I was once told by a patient (as a radiographer), “to you I must be another chest X-ray, but to me, this is the scariest day of my life, so thank you for being so kind”. And that really hit a nerve, you really do become desensitised towards the procedures you do. A CxR is the most common and (boring) projection to perform in my opinion, but after hearing a patients feedback on my work, and how it relates to them. Never again do I look at a CxR request form and get annoyed that I have to do it. So important to treat your patient like a person.

I’m a nurse! We put our pens in our pockets to avoid all of the doctors stealing them haha

As a nursing student, I was taught to NEVER apologize for calling a provider...even if it's in the middle of the night. That's their job. You are doing yours and they should be doing theirs. No apologies needed. Also....the "S" word (slow) is also frowned upon in the ED. 😉

I'm an ER housekeeper and can attest to the chaos after someone said the "Q" word. I have lost count on how many "death glares" I got from the ER staff for saying "quiet".

The lack of pens around nurses is on purpose - we keep them in our pockets, lockers, or purses exclusively so that we do not lose them, especially if we've just bought or found a new fresh box for ourselves.

As a retired nurse, I loved the last video where you said to treat each patient as a family member. I always tried to do this! It helped me give better care for sure.

I'm only in the health-care system as a patient, but I have the best doctors who, I'm convinced, have internalized these rules. And as a retired teacher, I can say that most of these rules apply to us as well. Great content!

Unwritten rule: turn on notifications for Dr Cellini’s channel

More unwritten rules of the hospital: Listen, listen and listen to us nurses. We are here for the pts 24/7, and know them best. When nurses share that a pt is transgender, please use their chosen name and pronouns. So very important! I always carry many pens, and only lend those that I am prepared to not get back. Do not type notes on your laptop as you are reviewing a pt. Very rude and disrespectful. Do not steal anyone's lunch/dinner/food in the staff fridge. If you didn't bring it to work, then it's not yours to eat. Please ask if you can eat the hospital provided food in the fridge. We might be saving it for a pt. Also ask if we have snacks. I know where the Tim Tams are, and keep them hidden! Thanks for a great video!

BWHAHAHAAHH!!! I was in Rehab yesterday and said..."man it's quiet down here"...The THREE Nurses behind the desk collectively yelled: "DON'T!!!!" I almost jumped out of my skin and tiptoed down the hall afterwards. LOL!!!!

Next time I want to give a 'thank you' gift to anyone at a hospital, I'm including a pack of pens. I've heard about the pen thing from SO many nurses and doctors, I feel like a big pack of decent pens (especially if you happened to know their brand/color preference) would be super welcome, lol. Love the part about teaching everyone, that's an excellent rule for ANY line of work!

I was a patient last year in the hospital for a long time, and #2 is so true! Being treated like a person instead of just another patient really helped me through my healing process, so I really appreciate healthcare workers who abide by the second rule in this video!

An unwritten rule should always be...listen to what the patient is telling you! Simple theory but few follow that truly smart rule. 🥰🙏💕

That last rule is kinda funny. Here in Germany we wish each other a "quiet shift" ("ruhige Schicht") when you arrive to or have finished your shift.

One more. Sometime nurses have to call a Doc at night. We don't want too, it is not our favorite thing to do. We get yelled at, our sanity questioned and worst of all, hung up on. I allow the Doc to express his frustration, because I know he has probably been called 3 times before my call. I then take my turn with all the information Doc needs to make a decision on the phone. As for the hangup, I immediately call back say politely, "I'm sorry, we got disconected." It never fails, God is completely different. So nice! After a while Docs get to know me and the calls are incredible!

Rule #3 is very important because without a pen you can’t document anything and of course that leads to lawsuits. I recommend taking numerous pictures to prove the hospital had no pens for you to use just in case you have to go to trial.

The pen thing drives me insane. I’m a pharmacist, I usually have 5 pens and a sharpie on me but I HATE when people ask to borrow a pen. Get your own pens!!

Unwritten rule: as a med student, hide your stethoscope so that the interns / residents won't ask for it to save their face infront of the attending. (I lived in constant dread of losing my stethoscope like half 3 or 4 times when i lent it to them)

I use pens as currency in my hospital.

Many of the concepts you speak of translate well to most work environments. Love your vids and attitude!

