Useless wankers at the hospital

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ForbiddenComma

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Just some of the useless wankers pulling a paycheck at my hospital and thus driving up healthcare costs with nothing valuable, relevant, or vaguely noticeable to show for it.

1. Nurse Care Coordinator - no, she does not do anything vaguely resembling actual "nursing" and will take offense if you compare her to the RNs who actually do useful work. No, she exists supposedly to arrange for prescriptions and home-healthcare devices such as O2 tank. "But wait, isn't the doctor supposed to do some of that, and the social worker the rest?" Ah, my naive padawan... but why do that when we can have another useless sack of flesh suckling at the healthcare teat? It's not like we have a problem with healthcare costs these days!

2. Nurse Case Manager - As you will notice, many of the people mentioned here have the word "nurse" in their title, although it's been years, perhaps decades since they actually took care of a living patient. It also lets them pollute their white coat with an alphabet soup of titles, some real, some imagined. "Jane Doe, Nurse Case Manager, RN, BSN, MSN, CNA, LOL, WTF." Anyway, I would have more to say about this particular specimen of wanker, except that I have no idea what she actually does. Absolutely none.

3. Med Student - Ok wiseass, I'll deprive you of this "gotcha" reply by being the first to admit to my profound uselessness. But you know what? At least I'm not making the hospital (and by extension, the patients) pay for my useless presence. In fact, last I checked, I was paying THEM for the privilege. Paying quite a handsome sum, in fact.

4. Physical Therapist - Now a special note here. I am NOT saying that PTs are useless. Far from it. All I'm saying is that the PTs AT MY HOSPITAL are useless like tits on a boar. I've seen "progress notes" from them saying, "Patient not seen. Reason: was in the bathroom." And then the PT does not try to see them again FOR THE REST OF THE ENTIRE DAY. Gee, I wonder what would happen if I tried that. "Well Dr. Attending, I didn't round on this patient this morning because he was taking a whiz when I stopped by. That's cool, right?" Oh and plus, this PT actually cancelled a discharge at the last moment for some reason that he didn't even bother to mention in any of his notes. He takes the time to write that he didn't see the patient because he was in the loo, but he can't be bothered to write that the planned discharge that he knew about well in advance is unsafe and only decides to make this pronouncement when the people from the nursing home were literally about to wheel the patient out. Grrrrr!
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5. Nurse Educator - No, this is not someone who teaches the nursing students. As we all know, the nursing schools have to pull teeth to find instructors these days. No, the "Nurse Educator" is supposed to teach the patients how to use their inhaler at home, when to take their pills, and so on. Only... not counting the fact that I never actually see them with a patient, as they spend all day in their office... isn't their job what doctors used to do? Must we really delegate away everything? How can we be sure the "Nurse Educator" would get it right, anyway? If she tells them to pop a Fosamax every day instead of every week, it's not her *** on the line. It's ours.

6. Child Life Specialist - These individuals get paid about 40k-60k a year to play with the kids. That's it. That's all they do. No training, no therapy, no teaching, no nothing. The sort of thing the candystripers used to do in an earlier, more sane world. Damn, I'd pay out of pocket for the ability to just play with sick kids 8 hours a day. And they make a career out of it! One ultimately paid for - and this is the best part - by the families of the sick kids themselves! Well done, you useless wankers. Perhaps you could get a night job as a "Beer Drinking Specialist" and get the bar to pay YOU for the right to drink their beer.
 
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You're right, doctors don't have enough to do. We should definitely take back the teaching responsibilities and coordination of O2 at home...

Let the nurses take that crap. Maybe we can convince the midlevel providers that those responsibilities are all it means to be an MD and we can get them to do it too, instead of making half-a$$ed diagnoses and writing scripts willy-nilly.
 
I like case managers. They get patients OTD faster.

I totally agree with you that med students are useless. I've known it for a while. The only time I doubted it was when I was an M2, and I had to have emergency gyn surgery, and the resident was like, "There's going to be a med student in your case." [I make a face.] "No, we need to have the med student there." Oh yeah, BS, as if other hospitals don't function without med students.

In the span of a week on surgery, I had an attending yell at me saying I wasn't helping in clinic and leave (not bad, I didn't want to be in clinic anyway, the residents pulled me from floor work). Then I had a patient who wanted more pain meds after surgery who just happened to be on the medicine service, not ours, tell me I was "useless" and ask "why are you even here if you can't do anything!?!" Yep yep. She's a pre-med... she's got a lot to learn.
 
