Pre-rounding

The actual point of pre-rounding is that the patient gets a chance to tell the medstudent he wouldn‘t have allergies just to deny what he just said in front of all the doctors at great rounds.

My pre-round post spinal surgery was surgical resident and anesthesiologist coming in to tell me that I made them laugh hysterically when they were putting me under. Because allegedly, I stopped them while they were injecting me, and went "Is that propofol?" them "yes." "FYI, that feels like fire in the veins, probably why we don't use it in the vet clinic. Anyways, have fun with my intestines and spine boys!" and was out.
...I remember NONE OF THIS INTERACTION PRE SURGERY.

why are hospitals so determined to deprive anyone and everyone of sleep? the staff is working 24 hour shifts, the patients are getting blood drawn at 2 am. it’s insane

Ideally, pre-round is for medical students to practice managing their assigned patients.
Back in my school, med students are allowed to write orders in medical chart which will not be taken w/o attending physician /residents signature. Not getting ur orders erased is like one of med student's honorary badge.

Pre-rounds are an exquisite excuse for us, poor, med students to take difficult histories that the patient isn’t willing to give. Also we wake up at extremely ungodly hours if we want to complete the ward. Then we get publicly ridiculed while “presenting the data” as the patient denies ever being diabetic.

Pre-rounds sounds like one of those things that an overachiever kept doing that quickly became the standard.

I always wondered the point of pre-rounds. Having a rare syndrome and being in a teaching hospital, I talk to a lot of med students. I generally like pre-rounds because it gives me someone to discuss things that I want to discuss with the doctor since the final round tends to go rather quick and the med student can have my back if I forget anything I wanted to ask.

Patient POV: My daughter has a condition that has led us to be in the hospital way too much. Anyway, when it's about your kid who's sick and you're happy they made it through the night, pre-rounds are something you set your alarm for, you schedule your poops around, you live for those things so the doctor can give you hope for the remainder of the day. Rounds are where you get an idea of where the entire team is at and what the goals for the day are. Pre-rounds usually feel more intimate, Rounds feel more like a couple coaches coming together to come up for a game plan . That's just me though

LMAOOOOO! This is so spot on it makes me want to laugh and cry! As a "professional patient", all the checks and stuff they are always waking me up for is the bane of my existence when I get stuck in the hospital. The way you explain how the medical system really works, but with savage humor, is amazing. You are truly One Of A Kind, don't ever change! Ever!

“Because that’s how we’ve always done it.” Is one of the biggest inhibitors of continuous improvement.

In vet med, pre-rounds are secretly extra-time to cuddle with the new puppy/kitty litter that was delivered overnight. The length of the round is also directly proportionate to the cuteness of the patients. All need to be informed repeatedly they are the goodest of girls/boys.
UPDATE: Wow, wasn't expecting this many likes. If you're reading this, please say a kind word to a veterinarian today. There is a dark side to this light banter - the DVM profession has one of the highest rates of suicides. This is due to being exposed to patients dying/performing eutanasia very often (compared to the majority of medical doctors), working under stress, being at the receiving end of angry/grieving owners. We're talking about highly empatic people, often with inadequate mental health care support, and having relatively easy access to medication that can be unfortunately used to end one's life. Thanks for reading.

So I worked the night shift at a nursing home a while back, specifically, memory care. This hits a little too close to home. I had one resident who would throw her poop at us when we came in. I literally started carrying a cardboard shield with me when I went into her room and threw it away every day, made a new one, and so on. I know how this works on an emotional level.

I always wondered what was the thinking behind so many sleep interruptions each time I had a surgery(9 of them so far). I really wish there was the option to recover at a recovery facility if home was not a good place to recover. It would have spead up my healing, in my opinion.

As a patient, I’m not appreciative of pre-rounds, they usually happen an hour after the last time my poor nurse takes my vitals before rounds, between 3-4am 🤣. I’m grateful to y’all regardless of the mild sleep deprivation 😎✊🏽🙏🏽

I kind of like when med students come meet me during their pre rounds because I’m what one med student called “medically interesting”, and it gives them time to ask a bunch of specific questions about my rare condition without the time constraints of the medical team.