One of the things I learned, and this goes along with your teaching others what you are doing like "advanced procedures". The rule is, "WATCH one, DO one, TEACH one". So you don't know how to do "it", watch someone do "it", next chance you get do "it" yourself (usually with someone watching you), then teach someone else who doesn't know how to do "it"!

I appreciate your medical etiquette and ethics so much! So true, you never know when you’ll need “that one person” for something some day. Goes with life in general, right?

I’m not sure why you popped up on my feed... but I needed to hear from you tonight. I have been in a hospital since last Thursday and it is now Monday evening and have had some awful experiences by two nurses here. I am so grateful for the professional other’s that have been here for me as a person. I often times wonder why some people pick their professions. These are young and relatively new to their careers. Within the last couple of years to grow so very hard and disrespectful. Already! 🥰🙏💕

These rules are fantastic Doc, I think your care for patients really shone through in the first few! Also the pen rule made me giggle 😂😂

Best golden and unspoken rules ,Great advise - keep your comments positive & encouraging about your staff and departments in the hospital Be always a team player. You are so on point with your advise. 👍Thank you

Love the pen advice. But, I am always held responsible for required signatures from Doctors. (Apparently, my potty training for my children has now been substituted for for training doctors to do their job and sign their stuff). Therefore, when I hand them something to sign, I give them a pen and then stand there, waiting to get my paper and my pen returned😜

Hi Dr Cellini! great video! I'm pretty sure I commented on your first unwritten rules video because I agreed so much with your rules. These also were right on the money. I worked in rehab and it was always hard not to refer to our patients as the knee/hip replacement in room___. I also giggled about the pen thing. So true! I thought when all our notes went electronic it wouldn't be as much of an issue. Boy was I wrong! Really loved this topic. Stay well! (-:

This is a great video series. Good job.

Before I became an EMT, I was a Correctional Officer in a prison. Inmates in custody of Dept of Corrections prisons are given a "DOC number" used as identification. My prison was large. Every male that was sentenced to prison first arrived to my prison to be processed. When my prison received inmates (refered as reception), assigned them into cells (refered as housed), and transferred them to other prisons (refered as shipped), it was vital to associate inmates with their DOC #. I'm currently an EMT and work for a non emergency patient (refered as passenger) stretcher transport company, I provide nurses the patient's name first then room number. Sometimes the room number my dispatch provided me doesn't match the room the patient is in. I agree not to refer to patients by their room number because they are humans. Secondly because the room numbers aren't always accurate.

A twist on the pen rule: medical students should always carry an extra cheap pen to ‘give’ to attendings/residents when they need them😅😂 Source: I’m a 3rd year

I had a CT scan this past year where the radiologist noted that my gallbladder was unremarkable. My gallbladder was removed 3 years ago. I hate cut and paste. Chart mistakes happen when providers hurry through notes. Read what you check ✔ and don't cut and paste.

One that i'm reading a lot on the med school reddit is that its wise to never tell your school that you missed / need to miss a day of clinical rotations -- just professionally inform your resident/attending and arrange for a make-up date with them, since getting the school involved with cause a giant headache. something i'll be thinking about as i start my 3rd year this summer!

🙏🏻Thank you for the video which allows me to relax before my great immunology exam tomorrow . .

Finishing clin’l rotations (us tech). Been to 6 hospitals; trauma 1 to micro. Size didn’t matter though. Culture did. A couple were Dr Cellini style and just outstanding places to learn. A couple others seemed a culture of indifference. The other two I can barely speak about. But whatever the culture, it ran through the facility like a great vessel. Probably from the top down. Good rules 👍

I noticed this the other day about the pens too. You seriously can’t find one! I’m a hospital chaplain resident and we as chaplains when we are on call doing rounds tell the staff (or on-call chaplains if we are fortunate enough to go home) that “I hope you have a boring night.”

This is great information even for my job as a teacher . Thank you 👍

Wow! AMAZING!

Love the one about the pen! So true

This part is better than part 1. One of your best videos!

Good advice.

Gonna be starting my work as a scribe soon so this video came at a great time for me!

Thanks. Please do a part 3.

The quiet word is very real and people really truly dislike people who say that word. Especially on nights. Lol

Loved 🥰 this!! I think some of these rules could apply elsewhere. Thank you 🙏🏼.

This man out here dropin Q's all over the place as i'm about to head to the hospital. Thanks Dre. Cellini, this is on you lol.

