All need to be informed repeatedly they are the goodest of girls/boys.
For my non-med friends, pre-rounds is also a way for med students or interns to learn, talking to the patient and getting additional info like fluids, urine output, pain and discomfort etc, which would take longer during rounds. It's so students gain experience and one-on-one time seeing the patient before the consultant or senior resident, otherwise they won't learn.
Consultants also check the students knowledge about the case during rounds so it's better they are more prepared beforehand. It's more encouraging for me to teach and explain the information to the residents and students if they are aware of the patient's condition. If you don't, then I'm assuming you're not making an effort to know your patient. They appreciate it when the people taking care of them do that.
I’d think the patient would appreciate a full night of sleep much more.
@not disappointed or surprised my understanding is that this only happens in public hospitals here. If you are rich enough to pay for private hospital care, you won't be helping train any new doctors or woken up at ungodly hours. Money is the differenciating factor.
@panic! Short answer: Is that extra 1-2h worth $2,600 to you because that's the average cost per day. Pushing all our 10-40+ patients off an hour would increase your likelihood of that occurring.
Long answer: Hospitals aren't the same type of businesses as hotels. We order labs to trend and assess your stability to leave. We would all rather be with our families or come in later, but our subspecialists are human too and will need to see you. Delays run the risk of having you be at the bottom of the list and unseen? The same goes with other needed treatments/ services.
The point of pre-rounding in the US is to identify emergent interventions and allow for a reasonable plan to be made when you can assess them the same day. It can help you get out the hospital ASAP and minimize your chance of catching an infection from the hospitalization or from getting injured while hospitalized.
Lastly, we have to chart and act on recommendations from consultants to expedite your care. Charting is important because the most dangerous time for patients is during transfers of care, so there is a ton that goes on for every patient. Again, multiply it all by 10-40 times. it isn't practical to push it off when staff already get there at 4-5 AM to review the chart and might be driving home at 10 PM (I've done that many times).
Contrary to how that may sound, we really do want our patients to have a rejuvenating stay and to see them improve and happy.
@they walking up to you and in a poor third would country in Asia. That's it. Don't worry you probably don't live there, you'll be fine.
We have a few karens but generally our countrymen are nice to the people trying to save their lives.
I think i should stop now. Looks like I've said a lot and if some people just don't want to get it, that's the way it is.
NEVER STOP making your content, you are brilliant 😂😂😂
Y'know, it's nice to know why I was woken up so frickin early everyday during my week stay in ICU. I swear I fell back to sleep on multiple days while my nurse was talking. I cannot wake up that early and function enough to give detailed answers 😂
This confirms my theory that alot of people don't realize how close they are to dying when they're in the ICU... :)
This is the absolute most frustrating thing as a patient. They keep telling you how important your rest is yet wake you up every single hour through the night by checking on you then wake you up when it’s still dark outside for rapid fire questions.
when my mom was in the hospital for a surgery and i was there to take care of her. it was very early morning and i barely slept a blink when the med students came to do pre rounds, but when i thought it was over and i can finally sleep in peace, the nurses and doctors came next to do the rounds ☠️ i felt more tired than my mom tbh lol
My friend took me with her to the hospital when she had fluid collecting in her lungs and needed it drained. She had to answer like 15 questions to get processed into a room in the er, then the same questions again before they moved her to a room in the actual hospital. Then another round of the same questions in the hospital room by her nurse, before getting those same questions again from a group of doctors, and one last time from her actual assigned doctor. All before they decided they weren't going to drain her lungs until the next day. It was insane.
I was in hospital for ten days over Christmas and New Year with a broken tibia and fibula. I would fall asleep around midnight, have at least one or two nurse visits during the night, then get woken up about 5am. Sometimes I'd nap in short bursts during the day, but I never understood why patients are woken up during the night. Surely a good block of sleep helps them feel better?
I still remember my experience staying at hospitals for about 2 weeks. I had trouble sleeping cause of my illness and 4am-6am is like the golden time for me..it's the time i was in deep sleep..but the nurse, med student & the sanitary staff kept coming & doing their activities, asked me to wake up, to move around so they can change the bed-sheet, checked on me, took my blood, intvwd me..and it's already 7am when they finally gone..then it's time for quick bath & breakfast. I got pretty annoyed at that time. 😁 I feel like screaming "I need my sleep! Please let me sleep!" But i said nothing cause i don't have any energy. 😂 Once i got out of hospital, i slept through the day to payback my sleep deprive. 😂
This is so funny. I recently spent about 3 weeks in the hospital, kidney issue. I saw the hospitalist maybe a total of 3 times. So about once a week. But they changed my meds every day. We’d finally find a routine that controlled the pain, the very next day, the doctor I hadn’t seen, goes in and changes them. It was INFURIATING, for myself and the nurses.
