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Dressing For The Wards


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Hi all,

I am a 2nd year starting clerkship this fall which is exciting and scary all at the same time. I am trying to shop ahead to get some necessities together before the year begins (good shoes, socks, etc.) but am a bit stressed re: what I need for different rotations. I've done a lot of reading and it seems variable from place to place, with a lot of stories from the States, so I'd appreciate a more Canadian perspective.

 

I've got the following basics down:

  • Clinics (formal dress) + wards:
    • Option I: Blouse or button up shirt + skirt + cardigan + stockings / hose + dress shoes
    • Option II: Dress + cardigan + stockings / house + dress shoes
    • Option III: Blouse or button up shirt + pants + cardigan + dress shoes
  • Call in non OB departments + Surg: Scrubs + a layering T-shirt + good socks + comfortable shoes / running shoes
     
  • Call in OB, Delivery: Scrubs + a layering T-shirt + good socks + old running shoes (which I was advised to replace after the OB Unit)

I understand that the following is recommended for deliveries:

  • Personal wear: Scrubs, good socks, old running shoes (dispose of after rotation)
  • PPE: Gown, glove, mask, boots or shoe protectors

And that the following is recommended for ORs:

  • Personal wear: Scrubs, layers, good socks, comfortable shoes because shoe protectors are a given
  • PPE: All that is provided 

My questions are more related to whether I need to get anything else other than what's listed here, and some more logistic questions. Apologies in advance for anything that seems too naive - I've only had observerships in clinics and the procedural rotations are a bit more stressful.  I am not bothered by things that are gross or messy - just worked in a lot of biohazard labs where PPE and being safe was always drilled into my head as the first priority in any situation with contamination. As well, I am not loaded, so if I can protect my clothes a bit, that would be a plus!

  • Would you recommend cloth caps for surgery / OB? I've heard some women say that they feel its gentler on their hair and keeps it clean. Would I be allowed to wear that?
  • Do we wear eye protection during deliveries? 
  • With respect to what I wear under my scrubs - I was planning to get pretty cheap shirts, from Old Navy or a similar store, just to layer, and some cheap leggings. Is there anything else I should be considering?
  • People advise having a set of formal wear on hand when in scrubs, just in case you're called to a clinic. If scrubs are what you wear to deal with situations that are more prone to contamination, how do you change into formal wear and keep that clean? Would that not also be contaminated?
  • If something got particularly messy, is there a place to shower and change before heading home?

 

I know these are a lot of questions so thank you very very much in advance! I'm sure I'll have more questions later and that in a year, I will look back and laugh on how worried I was now, but in the time being, any and all help is very welcome  :)

 

 

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Expect your shoes to get fluid on them in OB and Surg. Plan accordingly. This should mean shoes that can be relatively easily cleaned. Having ones you can simply throw away isn't a bad idea, but not ideal either - if they get soaked in blood or amniotic fluid on Day 1 of your rotation, you're screwed. The shoe protectors are cumbersome and often pretty useless - use them when told to or when everyone else is wearing them, but try not to put too much trust in them.

 

Haven't seen a clerk wear a cloth scrub cap at my site ever. Don't see much reason you couldn't, but you might stand out a bit and get a comment or two from residents/staff. I find the disposable ones work just fine, but I'm a guy and not too concerned about the effect it has on my hair, so take my advice with a grain of salt.

 

Cheap undershirts are a good idea for everyone, but especially for women. Scrubs can be uncomfortably deep-necked... Nothing else is really necessary, though I recommend keeping a change of socks in your bag. If they get dirty, or just get sweaty from being on your feet for 24+ hours straight, it's nice to have that replacement handy.

 

Unless I know I'm on clinics for certain, I just wear scrubs during surgery and don't bother bringing formal wear. If I end up in clinic anyway, I do them in scrubs. So do the other clerks I've worked with. Some sites/attendings may have their own preferences, so keeping a change in a locker or backpack isn't a terrible idea until you get used to things. When in doubt, ask a resident. As for contamination, if you're wearing formal wear in a situation where it's likely to get significant quantities of bodily fluids on them, you probably should just be wearing scrubs. Clinics can involve some office procedures, but none should be overly messy. If you do end up changing from scrubs to formal wear and you're messy from whatever you were doing before, clean yourself up before putting on the new clothes, no reason you should have to get your nicer clothes messy.

 

Showers are usually available near the ORs/delivery rooms if you do end up needing them, which should be fairly rarely, if at all. Change rooms or washrooms are available too.

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Second everything Ralk said.

 

I use http://www.factoryshoe.ca/store/index.php?action=dspProduct&productID=5265&categoryID=24&catalogID=8 as my OR shoes.

 

A clerk wearing a cloth cap will stand out at most places. Probably not the reason you want to stand out but a couple people in my class wore or purchased cloth caps made by a charity to support a village in a third world country. 

 

Most people didn't wear eye protection during deliveries. I wear glasses and never throw anything over them in delivery or the OR (unless Ortho OR).

 

Change your scrubs if they get dirty.

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Expect your shoes to get fluid on them in OB and Surg. Plan accordingly. This should mean shoes that can be relatively easily cleaned. Having ones you can simply throw away isn't a bad idea, but not ideal either - if they get soaked in blood or amniotic fluid on Day 1 of your rotation, you're screwed. The shoe protectors are cumbersome and often pretty useless - use them when told to or when everyone else is wearing them, but try not to put too much trust in them.

 

Haven't seen a clerk wear a cloth scrub cap at my site ever. Don't see much reason you couldn't, but you might stand out a bit and get a comment or two from residents/staff. I find the disposable ones work just fine, but I'm a guy and not too concerned about the effect it has on my hair, so take my advice with a grain of salt.

