Unwritten Rules of the Hospital - Part 1

[@MCHammer211]

Unwritten rule for ALL staff: never speak poorly of your colleague or another department/specialty in front of the patient. Always promote trust and teamwork within the medical team to patients and families!!!

[@LunarStarFox]

Also don’t bash on night shift and or day shift staff!

[@annacarter6559]

Being obviously lied to destroys all trust. Patients are not complete idiots

[@cd2290]

Needs to be a rule in schools too

[@sarahseifred84]

Just don’t speak poorly of them anyways. If you have got nothing good to day then don’t say anything

[@davidyoung3237]

That recommendation also fits with any other public facing possition regardless of industry symply as is unprofessional and disrespectful and paints you in a poor light regardless of weather you know for sure so and so caused x,y and z don't tell the member of the public that keep it behind closed doors. If the member of the public has a problem regardless of weather "you caused it own the problem and see that it gets fixed either on your own or with help from someone else deal with the who and why it happened after you've fixed the problem. This advice works well in hospitality which is my area of training.

[@TahirDahrouj]

All of these rules are unwritten because no one can find their pens

[@elisarose5159]

Comment winner

[@fevre_dream8542]

Can confirm, all my nice pens are always gone within days :{

[@billied17]

🤣

[@emtweire1]

I’m a terrible pen thief! I can’t help it, I swear. I at least warn my co-workers of my “reappropriaton of supplies.” 😊

[@savannahhaughton22]

😂😂😂

[@jessicacaldwell9275]

House keeper here. I prevented so many falls. Caught medical signs. Found people on the floor. And house keepers talk to the patients a lot more than you may think. I do clean up after staff more that patients most times

[@carolschedler3832]

You are so right Jessica! As a patient, I have seen exactly the things you are talking about. ❤️❤️❤️Housekeeping ❤️❤️❤️

[@jenncoers9823]

Housekeepers know alot, they are the eyes and ears of the WHOLE hospital, they go everywhere and see and know things

[@auzharai4103]

Yes house keeper here as well! I clean up after doctors and they are hella messy in the lounge and I wish they would respect me more but picking up after themselves

[@sunraes]

Just this last week, a housekeeper has notified of a patient fall while he was cleaning the room, extra set of eyes are always important esp in the howpital. Thank you for all the work you do 👏

[@zeldaron1]

Absolutely always respect every staff member that makes the team in a Hospital - the cleaners, techs, transport, as an RN I have good relationships with all from low to high and that gains respect both ways. I always thank everyone who helps me do my job daily

[@KR-ev9mp]

Thank you for saying that nurse's assistants are worth their weight in gold, cause we are, and no one seems to appreciate how hard we work

[@umpbumpfiz]

Patient's family member here: We can't give you a raise or days off (I wish we could!) but we love you!

[@hannahlillis236]

As a nurse, I constantly bring up how CNA’s should be paid more. It a TOUGH job and you guys make all the difference in how a patients stay goes. We rely on you for so much and the pay should better reflect that!

[@kati1017]

@@hannahlillis236 I so agree!

[@JennyT101]

My dad was is the hospital for three weeks last year and the nurses assistants were the best! I can't convey how much we appreciated them!

[@sana-cm7oc]

Some of us do appreciate you - every day. Because your service is an act of love with which we entrust to you for the care of our friends and family. :)

[@noreaction1]

Don’t be embarrassed to ask about something. A little humility goes a long way

[@DrCellini]

100%

[@Inkling777]

Quite right. Years ago I found myself working nights on a pediatric Hem-Onc unit with no orientation and sever very fragile children to care for. I made a strict rule. I only did what I knew was the right thing to do for a specific situation. If anything was different, I asked. For weeks thereafter, I asked a lot of questions. Two months after I started and under unusual circumstances I ran the unit on my own for two hours. I certainly did not know everything, but I'd learned the proper response to anything that might come up. Ask and learn. You will be glad you did.

[@umamahgull5876]

Sometimes doctors get annoyed when you ask alot , ifseems like they are in hurry and dont want to teach you 😒

[@monicaa57]

@@umamahgull5876 Too bad. It's their job.

[@martinkass4551]

Stay quiet and they will wonder about you . Speak up and you will remove any doubt

[@ProPanthers]

Unwritten rule: NEVER say it’s been slow, quiet, or not busy!!

[@ericdoerfler9799]

yeah I was surprised that didn't come up

[@khaleesiamde6215]

...you just said the Q word....

[@jaxmd35]

I saw calm now 😂

[@brasschick4214]

I may mention ‘civilised’ at times.

[@saphiriathebluedragonknight375]

I learned that just being a hostess at my local restaurant. I was scared to even think it.

[@emmar4786]

Thank you for bringing up Nurse Assistants (CNA's)! I am a CNA in an orthopedic unit, and sometimes I feel invisible to other team members. CNA's can use all the help we can get!

[@DrCellini]

Of course! Have to give credit where credit is due!

[@JeanneJ01]

If you would like to see a RN throw a fit try not staffing their unit with a CNA. I have even offered an extra RN which was turned down.

[@jvrock7]

Love CNAs. There was one I had in recovery after the birth of my first kiddo who was also one of my CNAs early in that pregnancy when I had to be in the hospital for a week and she remembered me and said I looked so much better and I thought that was so sweet! And was also kinda surprised because yah know they see hundreds if not thousands of patients in the span of 8 months. then again I suppose it might be hard to forget a pregnant patient who was emaciated from 3 weeks of literal starving lol.

[@cinimatics]

Good aides are the difference between a good shift and a terrible shift. They don't get paid enough for all the work they do.

[@wdeemarwdeemar8739]

I was a SNF administrator and also was an ICU nurse. CNAs are literally gifts from Heaven.

[@thailand177]

Unwritten rule: Bring your own pen. Its your most valuable resource.

[@Ginge94]

Also make sure its not a fancy expensive pen.... From personal experience 🤣

[@chiravuris]

I always bring my pen and extra pens in case the first one doesn't work. But I'm also a germphobe and don't like to give it to patients to sign forms and put it back in my pocket.

[@monykalynf3604]

LOL I always had a supply of cheap pens-the doc's would ask to "borrow" my GOOD pen-and I'd hand them the cheap one-learned the hard way the good pens never get given back to you!

[@chiravuris]

@@monykalynf3604 That's not nice. Even when I borrow a cheap pen from the stack that's on nurse's station, I always return it. But yeah, people never bother to return my pen either.

[@Ginge94]

Yeah, when I was working in the wards, I brought like a pack of 50 $10NZD for patients to use. But my good pen had a specific spot and also had a $2 pen that if a nurse needs a pen, I will let her/ him that.

[@cobaltgnome23]

Please respect laboratory workers as well! We are not "just techs", we are board-certified health professionals that play an integral role in patient care

[@CABOOSEBOB]

Pathgang pathgang

[@Phlorochyll]

The lab workers are the ones that tell you whether you'll be on the line with insurance for hours or not after a tumor biopsy!

[@marytrujillo8433]

Amen!! Blood banker here....

When examining a patient before a group of medical students/interns, greet the patient and present him/her to the students by name. Otherwise, the patient feels like a zoo attraction.

[@georgealderson4424]

...and include the patient in the conversation! I am the person who provides specimens, I am NOT the specimen!

[@LuckyNumber7Official]

Rule: If you didn't chart it, IT DIDNT HAPPEN Unwritten Rule of night shift: If you finish the coffee, brew another pot Unwritten Rule: Never promise a patient a second pillow

[@ananke0156]

Never promise a patient anything, you don’t know what’s gonna happen

[@GriffSquared]

We can't promise a patient one pillow where I'm at! 😂

[@patriciairwin9491]

I feel bad now. I hope I didn't get the nurse who did my IV and lactated ringers into trouble. They came to get me for xrays and I removed the ringer from my iv myself. when the nurse who did it came back in to give me the release papers and remove the IV he gave me such a dirty look. :\ Sorry dude, if you're out there reading this. Just didn't want to bother you.

[@__Smitty__]

@@patriciairwin9491 Why would the nurse get in trouble? You (the patient) removed it yourself?? The nurse would have just documented that you removed it yourself, hence removing any liability from themselves.

[@patriciairwin9491]

@@__Smitty__ , That's good then. I was worried. Don't want anyone getting strikes or losing their jobs because I am too lazy to wait around.Thank you!

[@mamadelosgatos26]

Possible unpopular opinion on 'patients come first'-- Absolutely yes, patients come first, however, manage your priorities. I've worked too many shifts myself where I haven't gotten to eat or take any sort of break, or where I've stayed late at work and it's been a detriment to me more than a help to my patient. Obviously, critical care comes first before anything, but nonurgent or routine things can and should be worked into caring for yourself also (eating or taking a 10-15 minute breather). You cannot fill a cup from one that's empty, and you'll provide your patients better care when your needs are also met. I read a quote that I remembered when thinking about this topic- Some people wear their burnout, hard-core work ethic, etc., like a badge of honor, but at the end of the day, admin can replace you. Don't sacrifice your own care or time with your family constantly for the sake of work ethic alone.