ForbiddenComma said:
5. Nurse Educator - No, this is not someone who teaches the nursing students. As we all know, the nursing schools have to pull teeth to find instructors these days. No, the "Nurse Educator" is supposed to teach the patients how to use their inhaler at home, when to take their pills, and so on. Only... not counting the fact that I never actually see them with a patient, as they spend all day in their office... isn't their job what doctors used to do? Must we really delegate away everything? How can we be sure the "Nurse Educator" would get it right, anyway? If she tells them to pop a Fosamax every day instead of every week, it's not her *** on the line. It's ours.
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I thought you were serious until I saw this. How much time do you want to spend telling patients how to use an inhaler, how to inject themselves, and then reading all of the precautions you have already written on the discharge instructions?
 
7. ForbiddenComa: Who hates all the people at the hospital who, properly utilized, could be making his life easier
 
Forbidden, keep on keepin' on. Isn't it awesome how the nursing world works? You work hard on the floors for a couple years and then settle into sweet deskjob where you make more to work less.

Keep on speaking the truth that no one wants to hear. I completely 100% agree with everything you said. I can't hate on the Child Life Specialists though, because for the most part they're young and hot. :D
 
Great thread.

Its bad enough that these people are sucking up paychecks, whats even worse is that most of these scoundrels are trying to change hte law to get reimbursed by Medicare/Medicaid for their "services"

That represents a "clear and present danger" to us doctors. The reason why is because whenever these "providers" get the ability to bill Medicare, their reimbursements come DIRECTLY out of doctors paychecks.

Its all the same pool of money. As the number of "providers" billing Medicare per patient increases, the amount of money that each doctor gets per patient DECREASES.

In the future, the phrase that the media likes to use, "Medicare payments to doctors" no longer has any meaning, because its really money being paid out to a bunch of people, most of them NOT being doctors.
 
Nice assessment and very true.

The case manager is useful unfortunately cause i want the damn patient out the door and society is so F-ed up and sad that they dont have placement to go home. People abuse the system so much.


Feel free to add inpatient nutritionists. Another useless consult in my opinion.
 
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ForbiddenComma said:
6. Child Life Specialist - These individuals get paid about 40k-60k a year to play with the kids. That's it. That's all they do. No training, no therapy, no teaching, no nothing. The sort of thing the candystripers used to do in an earlier, more sane world. Damn, I'd pay out of pocket for the ability to just play with sick kids 8 hours a day. And they make a career out of it! One ultimately paid for - and this is the best part - by the families of the sick kids themselves! Well done, you useless wankers. Perhaps you could get a night job as a "Beer Drinking Specialist" and get the bar to pay YOU for the right to drink their beer.
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velo said:
7. ForbiddenComa: Who hates all the people at the hospital who, properly utilized, could be making his life easier
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Since when do Child Life Specialists make your life easier? :confused:

And besides - it's seems like ForbiddenComma's biggest complaint about the system is NOT that these jobs exist...but rather that so much money is being spent to maintain personnel in these jobs. And I agree with him there - you could get volunteers/candy-stripers to get some stuff done, and that would save a lot of money.
 
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Oh no! The thread got moved! :(

If we we want to fix healthcare, certain sacrifices have to be made, such as doctors once again having to be doctors instead of relying on others to do their work for them.

There is another danger too. For an example of what happens if doctors delegate away too much of their job, I present to you...

7. Pathologists - Again, not all pathologists, just the ones at my hospital. We needed some electron microscopy done on a patient's biopsy sample, but it just wasn't getting done. Days dragged on, turned into a week, and the pt was becoming very unhappy with being cooped up in the hospital just to await the results of one damn study. Finally, the menacing oversized med student (me) went down in person to pathology to see what was up. It turns out that the two techs who run the electron microscope were both out sick or on vacation... and the pathologists themselves were unable to work the electron microscope without them. They delegated so much of their job away that they are now unable to perform their job as pathologist if the techs are gone! Next, we'll get OB/GYNs who can't work an ultrasound because techs do them all. If you need an army of techs and "nurse patient care specialists" to do your job for you, eventually they won't be the useless wankers. It will be you.
 
