Why nurses are the best teachers for medical students

--------------------------------------------------------------- Here are the stories you missed on KevinMD.  Thank you for your continuing readership.  --------------------------------------------------------------- Sponsors [New eBrief: The evolution of mobile strategies in healthcare](. Want to know the biggest missed opportunities with most hospitals' mobile strategies? Clinical involvement and strategic alignment. Discover the details in part 1 of our survey results. [See the results now](. Pre-eclampsia has increased 25% in the past 20 years -- including [claims of failure to diagnose it](. And postpartum hemorrhage accounts for 3% of all OB malpractice claims. [Here’s how to address the top risks in women’s health care](.  [Is your hospital communication system trapped in the dark ages?]( Just like a medieval page boy, pagers are annoying and inefficient. This leads to delayed patient care, frustrated providers, and potential HIPAA breaches. Learn why you need to ditch your [Page Boy]( today. Case Study: Learn how the Hospital for Special Surgery manages over 10 critical alarms for [faster and improved response times](.  ---------------------------------------------------------------  KevinMD Today: May. 29, 2017  [Why nurses are the best teachers for medical students]( It was 5:30 a.m., and I could barely contain my excitement. I was almost done with my clinical rotations. I had worked tirelessly to improve my medical knowledge and spent hours mastering my clinical skills. Now, as I was nearing the end of my third year of medical school, I felt more than ready for […] [You want doctors to be doctors again? Get out of the way.]( I have a confession to make. I don’t understand the concept of burnout. I mean, I get the idea. Medicine is, at least when you are the kind of doctor who deals with life and death, inherently stressful. And I feel the stress. It’s as if someone applied a vice grip to my insides in […]  [You’re wrong. Pain is not a vital sign.]( After years of exaggeration, misinformation and a national epidemic of opioid and heroin abuse, the nation is finally coming to terms with the fact that pain is not the fifth vital sign. This heresy, as I understand it, has existed for close to three decades and, in my opinion, has been directly responsible for the […]  --------------------------------------------------------------- Make your event memorable with an [inspirational KevinMD keynote](.  Please take a moment and [visit Kevin's new speaking page](.  --------------------------------------------------------------- [Xylocaine and Lyme disease: A deer tick story]( It was a small deer tick, hidden by the crus helix, embedded in the cymba conchae, the crevice just above the ear canal of my seven-year-old patient halfway through my Saturday clinic. He was worried that it would hurt. His parents hadn’t wanted to try removing it on their own. I had a hard time […]  [Here’s what doctors really think about where they work]( Maybe 10 to 15 years ago, my medical center at the time invited a prominent former resident to give grand rounds. He had become the statistical director for what was a large regional insurer absorbed by a national insurer shortly after that. He spoke very little about the prevalence of disease among his company’s beneficiaries […]  [Do expired EpiPens still work?]( A small study published this month showed that most Epipens retain their potency for at least 4 years after their expiration date. That’s no guarantee, of course. I’d still recommend as a “best practice” that families replace them as they expire. But it’s reassuring to know that they’ll usually be effective even when expired. And […]  [How big data will shape the future of medicine]( In any educational environment, there’s a set of buzzwords that create a common vocabulary. Medical students constantly hear about “bench-to-bedside research,” “evidence-based medicine,” and “compassionate care.” Meanwhile, business school students can’t stop talking about “aligning objectives,” “disruptive innovation,” and of course, “synergy.” One of the most frequently used phrases in both schools is “big data.” […]  [A physician broke down walls, or so she thought]( I woke up at 6 a.m. to my daughter’s annoyingly, loud alarm. Since I was on call, my first reflex was to look at my iPad to see if I had patients in labor. I am part of an 11 doctor call group, so when I am on call, I cover all the patients of […]  [Residents performing surgery: Why can’t we reach a middle ground?]( A comparison of appendectomy outcomes for senior general surgeons and general surgery residents revealed no significant differences in early and late complication rates, use of diagnostic imaging, time from emergency department to operating room, incidence of complicated appendicitis, postop length of stay, and duration of post-op antibiotic treatment. The only parameter in which a significant […]  [What emotions are doctors allowed to feel?]