[@venronux]

Absolutely right

[@toluoladele873]

Not at all unpopular. I came to the comment section to say the same thing. Too often in healthcare/medicine we gravitate towards sacrificing our well-being for that of the patient. But ultimately, you are replaceable. So while it is important to do your best for your patients, it is absolutely okay for you, your family and your commitments to come first sometimes.

[@bridie4583]

One of the biggest and hardest lessons I’ve had to learn during my undergraduate is that ‘the hospital provides care 24/7, you can handover’. Delegation and safely handing over the few things that are still outstanding, means I get to switch off after my shift and walk away to enjoy my personal life.

[@willemmeyer4596]

I absolutely agree. I was married to a doctor and this idea was one of the reasons that we are not married any more. From day one there was a third party in our relationship named the medical profession!

[@mamadelosgatos26]

@@niferanne53 I feel like my statement applies to all clinical healthcare workers. Nurses, CNAs, RTs, Radiology, you name it. Burnout what were all trying to avoid, and definitely "teamwork makes the dream work". I know RNs often don't get lunches, or even time to pee, but neither do lots of other clinical HCWs, but that doesn't mean that they shouldn't, or that it's expected of them to not eat or take breaks during shift.

[@daneickmeier6487]

I am a physician as well (18th year of practice, mostly as a rural GP but also time as a focused practice ER physician and hospitalist in Medium sized community hospitals). Things like respecting nurses and other staff are spot on but some of your other ideas like never handing over to the next team always staying late are inherently destructive and lay the foundations for the epidemic of physician burnout we are now facing. Trust me, I have usually been the guy staying late, giving up holidays and basically tossing myself on the sacrificial altar. I have had to work through at least two major episodes of burnout to this culture and the one I’m working through now has cost me essentially three years of life that I will never get back (I’ve worked through my burnout but that has harmed my health further and made me miss so many critical moments in my life including my mothers death during the pandemic). We have to change these “rules” now if we are to have a sustainable health care team in the future. So good work but it needs some tweaking to really be of value.

[@MagicMedicine204]

Absolutely agree. Healthcare is 24/7. With the understanding that time management is critical and don't be the person that always puts things off and leaves things that should have been done hours ago for the next shift.

[@TheRealityfades]

Hospital doctors are currently capped at 80 hours a week and as a patient, I do not want a sleep deprived doctor. 80 hours is better then what it was, but it should be less! No wonder you guys are burned out.

[@Those_Weirdos]

My read on 'never handing over' was more 'never put off stuff you don't want to do, and don't burden the next shift if you don't have to'. It wasn't "never hand over work", it was "don't hand over work just because you didn't want to do it".

[@katthegypsy7340]

I absolutely agree. This is a very toxic work culture that feeds into both feelings of invulnerability and burnout simultaneously. Absolutely agree that you should do what you can to manage your time and complete what needs to be done. But you have to care for yourself and set boundaries around workload.

[@obicat]

agree...care of patient is 24 hr. job..what you can't get done can be finished by next shift

[@lindarhodes7453]

For med admin: if the doctor's writing is illegible on a script always confirm the medication and dose don't assume or guess-ask for clarification. Your patient's life depends on it.

[@sams.1970]

Also, don't assume the med route or oral formula. If you're 99.99% sure the med only comes in an oral tablet, but the order doesn't give a route, call the prescriber or even the pharmacy to clarify.

[@mscurrie914]

Thank god for EMR

[@hckynrscnd8916]

As a nurse, it makes such a difference when doctors respect you and it’s great when it goes both ways. Also love when docs teach you something new or explain why they want a certain prescription from what they may have suggested as that reasoning sticks with you. This may be more for us younger novice nurses but I can’t see docs advise, if given respectfully, ever not being wanted

[@biancatownsend4688]

As a nursing student, it makes a big difference when the doctors speak to you and include you in the planning when speaking with the nurses. I just completed 5 weeks in an ICU department for my last clinical placement and the doctors included me like I was part of the team. It did wonders for my self-confidence and they actually listened when I gave them information about the patient.

[@livylu6287]

My OB used to stay behind after births to help the nurses and custodian clean up. She got mad respect from me for that.

[@sana-cm7oc]

I've seen surgical attendings help clean up particularly trashed rooms - massive respect earned.

[@YeshuaKingMessiah]

RNs clean up? I’ve never seen nor heard of this I’ve only seen them call in the techs/cnas & janitors It’s y hospital care takes forever. U have to wait for every individual thing to be called out n the person come. No one will DO anything.

[@Sit2090]

One example that really chokes me up inside is when my mother was first diagnosed with cancer, the doctor that found it knew me because I worked with him several times. He blatantly told me that he was going to get the best care for my mother because since we work together we are family and we take care of one another. He then put my mother at the top of his list for referrals to the best doctors in town. I never once asked for special treatment. Tbh, I didn’t even think he knew me because I kept quiet in his cases. When I found out he did that, I was overwhelmed with gratitude. He will forever hold a special place in my heart for taking such amazing care of my mom. Because of his fast response, my mother is alive today and cancer free. ❤️

[@jennyhughes4474]

This is what I thought happens: different levels of care/service depending on who you are & who you know = nice to be the lucky recipient but most of us don't; care MUST be based on need not being a medic or knowing one, PLEASE!

[@sandraarnold7528]

I wished I had known somebody - my mum isn’t here after her cancer diagnosis, the hospital in her region is very busy (too much country coverage) and I’m sure they did their best - but she fell between the cracks, even though she worked full time for 45 years in the very same hospital laundry ………..

[@jennyhughes4474]

​@@sandraarnold7528 I'm SO sorry. I expect very few medics know the people who wotk in the laundry (& cleaners & other 'invisible' & low-paid people = mainly women, STILL?) so IF they look after their 'own' maybe that only means medics & people they know who aren't? Obviously care should always be based on need, the NHS promises this but it isn't true - including for those of us seriously injured by NHS medics. Al the best to you.

[@Zyamaman]

That's proper hospital etiquette, in my opinion - you take care of your own. Because no one else will. And it doesn't matter if it's one of the doctors, or the cleaning lady's grandson - personnel get preferential treatment, that's just how it is.

[@cameronmalchow1837]

@@Zyamaman that's unethical.

[@brendielahooha]

Unwritten rule: Do not lose sight of your pen in the hospital.

[@Branman345]

Sooooo true I’ve lost my pen or someone has stolen my pen and when I need it I don’t have it. Drives me nuts 😝

[@olivias4895]

Ugh, this. I was sitting/watching a patient with my paperwork and pen on the desk behind me. People passed by all the time so I didn't worry, and it was on top of the paperwork that was clearly mine and someone stole my pen! Then like an hour later I see them walking by with my pen! I was pissed haha

[@fernandathompson4183]

Amen!

[@keltaruusutravels4024]

I'm super good at stealing pens. It will be in my hand for an hour before realizing I'm holding it. Where it came from? I must think hard the last time I wrote something. I started keeping a cup at home to put the pens then bring a boat load of them back to work. Guard your pens. 🤣

[@karataych0p]

I keep the junk pens in my front pocket to lend to ppl who ask. And I keep the good pens in my back pocket for myself.

[@meghan2175]

Along with all other staff, don’t forget your respiratory therapists! No one ever talks about us. We get low blows, because people don’t think we are important. But when it comes to that ventilator or that high flow, we are the experts and are here to help you!

[@dexterlockhart425]

I never forgot our RT’s work Respiratory ward for 30 yrs. Would call RT then the resident Finished work on the COVID unit barley seen Dr’s but RT never left the ward.( too busy) RT’s never got the recognition they deserved during the worst of the pandemic,take my hat off to you all.

[@redsummergarden2600]

It's true, RTs don't get a fraction of the respect they deserve. Most people never even hear of them until they meet one. One the other, I don't see them putting themselves out and promoting their profession. Why is that? Why don't you run public service ads and push for more visibility in the media? Nurses have done that for years. Basically, it's the profession's responsibility.

[@nancywelch6161]

I really appreciated your number 1 rule - respecting the nurses, CNAs and custodial staff. I've been a nurse for almost 40 years and teach nursing now, so I know how important teamwork is. We're all here to provide stellar patient care, right?! Thanks for all you do!

[@keithwolstenholme4238]

I was going in for surgery and I heard a surgeon for another patient berate the staff because the operating room wasn’t completely ready for him yet. I felt embarrassed for the staff and thought “what a jerk”. Never yell at staff.