ForbiddenComma said:
Oh no! The thread got moved! :(

If we we want to fix healthcare, certain sacrifices have to be made, such as doctors once again having to be doctors instead of relying on others to do their work for them.

There is another danger too. For an example of what happens if doctors delegate away too much of their job, I present to you...

7. Pathologists - Again, not all pathologists, just the ones at my hospital. We needed some electron microscopy done on a patient's biopsy sample, but it just wasn't getting done. Days dragged on, turned into a week, and the pt was becoming very unhappy with being cooped up in the hospital just to await the results of one damn study. Finally, the menacing oversized med student (me) went down in person to pathology to see what was up. It turns out that the two techs who run the electron microscope were both out sick or on vacation... and the pathologists themselves were unable to work the electron microscope without them. They delegated so much of their job away that they are now unable to perform their job as pathologist if the techs are gone! Next, we'll get OB/GYNs who can't work an ultrasound because techs do them all. If you need an army of techs and "nurse patient care specialists" to do your job for you, eventually they won't be the useless wankers. It will be you.
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touche

I basically had to beg on my surgery rotation for the privelege of being able to start IVs, draw blood, etc... These skills are so basic, that EVERYONE should know how to do them. Of course, after a little bit of begging, the nurses were happy for the help, and I learned a heck of a lot. However, there are currently students in my class that have never drawn blood. It's almost amazing that one could get to this stage of training and never draw blood. These guys then turn into those residents that can't draw blood and wait around 3:00 am for the "IV team." Anything that you delegate, you should know how to do. PERIOD. Having a resident draw blood at 3:00 am is scut. It's scut because they should already be good at it from medical school.
 
The pinnacle of insanity are the hospitals that require you to consult all of these 'misc. useless services' on EVERY patient regardless of whether they come in for a hangnail or an ascending arch replacement.
And even worse, if you don't consult 'nutrition consult' and 'smoking cessation consult' on your 26hr elective procedure admisison, some 'enforcer RN' with a clipboard will show up and enter the consult requests into your patients chart. Now, meddling into someone elses care is one thing, holding up discharge until all this BS is finished is another (the 'nurse case manager' will put the blame exceeding the allowable length of admission on the admitting physician....).
 
Inpatient Nutritionists: When asked why the hospital had run out of diabetic boost, they claimed it was pharmacies fault. Pharmacy claimed it was there fault. Extensive progress notes read: check prealbumin, add protein supplement, total calories :2000. Still hasn't corrected the nutritional deficiency which plagues the hospitals cafeteria. Another long white coat which needs to be eliminated.

Ward Team Pharmacists: Why are you rounding with our team? Whenever we ask you a question, you reach for your reference. I have hands too. I can check the online pdr faster than you thanks to my SDN typing skills. I check every medication, every day, and know why they are on my patients. I know what to dose per comorbidities, and how. If I don't, I look it up. You don't round with us on the weekends, and you only are present from 9am-12pm on AM rounds. Do the patients die from drug reactions on the weekends or after 3pm when you're at the beach? 80k a year for this?

Diabetes Nurse: 2 page hand-written progress notes. Long white coat. Tells the RN to do all the education with regards to blood glucose monitor, strips, insulin. Assessment? Poor glucose control (BG running in 140s). Plan? Recommend consult endocrinology. Assessment of position: useless. They are most like the accident-prone guy on office space who is fired for "not really doing much of anything". Plan: fire and save the hospital 65k.

Rapid Response Team: The third rail of nursing within our hospital. You criticise them, they call in honor killings on your family. Can be called by any RN, family member, etc. Runs around the hospital, ordering around interns about the dangers of 90% o2 sats. News flash: he has COPD and this is his baseline, and no, 100% o2 is not recommended, and no, it's not an ICU transfer, and no, you cannot write orders, and please, leave the patient and his family alone. After they show up, freaking out and using any opp they can to flash a stethoscope, 3/4 of the families on the floor require xanax. Usually a prime breeding ground for anti-md pre-CRNA students.

Assistant Nurse Managers: Wait, so we have a Nurse Manager for this floor, who wears a long white coat and is mistaken for a physician (yet never corrects anyone), and next door we have the assistant nurse manager? This is for a WARD, not even an entire floor. 18-20 beds tops. Are you kidding me?
 