( “This latte is too sweet,” I think to myself as the foamy hotness lights up the sweet receptors on my tongue. I stop and try to remember how many pumps the nice lady at the coffee shop slammed into my cup and think it’s somewhere around three or four — will have to go down […]  [Patients appreciate our honest concern. And that takes time.]( When we walked into the room, you could sense the anger and frustration on the patient’s face, as well as two other relatives in the room. We knew that the patient had had lung cancer for several months and had failed radiation and chemotherapy. He had labored breathing and looked miserable. I went to his […]  [Is telemedicine dumbing down the standard of care?]( Telemedicine is the new rage in medicine and a very needed service. It is vital in areas that are underserved and doctors hard to come by. Additionally, it can be a great convenience for patients who may not actually need to physically go to the doctor. But, is telemedicine dumbing down the standard of care? Doctors […]  [Defending the increase in duty hour limits]( The ACGME recently formally increased its work-hour limits for resident physicians, a change that was widely covered in the press.| This decision has also been significantly misreported.  While it may seem like all residents will now work for longer hours, in reality, only first-year interns will be allowed to work longer 24-hour shifts, where the previous […]  [4 ways to take a break from your career]( My cousin visited me in sunny Cali this past weekend. She lives a life that many in the medical community can appreciate: a stable and successful job for many years, but burnt out. She then decided to take six months to work on her writing and try establishing herself through various pursuits. While successful in […]  [Why is there hostility between medical specialties?]( I was walking home from classes last week when I ran into a few friends from my medical school class sitting outside at a local bar. I was done for the evening, so I pulled up a chair, ordered a beer, and joined the conversation. They were talking about the wards. I’ve been on a […]  [For doctors, treating pain is a pain]( Sometime during my medical training in the early 1980s, a wise, old attending orthopedist taught me this about pain management: “Pain is a message that something is wrong, a red flag that corrective action is needed. Narcotics should only be used when the cause of the pain is determined and corrected (Post-op or post injury), […]  [How to give constructive criticism as a physician]( Here are some questions that are still on my mind as I approach the tail end of my chief year. I’m thinking about the best ways to offer constructive feedback. What is the best way to approach a struggling learner? What is the best way to give guidance and feedback without being perceived as a tyrant […]  [The unhappy couples after a cancer diagnosis]( The couples I see for counseling are not always perfect, not that any couples ever are. But when cancer enters the relationship, for some couples, things get ugly and get ugly fast. I believe that we like to think that cancer makes people “better”; that people rise to the challenge and become the best they […]  [MKSAP: 57-year-old woman is evaluated after a recent screening colonoscopy]( Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 57-year-old woman is evaluated after a recent screening colonoscopy. The colonoscopy disclosed a 12-mm polyp in the ascending colon, which was removed. No other lesions were noted. On pathology, the lesion was found to be a sessile serrated polyp. Physical […]  [Bearing witness: An oncologist’s role at the end of life]( My patient was sitting in a wheelchair. He was in his mid-forties, and before the cancer, had held a physically demanding job that he loved. Now, the cancer in his spine had ended not only his ability to work, but any ability to use his legs. His wife was devoted to him in a way that […]  [This is what practicing medicine in rural America is really like]( “So tell me why you think you you’re having a stroke?” The nice lady, mid 40s, sat on the ER exam table in work-clothes, an anxious look on her face. “Well, I was working the cattle up in the timber, and when I got back to my 4-wheeler my heart was racing, and I was […]  [Reflections from the Hill: How residents participate in advocacy]( Advocacy on the Hill can be a challenging, since it’s never clear how much a single person or small group of people can impact an issue. However, that fact alone should never stop anyone from doing advocacy work. Jessica Isom, Nkemka Esiobu, and myself had met with Dr. John Krystal (chair of the Yale psychiatry […]    --------------------------------------------------------------- You are receiving this email because you subscribed to the KevinMD e-newsletter. If a friend sent you this email and you want to subscribe, go to [KevinMD](.  --------------------------------------------------------------- 173 Daniel Webster Highway Nashua, New Hampshire 03062 [Unsubscribe]( | [Change Subscriber Options](