[@Eckh4rt]

Depends on the context. Sometimes the squad needs a kick between the legs to keep them in line. Not as a power thing, but for safety for the patient and staff as well. Surgery is very meticulous and the dr wants everything to go smoothly so the patient can go back home healthy.

[@maryann9400]

And you really think that screaming at people makes them work faster? Sometimes the circumstances of the previous users slows things down. Do you really want them to cut safety corners to speed things up? Should they cut cleaning time? Or maybe skip autoclaving time?

[@jessicakosak4138]

As an RN I can’t say I have ever messed with an MD paging them! 😂 The better the MD can anticipate the patient’s needs and have orders in place to cover those, the less you will get paged. We can only function within our orders.👍

[@mayavril1]

I think ref paging, in my hospital you just have to do it to cover yourself. Try and be the nice guy to save disturbing an intern and you might find yourself in front of a court defending your licence

[@Inkling777]

Working nights, I never 'messed with' our residents by calling them unnecessarily, but at times I wondered-given that I could hassle and even wake them at any time-who was really in charge. When orders are issued, you can spare residents a later interruption by getting them to make their orders more specific. "What constitutes a problem? At what point do you want to be called?" And make sure that goes in the patient's notes.

[@pjsmith4369]

@@Inkling777 At thé teaching Hospital where I trained and worked, on nights, we nurses on the ward would NEVER call a Doctor( intern, resident or patient’s family dr. ) ourselves. We called the night nursing supervisor for our ward who was aware of everything going on. Sometimes she/he would first come herself, but most often, would call the doctor for us.

[@jr6040]

Another RN here...never intentionally “mess with” a doc. Have never witnessed another RN doing this. Sometimes things that seem insignificant are found out later on, and nightshift will try to get it taken care of/clarified before dayshift if we can. 🤷🏻‍♀️

[@PainRack]

I never messed with an MD by unneccesary calls. We just mess things up by not anticipating and correcting you. Like the time the surgeons refused to listen to us, nurses in a gen med ward that the patient wasn't from a nursing home but a homeless shelter.

[@gwenking7700]

This is true of anything. When I graduated nursing school as a fresh faced RN I learned more from my LVNs than anyone else. They taught me more than nursing school ever could. Much respect for every LVN. On the flip side I worked with BSNs and Masters RNs that didn't know their azz from a hole in the ground and constantly left things undone for me to finish. It was very frustrating.

[@tracy1394]

Me too

[@chiravuris]

Also, if a patient wants a glass of water, bring it yourself. It doesn't have to be a nurse's job. You'll be more likeable to both your patient and the nurse.

[@Inkling777]

And keep in mind that you're not even saving time. You can bring a patient that glass faster than you can find a nurse to do it. Don't be so obsessed with the 'who does what' pecking order.

[@alexandraruoff3775]

No! This is a nurses assistant‘s job. I have other things to do. And if I don’t go and get my things done now cause I fretch a glass of water for everyone who might ask for it I will have to stay an hour longer that day to get my doctors work done (that on nurse will do for me…)

[@chiravuris]

@@alexandraruoff3775 It also takes the same amount of time to find a nurse or nurse asst. Little gestures like that means not being paged for silly things throughout the night. Also, I work as a nocturnist and there's not enough staff at night. But do whatever works for you.

[@ItsAsparageese]

@@alexandraruoff3775 Nobody's saying to do it every time or when you have other pressing urgent priorities. Everyone who's worked in clinical environments gets that there's not always time for quick easy things. But it is a quick easy thing that, when you can do it, makes a really big difference in your patient and staff relationships relative to the time invested. And improved patient relationships lead to better trust in clinicians, which leads to better compliance, which leads to better outcomes. When you can get a water, just get the water. And it's a good opportunity to chug a quick cupful yourself while you do it. :P

[@XxKristixX92]

Ya but what if they’re NPO or on fluid restrictions. You should ask the nurse

[@lindagerman1782]

Lab technicians are the unsung heros in the medical world. We are usually in a hidden area of the hospital..like lab rats. The treatment of a patients begin and end with the lab!

[@CoachBeckyTaylor]

Thank you for saying that! Without the lab, the Dr’s are only guessing! ;)

[@maryb8150]

And doctors, don’t leave a hard blood draw for the techs. I was a lab tech and worked part time as a phlebotomist. Had a doctor that wanted blood cultures on a 3 week old. At that age, blood should be drawn fro the umbilicus, if it’s still viable, or a scalp vein, both of which have to be done by a doctor. The doc wouldn’t draw the blood. I had to use a 26 gauge needle on a 1cc syringe and just barely got enough for the cultures. Yes, I was cussing to myself the whole time.

[@elkevermeulen7343]

Oh yeah, we're literally out in a shed behind the hospital. Anyway, we're happy to help when people ask us questions about tests, it's easier to have a friendly conversation over the phone than us having to call you because it was the wrong specimen types, and then people get all annoyed and stuff like that

[@michaelkeith8992]

Amen!

[@marytrujillo8433]

Agreed 💯! 40 year lab ratt here....

[@cherylcarlson3315]

You just made an old nurse very happy. We never paged just to mess with someone, it was to reinforce the lesson to cover all basic orders: diet, activity, labs, routine meds, pain meds, preps for procedure and to double check them. Admitting orders have to address why the pt is there. If sr has told you, nurse has gone over orders with you twice and you still fail to get orders written that cover all the bases, you will die a death of many pages. If a nurse calls 911 repeatedly over an hour, don't be surprised if she gets the orders from the head of dept even at 2030 on a weekend. If you do any sharps, the only place your hand can leave it is the needle box. If you are asked to help move a pt, use this time to do more indepth assessment of pt, guarantee that nurse is. Buy your pens in bulk and always carry 3, hospitals do not provide pens, stethoscopes, food to nurses and female nurses of reproductive age have hormone swings that may endanger you if you make a bad night worse by shopping at the nursemart. No matter how busy you are, brush your teeth and change your scrub top every 4-6 hrs, tending to your pits, COD should never be stank of medical staff.

[@vaniawoot5421]

So glad you mentioned the custodial staff. They’re so important but also never mentioned

[@martinkass4551]

They also see everything and talk about it wherever they go

[@kati1017]

They are extremely important esp. in these COVID, MRSA and c.diff times!

[@PainRack]

I love the fact that my nursing manager/clinician knows the custodial staff and their background, health issues and etc. It assures me that they care for me too.

[@Y2ser-]

Don’t order food without telling your friends in the hospital

[@uikonimi]

Unwritten rule for life: don't disrespect the people who make your food.

[@lovelydespair20]

@Marissa Lynne perhaps he meant the kitchen staff at the hospital cafeteria.

[@harrietcarpenter2387]

@Marissa Lynne that's very true of anyone dealing with ur food. That doesn't take much brains to figure that out. Don't be so stupid.

[@Mryeo5354]

@Marissa Lynne nah more like you need them to survive, so be nice

[@mscurrie914]

Don't eat processed food or anything I don't make myself

[@NancyB35]

One thing I would add is, LISTEN to your patients & dont act like u know everything!!! Example: I had a bad reaction to a tetanus booster & had to go to the ER. The PA walked in, asked about my immune suppressor medication, what it was used for & how it works! -- I had so much respect for that PA for wanting to LEARN from me as the patient ❤️

[@kateysandon]

That’s awesome!!! I can’t stand it when you get a doctor who doesn’t care or even want to listen to you. When you find a PA or a doc who really listens to you and wants to learn about your medication that’s awesome.

[@NancyB35]

@@kateysandon Totally agree!

[@brendielahooha]

Thats cool. But maybe who doesnt ask already knows what that medication is, or the answer is something that wont change your treatment. After all, emergency consults must be quick and direct. Not like a family doctor!

[@NancyB35]

@@brendielahooha Every medication & treatment is different for each individual patient 💯 Thats what doctors are missing these days. Listening to the patient.

[@Veronica-ew8yc]

So true i have meet dochtors that have Believe the now enything ther ego

[@drparisis]

Unwritten rule: always go and SEE the patient!

[@brendielahooha]

Im pretty sure thats written

[@AubsAndreya]

Yes! If someone tells you I don’t like how this patient looks… GO!

[@kokocrazy2590]

Checked out your channel great videos!

[@drparisis]

@@kokocrazy2590 thank you!! That means a lot

[@nicoled1013]

Omg yes!!

[@LJStability]

I think the "practice what you preach" is the most important rule. I finished my family medicine rotation and noticed a lot of unprofessional behavior from the residents and attendings. Granted, they were having a hard time at the hospital. But as a medical student, there's nothing that will dissuade you from going to a specialty than seeing unprofessional behavior. My biggest pet peeve is not to make fun of or complain about patients behind their back. It sends a message to your colleagues that you probably do the same to them when you leave the building. In all honesty, the most professional physicians or residents I meet encourage me to overlook the frustrations and keep a good attitude. It's why I try to do that everyday as a medical student to embody that attitude rather than act like a child.