:laugh::laugh:

ForbiddenComma said:
6. Child Life Specialist - These individuals get paid about 40k-60k a year to play with the kids. That's it. That's all they do. No training, no therapy, no teaching, no nothing. The sort of thing the candystripers used to do in an earlier, more sane world. Damn, I'd pay out of pocket for the ability to just play with sick kids 8 hours a day. And they make a career out of it! One ultimately paid for - and this is the best part - by the families of the sick kids themselves! Well done, you useless wankers. Perhaps you could get a night job as a "Beer Drinking Specialist" and get the bar to pay YOU for the right to drink their beer.
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Since my hospital may use different titles for some of these positions I won't quote directly from the OP but...

Case Coordinator and Social Worker While I agree that a lazy Case Coordinator is not only a drain on the hospital but someone who can actively interfere with you getting your job done (one individual here springs to mind) by and large I find these people to be hardworking, under-appreciated members of the staff who do great work helping us get patients OTD faster and to a place with the appropriate level of care.

Physical Therapy Again, I've had a run-in or two with PT that was irritating, but by and large these are very helpful people when consulted correctly. The problem is they are so rarely consulted correctly. At my hospital there are pre-printed admit forms that have a box for "PT/OT to eval/treat." What the hell is that? First of all PT and OT are not at all the same thing and second of all think of how irritating is it for you when you're on a consult service and some one calls you to "come on by and take a look at this guy" without really saying what's wrong with them. What if every one of your consults was like that? Ridiculous. When I have a focused issue I'd like the PTs to address I don't even have a place on the form to tell them about it.

Clinical Pharmacist Good ones are worth their weight in gold I think. On ID consults our clinical pharm team had information about patterns of resistance in bacteria specific to this hospital. As in, "the acinetobacter the lab has been isolating recently is often only sensitive to colistin" or "our recent MRSA isolates often require a vanc MIC of 1.5 to 2 so we could consider dapto." Also very useful in the ICU, and on the floor they are usually more in the background but when they do chip in it's usually a useful suggestion.


Just want to balance out this thread, I've had good experiences working with most of the positions you've singled out and I don't think it's fair to malign their whole profession just because some individuals in these positions are, indeed, "useless wankers." I'm sure we've all seen plenty of individual residents who are lazy, incompetent, un-productive, and useless but we wouldn't want our hard work belittled just because they suck...
 
Inpatient Nutritionists: When asked why the hospital had run out of diabetic boost, they claimed it was pharmacies fault. Pharmacy claimed it was there fault. Extensive progress notes read: check prealbumin, add protein supplement, total calories :2000. Still hasn't corrected the nutritional deficiency which plagues the hospitals cafeteria. Another long white coat which needs to be eliminated.
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Bwhahahaha!

Maybe we work at the same hospital. These parasites show up without orders or consults written for them. My favorite was when one showed up on a routine elective c-section... who was NPO. Of couse she would need to eat after but how hard is it to write "NPO until flatus, then ad lib as tolerated?" Woah, wait a minute, I just did! Give me my dietician's salary!

At least the Rapid Responses here are currently run by a pulmonologist M.D., but I'm sure it won't be long before they get forced out.

by and large I find these people [social workers] to be hardworking, under-appreciated members of the staff who do great work helping us get patients OTD faster and to a place with the appropriate level of care.
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No argument here. A good LCSW is one of the greatest assets to a team. Unlike say, the "nurse care coordinators."
 
ForbiddenComma said:
2. Nurse Case Manager - As you will notice, many of the people mentioned here have the word "nurse" in their title, although it's been years, perhaps decades since they actually took care of a living patient. It also lets them pollute their white coat with an alphabet soup of titles, some real, some imagined. "Jane Doe, Nurse Case Manager, RN, BSN, MSN, CNA, LOL, WTF." Anyway, I would have more to say about this particular specimen of wanker, except that I have no idea what she actually does. Absolutely none.
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Hahahaaaa
 
smq123 said:
:confused:

What's your problem? There's a fair amount of truth in what ForbiddenComma says.
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Perhaps that there are 150,000 other threads around here bashing these jobs, and it gets old? Hey, I've never performed any of them, but neither has the OP. All I know is that if their job disappears I don't want WHATEVER they do to fall on my shoulders.