 

Cheap undershirts are a good idea for everyone, but especially for women. Scrubs can be uncomfortably deep-necked... Nothing else is really necessary, though I recommend keeping a change of socks in your bag. If they get dirty, or just get sweaty from being on your feet for 24+ hours straight, it's nice to have that replacement handy.

 

Unless I know I'm on clinics for certain, I just wear scrubs during surgery and don't bother bringing formal wear. If I end up in clinic anyway, I do them in scrubs. So do the other clerks I've worked with. Some sites/attendings may have their own preferences, so keeping a change in a locker or backpack isn't a terrible idea until you get used to things. When in doubt, ask a resident. As for contamination, if you're wearing formal wear in a situation where it's likely to get significant quantities of bodily fluids on them, you probably should just be wearing scrubs. Clinics can involve some office procedures, but none should be overly messy. If you do end up changing from scrubs to formal wear and you're messy from whatever you were doing before, clean yourself up before putting on the new clothes, no reason you should have to get your nicer clothes messy.

 

Showers are usually available near the ORs/delivery rooms if you do end up needing them, which should be fairly rarely, if at all. Change rooms or washrooms are available too.

 

Thank you so much! This is really wonderful and I appreciate all of the help! Your descriptions helped me get a much better picture of what things were like - a lot of the stuff I had read was not very comprehensive so it was hard to know anything beyond the precise situation being described. In response to one of the comments you mentioned re: the disposable caps, are they available in situations of messy procedures? My hair is long enough that it can be wrapped back with a headband, so it does get in the way, but short enough that it cannot be put into a ponytail or a bun. I was considering just wearing a headband but those tend to cause bad headaches over time and can come across a bit childish. 

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Second everything Ralk said.

 

I use http://www.factoryshoe.ca/store/index.php?action=dspProduct&productID=5265&categoryID=24&catalogID=8 as my OR shoes.

 

A clerk wearing a cloth cap will stand out at most places. Probably not the reason you want to stand out but a couple people in my class wore or purchased cloth caps made by a charity to support a village in a third world country. 

 

Most people didn't wear eye protection during deliveries. I wear glasses and never throw anything over them in delivery or the OR (unless Ortho OR).

 

Change your scrubs if they get dirty.

 

Thank you so much! This is also amazing! Those shoes are fantastic and apparently they make a version for women so that is perfect! As Ralk mentioned re: the soaked shoes, that was another one of my worries - just forgot to add it, so thank you very very much for the link!!!

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Thank you so much! This is really wonderful and I appreciate all of the help! Your descriptions helped me get a much better picture of what things were like - a lot of the stuff I had read was not very comprehensive so it was hard to know anything beyond the precise situation being described. In response to one of the comments you mentioned re: the disposable caps, are they available in situations of messy procedures? My hair is long enough that it can be wrapped back with a headband, so it does get in the way, but short enough that it cannot be put into a ponytail or a bun. I was considering just wearing a headband but those tend to cause bad headaches over time and can come across a bit childish. 

Headwear is found in ORs but in general is not in ERs/Wards/Office Procedures. They are more so for keeping hair from getting into the sterile field than keeping us clean.

 

Procedures tend not to be messy and body fluids rarely if ever go flying (arterial procedures being the exception) and the reason that shoes are the items that get the most dirty is gravity. Even then we have fluid catchers and when there is a spill on the floor nurses throw towels on the ground to mop them up. I think you'll be pleasantly surprised at how "clean" most procedures are.

 

It wouldn't be a terrible idea to keep a headband in your pocket and throw it on if you are doing a minor procedure to keep the hair out of your eyes.

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  • 2 weeks later...

  • Would you recommend cloth caps for surgery / OB? I've heard some women say that they feel its gentler on their hair and keeps it clean. Would I be allowed to wear that?

- I wouldn't, because if it's gonna get dirty, I wouldn't want to wash it in my laundry machine. 

  • Do we wear eye protection during deliveries? 

- You could, but in the rush of the moment you are likely to forget or waste time scramble to find one.

  • With respect to what I wear under my scrubs - I was planning to get pretty cheap shirts, from Old Navy or a similar store, just to layer, and some cheap leggings. Is there anything else I should be considering?

If you really wanna save money wear a bigger size scrub on top of a smaller sized scrub, that way you don't even have to spend money on new shirts.

  • People advise having a set of formal wear on hand when in scrubs, just in case you're called to a clinic. If scrubs are what you wear to deal with situations that are more prone to contamination, how do you change into formal wear and keep that clean? Would that not also be contaminated?

Personally I've degenerated into scrubs for every occasion, clinics, OR, procedure, CTU, surgery, ER, everything. Ok maybe not psych or derm but if you aren't gunning for those two you may even sneak by with scrubs.

  • If something got particularly messy, is there a place to shower and change before heading home?

Try call rooms.

 

My bottom line: to save money, time and hassle, scrubs OD.

 

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I'd recommend getting a pair of Birks or similar rubber shoes/clogs for the OR and OB in particular. They have removable footbeds and otherwise can be literally rinsed off in the tub. They'll keep your feet high and dry!

I wear Birki's daily. I just had to get a new pair since the ones I bought in clerkship cracked in half on me last month. 7 years isn't bad from a pair of shoes I figure.

 

As for layering under scrubs, at many centers you aren't allowed to do this in the OR. And being a med student, the nurses will call you out on it.

 

Cloth hats: Banned at many hospital for ORs now (theoretical infection risk I am told). Some people still wear them then put a buffont hat over them, but I don't see the point of that personally. I just wear the buffont or disposable hats.

 

For open surgery (not lap or endo) wear eye protection and double glove. I wear a half size bigger as my under gloves.

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  • 2 weeks later...

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