Doctor please ... I want to go to the bathroom - USMLE Forums
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USMLE Step 2 CS SP Challenges Challenging situations presented by the Standardized Patient (SP) during the the USMLE Step 2 CS Encounter.


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  #1  
Old 12-22-2009
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Question Doctor please ... I want to go to the bathroom

If the SP insisted on going to the bathroom as he can't hold it anymore
What should we do
Should we allow him to go!!
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  #2  
Old 12-22-2009
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This is interesting
I want to know the answer to this also
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  #3  
Old 12-23-2009
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Quote:
Originally Posted by Evgeniy View Post
If the SP insisted on going to the bathroom as he can't hold it anymore
What should we do
Should we allow him to go!!
sure..imagine u r a patient in such situation... and the doctor is not allowing to go...
but i know such case wont happen!
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  #4  
Old 12-23-2009
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Quote:
Originally Posted by syedaanaqvi View Post
sure..imagine u r a patient in such situation... and the doctor is not allowing to go...
but i know such case wont happen!
In fact.....I had acute retention of urine in my real exam, so the patient was in distress, said he has to go to bathroom if he can pass now, i told him, i am just gonna take his 15 minutes , and in these 15 minutes , i will be trying to assess as to why he is having this problem and how I can be of help, so he has to let me help him and I REASSURED HIM THAT SOMETHING BENEFICIAL IS GONNA COME OUT OF THIS TALK, and that i totally understand the kind of discomfort he is going through also then he can can go and take a try of naturally passing urine and even after that try, he is not able to, i have a way of relieving him of his problem by putting a tube through his urinary passage and now that you are in my care, everything will be streamlined....
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  #5  
Old 12-23-2009
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Originally Posted by accurate View Post
In fact.....I had acute retention of urine in my real exam, so the patient was in distress, said he has to go to bathroom if he can pass now, i told him, i am just gonna take his 15 minutes , and in these 15 minutes , i will be trying to assess as to why he is having this problem and how I can be of help, so he has to let me help him and I REASSURED HIM THAT SOMETHING BENEFICIAL IS GONNA COME OUT OF THIS TALK, and that i totally understand the kind of discomfort he is going through also then he can can go and take a try of naturally passing urine and even after that try, he is not able to, i have a way of relieving him of his problem by putting a tube through his urinary passage and now that you are in my care, everything will be streamlined....
nice.. i agree with u.
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  #6  
Old 12-24-2009
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This has happened with my friends exam
The answer given by accurate is not so accurate

Although this is a mock exam and the patients are not real but you have to pretend it's a real situation.
Attending to patients immediate needs are of utmost importance to show your sympathy and rapport.
If the patient asks you to go to the bathroom you have to let him/her go.
The SP will leave the room and re-enter it after few seconds saying to you thanks Doc now am relieved
The SP is testing your sympathy and understanding but they know very well and they have been instructed not to waste your precious time so if such things happen they'll leave the room for only few seconds and they will not really spend time in the bathroom.

Good luck to all
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Old 12-24-2009
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I described the counseling that could be done for acute retention of urine , not hyperactive bladder, what 1a4usmle's friend got must be just the opposite as mine, sp I got just wanted to try to pass now after he felt, he could, i had to tell him what i did......i can't understand why 1a4usmle misinterpreted my scenario
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  #8  
Old 12-24-2009
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Quote:
Originally Posted by accurate View Post
I described the counseling that could be done for acute retention of urine , not hyperactive bladder, what 1a4usmle's friend got must be just the opposite as mine, sp I got just wanted to try to pass now after he felt, he could, i had to tell him what i did......i can't understand why 1a4usmle misinterpreted my scenario
I did not misinterpret your scenario.
The solution should be the same even if it's urine retention. You let the patient go.
Nothing personal here ... dude
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Old 12-24-2009
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DEFINITELY NOT PERSONAL, THIS ALL IS EDUCATIONAL,I disagree,In acute retention of urine, as the case that i described my most probable diagnosis was BPH, he was 50 year old guy with both irritative and obstructive symptoms since a really long time, so as per disease pathology he would keeping on feeling that he can pass urine(irritative symptoms)due to enlarged prostate, so letting him go would have meant, i am not aware of presentation ofthe disease -a , then would have sent a message that i cannot convince him that i can help-b, that i have a solution of catheterization-c, this exam meant for displaying your medical knowledge and clinical skills and not behave like a lay man
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Old 03-08-2010
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do not go so deep ,u will never got like this cases life is easy baby .
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Old 03-12-2010
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Hi
Rule number one in the CS exam is the patient comfort. Ask him if goining to the bathroom makes him feels better right now, he will tell you: no it is ok or he will tell you I tried but I couldn't. Then ask him if we can proceed with the history and physical exam (because he knows that this is a time limited simulated test and he don't want to waste your time) but that way you earn a point in empathy and patient satisfaction.
Goodluck
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  #12  
Old 03-12-2010
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Quote:
Originally Posted by ApplicantGuide View Post
Hi
Rule number one in the CS exam is the patient comfort. Ask him if goining to the bathroom makes him feels better right now, he will tell you: no it is ok or he will tell you I tried but I couldn't. Then ask him if we can proceed with the history and physical exam (because he knows that this is a time limited simulated test and he don't want to waste your time) but that way you earn a point in empathy and patient satisfaction.
Goodluck
Your solution is the best
You are awesome Applicant Guide
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  #13  
Old 04-11-2016
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Good to know. Never imagined this scenario.
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  #14  
Old 05-02-2016
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X Ray thanks for sharing !!

Thanks for sharing. Interesting scenario.
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  #15  
Old 06-27-2016
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wow thats crazy! nice response though!
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