[@hedayaal3395]

1.Respect nurses and all your team 2.Load the boat 3.Your patient comes first 4.Don't leave anything to the next shift 5.Always protecf yourself especially if you are a jonior 6.Clean up after yourself just like your mother told you 7.Help out your colleages 8.be presentable for your patients 9.treat your patients like family 10.practice what you preach 11.always be on time...be early also 12.

[@embr4065]

Unwritten rule: really THINK about why you are ordering that radiology scan. Don't order stupid stuff. READ THE PT CHART before ordering so the poor ultrasound tech called in at 2am doesn't get there and find out they had the same exact scan 48 hours prior and you didn't read the chart before ordering another one!! :)

[@XxKristixX92]

Unwritten rule: NEVER say “wow it’s quiet” or “it’s been slow today” ‼️

[@bunnyearz8069]

Omg, I came here for this comment!!

[@drparisis]

Especially in the ED!

[@valerieannrumpf4151]

As a patient who has a physical disability, please take the time to listen to us describe our symptoms that we're having because if you dont, you could miss something important.

[@miketj2516]

Also, listen when people with disabilities are telling you how to care for them. They know what works and what doesn't work for them in terms of mobility, where/how to support them during transfers, etc.

[@sharidavenport5283]

@@miketj2516 - YES!! Thank you! I swear, I wanted to slap a doc on rounds once a few years ago, when I was in the hospital on the Cardiac Step Down unit to be monitored ×3 days for a new heart medication trial for treating my AFib. I am also severely disabled, with very little tolerance to physical activity. I walk very slowly with a severe limp, a cane for very short distances, like in my house from my bed in the living room to the bathroom, or to the kitchen, and back again. Out of the house, I have my wheelchair. I have been disabled permanently since 2012, and it had been coming on gradually for years, due to inherited severe osteoarthritis in my spine. I have spinal stenosis, spondylolisthesis, facet disease at 5 levels bilaterally, and severe arthritis in both knees, in my hips, and damage to both shoulders. I am an automatic fall risk in the hospital, and required to ring for help to get out of bed and walk 5 feet to the bathroom. I'm under the care of a pain management specialist, and I'm on a snootfull of pain medication, which was of course continued while I was there, so on my chart! And plus the cardiac meds I had already been taking for the AFib, and have also had an ablation for that in the early 2000's, which worked fine for a while, until it didn't any more. Since the last two major spine surgeries I've had did minimal benefit - the first was a wide lami for nerve impingement, which left my feet on fire for a week from the nerves being freed up. Plus others. The last one (5 years later)was 45 minutes of removing spurs and scar tissue, followed by a fusion with hardware, and I'm not a candidate for more surgery because all they can do is fuse me higher, which won't do me any good. I used to be a highly active young woman, and a CST (Certified Surgical Technologist) who worked full time and loved it. That is all gone from me now. The first morning, I was awakened at 5:00 AM by a doctor with his tablet in his hands, and a stethoscope around his neck, and absolutely no name tag and no introduction. I had never seen this man in my life - I assumed he was part of the group I had never met, but he never said. He gave me a very cursory look over while I was trying to wake up, and part of his instructions to me before he left was to make sure to get plenty of exercise by walking up and down the hallways! THAT woke me up! I asked if he had even bothered to look at my chart at all before he came in my room, because if he had, he would automatically understand how ludicrous his advice was! I was really mad. And made sure he knew it. Oddly enough, even after I ended up staying for 6 days because of complications, I never saw him again! And I also got more intelligent conversations from the others who came to see me after him!

[@ChrisW228]

Yes, all of this. At the very least, if you don’t believe us, look deeper into our charts. Doctors argue with me about a condition I’ve been managing since before they were born.

[@brandonotoole4374]

Unwritten rule: Learn the job descriptions and policies of the specialties and use them. The RDs, therapists and speech pathologists get asked to do stuff out of scope or aren't consulted when they are most needed.

[@KillerAJ]

Ask the pharmacists for help about picking drug therapy and trust their judgment. If they are telling you what you ordered is wrong, then that means what you ordered is wrong, 99% of the time.

[@sana-cm7oc]

Help your hospital hire/free up a pharmacist for ICU rounds and codes. They are wonderful assets.

[@brendielahooha]

Unwritten rule: Never forget the Hospital Staff Mantra - “Goodmorning”

[@AJG854]

Truth 😂

[@ItsAsparageese]

Can you elaborate on this? Not sure what you mean by it XD

[@jennymarms]

YES!!!

[@fevre_dream8542]

I don't care what time I come in for my shift, it's always "Good morning".

[@calebnation6155]

MissManaged my clock goes off at 1645. That means 1645 is morning. No if’s, ands, or buts.

[@Amandaaa2244]

I call my (nurse) mom to ask her questions all the time even though I'm in PA school 😂 Last week she was like "you know more than you think, you don't need me." NO MOM. Nurses know everything. I am nothing without them 🥺

[@maryerb6062]

She's also your personal encyclopedia for her years of experience. Continue to kiss up. She's a real treasure!

[@megiddo7664]

That’s funny because I’m a nurse and feel like I know absolutely nothing 😂

[@kelly1827]

Re: custodial staff / environmental services They are the primary agents of infection control in the hospital. They are critically important and should be treated that way! (Nope, I'm not EVS, nor am I married to someone who is ;-) )

[@elisalatinasag]

They're the unsung heroes. I was hospitalized a lot last year (during covid times, but not for covid reasons) and every time a custodial staff came to sterilize my room or I saw them working in the hallway, I always greeted them and thanked them for their hard work.

[@cloudsunicorns194]

Oddly specific

[@Mel-tw6qv]

Yes the backbone of the hospital. When I was a RN student many years ago the ems staff was on strike. We had to clean what we could and take care of our patients. The amount of work was just as impossible as a patient load. There is not a "pecking order" in the hospital. Literally one dept cannot function without the other.

[@dorothyyoung5094]

Y@@elisalatinasag bub

[@Rvalencia07]

Communicate with your nurses! Especially when writing a new medication or test. It lets the nurses know what the plan is, and we are able to reinforce this to the patient and family. Keeps everyone on the same page and less phone calls further down the line.

[@AllyRose24]

You left out the single most important rule: Never EVER say the "Q" word. You will either jinx the rest of your shift, or the next shift, depending on when the word was said. And believe me, that jinx extends to the whole hospital, not just your department.

[@khattab5351]

What's the q word lol

[@cocococonut8650]

@@khattab5351 "quiet" lol, it is said to get hectic when someone says it is quiet haha, like it gets busy with restaurants when someone says it is "slow"

[@AllyRose24]

@@cocococonut8650 Thank you for answering, I couldn't bring myself to even type it out

[@cocococonut8650]

@@AllyRose24 hahaha no worries x

[@cocococonut8650]

It is a forbidden word lol

[@makeupnmedicine]

These points are GOLDEN. Be on time! Get there 5 min early so you dont feel overwhelmed at sign out!I swear I was the only one in residency that would clean up the work space. It was so gross with like 12 residents plus Medical students in the room. I would also wipe down my own computer each shift -- people would laugh at me but it really helped keep me from getting sick!

[@thestrawberry42]

First time watching. I spent 6 months as patient and the nurses were my only real source of information. I will say a few of them were mean as heck and literally gave me PTSD but the others made up for it. Nurses absolutely talk about which doctors they respect and which ones they do not, and unwritten rule: Sound carries down the halls. It really is the nurses world and the doctors just work in it. thanks for the video, I will watch more

[@MaureenMccloud]

More info

[@fromflabtofourteener9596]

I’ve been on the receiving end of medical care more than I care to be. I have found that just saying please and thank you get you a whole lot further with doctors and nurses!

[@brendielahooha]

True!

[@janr.1077]

I can totally understand that! :)

[@mitchhennen3988]

I do inpatient transport for my hospital and I’m the overnight transporter so I work by myself from 11pm-7am compared to days were we have up to 7 transporters. So I do everything for a 400 bed hospital from ER patients ICU patients to OR patients to radiology patients and get them were they need to be. The doctors are so patient and willing to help especially on overnights. But I’m also a nurse so I can do little more then my coworkers.But saying thank you goes a looooong way. Trust me.....

[@DarcieGlam]

God bless you.

[@steveguest2003]

Top rule: Never say it's quiet! That's like opening Pandoras box of hell.