Although I agree with #3, of course :)
 
MattD said:
Perhaps that there are 150,000 other threads around here bashing these jobs, and it gets old? Hey, I've never performed any of them, but neither has the OP. All I know is that if their job disappears I don't want WHATEVER they do to fall on my shoulders.
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But that's the thing.

1) Even if their jobs disappeared, it wouldn't necessarily fall on YOUR shoulders.

For instance, "Child Life Specialist"? What, a pre-med student looking for a good volunteer opportunity to boost their app couldn't play with some kids? How hard is it? Heck, I'd love to do that. And it sounds like the PERFECT job for your local pre-med society at your local college.

After all, how many threads are there over in pre-allo looking for "good clinical volunteering opportunities"? Dozens. Maybe hundreds. Well, there you have it. Go play with sick kids - enrich your life and boost your app. And save the hospital 60K a year.

2) Guess what? These jobs ARE there...and yet their responsibilities STILL fall on your shoulders!!!

Wait until your community internal med rotation. The social worker isn't being speedy about sending Mr. Jones to sub-acute rehab? The casemanager has been AWOL for the past 2 days while Mrs. Smith is waiting for a bed at her SNF? Guess who gets to make a ton of phone calls to every sub-acute rehab center in a 60 mile radius? Guess who gets to wrangle with the manager of the nearby SNF? THAT'S RIGHT!! THE MED STUDENT!!!

Why are THEY getting paid, when I did so much of THEIR work? The good ones are fantastic, and deserve to be appreciated - because some of their coworkers, frankly, suck at their jobs.
 
smq123 said:
Why are THEY getting paid, when I did so much of THEIR work? The good ones are fantastic, and deserve to be appreciated - because some of their coworkers, frankly, suck at their jobs.
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So bitch about individuals. When you bitch about them all, you're lumping the good ones in with the bad.

But frankly, I just wasn't in the mood to read more whining that day, so I said so. It's allowed, and we'll all live. Hell it seems you took more offense than the OP did.

Make love, not war ;)

BTW, you just got finished telling me the jobs wouldn't necessarily fall on MY shoulders if the positions weren't there, but then, with the exception of Child Life Specialist, you ranted about how the job ALREADY falls on the med student's shoulders when the people with the positions don't perform. Contradictory much?
 
"Rapid Response Team: The third rail of nursing within our hospital. You criticise them, they call in honor killings on your family. Can be called by any RN, family member, etc. Runs around the hospital, ordering around interns about the dangers of 90% o2 sats. News flash: he has COPD and this is his baseline, and no, 100% o2 is not recommended, and no, it's not an ICU transfer, and no, you cannot write orders, and please, leave the patient and his family alone. After they show up, freaking out and using any opp they can to flash a stethoscope, 3/4 of the families on the floor require xanax. Usually a prime breeding ground for anti-md pre-CRNA students"

AGREE- SOMETIMES they show up to apply common sense and do all the obvious stuff that should have been done earlier if the regular floor staff had their wits about them....other times they shouldn't be there at all....I have literally kicked them out of the room before when someone called for a guy with rib fxs having chest pain....HE HAS RIB FXS! THEY HURT! HE JUST NEEDS MORE ANALGESIC NOT AN ACTIVATION OF THE CATH LAB TEAM!
 
lord_jeebus said:
Challenge! Find the nurse with the most letters after his/her name.

My record is 24 (second on this list)
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Heh. All the MDs on that list look like peons in comparison. All you have is one degree? 'scuse me while I whip this out. :laugh:

By the way, pathologists do not normally know how to run electron microscopes. For the same reason that the vast majority of internists do not know how to actually perform any of the tests they order. That's why you have people who do these things as their job. Don't be silly. The fact that they had no one to come in and perform the test is poor form, however. The truth is that EM rarely adds anything to a diagnosis apart from in renal pathology and selected instances in pediatric path. When pathologists have to resort to doing EM on a tumor it's usually, these days, pretty much a last resort.
 
It was actually for a renal case, a complicated one at that... so yeah we needed that EM report.

Not too long ago, doctors were trained how to do IVs, run labs and that sort of thing. Now, we are helpless without the IV team and phebotomists. Sure that's not a problem at a big hospital (not usually anyway) but what if you are out in the boondocks? What if you're with Doctors Without Borders? What if you're in the military? What if you are with an ambulance crew or flight med crew? What if the nurses or techs go on strike? What if there's another Katrina or 9/11? Do you really want to be a useless wanker when your patient just needs fluids?