RN’s never let docs borrow their stethoscope! Like pens, they grow legs and walk away

ALWAYS restock your supply carts after using them. I work in an ICU and it is common practice for us (and I'm assuming in many hospitals) to keep supplies stocked in carts that are in each patient room or in each unit. In our ICU and in the ED, we have carts of supplies with syringes, blunt tip needles, saline flushes, gauze, angiocatheters, etc. and procedure-specific carts that the providers use such as our "line cart" which is used for inserting central lines or chest tubes. I cannot emphasize enough how EMBARRASSING it is to bring our line cart into a patient's room because the physician is getting ready to insert a central line into a patient and we can't find ANYTHING we need stocked in the line cart. If you use it, restock it!

Hi Dr. Cellini, hope you are doing well. Loving this new content. Love from FL Hahaha the pen one 😂 so true! As a previous scribe you can’t imagine the amount of times I laid in bed thinking, did I chart that last set of vitals on pt x in room 24?!? The struggle was real

Very nice video amigo !!!!!! Stay Safe all ! ER doc here :)

I was laughing through this like crazy! Super cool Dr. Cellini! Although, I’ve never actually heard anyone say the “Q word” in a hospital setting although it’s an unwritten rule. Lol.

Truth on the pen stuff man! It's crazy😅

Can you do unwritten rules in the hospital for patients? Thanks!

Never mention the name of an ER frequent flyer patient…it will surely bring them in the door 😂

Just a nomination from a patiant: never make bad jokes to the patient or jell at them for there vital funktions. I have a cuple of problems so I'm at hospital at least once a year for at least a week. Last time the surgen told me BEVOR my fist heart surgery (performed just with lokal anesthesia) I was the first person he operate on without a superviser. Later the same one jelled at me because I've got aterial fiblilation and he wanted me to stop it. It was over a year ago but I still have nightmares about that day.

Can you do a video on hardships that you had to overcome in order to get through medical school and become a doctor?

That pen rule speaks on another level!

I worked I'm dialysis for 4.5 years and I refused to treat my patients like patients. They're people that needed dialysis, so they get treated like people. We'd joke and talk and I was always honest with them about everything. I never had a problem with any of them and even had patients asking me to come take care of them when they had an issue occur with another employee because they trusted me. Treat your patients like people and joke with them and educate them and they're infinitely more comfortable... I even had one patient calling me Dr josh because she heard me always teaching new patients about the monitors so they wouldn't be uncomfortable

GREAT VID! Don't forget to try to est, very important, but you are the doctor LOL. THIS IS WHY THEY SAY DOCTOR ARE THE WORST PATIENTS!

Re: No 4 " if you didn't chart it, it didn't happen ". I was thinking about this recently. I think that is a potential loophole clinicians can exploit that we radiologists cannot. Say if a clinical finding was missed on examination and therefore isn't documented then, the assumption is that it must not have been present. However for us, our work is always available for someone else to critique retrospectively which opens us more to litigation.

Oh wow..the pen thing is so true!!

As a Neonatal ICU nurse, the Q word is looked upon as if you were summoning the devil himself! I can honestly say that anytime I’ve been on shift and the Q word was used, all hell would break loose. And I mean every single time. Over the years I’ve even noticed that I will not even use that word outside of work either. 😂

Hi I’m a med school dropout (hated it) but I did learn one hospital rule: besides never saying anything bad about a fellow provider, also never say anything good about a fellow provider. I saw my supervisor make this error and the patient thought he was bragging and the provider whom he had said the good thing about was very put out. Also it can backfire if the patient doesn’t like the one you are praising. The best thing to say to a patient about anyone else in the hospital, as far as I could tell, is nothing at all. If the patient complains about another provider, ask the patient to describe the problem in as much detail as possible. That usually seemed safe. And now that I am (unhappily) often a patient (Parkinson’s and long-term after efforts of cancer surgery) I see docs respond this way - with questions- whenever I say anything about another provider.

I actually knew a few people that worked in the hospital that had side gigs that required some sales or marketing (like their own KZfaq channel, But I retired more than 10 years ago so KZfaq channels were not so popular, yet), somebody got the smart idea to get marketing pens printed up for their side gig and intentionally leave them in the nursing stations and anywhere else people are always looking for pens. Win-win all the way around.