[@nihitkhunteta6137]

**Flashbacks to my colleague saying that, nope, that was horrific day for me**

[@coreyjacq]

Unwritten rule: don’t give ur involuntary psych patients ur id Card. They will escape 🤩 can’t believe I had to say that but someone at my hospital clearly needs to know

[@DrCellini]

lol

[@brendielahooha]

What?

[@reeseanderson4432]

💀💀

[@coreyjacq]

@@brendielahooha the kitchen people leave the meal cart right outside the unit and a nurse couldn’t get it cause they were short staffed and couldn’t leave patients in a room alone so she gave one of the patients her swipe and told them to get it 😩… they returned with police a few hours later

[@lisa6621]

hahahahaha thats hilarious...

[@BobbyBobBob1]

Unwritten rule : if you lend your stethoscope to someone DO NOT KEEP IT OUT OF YOUR SIGHT

[@brasschick4214]

I have my name engraved on the bell. 😂

[@susiessoapstuff1459]

I started buying only hot pink stethoscopes. Amazingly, I kept them much longer.

[@martinkass4551]

Same for your pen

[@kati1017]

So true! IT WILL GO AWAY!

[@autumnloichle7506]

@@brasschick4214 So do I and it was still stolen...

[@alterEGO2818]

I’m a nurse and we don’t “mess” with doctors. We don’t have time for that. If we are paging and calling at 3am it’s because we have to. Unfortunately we cannot put orders without getting the actual order. No one has any time for “messing” with someone.

[@ItsAsparageese]

Yeah, I'm sure it happens in some cases sometimes but you're exactly right that there's no logic in the idea that it's normal. I thought this part was a bit concerning and also a weak argument for his point. The real motivation for being respectful to nurses and other staff shouldn't be selfish "I'll get messed with", it should be the fact that a cooperative and mutually respectful team also communicates better and trusts one another more, and this improves patient outcomes. (And also it's just the right thing to do, of course, but people who need to be told this message in the first place generally will need more pragmatic justifications rather than moral ones.) And it makes nurses sound a bit childish and spiteful. I figure he didn't intend to convey these implications but I hope he thinks ahead more in the future about how he chooses to support his points.

[@susanferretti6231]

I'm a nurse too. Some will mess with them. There are a lot of nurses out there, types will vary. Overall though, we are usually too damn busy.

[@sammitchell7310]

The nurses at his hospital sound like high schoolers

[@billiekan9243]

@@ItsAsparageese very well said

[@ItsAsparageese]

@@billiekan9243 Thank you! I appreciate that a lot ☺️

[@tamiduncan3417]

You are probably one of the smartest doctors I've ever seen. Retired nurse for 40 years. Respect your co-workers and it is true we used to make 1st year resident's life hell if they were rude or condescending. Housekeepers know everything that happens in a hospital. Most people don't worry about them , ut they have the fastest grape vine around and if you want to know anything , just ask, and they'll tell you.

[@psleep4255]

These are unwritten rules for EVERY job. If you treat those “below” you badly it will come back to bite you in the butt. I worked at a nuclear plant that was exactly as you described. The elders always know how to get things done and will have your back even if you’re a secretary. The President of our company always made a point to meet every single employee. He asked your name, job title and something unique to you. Plant operations covered hundreds of acres and no matter where on the project he saw you he always remembered your name and had a personal comment. It meant a lot. One night I worked overtime and had to go to the main bldg to cook my dinner. I saw the President and invited him to share my dinner. I know he had a few bites to make me feel better but it was nice to be treated like any other person. Ty for doing this video. It applies to most work environments. ❤️🙌🏻🥰

[@Katrn30]

If you are respectful of your nurses, they will save your ass…if not, they will let you drown. As a 30 year RN, I can’t count how many mistakes by docs I and my colleagues have caught before they hurt the patients. We can save your career…or not…it’s up to you! Doctor Cellini sounds like one of the good ones, they get our respect!

[@jodeming5088]

Great advice as a retired nurse. Respect all staff and your patient’s. Listen to them. If they look unsure they may be new or it’s maybe something they are not familiar with. Teach them as well. I always enjoyed the resident’s even those with the I know it all attitude. Someday they will need help too. If you don’t enjoy what you are doing please find something else. Most importantly I thank you ahead of time for all those that really care for their patients. It can be a wonderful career. God bless all in the medical environment.

[@reneehomen2226]

As a nurse, thank you for that respect.

[@stephanieglowicki6016]

Before you leave, see if any of your same shift coworkers are still there. If so, ask "what can I do so you can go home?" When you start your shift, ask the offgoing staff "what needs to be done so you can go home?" Whenever possible, try to not leave work undone for the next shift. BUT, 24 hour facilities have 24 hour staff. There does come a point at which you have to acknowledge "my shift is now over."

[@victoriasparrow_]

Environmental staff are the cement that hold the hospital together. I’ve always treated them with respect and I have my favorites who always chat with me and I give them fresh eggs from my hens and they’ve given me candy from Mexico when they visited family and fresh oranges from their trees. They never get the respect they deserve.

[@andreaa.9709]

Unspoken rule I've learned as a nursing student is CYA's or ways to "cover your ass" if a patient case comes up in court and you get called in. It kind of goes along with, if you didn't chart it you didn't do it. If you peak in on a patient and they're fine, chart that observation. If you reassessed BP after meds, chart it. If you notified a doctor of something, chart what was communicated and when, even if the doc hasn't responded yet. Every little thing that is evidence that you took good care of your patient has to be documented. It sucks, but it works

[@sana-cm7oc]

Patients sue clinicians they don't like.

[@junior29557]

Valuable advice, applies to doctors as well. We tend to trust people with the communication bit & not enter it, especially if it’s someone senior.

[@kiaharper7172]

Definitely not unwritten! Lol That was literally on my nursing exams 🤭

[@LexKaiNix]

Oh yeah, you mean the doctors who didn’t put in my mother’s file that she had a blood transfusion because her (ectopic) tube burst on the table? Either they’re negligent, ignorant, or “covering their ass” for a mistake they made. I have no faith in doctors any more.

[@drkrishnap]

@@LexKaiNix you wanted them to leave her there and go write it down immediately? I have seen plenty of people like you ending up in long term treatment later in life and seeing things properly, then. Or when your own family member go into medicine and get sued and lose everything.

[@emilyg4878]

Semi-disagree with your rule about "never" leaving something for the next shift. Unfortunately sometimes this is inevitable... speaking as a nurse. Sometimes your shift will be so busy that you cannot possibly get to all of the tasks you wanted. It's not fair for you to have to stay late and risk your own health (and patient safety!) to complete unpaid labour. This only contributes to burnout (and we know that there is already a major mental health crises among medical residents). The hospital is a 24-hour facility; it's okay to pass things along to the next shift every once in a while. You worked hard all day, and you deserve a break. As a team, your colleagues should be adaptable and carry the torch into the next shift; they can get done whatever needs to get done.

[@miketj2516]

Agree Emily. This is basically an issue of trust. We pretty quickly figure out the people who dump stuff on the next shift and those who only leave stuff when they are truly slammed. If you're in the second category, the next shift will not complain, we'll just get it done.

[@pucksapprentice]

Totally agree! It's one thing to have a random start or to rarely clean up after a person. It's different if that person is always dumping on the next shift. But you figure out really fast which ones do that!

[@calebnation6155]

“That sounds like a DSP (day shift problem)”

[@marilynvans9044]

@@calebnation6155 I cringe every time I hear a nurse say that… lame 😒

[@sana-cm7oc]

@@miketj2516 It's ok to leave stuff if you've already executed the plan to get it done.

[@RetiredLCDR]

I am not a doctor but as a patient always show respect to your nurse. They control the size of your needle and catheter. It may be funny but it is true.

[@pjsmith4369]

Nurses - I was an RN who left nursing because of the bullying, nastiness and bitterness behind the scenes in the nursing profession. Saw many 3rd year med students who became interns the next year and then possibly residents the years after ( large teaching hospital ) Mostly very good at listening to the seasoned nurses. But these same nurses treated the Med Students/ Interns with great respect compared to their own colleagues. Many a wonderful nurse left the profession because of other nurses. Sad 😕

[@joywebster2678]

Nurses eat their young!

[@graceinsinga5831]

Such an easy thing to be respectful of everyone. You are very wise Doc

[@petersinclair3997]

From a patient’s perspective. I had an issue with a blocked bowel a few weeks before travelling and have neurological intermittent claudication and lost control of my legs in the shower at home, before travelling. After being ambulanced to my home hospital before interstate travelling, by car, I was told if my symptoms repeated, to immediately go to an emergency room of a hospital. As it happened, when travelling, I found I couldn’t walk and simultaneously had had constipation for a week. So called into a regional hospital. My wife drove. The intern told me nothing was wrong and I was having an anxiety attack and what a good memory he had, when interviewing me. I was in track pants and a t-shirt and hadn’t had shave for four days. Being seventy too, I looked like some the cat dragged in and was mentally vague. Think there were first impressions made. Perhaps, I was a panicked farmer coming off the field? Very much, he talked down to me. What I didn’t tell him was I had three higher degrees than him, including a PhD and two Master’s degrees and three Fellowships and was the retired Executive Dean of three university facilities. Non-the-less to prove me an idiot, the intern ran a scan and ran blood tests. A few hours later, he was in the emergency assessment room apologising. Lucky, I didn’t sue him. p.s. My mother in law had just retired being Mayor of the country town and it’s shire.

