What To Carry In Your White Coat?

I have to get this off my chest, but I love wearing my white coat. This comes down to one simple thing: pockets. I love being able to carry around supplies, utensils, and references I would otherwise not be able to shove in my clothing pockets. Pens? Check. Peripheral brain? Check. Notepad? Check.

However, I must admit that as my time as a resident I have always been curious what others carry in their pockets? Outside of folded patient censuses, sign-out notes, and various notes, there are somethings that stick out. All to often I point and will ask, "What is that in your pocket?" And no, that is not an innuendo despite that momentary thought. As such, over the years I have accumulated certain items in my pocket that I cannot part with. On the other hand, I at times reach to the bottom of my pocket to find an item that I had thought would be so useful, only to be buried under everything else.

So to begin, there is always a peripheral brain or reference sitting in my pocket. Whether this be a notebook that I have scratched in over the years (eg. drip rate for a ketamine infusion), or a purchased pocket reference, it is always worn down on its edges as time progresses. I have noticed that many prefer to at least have a pocket reference in particular to their specialization or what ever service they are on. All to often they appear and and flipped through as a question arises on rounds, or a dose is sought for a condition.

Taking this into consideration, there are several pocket references that I have seen over the years and that I myself have used multiple times:

• Pocket Medicine: The Massachusetts General Hospital Handbook of Internal Medicine -- This reference is not actually a book but a tiny 3-ring binder that is full of core diseases encountered on the general hospital floor. Information for identifying signs and symptoms, diagnosis and tests, and medications for treatment are included. The particular part I enjoy is that the sections will include the key studies and their references that supports its use.
• Maxwell Quick Medical Reference -- A spiral bound notebook with a hard-cardboard cover that contains quick references to lab values, ACLS procedures, and various physical tests. This is quite useful as a quick reference to data that may be encountered when working up patients. Each section is coded in a different color and makes it easier to peruse.
• The Sanford Guide to Antimicrobial Theory -- This is a yearly serial pocket reference that is very valuable when trying to decide what antibacterial agent to utilize. The guide can be convoluted at times, and all to often I find most users will dog-ear the pages they find most significant to their practice for quick reference. A benefit of the guide is that it offers empirical therapy due to infection by organ system. In addition, specific therapies for treatment of suspected bacteria is available along with cross-references to the spectrum of activity for medications. This is a valuable guide for those unaccustomed to what infective organisms they may come across and desire a pathway to treatment.
• Tarascon Pocket Pharmacopoeia Shirt-Pocket Edition -- Tarascon produces a whole series of medical references for pocket use. These include references of medications, critical care, internal medicine, and others. I find these references are more beneficial to a specific area that someone may feel weak in. This could include a starting resident or medical student that would like to have a reference to medications and their standard dosing, costs, and indications.

There are multiple times where my pockets are filled with rumpled papers. They contain censuses, patient work-ups, sign-outs, etc. I had spent a long time trying to find a way to keep them organized and wound up making my own pocket folder to contain them in. Then one day, I saw my female compatriot with a pink object in her white coat. I meant to ask her what it was after rounds, but she beat me to it. As rounds started she brought it out, and unfolded it. It was a pocket clipboard! I think this has been one of the most shocking things I have seen in use. A fold-able clipboard, that I can hold papers in, and a writing surface while rounding?! Amazing. I had to have one. In all honesty, this is one thing that I find myself carrying no matter what, and has stood the test of time. Its metal design will put up with whatever you drop or hit it against while keeping its contacts secure. In addition, I love the fact that it has on its surface medical information that serves as a great quick reference (eg. standard lab values, assessments, etc.). Here is the link: White Coat Clipboards.

Pens. Pens. Pens. These things are all over my white coat, and I cannot get enough of them. What is often the case that I have seen, is that a resident will become dedicated to a certain pend and love it dearly and search for it desperately if lost, or they will use whatever is around. As you can probably guess, I am the former.

For me, I love a fine tipped pen when writing in a chart in order to cram in as much information as possible in as small of a space. I am not one to scrawl all over a patients chart, but I often find that a smaller fine line allows me to write better. Currently, my favorite pen is the Uni-ball Signo 0.28 Gel Ink Pen. It writes smoothly and is the makes the finest lines I have ever written. In addition to pens, I always carry a highlighter, which I am none to preferential on. Lastly, I like a multi-pen. I am more preferential for the Bic 4-color ball point pen. This is a quick way for me to highlight parts of papers or articles that I read, and I find it beneficial when I need something other than black.

Lastly, if you happen to be a pen connoisseur and enjoy a variety of different pens I have a recommendation: Jet Pens. This site has it ALL. Fountain pens. Ball point pens. Pencils. Gel pens. The service is great and beneficial, and a great place to find writing utensils not found in other stores.

Lastly, there are several things that I carry for my own benefit. This includes post-it notes, and post-it flags to place in charts as reminders for others and myself. I also carry an iTouch for electronic references. I have seen some shove a whole iPad in their white coat, but it just looks to cumbersome for me. I also have a pager, but I prefer it on my coat than sticking it on my belt. Lastly, my ID badge I have on a clip which I hang from my top pocket that I ensure is visible and attached at all times, primarily due to locked areas of the hospital requiring access.

If nothing else to take away, there are two things I recommend. Hand sanitizer. All to often you come into contact with something that requires you to wash your hand as you wonder the hospital, and instant hand wash dispensers are not always within visible reach. Lastly, wash your coat. It needs it.