Pens disappear in any kind of care setting. I worked in group homes and we could never find pens either. Next time my son goes into the hospital though; I'll remember to bring a box of pens. (He's got chronic medical issues so he's in and out of hospitals frequently.) And here's another "unspoken rule" doctors should be aware of. DO NOT ASSUME your patient or their family does not know anything about their medical condition(s). Especially someone who has a chronic long term health issue like epilepsy. And particularly parents of sick children. I have a young adult son now who's had epilepsy since he was a baby. I have access to the same Internet the doctor does. Except if I'm not a university student and I want to read a study; I have to pay for access to it. And after 17 years of trying to solve the mystery of my son's form of epilepsy; yes, I can pick out a "spike wave discharges" from "movement artifact" on an EEG. So don't you dare lie to me and tell me a test is "normal" when I know it's not. Due to "mychart" type online records; I also can read the reports and the test results. And if there's something on the report that I don't know what it means; I'll go look it up. I know most people don't do that. But I also know that if my son is going to have the best shot at the highest level of independence that he's capable of attaining. Patient education is very important. Doctors aren't the only ones "putting time into" trying to solve complicated medical issues. Your patient, or their family member may actually be right!

As a younger x-ray tech, I would run to the ER nurses station on 3rd shift and say " It sure in quiet". I would then run away as fast as I could.

One of my favorite doctors is the one that says I don’t know to my question In the same breath he says I will find out or let me look this up So much better than bullshit

As a nurse for many years, I’ve gone home with 4 or 5 pens in my ponytail. Just a habit, lol.

I pick up patients at ER in taxi- nurses always smile at me when I say "have an OK day - I won't use the Q word to you!"

I work at the front desk at a hospital, and now that I've heard so many things about missing pens, I'm just going to take a handful of pens to the nurse stations at the start of my shift

My mom is an RN and moved to a different hospital a few months ago. Two of her managers just got fired because they got into a shouting match in the hallway in the middle of A main hallway between their women’s services units and pediatrics😬😬

As a patient when I was in the medical unit after breakthrough seizures in the mental health unit I kept hearing different codes. I had no clue what the codes meant. I feel it is important that the patients know what the different codes mean. The only one I somewhat knew was code red was because every time it was called the door to the room was closed. Yet, that was all I knew about that code. I didn’t know what any of the other codes meant though. The only one that was really easy to understand was rapid response team to a location or room number.

Your rule about the pens is sooooo on target. I used to swear that people were eating them as snacks. You open up a new box of pens take one and put the rest in a drawer, you go back an hour later because someone used and walked away with the pen you got an hour ago, and the box of pens is totally empty. My nurse manager did a really cool thing one year. She had a bring back the pens work day, where you were supposed to bring back all the pens, scissors, hemostats, carpujets/and the ones that replaced them, and/or anything else you accidentally took home. There were prizes for each shift for the people who brought back the most items. It made for a "fun day" and for at least a week we had pen galore. I suggested we might need to do this monthly, LOL. I was accused of not writing a discharge note, which eventually led to my dismissal from that particular hospital. My best friend/coworker said that they eventually found the discharge note. There was some kind of a computer glitch, and that part of the record went to cyber HELL for a time period of time. You talk about not being afraid to ask questions. When I started right out of nursing school, there was an aid (I honestly don't think she was even a CNA) who had worked at this hospital since they put the plumbing into the original hospital and we had long since been in the new building and the old had been torn down. Anyway, she almost always knew the answers to questions and was fun to work with. She also had horror stories to tell about things that had happened over the years and how things have changed! LOADING THE BOAT...I was so afraid of codes that I was always the 1st or 2nd person on the scene because they were the people who go relieved and became the runners and fetchers for things that were needed or went out to help on the floor during the code. Anyway, I wanted to know about pushing the code drugs and how fast they could be pushed. One of my coworkers gave a "flippant" answer, BUT because it was flippant I never forgot it. She said, "David, push those drugs as fast as you can, they are already dead you can't kill them again!" The first time I said the "Q" word I thought my colleagues were going to kill me. They said the only time we were allowed to say that was at the final report before leaving, LOL!

I am never afraid to say ‘quiet’. I dont believe in magic because I am a grown up. I think people just tend to focus on the bad stuff and blame things like superstitions to make themselves feel better. I have had plenty of quiet nights and days where I had commented on how quiet it was with no issues. I have also had days where I never mentioned the word and things went to sh’t. It is the same thinking of ‘clouds’. It all equalizes in the end, the result is just based on what your mind wants to focus on.