[@chronos401]

About six years ago prior to prepping for an emergency operation, the surgeon asked me if I had any questions for him. I asked only two: how many times he did the same procedure before and whether he had a good night sleep. He responded with a huge smile on his face. His residents and medical student on the hand all had shocked expressions. After it was over, he gave me his cellphone number and said to call him personally if I encountered any problems. This guy had no presence on the internet. He was very young looking. No one told me he was one of the top surgeons in his field until I was gathering my belongings to leave. While we never spoke or met again after that day, I will always remember him. The doctor and nurses involved in my aftercare were former coworkers and super fans of his. Your advice is spot on in how new doctors should treat coworkers and patients. Since what you suggest is not a very common practice, they'll stand out and be remembered very positively.

[@ItsAsparageese]

I love this story. What a humble and considerate surgeon. I love that he clearly took pleasure in you asking such candid and justified and pragmatic questions. Like hell yeah patients should care about exactly those things, I like to think I'd be as pleased with you if I were in his shoes lol. Thanks for sharing this, I'll remember this one.

[@Mypandaloves]

Thank you for including the custodial staff in this. I worked in housekeeping in a hospital and we are probably one of the few invisible people that are taken for granted. Also the dietary people as well. And I agree. Always be nice to the nurses. I tried to always keep an eye out for pills or things to clean up without them having to ask and some nurses will go out of their way to thank you. Which was always appreciated and made me want to help them in whatever ways I could.

[@kellyogg5818]

as a cna in the operating room, THANK YOU! it’s july so it’s time for all the new docs to come in, and i feel like i’m invisible most of the time

[@shanae142689]

Thank you for bring up housekeeping. I am an OR HK. I am last one in the OR and most of surgeons treat me fantastic! For some I am invisible, for most I am God sent.I cannot tell you how many charts, specimens, cells phones, pagers you name it get left behind. I always go above and beyond to make sure those items get back to there proper place. I take care of them (RN, PA, ST, and MD/DO) and they take care of me also. I feel more apart of the OR family than I do in my own department.

[@Edwinpeewee]

Unwritten rule: please wear deodorant, BO is outdated.

[@btrswt35]

I work in environmental services in the neonatal intensive care unit. Been doing it for over three years. It's a amazingly well organized and greased machine when everyone works together, is situationally aware of what is going on around them, cooperation is practiced, and the egos are left at the door. Watching a new born baby, who's already had a rough start to life, come into the triage it's a true symphony when everyone knows their places and the focus is put on the needs of the patient. On the other side of same coin, my utmost respect and support goes to the nursing/medical staff when patients don't survive. They are there all the way to the end. Not only are they Healers for the sick but they are also the Bearers for the dying.

[@sams.1970]

Also, listen to your patients like you'll be quizzed in a deposition. Years ago, I went to the ED for chest pain after taking a Z-pak. The ED staff assured me that the Z-pak could not have caused this, and I just had costochondritis. They gave me Toradol. I had a hx of SVT, but I had to beg for TWO HOURS to get an ECG. As it turned out, I had prolonged QT intervals and trigeminy. A few months later, the big Harvard study came out showing how lethal Z-paks can be with arrhythmias. THEY GAVE ME TORADOL (and discharge papers).

[@chukah9484]

? You can go into the ed with chest pain without an ekg? Pretty sure that’s protocol.

[@calebnation6155]

Chukah literally every patient in my ED gets a 12 lead for anything that isn’t an isolated extremity issue.

[@TomJakobW]

@@chukah9484 unless the protocol is accumulating law suits.

[@drkrishnap]

Were you really young? Don't know why EKG wasn't done unless you were really young. Also you yourself said that study came out later. How can doctors know things before?

[@MyJacob88]

Please be nice to us you’re maintenance staff!!! Such a difference working with nice nurses and or doctors. We will always remember this and be willing to go the extra mile for them !

[@martinkass4551]

Worked with a cardiac surgeon who treated maintenance staff as if they were equal. So rare and so wonderful. Everyone lovedhim

[@pm7317]

Spot on. The one thing that I would have hoped that you would clarify is that when you say "no one wants an unhealthy doctor", I hope you mean no one wants a doctor with unhealthy habits. I have come across so many outstanding physicians and other providers who have disabilities or a variety of healthcare ailments, and their patients adore them.

[@ItsAsparageese]

Agreed, but I would place addiction in that "disabilities" category too, for this context. It's very much a disease, and someone will be no less prone to it just because they routinely see its consequences in patients. Someone trying their best is making valid effort toward health, and as long as that's what they also expect from patients instead of expecting perfection, it's not hypocritical.

[@lovemusicbandchorus]

Thank you! I trust a doctor with a disability WAY more treating my disability than I'd trust an able bodied doctor

[@henryh65]

As a registered nurse, we also cover for the MDs. When the patient wants to speak with the MD in the middle of the night for something incredibly MINOR, and they are adamant that they see the MD now, I will tell them know that the MD needs his/her rest in order to make the best decisions. I have told the patients that the MD is in the OR, and he/she is not currently available, so the patient has to leave the MD alone for the night.

[@denisebryson6890]

Thank you!

[@Freeyourself206]

Not cool to lie

[@pochopmartin]

@@Freeyourself206 Do you work in heath care? These kinds of RNs are absolute SAINTs. Not every patient request is urgent or even remotely necessary. A good RN will recognize when a doctor is needed and when not. White lies are the fabric of society, medicine is no different. Patients who think they are entitled to bother a busy doctor with every little unese question are one of many contributors to burn out. Would you rather your doctor answer your questions fresh and rested in the more or tired and annoyed in the middle of the night?

[@joywebster2678]

@@pochopmartin perhaps she means just be firm and say No that does not require me waking an MD for, let's try this instead. Vs a made up story.

[@karensamuels390]

Yeah, do that until someone dies, then see how your guilting the patient pans out.

[@kathleencolwell8947]

I agree with everything you have said👍🏻 As a critical care (CVICU, Cardiac cath lab) for thirty years, I would like to add something for nurses, especially the old ones (like me). There is no such thing as unwritten “rules”. There are “policies” (and procedures) and there are “habits”. As a traveler, I have asked so many nurses why they do things a certain way. Most of the time the reason is “that’s the way we always do it”. You should know WHY, and it should have something to do with, oh I don’t know, what is safe for the patient. If it’s really a “policy” show me. Interestingly, Radiology Technologists, PCT, Respiratory Therapists all seem to know “why”. 😊

[@mustangmare]

Nurse here and I seriously appreciate the doctors who give me grace and tolerance, (in the high operational tempo when my own flaws glare.) We are a team for the patient, (albeit a team of independent minded people, we are still a team.) Agree, never intentionally leave something for the next shift, yet equally understand that the care is 24 hours and we have to trust that we can pass the baton and go home to return the next day.

[@Sit2090]

I can’t stress the importance of respecting and helping your fellow staff members. Ancillary staff play important roles that wouldn’t make it possible for the doctors and nurses to do the their jobs efficiently and effectively. I can’t value enough my nurse friends for helping me out when I’m trying to position a patient for an X-ray. I’ve hurt my back twice by being too stubborn to ask for help. I love my nurses. They are the most amazing people ever. And the MDs I work with are so intelligent and caring that I am intimidated by them. I think they can smell the fear of me not trying to make them mad at me for any reason at all. There are some doctors I’ve become friends with and I would drop whatever I am doing to help them because I know they would do the same for me.

[@dianakidd5688]

As a retired ICU Nurse, I want to say Thank You for your wonderful comments about respecting the Nurses, techs & Axill. Staff . I totally agree with your tips. Well done!

[@kathysedillos5108]

Great advice!! I especially loved the mention of custodial staff. They make our jobs easier; spoken from a daughter whose father was a custodian ❤️!!

[@sana-cm7oc]

Custodial staff save more lives than everyone else in the hospital combined. I have told them this and they sometimes start to cry.

[@AzzaRudd]

I've been a nurse since 2014, I've learned so much from my Newly qualified Drs, from respiratory physios, occupational therapists, general physios, radiographers, porters, healthcare assistants, cleaners, kitchen staff, clinical site managers, registrars, consultants etc..... It's a team excercise at every point of care.