I will say that when having a loved one in the hospital, pre-rounds gave me comfort that they were being taken care of & that the med team actually cared. I’m sure it’s cumbersome on your side, but thank you so much for doing them.

As someone who isn’t into medicine this seems like a perfectly reasonable thing for med students to do. It’s kinda like reading through a chapter before attending class

It's a precious moment of autonomy, when med students can safely develop the social skills required to interact with patients one-on-one.

💞Asi con toy y sus mañas no se la loveme.Uno/uchi
Megan: "Hotter"
Hopi: "Sweeter"
Joonie: "Cooler"
Yoongi: "Butter"
Son unos de los mejores conciertos
, no puede ir pero de tan solo verlos desde pantalla, se que estuvo sorprendente. ...

Yes. Hospitals are a great place to stay if your condition is dangerous, or you need urgent or emergency care. They are a terrible place to stay if you need rest and convalescence.

As a chronic illness patient, I don't even question it anymore lol I love talking to the student. I was able to calm a nervous student down once and was so happy!

Asi con toy y sus malas no se la loveme.Uno/PROZEN 💕
Megan: "Hotter"
Hopi: "Sweeter"
Joonie: "Cooler"
Yoongi: "Butter"
Son unos de los mejores conciertos
, no puede ir pero de tan solo verlos desde pantalla, se que estuvo sorprendente .

Asi con toy y sus malas no se la loveme.Uno/PROZEN 💕
Megan: "Hotter"
Hopi: "Sweeter"
Joonie: "Cooler"
Yoongi: "Butter"
Son unos de los mejores conciertos
, no puede ir pero de tan solo verlos desde pantalla, se que estuvo sorprendente .

As a parent of a child that is frequently hospitalized, I actually liked the pre-rounds. Those students were very thoughtful and inquisitive and made sure to ask the team any questions I may have. Being surrounded by a whole team would sometimes feel intimidating.

The point of pre-rounds is to avoid getting destroyed during the rounds.

I feel this on a spiritual level, especially rounding on surgical wards. I genuinely don't understand how this isn't seen as a barrier to better pt recovery. Ok now your elderly post-op is sleeping until 11 because you woke them at 6, and they're too tired for morning physio which means they might get left until tomorrow. Make it make sense.

THIS!! I’m an MA and every time we had a student go to see a patient first it was just take twice as long to get the patient in and out. Of course it’s important for them to get this experience while on clinical rotations, but there’s gotta be a more efficient way of doing things 😩

Someone give this man a trophy. He speaks straight facts!

I was hospitalized for COVID for 15 days, my husband for 2 months before passing away from COVID, and I totally understand this video. You even made me laugh 😂

When I was in the hospital recently, the rounds were completely useless from the patient's perspective. The docs would barely talk to the patients about their conditions or let them share about their symptoms or ask questions. So I would have appreciated the pre-rounds because it sounds like an opportunity to actually talk to someone and not just be treated like a piece of furniture.

"The bureaucracy is expanding to meet the needs of the growing bureaucracy"

to clear up some confusion, rounds are where your examination skills are evaluated by the attendings. its not about efficiency, it's about education. non education hospitals dont need this, attendings will just go over all 30 patients in like 1 hour.
med students need longer time to examine the patients because :
1. we are performing tests not routinely done by attendings
2. we may have to look up how to perform some tests as we go
3. we are way less experienced, meaning we may be digging up some unnecessary data or letting the patient ramble pointlessly. a good physician knows when and how to cut off the patient

So basically pre rounds are unnecessary except for when the med student gets to be scolded about something they did or didn't do 🤣

I loved pre-rounds 🙄 5 yrs living mostly in hospital with my daughter; every 3 hr vitals followed by pre-rounds. I was so deprived of sleep for years; my lucky kid would sleep through all of it. I drew the line at them doing a physical during pre-rounds because that would wake her, and then I’m stuck with a grumpy baby/toddler lol

Watching these medical shorts always informs me of how little actual care I have received during my medical needs. Saying, they’re showing me how things are supposed to be done.