Or what if you just do it to help out, when the RNs are overworked or the slacker phlebotomist isn't showing up until 10 am?

I could go on, but the main thing is, I personally don't want gaps and limitations in my medical training like that. Even if I never need to start an IV for my entire career, I want to know that I can.
 
ForbiddenComma said:
It was actually for a renal case, a complicated one at that... so yeah we needed that EM report.

Not too long ago, doctors were trained how to do IVs, run labs and that sort of thing. Now, we are helpless without the IV team and phebotomists. Sure that's not a problem at a big hospital (not usually anyway) but what if you are out in the boondocks? What if you're with Doctors Without Borders? What if you're in the military? What if you are with an ambulance crew or flight med crew? What if the nurses or techs go on strike? What if there's another Katrina or 9/11? Do you really want to be a useless wanker when your patient just needs fluids?

Or what if you just do it to help out, when the RNs are overworked or the slacker phlebotomist isn't showing up until 10 am?

I could go on, but the main thing is, I personally don't want gaps and limitations in my medical training like that. Even if I never need to start an IV for my entire career, I want to know that I can.
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you can always have one of the pa's do that stuff for you.....:)
 
ForbiddenComma said:
It was actually for a renal case, a complicated one at that... so yeah we needed that EM report.

Not too long ago, doctors were trained how to do IVs, run labs and that sort of thing. Now, we are helpless without the IV team and phebotomists. Sure that's not a problem at a big hospital (not usually anyway) but what if you are out in the boondocks? What if you're with Doctors Without Borders? What if you're in the military? What if you are with an ambulance crew or flight med crew? What if the nurses or techs go on strike? What if there's another Katrina or 9/11? Do you really want to be a useless wanker when your patient just needs fluids?

Or what if you just do it to help out, when the RNs are overworked or the slacker phlebotomist isn't showing up until 10 am?

I could go on, but the main thing is, I personally don't want gaps and limitations in my medical training like that. Even if I never need to start an IV for my entire career, I want to know that I can.
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But you won't be able to. Even if you know how to start an IV it's a manual skill. If you haven't done it in 20 years odds are you'll fail. Same with the case manager. She will know what nursing home will take whatever insurance they take which changes every few months. Unless you're willing to keep up on that crap let them do it.
 
ForbiddenComma said:
It was actually for a renal case, a complicated one at that... so yeah we needed that EM report.

Not too long ago, doctors were trained how to do IVs, run labs and that sort of thing. Now, we are helpless without the IV team and phebotomists. Sure that's not a problem at a big hospital (not usually anyway) but what if you are out in the boondocks? What if you're with Doctors Without Borders? What if you're in the military? What if you are with an ambulance crew or flight med crew? What if the nurses or techs go on strike? What if there's another Katrina or 9/11? Do you really want to be a useless wanker when your patient just needs fluids?

Or what if you just do it to help out, when the RNs are overworked or the slacker phlebotomist isn't showing up until 10 am?

I could go on, but the main thing is, I personally don't want gaps and limitations in my medical training like that. Even if I never need to start an IV for my entire career, I want to know that I can.
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Not long ago there were only a few things you needed to know how to do - the breadth of knowledge was not as big. I mean, in pathology 50 years ago there were like 50 total diagnoses you would ever make. Now there are about 50 diagnoses you can make in just the prostate.

Personally, I agree, you should be able to do things that are common and are important - like IVs if you're in a hospital setting. But these days we can't even get people to fill out requisition forms correctly, so I don't know how we should expect them to do complicated things like drawing their own bloodwork! But you can't become in expert in everything, all the minutae, things that you need to be fully trained in to be competent at (like running an EM). If you spend months learning how to accurately run an EM, then you aren't learning more important and vital things.
 
ForbiddenComma said:
It was actually for a renal case, a complicated one at that... so yeah we needed that EM report.

Not too long ago, doctors were trained how to do IVs, run labs and that sort of thing. Now, we are helpless without the IV team and phebotomists. Sure that's not a problem at a big hospital (not usually anyway) but what if you are out in the boondocks? What if you're with Doctors Without Borders? What if you're in the military? What if you are with an ambulance crew or flight med crew? What if the nurses or techs go on strike? What if there's another Katrina or 9/11? Do you really want to be a useless wanker when your patient just needs fluids?