[@notanurse2373]

Don’t ever piss off the lab. They don’t even get a mention here, which seems about right.

[@truenorthpositivejuniorten4628]

Yes sooooo true. And please don’t order a chem 12, potassium and sodium and complain we (or the computer) canceled it. Bro we canceled it because those are in the chem 12.

[@notanurse2373]

@@truenorthpositivejuniorten4628 tell me more of the legend of the CBC, H&H and manual diff on a normal patient. 🙄 stay strong!

[@teresaboyer5707]

Don’t order stat urines on every patient just because you can!

[@alisamarie3377]

I was so disappointed when we didn't even get a mention... Maybe things work differently at his hospital, but I have NEVER seen a Dr draw blood.

[@karrenwebb3341]

I've been a Med Tech since the early 80's....when do you think they usually put the lab in the basement (no windows) and next to the morgue!😁?

[@elisastrange1996]

I used to work at a rehab hospital. A CNA told me in the first day. You might hear often, "it's not my patient". Well unwritten rule. "It's not your/my patient, it's OUR patient". Make sure you prioritize patient's safety rather than your schedule.

[@InoueTsubasa]

Agreed with the ancillary staff part. I work as a med tech in a lab. ER is stressful and the doc needs results, understandable, but analyzers don’t give results in seconds like POC devices. I can’t make it run any faster… But for the polite docs and nurses that call, I pay 100% plus extra attention to their specimens among the haystack we have. Manners do matter.

[@lisaellis9718]

Omg thank you for saying that about nurses and all staff. It is sad that you have to tell new medical students and interns this but it it so true. I’ve been a RN for over 30 years and have seen more than I could ever remember but the one thing that I learned is that things work out much better when there is team work and honestly I always felt like the nurses have to prove themselves not only to the other more seasoned nurses but to the doctors, must prove you know what you are talking about in order to gain the respect of everyone. Once that happens things can go much smoothly. BTW I love your posts they are so true and you are just so upfront and truthful about everything. Thank you. Keep doing you

[@NurseHowie]

I’m a Filipino nurse so the unwritten rule is that I, at some point during the month, have to bring lumpia to a hospital potluck. 😆 Are potlucks even a thing anymore? 🤷‍♂️

[@zinn01hobissprite62]

Yooo I did my medicine in Manila We did the same thing once month but we actually collected money and order pizza, chicken and drinks It was like a self party to self 😂

[@MHSMagicLuver]

I am a PA who used to be a CNA and then MA. I worked nights as a CNA (7p-7a) so I didn't see many doctors, but I remember if I crossed paths with any in the hallway, I would just give a little smile. In my mind, no doctor (or provider) would think anything about me at all and I definitely felt miniscule. As a PA, i'm thankful for my experience as a CNA and MA because I think it makes me a better provider because I understand everything they have to do, as well as I can do those things I learned back then in those positions and help when it is needed

[@Absbabs88]

Always act like the patient can hear you. Always. Can't tell you how many times I talk to my intubated, or non verbal patients while taking an x-ray, and the nurse chimes in like I'm stupid. No. That's the first thing they teach us in school. Act like the patient can hear you. And even If they can't, what harm is speaking to them nicely going to do?

[@michaelwaldman5023]

I've had nurses think I didnt hear them and say shit in the hallway. One time I heard the charge nurse telling a patients family my personal info. Definitely contacted patient relations on her. Shes no longer a charge nurse. Have also had a nurse make me wait two hours for meds bc she swore I was trying to get high. Also had a nurse pocket a vial of dilauidid right in front.of me. I knew she shorted me bc I was sick and detoxing an hr later. Never reported her me being an addict know what it is and figure shell screw herself in the long run...

[@Absbabs88]

@@michaelwaldman5023 you were a patient, and the nurse was giving another patient your personal info??? Why?? That's just..... no. I can't believe someone would do that, but very clear why they are not in charge anymore. Well, I guess the moral of your story is not only act like patients can hear you at all times, but also act like they can see you

[@ItsAsparageese]

"And if they can't, what harm (will this) do?" THIS! This is the part that people desperately need to understand about this and so many other best practices in life. For instance: I was raised on "there are two ways to use your turn signal -- always, and never". The principle and habit has stayed with me, and more than once I've been teased for using my signal even alone in a parking lot, but I prefer to keep the constant muscle memory intact because it's *best practice darn it*, and the inherent nature of a harmless communication is that it's not necessarily for cars I do see, but in some cases sometimes it may be useful to communicate to ones I *don't* see. If something is harmless and trivially costless, and carries even slight rare chance of benefit, then just frickin' do it. I think it's legitimately terrifying how much work it often takes to explain this basic principle to people. I went off on a broad application of this idea lol but yeah particularly in medicine and particularly when people are in uncertain neural states, this is so, so, so important. And I swear patients respond to subtleties of kind intentions. Who knows what subtle physiological shifts happen in the caretaker when actively practicing kind and caring speech, which might make us release some sort of trace pheromones that we won't identify until 300 years from now or whatever which aid other humans in healing from neurologic damage or some wild thing like that. And even if the difference doesn't exist or is so subtle as to be effectively nonexistent, then at least the person doing the caring is absolutely benefiting their own mindset and health by being mindful and compassionate as a matter of consistent practice. The fact that anyone would argue against this or mock it just blows my frickin' mind. (But hey, I'm the type of loser who once explained how a little countertop lab test worked ... to a dog >.> ... So who knows, maybe I'm just crazy 🤣 His bro was on the exam table getting attention from their mom and the vet, so this guy wandered over to see what I was doing, so I told him how I was taking his bro's blood sample and mixing it with the diluent to check for heartworm and blah blah, and I honestly was just on autopilot and didn't even give it a second thought until I realized his mom had noticed our little chat and was giggling at me, and then it clicked that I was explaining a lab test to a dog lmao. In my defense, he DID ask!) This unintentionally very long comment brought to you by worn off ADHD meds and sleep dep, thanks for coming to my TED talk

[@sharidavenport5283]

@@janr.1077 - Then there's ALWAYS the cases of "selective" hearing loss. My mother told me when I was a teenager about my great grandmother - my maternal grandfather's mother - who lived with them in the early 50s. My grandparents had a farm after WWII, and my grandfather got out of the Army, after being part of Patton's staff. They bought this nice farm, with a beautiful house, and his mother came to live with them, because she was getting on in years and it was either that or going into a "home" which she was adamant about not doing. My mom and my grandmother noticed that she had recently developed a hearing "deficit," and wanted to take her to see the "hearing doctor" as Great Grandmother called him. She also called him a few other things, including a "quack" and refused to see him. She said all he wanted was to get his hands on people's money, instead of really helping them. So, mom looked at Grandma, and Grandma looked at mom, and they both shrugged, and decided to talk to Grandpa about the situation that night after dinner. After all, she was HIS mother. Later that evening, after finishing dinner, Grandma and Mom were clearing the dinner dishes, and talking in the kitchen about what they could do. Grandma had an idea. She called Grandpa into the kitchen, and told him what was going on, and what they wanted to try to do about it. He agreed, because he had noticed the same problem. So, they got the ice cream bowls out for the three of them, dished themselves out some Neapolitan ice cream, and carried it back to the dining room. Great Grandma had made herself scarce the minute the conversation at the table had shifted to the subject of clearing the table, washing the dishes and cleaning up the kitchen. She was truly nowhere to be found downstairs when they came back with their ice cream and sat down at the table. They heard a noise upstairs, and realized that she was upstairs in her bedroom, But not sure what exactly she was up to. Grandma tried calling her - once. No response. They continued to finish up the ice cream, and once they were done, stacked those dishes up, adding the spoons to the top. They waited a minute, before getting up and leaving the table, taking those dishes and a few other odds and ends off the table and putting them up on the buffet, or taking them to the kitchen for washing. Mom and Grandma finished up the dishes, rinsing, drying and putting them away. Some got put away in the China cabinet, others in the kitchen cabinet. Once they were done, and drying their hands in the kitchen, suddenly Great Grandma reappears, and sits herself down in her rocker in the living room, and picks up her knitting. The rest follow, turning on the radio at low volume for some music, or a radio program - not sure which. The subject turns to the dinner they had just finished, discussing each item, with some sly smiles and a few winks. Someone mentioned the "dessert" they had just finished, happy they had found their favorite ice cream in the freezer! Suddenly, Great Grandma's ears perk up, and she stops knitting, turning her attention to their conversation! "Why didn't I get dessert - nobody told me they had ice cream for dessert!?" Grandma looked at my mom, then at Great Grandma, and said, "We talked about dessert at the end of the meal, but as usual, you had disappeared once it was also time to talk about washing dishes, cleaning up the kitchen, and sweeping the floor. We figured you weren't interested!" Grandma left it at that, and Great Grandma was left to stew in her own juices, knowing that missing a dish of ice cream wasn't going to hurt her a bit. "There is no more ice cream," was the answer when she asked about getting her a dish of her own. "We figured you weren't wanting any, since you left the table right after dinner, so we divided it up among the three of us. There's some apple pie left from this past weekend." Knowing she didn't care for the way my mom made apple pie, that was left to sit in the fridge for Grandpa's lunch the following day. From then on, Great Grandma's "hearing issues" suddenly improved significantly! She heard and responded when anything was discussed within her earshot, including things like dusting and tidying up the downstairs, and she never missed ice cream, or any other favorite dessert item again, even when it was mentioned along with the usual discussions of tidying up after meals, and so on.