I remember when I went to my dream job for a week (to check out if it was what I wanted) we started work at 6 and then we had to say good morning to all the patients, and we chilled. It was so peaceful.
I can imagine how ER is. Or any other place. Rehabilitation for injuries is better in that place imo

This reminds me about a policy where my dad worked. 2 VPs had to sign a document rather than 1. My dad asked why. The response was, "Because it's policy."
"Why is it policy?"
"Because we get audited on it."
"Why are we audited on it?"
"Because it's policy."
"Why is it policy?"
"Because we get audited on it."
The convo kept going like that until my dad gave up and hunted down another VP and explained the same thing to him with a diagram.

I had a nursing student that came in and asked me questions. She said she was a student and this was required. I did my best to be helpful. She was sweet and being trained to be an awesome nurse. I wish the best for her. 😀

Lmao, this is so true! The patients always hate being awakened at ungodly hours especially after they were already awakened at 2am for vitals. Noone ever really sleeps.

If you're here watching This and feeling inspired then keep going grinding away! keep up the good work and Never Give Up!

Reminds me of an old saying. "The light on top of the tower is for planes so that they see it and don't crash. And the point of the tower is to hold up the light."

You missed the best part of pre-rounds -- none of the blood work has come back (or hasn't even been drawn) and last vitals were at 2 am, so absolutely nothing relevant to present to the team other than patient cursed at me for waking them up early. Good times.

That final line really got me giggling the way he said it 😂

no joke, i was the most tired i've ever been in my life after spending 4 days at the hospital, which was after they admitted me because my hemaglobin was lower than 5. so basically i was more tired from the hospital stay than from having no blood lol

I remember having my appendectomy last year and afterwards being told to get lots of rest to help me recover faster only to be woken up every few hours for the next 4 days.

Actually I read a study once where pre-rounds was a concept specifically to help train med students so that way they had good bedside manner there was something else too but I'm struggling to remember lol

As a person who has spent a great deal of time as a hospital patient, watching all these shorts and tiktoks made by doctors and nurses, I find it so interesting seeing how so many of these hospital practices or as confusing for the staff as they are for the patients.

Prerounds to me if they're kept to trainees are a great way for some hands on training yes its repetitive but that works when it comes to learn how to read charts and questioning patients

In vet med, pre-rounds are secretly extra-time to cuddle with the new puppy/kitty litter that was delivered overnight. The length of the round is also directly proportionate to the cuteness of the patients. All need to be informed repeatedly they are the goodest of girls/boys.

It's a great chance to have all the patients wake up, and use their call lights just before just shift change. It's a wonderful way to lower Nelson Denney scores, because they've been woken up AND neglected by nursing staff who are stressed to the max 😌👍🏾

Oh my gosh the sleep deprivation I went through when I was having surgeries to reconstruct my leg, it was so excruciating. They also wake you around 4am for blood draws.

"So pre-rounding is when you find out what happened overnight?" "Well, actually we hear about overnight events during sign-out." "Signout? what's that?"

As a caregiver who spent years trying to hold down a full time job (average 60-70 hour weeks) while sleeping on the little hospital couches...yeah that extra hour of sleep would've really helped.

When I was a long term patient at one point in my life, sleep was impossible.
2am blood draw
4am xray
6am vitals
8am breakfast
10am family visit/doctor rounds
1pm lunch
3pm Physical Therapy/misc treatment
4pm Vitals
5pm family visit
6pm dinner
8pm misc treatment
10 pm lights out
And I've had chronic insomnia ever since.

Say it louder for the people in the back!!! I know when I stayed in a teaching hospital that had this kind of system,we won't even get into the disaster that was that stay and how unorganized everyone was,us patients were waken up throughout the night for vitals,blood draw at somewhere from 1-3 a.m,i.v pole going off or my roommate's,her vitals didn't get done the same time as mine so the lights got turned on by each other's nurses,then pre round comes in between 5-6 then the group came in around 7ish. And again my roommate had a different team then me so this was done twice essentially. But then they get mad and wonder why you're trying to sleep during the day. 🤦‍♀️😧 all my other stays weren't at a teaching hospital but the other stuff like vitals,blood draws and what not ring true regardless of where ya stay. Along with the why are you sleeping it's not night.

