overheard in the ED

7 Jun

A resident to his student:

Always ask the nurses what they think, and take their advice. Β They know their patients; they know their shit; ED nurses are never wrong.

11 Responses to “overheard in the ED”

  1. John Bennett MD June 7, 2012 at 11:45 am #

    Yes, that is great advice. The head nurse of most ERs I worked at could easily change uniforms with the doctor, and the ER would not miss a beat.

    That brings up a basic issue of effective doctoring; a smart doctor will learn how to get along with the nurses, and not fight them, but utilize their skills to reach the best outcome.
    Fighting with the nurses is not only stressful, but counterproductive to everyone involved.

    The sooner a doctor realizes that a seasoned ER nurse has probably forgotten more than the ER doctor knows, the better off the doctor will be.


    • annaojesus June 9, 2012 at 11:35 pm #

      JB, thank you so much for commenting! I appreciate the feedback a great deal. My husband was quick to point out that this statement is an exaggeration, as it can be dangerous to think of anyone in an emergency setting as being always right. Still, on a selfish note, I learned a great deal from the nurses on this service, particularly when it came to a general gestalt about patient presentation–completely invaluable!

      Regarding your comment about getting along with nurses, I couldn’t agree more, and I was very happy to see that, for the most part the relationships I saw on surgery and in the ED were both positive and productive–a great deal of mutual respect. (This was no quite the case on some of the services I was on prior.)

      Thank you again, and thanks for checking in!

  2. Toni Lupro June 9, 2012 at 6:37 pm #

    Hey there! πŸ™‚ I was flipping through your blog and read something about you taking your MCAT three times. Have you wrote anything on here about the process/scores/improvement/changing approach? (Or on SDN? I think that’s how I found your blog in the first place, lol.) I’d love some good motivation and tips going into my second attempt here — it’s just seeming so daunting,

    • annaojesus June 9, 2012 at 11:28 pm #

      Hello! Thanks so much for commenting. I haven’t written much about the MCAT because I think the process is, unfortunately, quite flawed and frustrating. I’m not a member of SDN, but I’m quite flattered if the network linked you to my blog πŸ™‚

      I would be happy to discuss MCAT strategies–please let me know if you would prefer specifics. After taking the test three times, I was hired by Kaplan to teach the prep course and tutor privately, so I believe this is a test with which I’m intimately familiar. The biggest piece of advice/motivation I can give–trite as it might be–is that the MCAT is certainly, in part, a psychological exercise. I took the MCAT a third time literally 10 days after receiving the scores back from my second attempt, with very little preparation in between, because I had some wonderful people in my life who were able to convince me that I was prepared already and that tests are imperfect. I went into my third attempt hungry and, frankly, pissed as hell. I think those emotions helped me get over anxiety and fear, and I performed much better as a result even though it didn’t necessarily feel that way during or after the test.

      Another thing to keep in mind is that this test is curved…so if it feels like it’s kicking your butt, it’s a hard test and will be scored appropriately. It’s so easy to fall into the trap of getting defeated halfway through a test because it’s making you feel like shit. I know so many brilliant classmates of mine who took the test more than once, and many of them struggled with this particular aspect.

      And, on that note, keep in mind that I LOT of people take this test more than once. It does not look poorly on your application, and it does not say anything about how prepared you are for med school. Study efficiently (but don’t over-study), do lots of practice questions/tests (I found this more useful than studying the science), take the day off before the test to do something fun (I planned a party for myself for following day and played hookie from work) and, even if you don’t feel 100% confident going into the exam, fake it–the power of suggestion on your test-taking ability is huge! The very best of luck! Kick ass!

      • Toni Lupro June 23, 2012 at 11:56 am #

        Thank you SO much for this encouragement! Honestly! πŸ™‚ I just need to like copy and paste it into a Word Doc or something, lol.

        I have a few questions here so sorry if it’s overwhelming, but seriously any help is appreciated SO much. I know it’s really about practice, practice, practice… So if you wouldn’t mind sharing, what would a typical day of MCAT studying have looked like for you? Between, say, reviewing, taking practice passages (how many? etc.), etc. (Understanding that full-length practice days are different than normal study days.) Oh, and with taking it multiple times, was there a certain company you turned to for full-lengths? I have some TPR left but only one AAMC (which I’ll then probably take toward the end). I find TPR *highly* difficult compared to the AAMC and even my actual exam. Did you retake any full-lengths from a previous time? (Sorry for the SLEW of questions but I guess questions toward someone else who has retaken is a bit more helpful.) Hm, and one final question, I think: People say the MCAT is changing, that some study guides are outdated, etc. (especially in the bio concepts currently being tested). Beyond the MCAT prep material, is there anything you would suggest reviewing to prepare for this discrepancy?

