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Tuesday, March 25th 2008

When To Leave The Hospital

I’m on a surgical rotation right now with one other medical student and, on this particular day, only one operating room for the service. It’s near Spring Break, so many faculty have taken some time off, and so the service only had two cases scheduled for the day. Anyone who knows the speed at which public hospitals move knows that doesn’t guarantee a quick and easy day.

In anycase, the other medical student had scrubbed into the early case. That one finished up around 4 in the afternoon. Well, it turns out that a bunch of scrub techs and circulators called in sick and there isn’t enough hospital staff for our next case to go right away and they can’t tell us when the case will be able to go.

Now, my service has two interns, a junior resident and a fellow. I’m hanging out with the junior resident, helping to put in a chest tube. He tells me I should probably stick around and scrub into the next case and then he lets the other medical student go. An hour passes and I’m literally just twiddling my thumbs, admittedly just slightly annoyed I’m still up at the hospital.

My resident is a good guy, don’t get me wrong. But he’s made it clear I should stick around and I’m not thrilled about it. I’m hanging out at the hospital despite the case being indefinitely delayed and despite the fact I have my NBME shelf exam in a week and I could be studying. The patient isn’t even in the holding area and although the OR is clean, even if the patient was sent for right now it’ll be at least an hour before they make an incision. Add at least two hours for the operation (it ended up taking longer from what I understand), and I’m probably looking at getting out of the hospital at 8:00 or 9:00 at night. Not totally unexpected as a medical student, but to just be sitting around waiting and the fact my exam is so near makes the experience a little miserable.

I go down to see if the patient is in pre-op holding and I run into my fellow, who will be doing the operation. He wants to know what I’m still doing at the hospital and tells me to scram. I obviously jump at the chance.

It isn’t like I went looking for the privilege to leave. The fellow, the man both I and my resident answer to, told me to leave without me even mentioning it. But clearly my resident thought it was my responsibility, as part of my surgical education, to stick around and scrub into this last surgery. My fellow is in charge of the service, the one the residents and I answer to but it still seemed a little sketchy to just bolt without even going and finding my resident.

Not sketchy enough that I didn’t get to my car and home as quick as I could. And as far as I can tell the next day my resident didn’t care; but getting conflicting instructions from two of your superiors on any service makes things a little bit awkward.

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