Becoming my own advocate

by Lorien E. Menhennett

The first day of my ob/gyn rotation, I remember the clerkship director telling us one way in which pre-clinical and clinical experiences are different. In the classroom, she said, the focus is on you the student. In the hospital, the focus is on the patient. That seems obvious. I quickly learned what that means, though, is that I need to be a constant, assertive advocate for my education.

While on labor and delivery, for example, I’ve discovered that keeping my eyes and ears open is the best way to stay involved. When I overhear a nurse saying that the patient in room 5 is fully dilated and starting to push, I rush to the room so I can help — and learn. When I see on the patient list that someone new has just arrived in the triage area, I quickly tell the nearest resident that I can go see her. I pull up her outpatient chart to review and start a note with our triage template so we can easily add the information from the patient interview. When I hear a resident mention that she needs to do an EKG on a patient with an irregular heartbeat but our machine is broken, I offer to run to the SICU (surgical intensive care unit) the next floor up and borrow theirs. Then I finish the EKG myself.

There are certainly times when someone specifically invites me to participate. One night, for example, a resident told me they were removing a cerclage (a stitch that holds the cervix closed), took the time to briefly describe the case to me, and suggested I go watch. But often, it’s up to me to insert myself. Then once I’m in the room, the resident or attending will explain what’s going on. It’s not that the doctors and nurses are trying to withhold information from us medical students. It’s that they’re busy taking care of patients — that’s their priority, and understandably so.

Assertive self-advocacy wasn’t necessarily a skill I expected to strengthen in medical school. I’m realizing, though, that while medical education entails learning about medicine, it’s also about so much more.