My mother, may G_D rest her soul, was a RN, once witnessed 2 doctors fight over a patient in the parking lot of the hospital!

I have had two doctors come to blows over me and a sugical intervention. My Dad was a doctor. So of course I was shocked. I was prepped and on the gurney almost in the surgery suite. Luckily I got out of surgery and healed on my own.

Yes pens for sure. They just dissappear. I love your videos. Thank you for making them. Oh yea the q word for sure .

Bravo!! I haven’t worked in a hospital in a while. I see things haven’t changed one bit!! I have one though, I had a dream about a week ago that I was back working in the hospital and I came home with 17 pens in my pocket😂😂😂😂😂

As a retired nurse, I walk off with pens, even bank pens with the flowers on top.

Great Video as always! Are there any news about the Podcast? Really looking forward to that

Hahah that last rule is hilarious! As a doctor in Jamaica… we also do NOT say the “Q” word… if anything when wishing our colleagues well as we leave and they come on for the night shift… we will spell out the word but NEVER say it lol

Great tips! Have you thought of doing a video on teleradiology?

I don't mind being referred to as a room number. lol What I dislike: 1) patients are viewed as body parts rather than a whole person; 2) health and fitness aren't promoted to patients and med providers; and 3) direct drug advertising to the public. A couple months ago, Dr Mark Williams wrote an article on Medscape about a new patient who was taking 43 prescribed meds and almost as many OTC drugs. I've never crossed paths with anyone that extreme but have with many who were diagnosed with two or three dozen conditions directly related to my three dislikes.

Agree, and you should do a third video

Ive been in the hospital over 500 days since 2016. I leaned quickly to bring pics… makes you very humanized to your health care providers. I have kids. I am a daughter. I am a granddaughter. And when they see pics, they treat you VERY differently, not just a number

The word it’s Quiet is a no no in the hospital.

I have seen the "q" word work it's magic on more than one occasion.

I’ve had patients ask me about doctors if they were any good or knew what they were doing. I was very careful how I answered! All the cardiologists I worked with were very good at what they did. I liked the Q word advice! You’ll learn not to say or have this in your thoughts. Another thing not to say is, I’ve seen it all. No, no you haven’t. I worked in the medical field for 24 years, and even up to the time I left was surprised by something new.

Excessive documentation demands including multiple unneeded fields and slowed internet does effect direct patient care.

Pens are gold in a restaurant too!

I genuinely shuddered every time you said the "Q" word, even though it is just a video.

From a patient, watch your speech around patients. Just because it’s 3:00 AM and you’re in the hall, don’t assume the patient in bed A is asleep and can’t hear you. I woke up following emergency surgery and three CNAs were just outside the door, mocking my surgeon for his lack of sexual prowess and small private parts--the guy who’d just had his hands in my abdominal cavity four hours earlier. Their choice of adjectives was lewd and mean-spirited. When I filled out the patient satisfaction form at discharge, the CNA’s lack of professionalism was the only seriously negative thing I had to say except that the creamed beef looked unappealing. (Nothing served in a hospital should resemble vomit. I couldn’t eat it because it looked like someone already had!)

Love these videos. But I need to say it. I can't stop thinking about how much Dr. Cellini looks like Zach Braff and Andrew Lincoln's lovechild.

Really appreciate your content. The ultimate aim for me is interventional neuroradiology. Would you happen to know if its more advisable to apply for it after a neurology residency or an diagnostic radiology residency? Thank you

Thanks!

Happened to go onto KZfaq after 19 seconds of posting, but I’m sure it’s a good one

The “Q” even happens in Venezuelan hospital too!!

As a nurse I will have no less than 2 ink pens in the right pocket and 2 sharpies in the left. Also I will unknowingly collect unattended pens throughout the day and empty my pockets before leaving my shift:)

I work in the food management industry. I keep pens in my purse. Lol

I was in the Army for 6 years, our doctors are notoriously bad. One almost killed me by sending me home. That night I had to walk to the ER, had a fever of 104, and ended up spending 2 weeks in a Korean hospital. Nobody spoke English, the medics had to leave to go back to man the ER. They kept wanting me to sign things in Korean. I flipped out so much they gave me a private room and all the morphine I could want. But also put my IV in my right hand so I had a hell of a time showering or brushing my hair. Army doctors...

So, saying it's quiet is akin to saying shutout in hockey. 😃