Or what if you just do it to help out, when the RNs are overworked or the slacker phlebotomist isn't showing up until 10 am?

I could go on, but the main thing is, I personally don't want gaps and limitations in my medical training like that. Even if I never need to start an IV for my entire career, I want to know that I can.
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If you're in the field with MSF and you're trying to get electron microscopy done.....

:-D
 
ForbiddenComma said:
2. Nurse Case Manager - As you will notice, many of the people mentioned here have the word "nurse" in their title, although it's been years, perhaps decades since they actually took care of a living patient. It also lets them pollute their white coat with an alphabet soup of titles, some real, some imagined. "Jane Doe, Nurse Case Manager, RN, BSN, MSN, CNA, LOL, WTF." Anyway, I would have more to say about this particular specimen of wanker, except that I have no idea what she actually does. Absolutely none.
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LOL. Those nurses with 10 different abbreviations after their name are the worst. It's such an ego trip. I would love to play a prank of getting a hold of one of their white coats and embroidering "OMGWTFBBQ" at the end of their list.
 
Rapid Response Team: The third rail of nursing within our hospital. You criticise them, they call in honor killings on your family. Can be called by any RN, family member, etc. Runs around the hospital, ordering around interns about the dangers of 90% o2 sats. News flash: he has COPD and this is his baseline, and no, 100% o2 is not recommended, and no, it's not an ICU transfer, and no, you cannot write orders, and please, leave the patient and his family alone. After they show up, freaking out and using any opp they can to flash a stethoscope, 3/4 of the families on the floor require xanax. Usually a prime breeding ground for anti-md pre-CRNA students.
Click to expand...

Coastie: If you ever decide to leave medicine, I think you should try your hand at writing humor. I was laughing so hard I was crying. I also have a really bad case of bronchitis, so then I started wheezing from laughing so hard, which necessitated a prn hit on my albuterol inhaler--THANKS A LOT!
 
Nurse Manager: Or at least the person who claims to be the nurse manager, because to be honest, I had never seen you the entire year I've been managing patients on this ward until now. So let me get this straight. You have charge nurses that direct the floor nurses. You have a scheduling committee who does everyone's schedule. You have CNS's who do inservices for the staff. What exactly are you managing again? Go back to your office and return to your solitaire and/or porn. Your existence is not required here.

Risk Management: Are you joking? Do you have any idea how much dangerous **** goes on around here? My septic patient down the hall didn't get antibiotics for 12hrs because the fax machine in pharmacy was broken. My afib patient had his beta-blocker held because "BP was normal". Managing risk in a hospital is like trying to stop a runaway train with pillow and a big rubber band.

That fat guy in scrubs who I see 29 times a day standing in the hall chatting with other staff members: I really wish you wore a nametag, because I desperately want to drop out of internship and apply for your job.
 
Tired said:
That fat guy in scrubs who I see 29 times a day standing in the hall chatting with other staff members: I really wish you wore a nametag, because I desperately want to drop out of internship and apply for your job.
Click to expand...

Pst, that is your chairman.
 
Sounds like somebody needs Rapid Response!

fab4fan said:
Coastie: If you ever decide to leave medicine, I think you should try your hand at writing humor. I was laughing so hard I was crying. I also have a really bad case of bronchitis, so then I started wheezing from laughing so hard, which necessitated a prn hit on my albuterol inhaler--THANKS A LOT!
Click to expand...
 
That fat guy in scrubs who I see 29 times a day standing in the hall chatting with other staff members: I really wish you wore a nametag, because I desperately want to drop out of internship and apply for your job.
Click to expand...

Pst, that is your chairman.
Click to expand...

Winner... and another winner! :laugh:
 
Speech Therapy: So let me get this straight. I watched the patient choke when drinking liquids, and I want to get a fluoro study to see what consistency he aspirates. But in order to do that, I have to call you, so that you can watch the patient choke when drinking liquids, then tell me to get a fluoro study to see what consistency he aspirates. Brilliant.

Biomedical Engineering: Theoretically you are supposed to take broken equiptment, fix it, and return it. But instead you take it away, and it never returns. A more appropriate title would be "garbage man".

Nurse Educator: Seriously, it's not working.
 