[@janr.1077]

@@sharidavenport5283 thanks for giving me a chuckle;)

[@jellyfishattack]

From my POV as a patient it was wonderful to hear you recommend that MDs treat patients as they would their own family. As a person who's had 8 operations, and I've also had brief stays due to illness, I always thank everyone for their work, from the person who cleans my room, to the MDs. I've had 3 or 4 of the staff chatting at my room. The highlights of my stays was learning about them, and laughing. Company is such an asset. It's the highlight os a patient's day. It certainly isn't possible with more and more gravely ill patients. I also learned to preface a request for another pillow, or hot blanket with, "I know you're busy, but if you find a moment...", please and thank you go a long way, as does doing what you're told, e.g. don't ambulate without one of us, or walk at will. People are happy when you don't complain, e.g. a man in a separate ward was screaming very loudly, but he clearly sounded old and out of it. I mentioned it to an RN, just to talk, then I saw her look stressed. She looked relieved when I said I'd figured he was, and he was crying out every minute but I could tell why. Sadly, he was non vocal but you could hear his pain. We shut my door.

[@alisyed5865]

As an incoming first year med student I’m glad I’ve got a bit of a guide before walking into med school blind. Thanks Dr.C :)

[@DrCellini]

Glad I could help!

[@brendielahooha]

Important things to know before starting to rotate in the hospital!

[@witewashed89]

Unwritten Medstudent Rule: -"Anything else I can help out with?" = Go home early without getting a bad eval. -If anyone asks what specialty you are going into, the correct answer is whatever rotation you are on. -"Did not get in the way" is the best compliment a student can get on an eval. -Don't ever put pheochromocytoma on your differential, it's never a freaking pheo (Caveat, you will look like a genius the one time it is) -IR is the coolest specialty ever. I tell my mom it's like being a blood vessel ninja. Make sure you take the elective!!!

[@awmyg314]

I would push back on #2. I can't speak for every physician or rotation but being honest about what you actually prefer can allow your attending/chief resident to tailor your rotation experience towards your interests, if possible. I love neuro and psych so during my IM rotation, when a new admit had a complaint under one of those fields, I was given those patients to follow

[@zinn01hobissprite62]

God the 2nd one Had rotation in ob-gyn told them i wanted to pursue Medicine i think she got pissed told me make a referral to IM and then we will see how much you medicine I hated my life for those words And yes obviously i was grilled badly never forgetting that Though i still want to pursue Medicine

[@jimbelter2]

Definitely treat the patient *and their family* with respect. My mom recently had to see a specialist and the PA was wonderful. However the doc just ignored me as if I was a fly on the wall, and I'm the caregiver! I thought it may have been a one time thing so the next appointment the same thing happened; no matter what I said and how well I could articulate what was happening, she never acknowledged me one bit. Even when my mom said to ask me when she couldn't explain it. It's not that I just jump in and speak entirely for her, I do allow her to speak for herself and I provide any additional necessary info. Since this doc wants to treat me like I don't exist, I told my mom we are changing docs to one who will allow me to speak and provide the necessary input he is looking for. The level of care has greatly improved because of this change. I'm the caregiver and family member that lives with her. Those two points will give any doctor all the information they will ever need and are a valuable asset to the patient's care and treatment. I may not be in the medical field however that doesn't mean you can ignore me either. I do understand the medical side of things and can articulate it as well. *Never underestimate the family's role and their abilities*

[@janetvanantwerp8899]

Thanks for including respect the nurses! As a hospital nurse of almost 30 years, condescending doctors become difficult to deal with. And the stupid calls about things at 3:00 am actually mostly do not come from sort of revenge, but more from a fear of getting chewed out for doing the wrong thing when changing a diet order really isn’t even our responsibility . New nurses are especially reluctant to do things like change a diet order or discontinue something. If doctors would sometimes consider this a teaching or learning opportunity for nurses and explain things rather than just yell at a nurse, nurses are smart enough to use that learning in the future. There are so many new nurses in the hospitals these days, and they are reluctant to do anything without an order…and truly some of them don’t even have an idea where they can take liberties because one doctor chews them out for putting in an order without talking to them and another gets angry because they didn’t use “common sense”. How about this unspoken rule: template orders in Epic can give nurses the wrong info….so make sure all of the info is individualized for the patient. I took a foley out of a patient one day because the templates order said “d/c when ambulating” then got chewed out by a doc because I should have known not to take it out until he came in and specifically wrote a d/c order…..well, obviously, I didn’t know. Gives us that other rule…..never assume!

[@crimson_auror]

As a med student and former CNA, I *always* go out of my way to help nurse assistants. I went through hell as a CNA because people above me refused to help. I never want someone to have the experience I did.

[@hansyjp]

You are telling our secrets 😅 you just saved some interns and residents a LOT of heartache! 👍

[@lesliecurtis8073]

As a phlebotomist in a hospital I'm here to tell you HE'S RIGHT!!! IF you decide to treat us like crap we have our ways of making those above us unhappy! HOWEVER, if you treat us with respect, we are WAY more willing to be ahead of everything if you're nice, and help us help you!

[@DrCellini]

Agreed!

[@Lex-rc1gr]

I’m sorry I have to disagree, I don’t think it’s ever okay/professional to retaliate like that. Of course doctors need to watch their step and be respectful towards nurses, techs, Etc. they pull the heavy weights!! But I just don’t think it’s okay to make someone’s life a living hell bc if it. It’s passive aggressive and childish and it should be communicated and fixed. We are all adults and it’s never okay to be unprofessional by Drs being disrespectful to you guys and for you guys to by retaliate like that. It can affect quality of care all around on both sides of the fence.

[@lesliecurtis8073]

@@Lex-rc1gr This is true, and in most cases Dr.'s and staff get along, BUT there are exceptions to the rule, and in that case if you I revert back to what you're taught which is "TREAT OTHERS THE WAY YOU WISH TO BE TREATED!!!" In the end it all gets done, but if you think I'm going to rush to help someone that treats me like crap... uh not going to happen! RESPECT goes both ways!

[@Lex-rc1gr]

@@lesliecurtis8073 yup my mom always preached that to me, 🤣 I see your viewpoint

[@beaubritton4362]

Yes, I worked in ER for many years. I’m a PA and I worked nights. I have a lot nurse friends, and they told me about this phenomenal advice, “without us the hospital would have to close”. Nurses are the key to success, listen to them. If they like you, your life is golden, but if you piss one off, your job will be hell. In the ER I wore scrubs. No way would I do a 12 hour shift 3-4 nights a week in a suit and tie.

[@Kris-cu1vx]

I love this so hard. all of this definitely applies to us nurses too. our CNAs can make or break us, plus they're the one's doing the hard dirty work of healthcare.. and are getting paid poorly for it too.

[@TheDOS]

“Practice what you preach” Sleep sleep sleep! Sleep is super important as medical researchers are delving more and more. Yet this hasn’t had much impact on the medical professionals and even comes up in part 2 of this video. Smoking, exercising, healthy weight are commonly brought up in this context, but sleep ís unfortunately extremely important too for both physical and mental health (I say this as a recovering workaholic who had very little respect for sleep growing up). Love your content, just a pet peeve of mine regarding the practical aspects of medical practice. Thank you.

[@kathleenfarris8710]

True about respect nurses. RN here since the 80s. The jerk older “god” doctors are always knocked down a peg or two by nurses messing with them.

[@sana-cm7oc]

Doctors don't realize that It's really the RNs world and they are just guests.

[@MsPea]

I had heart bypass surgery not too long ago and the CNAs I had were wonderful. So kind and helpful. Also, the housekeeper who would come in my room every morning. She couldn't have been any nicer. And the transporters who wheeled me for ultrasound or other tests. Great guys. Even the phlebotomists who came to draw blood were nice. They really don't want to hurt you. The ones I had were all gentle, but sometimes they can't help it. Unwritten rule for patients -- never be condescending or insulting to the staff that do things for you. Don't be demanding. Give them a chance to get to you. They might be helping another patient. They all deserve respect.