As a recent patient in the hospital, I was ALWAYS asleep when the med student would come in at 5am. They will wake you up and smile in your face while talking loud as you glare at them. I finally asked one of them to come back after they visited the other patients since I was just plain exhausted. They weren't the only ones that never let me sleep. You don't get any rest while in the hospital.

I was awake in the middle of the night looking for sleep meditation, and ended up here on this video. So i watched several of your videos. Of course, I love them. Now to find that sleep meditation.

I love this guy! One time my attending asked why I didnt wake up a completely stable getting outpatient workup inpatient patient....lols.

For my non-med friends, pre-rounds is also a way for med students or interns to learn, talking to the patient and getting additional info like fluids, urine output, pain and discomfort etc, which would take longer during rounds. It's so students gain experience and one-on-one time seeing the patient before the consultant or senior resident, otherwise they won't learn.
Consultants also check the students knowledge about the case during rounds so it's better they are more prepared beforehand. It's more encouraging for me to teach and explain the information to the residents and students if they are aware of the patient's condition. If you don't, then I'm assuming you're not making an effort to know your patient. They appreciate it when the people taking care of them do that.

When I left hospital I was EXHAUSTED, getting home I was able to actually recover & begin to feel better.
Although I did have a nurse come in for 2 hours every day. But she came to me last every day. She could hook up my PICC to IV antibiotics. They take hour n half to run through.
So she did her notes, we watched TV, had chats (I know she was "sneakily" getting more info about my recovery.
It was middle of July & hot as balls. So when the ice-cream truck came outside, my brother (he lurked around our house until my husband got home from work) would head to the ice-cream van and get us all frozen yummies.
But I was so much better rested after I left hospital...

I remember when I spent the night in ICU-like room and the doctor and his minions had a "round." The one on my left side was a burn victim, the one across was in a car accident, while me got a severed artery resulted from a gunshot on the leg. The doctor and his minions did their Q&As in front of the patients but they just completely ignored me when it was my turn. 😅 I was like, "what? My case is not interesting enough?"
The suck part was I also got shot on the left forearm, the bullet actually created a hairline fracture on my radial. The nurse only noticed my forearm injury when she cleaned up the rest of my dried up wound in the morning. I did not feel it since I was still numbed from the post surgery.

Lol as someone with severe medical conditions who has spent years in and out of the hospital, the amount of times someone comes in to ask you a question by the time rounds comes around… 🤣

I remember not getting much sleep when I was hospitalized , but only cause they were terrified of the noises the machine would make every time I drifted to sleep 😅
My O2 sat would drop like a rock, and they just wanted to make sure I wasn’t dead or dying. I was fine. Turns out I just have congenital PAH, diagnosed in 2014 👍 thanks docs

NEVER STOP making your content, you are brilliant 😂😂😂

"Because we have to pre-round"...the sound of his voice was reminiscent of my days when you calculated your drinking to include a good pre-game before transportation and the actual party time. Lmfao 🤣🤣🤣🤣🤣🤣😜🤪

As a patient I fully appreciate the awareness that they keep waking me up

If I had a dime for all times I’ve had this exact conversation my student loans would be paid off 😂

I always thought pre rounds is where the med students make their analysis as if they were the doctors and then in the rounds they confirm or deny if they got things right, it's like their practice

My friend took me with her to the hospital when she had fluid collecting in her lungs and needed it drained. She had to answer like 15 questions to get processed into a room in the er, then the same questions again before they moved her to a room in the actual hospital. Then another round of the same questions in the hospital room by her nurse, before getting those same questions again from a group of doctors, and one last time from her actual assigned doctor. All before they decided they weren't going to drain her lungs until the next day. It was insane.