The whole sleep part.. as a nurse I always say.. you didn’t come to the hospital to rest 😂 the sleep is minimal for patients cause nurses do vitals over night as well
As someone who has been “pre-rounded” on I can tell you that my answers where fairly gibberish
Omg- I remember I was visiting my Dr for a checkup on my medication and she had student with her who came to see me before and it was weird and awkward cause with was like "New person- Not okay" and then I had the Exact same conversation when the Dr came in but this time with my Dr. Idk, I guess it's a good learning experience? The student was really nice and asked me if I was in school and how school was going and was super shocked when I told her I was still in high school after asking me what I was studying for. 😅 I often get the reaction of people thinking I'm much younger or much older so- she legit double checked my paper and was like "Oh, right, you're sixteen I'm sorry!" In her defense I was there for medication for a stress headache disorder so I would also assume myself an overworked college student ¯\_(ツ)_/¯ but nah, I'm just a mentally ill student with a stress disorder an anxiety disorder and a stressful family 😌 Fucking amazing when your body realizes you're not doing well and so makes your head feel like it's being hit with a damned hammer
I'm never going to understand why the medical community seems so hellbent on busy work that takes up valuable time that could be used on sleep or not being at work. The sheer amount of time that they expect you to spend at work horrifies me.
Me, a hospital security officer: "Who called the code gray? (Combative patient)"
Doc: "It was me, he just got combative out of nowhere!"
Me: "Are you sure nothing lead up to this?"
Doc: "Well the nurse woke up him every hour between midnight at 5 AM for meds and he kept telling her to leave him alone so he can sleep but that probably doesn't have anything to do with it".
Me: (attempts to not facepalm in front of the doctor so I don't get fired)
😳😬
I’ve had them come in at like 4 am for my daughter. I get a “Mom, I’m Dr. So and So. Just checking on your daughter and see how things are going.” 😴 I jump up because they scared the shit out of me. Lol
I remember not getting much sleep when I was hospitalized , but only cause they were terrified of the noises the machine would make every time I drifted to sleep 😅
My O2 sat would drop like a rock, and they just wanted to make sure I wasn’t dead or dying. I was fine. Turns out I just have congenital PAH, diagnosed in 2014 👍 thanks docs
As someone who had a heart transplant… Doctors constantly checking in was the bane of my existence. And on top of it UCLA is a learning hospital so add a whole bunch more to whatever is “normal“. I can count on one hand the amount of time I got more than four hours of sleep entire time I was there. I am fairly sure that my recovery would have been drastically improved if I had been able to sleep!
As a caregiver who spent years trying to hold down a full time job (average 60-70 hour weeks) while sleeping on the little hospital couches...yeah that extra hour of sleep would've really helped.
I was a PCA on med/surg neuro for 2 years, and I can confirm that we do not allow patients to sleep at night in the hospital 😂😂
Based on my (unfortunately) extensive experience as an admitted patient, the med student also has to have this conversation w the majority of the patients they’ve woken. Along with, “we really have to do this again?” and, “you and the vampire phlebotomist! Why is it always when I’m asleep?!”
😂 things like this always cracks me up, that's why I love shows like Grey's Anatomy. The medical system is just as dumb as the education system.
if they don't pre-round they'll go up into flames
As patient, I once talked to medstudent during pre-round but forgot to mention certain details. During round, the doctors talked to me and scolded the medstudent for not getting all details. She almost burst into tears. I felt really bad for her and feeling guilty.
I always thought pre rounds is where the med students make their analysis as if they were the doctors and then in the rounds they confirm or deny if they got things right, it's like their practice
"Because we have to pre-round." is the medical community's version of "These amps go to 11."
As a 4th yr medical student, this is so relatable! 😂😂😂
Because what could be worse than letting your patients get a restful night’s sleep :,)
Nah because they make us get morning labs at 4am. So you not only get woken up but you also get stabbed! Sometimes repeatedly! 🙃
I love the contradictory orders i get to deal with - "delirium precautions" and "routine neuro/cms checks every 4 hours" cannot both be followed. That 4am check is gonna be closer to 6 when phlebotomy, the pre-round med student/ortho intern, or the scheduled Tylenol is due.
@Abel Feltes and oh no! Turns out the patient is in fact, still asleep and now they’re gonna be stuck in the hospital for a very long time!
They been laying around all day 😂
The only thing worse is letting them get a restful eternity's sleep!
LOL 😂 I just got out of a two month stay in the hospital and this literally drove me nuts!!! 6am they would wake me.... eventually I put a note on my door saying "NO 6am visits!! Patient sleeping".
I’d love to know the “rounds” routine of advanced countries. 🏥
"Isn't the patient sleeping?"
Me, a patient with bags under my eyes: *like*