        I love reading your blog and others like it — totally inspires me when I’m feeling down about studying to keep working toward that end goal, :).

      • annaojesus July 1, 2012 at 2:00 pm #

        Hi Toni!

        Sorry for the delay–been light on posting and keeping up with, well, everything while on vacation πŸ™‚

        Not overwhelming in the least, ask away!

        Typical MCAT study day: my MCAT instructor once said something about 3 hours being the maximum amount of time someone could really study efficiently. So, with the the exception of practice tests (which I think take a little longer), I would plan for no more than 3 hours–especially for something like the MCAT, which includes some not exactly exciting material. I was working when studying for the MCAT, so it worked out nicely for me to just stay in the office after a break (like a quick run or something), where it was quiet with few distractions. Let me know if I’m wrong, but it seems like you’re probably already past going through a study guide as a first pass? Probably the TPR? If so, I would try to focus on the places where you’re weak and structure your study time accordingly. For me, verbal (ironic, given that I have an MA in English πŸ™‚ ) and anything having to do with electrochemistry were my downfalls. I would spend half my time working on those (reviewing material in the books, doing questions in those topics). For verbal, I strongly recommend ExamKrackers 101 passages. I would give myself 8 minutes to complete a passage and questions, grade them without looking at the explanation, and then I would try to figure out on my own why my wrong answers were wrong and understand why the correct answer was such–totally time-consuming and exhaustive, but it helped me a great deal. Then I would spend the rest of my time with practice passages in all areas to keep things fresh and improve my test-taking ability. (And it’s always nice to end a study day on a passage that you do well on…builds confidence, which is important, and I still do that when studying my shelf exams). Does that answer the question? Happy to clarify anytime!

        Practice Tests: Personally, I don’t have experience with TPR, but I have friends who loved it and were successful. I enjoyed Kaplan and, similarly to your impression of TPR, I found their passages/practice tests more challenging than AAMC and, as a result, I felt like they better prepared me for the actual MCAT. I never quite figured out (or paid attention to) the precise differences between the tests, but I think that the passages in Kaplan were longer (or they felt longer), and I struggled for time more, which in the end helped me gain speed (this might not be a concern for you, but it definitely was for me). I did revisit a few AAMC tests that I had not done for several months; it was helpful more in the sense of getting a better idea of the questions I kept getting wrong.

        Outdated material: that’s an excellent question, and I’m afraid I have no idea. I took the test for the last time in March of 2009, so I’m not sure if the AAMC practice tests have changed since then, but even then people were saying they were outdated. Kaplan and TPR should both have current material though, so I wouldn’t worry about going further than one of those two companies.

        I can’t tell you enough how flattered I am that you like my blog! It’s been a wonderful way for me to appreciate my time in school. I promise, looking back on things, it truly does get better every step of the way. This past year was better than last year which was worlds beyond premed and MCAT prep (though I have a sinking feeling studying for Step 1 might give MCAT studying a run for its money πŸ™‚ ). I hope my comments were slightly more helpful than monotonous. Best of luck!!!

  3. Toni Lupro July 7, 2012 at 9:59 pm #

    Thank you so much for all your help above! πŸ˜€ MUCH appreciated!

    • annaojesus July 7, 2012 at 10:27 pm #

      my pleasure! i hope it was a little helpful and not just stress-inducing :/ i wish you the best of luck! i think you’ll feel better about the second time.

  4. Roddie 808 August 5, 2012 at 8:57 am #

    Hi anna

    • Roddie 808 August 5, 2012 at 9:06 am #

      Sorry about that… here’s my real comment:

      Before I started studying for the MCAT, I thought I could have kept my emotions all bottled up, but man was I wrong. These past few months have been tough, and after coming across your blog after another restless night worrying about the exam, it was refreshing and encouraging to read your comments; to read the challenges you’ve gone through, and the rewards you’ve reaped. Your words have brought me back to the realization that if I need to retake it, it’ll be just fine.

      Mahalo (thanks)

      • annaojesus August 5, 2012 at 9:45 am #

        Hi Robbie,

        Thank you so much for your comment–I’m really touched that you found my blog encouraging!

        I was just talking with a close friend about how tough post-bac and the MCAT were for me. It’s funny, because it’s not like med school is less stressful, but it’s such a different kind of stress. There’s a stronger support system, and you really feel like you’re working toward something, which was not an experience I had while studying for the MCAT–it just felt daunting and irrelevant.

        I wish you the very best of the luck on the MCAT. Go in with your game face on and crush it! But it’s okay to realize that it is just one test and, in my opinion, only really reflective of how you happy to perform on a given day. I hope you’re satisfied with your results the first time, but if you’re not, absolutely retake it. Med schools are designed for passionate people who are willing to work through challenges to get what they want.

        Good luck, and thank you again! And I hope you’re able to get some sleep πŸ™‚

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