This is so funny. I recently spent about 3 weeks in the hospital, kidney issue. I saw the hospitalist maybe a total of 3 times. So about once a week. But they changed my meds every day. We’d finally find a routine that controlled the pain, the very next day, the doctor I hadn’t seen, goes in and changes them. It was INFURIATING, for myself and the nurses.

I was a PCA on med/surg neuro for 2 years, and I can confirm that we do not allow patients to sleep at night in the hospital 😂😂

god bless the "pre-rounders"
mom had secondary pulmonary hypertension. i made it a point to be bedside when they came to see her. an M1 took it upon herself to call me every afternoon with any updates. i am sure she and the intern she worked with knew mom inside out and were able to provide detailed info to the team resulting in the excellent care mom received.

As someone who had a heart transplant… Doctors constantly checking in was the bane of my existence. And on top of it UCLA is a learning hospital so add a whole bunch more to whatever is “normal“. I can count on one hand the amount of time I got more than four hours of sleep entire time I was there. I am fairly sure that my recovery would have been drastically improved if I had been able to sleep!

The whole sleep part.. as a nurse I always say.. you didn’t come to the hospital to rest 😂 the sleep is minimal for patients cause nurses do vitals over night as well

Sounds to me like pre-rounds is an excellent learning and practice opportunity for med students who will then eventually be doing rounds for the rest of their lives.
Then again, it's just a med student, so the actual rounds must be done by actual medical professionals just in case anything was missed.

As the exhausted patient please don’t do the pre rounds. The only thing that happened during the night was we were woken up for vitals and gave blood every time we fell asleep good. You missed nothing.

Because what could be worse than letting your patients get a restful night’s sleep :,)

when my mom was in the hospital for a surgery and i was there to take care of her. it was very early morning and i barely slept a blink when the med students came to do pre rounds, but when i thought it was over and i can finally sleep in peace, the nurses and doctors came next to do the rounds ☠️ i felt more tired than my mom tbh lol

YAAASSSSSSSSS LET THE PATIENT SLEEEEEEP AND COME BACK AND TALK TO THEM WHEN THEY'RE AWAKE SO THE PATIENT CAN UNDERSTAND AND REMEMBER WHAT THE DOCTORS TALKED ABOUT! 😇

Based on my (unfortunately) extensive experience as an admitted patient, the med student also has to have this conversation w the majority of the patients they’ve woken. Along with, “we really have to do this again?” and, “you and the vampire phlebotomist! Why is it always when I’m asleep?!”

As a 4th yr medical student, this is so relatable! 😂😂😂

only just realizing as a patient this was what you guys were doing every morning. from my pov it's just getting woken up at 5 to get poked for blood, then 6 and then 7 or 8 😂.
I was hospitalised for so long I learned to sleep through the blood taking and then through breakfast altogether.

Pre-rounding is done to gather subjective data from the patient, and objective data from your physical exam, and then for you as a provider to form a plan to present during rounds. Whether that plan is accepted or not by the attending is another matter, but the idea is that the attending will not be spending more than a fraction of the time you as the primary “responding clinician” does with your patients (attendings will be overseeing an order of 2-4x more patients than residents/NPs/PAs/etc.) The practice of multi-hour walking rounds is meant to teach students/residents in teaching hospitals, but IMO is too cumbersome for many specialties. It works well for ICUs, not sure about other types of units where the number of patients is higher. In my experience pre-rounding combined with sit-down rounds (in a conference/meeting room) is much better for patient and staff quality of life. I usually let my patients “sleep” until 8am, but they have usually already been awoken for vital signs and labs at or before 6am, because we want/need those lab values to help formulate that plan we present at rounds.

