skyfall Posted October 1, 2014 Share Posted October 1, 2014 Just started doing a GYN rotation. Today the doc asked me what I noticed about this mildly obese patient's breasts. I told her it felt and looked normal to me, no bumps, lesions, asymmetry etc. Then she told me the pt had breast implants. I asked her iif they suppose to be more firm since I guess it wasn't as soft as other patients. She said no and left it at that. So if surgical scars aren't apparent, how do you tell by touching? Link to comment Share on other sites More sharing options...
navyflyPAC Posted October 1, 2014 Share Posted October 1, 2014 Hahaha. And why would this be a real question........... Link to comment Share on other sites More sharing options...
Corpsman2PA Posted October 2, 2014 Share Posted October 2, 2014 So if surgical scars aren't apparent, how do you tell by touching? I'll take the bait... There's this crazy, kind of outdated practice called "History Taking" where you ask the patient any past medical hx and past SURGICAL hx BEFORE you touch them. Or, you have an awesome staff that already did this and you review it in the chart. Kinda archaic, but saves the guessing game... Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
cinntsp Posted October 3, 2014 Share Posted October 3, 2014 I'll take the bait... There's this crazy, kind of outdated practice called "History Taking" where you ask the patient any past medical hx and past SURGICAL hx BEFORE you touch them. Or, you have an awesome staff that already did this and you review it in the chart. Kinda archaic, but saves the guessing game... Sent from my iPhone using Tapatalk Yeah because we know patients are awesome historians and always tell providers everything. Sent from my Nexus 7 using Tapatalk Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted October 3, 2014 Moderator Share Posted October 3, 2014 Yeah because we know patients are awesome historians and always tell providers everything. Sent from my Nexus 7 using Tapatalk And I've never seen one add or change their story on second questioning. Link to comment Share on other sites More sharing options...
whoRyou Posted October 3, 2014 Share Posted October 3, 2014 Jasmine Tridevel, the Tampa woman who became an internet sensation when she announced she had cosmetic surgery to add a third breast The 21-year-old massage therapist claims she had to ask over 50 doctors to perform the surgery, which involved taking skin tissue from her abdomen and adding a silicon implant. She also got an areola tattooed on. The procedure cost $20,000, and Tridevil had to sign an NDA so [she] couldn't disclose what doctor performed it. Read more at http://www.snopes.com/photos/bodymods/jasminetridevil.asp#acMMwGmZdRRAYGXP.99 Link to comment Share on other sites More sharing options...
Corpsman2PA Posted October 6, 2014 Share Posted October 6, 2014 Yeah because we know patients are awesome historians and always tell providers everything. So you don't take a history or value it's use? Or look at old records? Interesting approach. Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
skyfall Posted October 26, 2014 Author Share Posted October 26, 2014 My preceptor doesn't let me take their history or do any charting. Students are not allowed to be in with the patient by themselves- her rules. She already knows their medical/surgical history and only has her staff members take history. Charts are all on her computer which I don't get to go on. She only allows me to do physical exams, and only on "normal" patients. Whatever, I'll just wait until the next rotation when I'm allowed more freedom again. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted October 26, 2014 Administrator Share Posted October 26, 2014 My preceptor doesn't let me take their history or do any charting. Students are not allowed to be in with the patient by themselves- her rules. She already knows their medical/surgical history and only has her staff members take history. Charts are all on her computer which I don't get to go on. She only allows me to do physical exams, and only on "normal" patients. Whatever, I'll just wait until the next rotation when I'm allowed more freedom again. So... you're paying to shadow? Talk to your clinical coordinator--you are not getting your money's worth. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted October 26, 2014 Moderator Share Posted October 26, 2014 agree with Rev- Being a student on rotations means they let you do the whole deal then talk to you about it and repeat pertinent parts....that's called graduated responsibility. it's how medicine is taught. Link to comment Share on other sites More sharing options...
skyfall Posted October 31, 2014 Author Share Posted October 31, 2014 I agree, next time I'm trusting my instincts and will talk to the faculty about it if I'm in this kind of situation again. In my first rotation I was allowed a lot of autonomy and the preceptor was happy to teach and was receptive to all my questions. I may have got off to a wrong footing in this one, however. This gyn rotation is only my second. I was naive to think things would improve if I were more proactive and asked to help out with hx taking, exams, etc. However, I could tell by her tone she was irritated by this and that's when she told me her rules. Later a classmate informed me she rather students not ask and she will offer them opportunities as she sees fit. So I took a more passive stance, gave her the space she needed. She allowed me to do breast and pelvic exams by the 2nd week. Paps finally in the 3rd. I thought she'd let me do a little more each week, but it only went as far as that. Definitely did not learn the way I wanted to. Link to comment Share on other sites More sharing options...
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