As someone who spends a lot of time in the hospital because of a autoimmune disorder, it sometimes can be so frustrating but other times we have a nice talk with everyone, also sometimes they don’t wake the patients up, they will just stand at your door without acknowledging you, talk a bit and then leave so that’s cool ✌🏽

Ah yes, the nice 6am pre-round. Just as you've fallen asleep after the 3am obs 😂

As someone who has had 74 surgeries and been in the hospital for a LOT of their childhood/teenaged years (and some adult years), the point of pre-rounds is to wake the patient up, or in my case a lot of the time, my parent that's staying with me, so when the doctor comes by you can actually be coherent and semi remember any questions you had and what the doctor had to say. My mom use to grumble because she had to get up, get dressed and do her hair at like 5am or earlier. 😂

The way he says “Because we have to pre-round” sounds like he’s questioning everything 😂

I still remember my experience staying at hospitals for about 2 weeks. I had trouble sleeping cause of my illness and 4am-6am is like the golden time for me..it's the time i was in deep sleep..but the nurse, med student & the sanitary staff kept coming & doing their activities, asked me to wake up, to move around so they can change the bed-sheet, checked on me, took my blood, intvwd me..and it's already 7am when they finally gone..then it's time for quick bath & breakfast. I got pretty annoyed at that time. 😁 I feel like screaming "I need my sleep! Please let me sleep!" But i said nothing cause i don't have any energy. 😂 Once i got out of hospital, i slept through the day to payback my sleep deprive. 😂

I love how doctor's are all "rest and recover" and you're awoken at 12am, 3 am, 5am, etc.
"Yeah doc, rest is NOT happening." 😒

Every time I’ve experienced this as a patient, the pre-rounder asks me questions to get all my info, then the doctor comes in and asks all the same questions lol

Pre round at 6am- To wake up the patient and make him wonder if I ever went back home after he went to sleep and make sure he's well awake to watch me getting totalled during rounds!

Never was I so annoyed when, in all my post-partem glory, a med student cane in at 6am and started talking at my sleeping body, awakening me in the middle of whatever it was she was saying to me.

Y'know, it's nice to know why I was woken up so frickin early everyday during my week stay in ICU. I swear I fell back to sleep on multiple days while my nurse was talking. I cannot wake up that early and function enough to give detailed answers 😂

As someone who’s in the hospital a lot (I have an extremely rare eating disorder and constantly need some sort of medical attention) I can say that last time I was hospitalized Pre rounds started around 5:30 am and rounds started around 6 or 6:45 am. And some days the people who do pre rounds are the LOUDEST people in the world.

Omg- I remember I was visiting my Dr for a checkup on my medication and she had student with her who came to see me before and it was weird and awkward cause with was like "New person- Not okay" and then I had the Exact same conversation when the Dr came in but this time with my Dr. Idk, I guess it's a good learning experience? The student was really nice and asked me if I was in school and how school was going and was super shocked when I told her I was still in high school after asking me what I was studying for. 😅 I often get the reaction of people thinking I'm much younger or much older so- she legit double checked my paper and was like "Oh, right, you're sixteen I'm sorry!" In her defense I was there for medication for a stress headache disorder so I would also assume myself an overworked college student ¯\_(ツ)_/¯ but nah, I'm just a mentally ill student with a stress disorder an anxiety disorder and a stressful family 😌 Fucking amazing when your body realizes you're not doing well and so makes your head feel like it's being hit with a damned hammer

I was in the icu for 5 days 2 years ago, I never slept. Eother the monitor of mine or someone else's was going off, or them taking blood,blood pressure, docs and nurses coming in asking how I'm doing!
Honestly loved it! I loved the attention, and I was so exhausted that I would fall back asleep over and over again.

Me, a hospital security officer: "Who called the code gray? (Combative patient)"
Doc: "It was me, he just got combative out of nowhere!"
Me: "Are you sure nothing lead up to this?"
Doc: "Well the nurse woke up him every hour between midnight at 5 AM for meds and he kept telling her to leave him alone so he can sleep but that probably doesn't have anything to do with it".
Me: (attempts to not facepalm in front of the doctor so I don't get fired)

As someone who has been “pre-rounded” on I can tell you that my answers where fairly gibberish

In nursing school we would spend hours the night before clinicals researching our patient and writing up their med list, nursing goals, etc. Half the time we would get there in the morning and they would be discharged and we had to write up everything on a different patient 😬 don't miss those days at all

I remember my daughter was in the hospital and I would sleep overnight in her room. Every morning I would wake up to atleast 10 people standing in the doorway chatting with each other. Now I know what that's called. Thank you.