Tired said:
Speech Therapy: So let me get this straight. I watched the patient choke when drinking liquids, and I want to get a fluoro study to see what consistency he aspirates. But in order to do that, I have to call you, so that you can watch the patient choke when drinking liquids, then tell me to get a fluoro study to see what consistency he aspirates. Brilliant.
Click to expand...

Soooo.. true.

Tired said:
Biomedical Engineering: Theoretically you are supposed to take broken equiptment, fix it, and return it. But instead you take it away, and it never returns. A more appropriate title would be "garbage man".
Click to expand...

Most instruments get returned to their company to be replaced. The biomedical engineers that actually want to work will never come to hospitals for a job, that's a dead end job.
 
Im a Registered Respiratory Therapist on a Rapid Response Team at a Philly Trauma hospital. I take offense to the Insults. I like running around and scaring families. Don't take that away from me. Its the highlight of my day.I love bossing around Med students,nursing students, all students LOL. Well now that im about to become a med student..I hope karma doesn't come back and bite me in the butt. Last time i checked its not illegal to Scare people is it?
 
Coastie said:
Inpatient Nutritionists: When asked why the hospital had run out of diabetic boost, they claimed it was pharmacies fault. Pharmacy claimed it was there fault. Extensive progress notes read: check prealbumin, add protein supplement, total calories :2000. Still hasn't corrected the nutritional deficiency which plagues the hospitals cafeteria. Another long white coat which needs to be eliminated.

Ward Team Pharmacists: Why are you rounding with our team? Whenever we ask you a question, you reach for your reference. I have hands too. I can check the online pdr faster than you thanks to my SDN typing skills. I check every medication, every day, and know why they are on my patients. I know what to dose per comorbidities, and how. If I don't, I look it up. You don't round with us on the weekends, and you only are present from 9am-12pm on AM rounds. Do the patients die from drug reactions on the weekends or after 3pm when you're at the beach? 80k a year for this?

Diabetes Nurse: 2 page hand-written progress notes. Long white coat. Tells the RN to do all the education with regards to blood glucose monitor, strips, insulin. Assessment? Poor glucose control (BG running in 140s). Plan? Recommend consult endocrinology. Assessment of position: useless. They are most like the accident-prone guy on office space who is fired for "not really doing much of anything". Plan: fire and save the hospital 65k.

Rapid Response Team: The third rail of nursing within our hospital. You criticise them, they call in honor killings on your family. Can be called by any RN, family member, etc. Runs around the hospital, ordering around interns about the dangers of 90% o2 sats. News flash: he has COPD and this is his baseline, and no, 100% o2 is not recommended, and no, it's not an ICU transfer, and no, you cannot write orders, and please, leave the patient and his family alone. After they show up, freaking out and using any opp they can to flash a stethoscope, 3/4 of the families on the floor require xanax. Usually a prime breeding ground for anti-md pre-CRNA students.

Assistant Nurse Managers: Wait, so we have a Nurse Manager for this floor, who wears a long white coat and is mistaken for a physician (yet never corrects anyone), and next door we have the assistant nurse manager? This is for a WARD, not even an entire floor. 18-20 beds tops. Are you kidding me?
Click to expand...


sorry rrt is definitely useful. For people who are not coding but looking pretty bad...
 
Also, a lot of the extra nursing faculty has to be in place so the company looks good when they apply for magnet status.
 
shmrshines said:
sorry rrt is definitely useful. For people who are not coding but looking pretty bad...
Click to expand...

Yes, it's crucial to get someone to the bedside to give oxygen, check vital signs, take an EKG, draw labs, and call the primary physician.

Of course, that "someone" used to be the bedside nurse(s). Fortunately for them there are now RRTs.

Now online shoe-shopping need not be interrupted for trivial things like changes in the patient's status.
 
Surgical Scheduler:

I see the patient preop, take an H&P, and order preop labs and discharge meds. I call the OR to check on room and staff availability. I send the patient to the Anesthesia preop center. I write down all of this on an overly-complex form which includes the date, time, and room we will be operating in.

I give you all the paperwork. You type something on your computer for five minutes, and hand everything back to me.

And all I can wonder is what purpose you could possibly serve, and why you get an office while I get a cubicle.
 
Im going to have to go with nutrition. Their major help to me is when there is tube feeding or tpn. Otherwise..the 10 minute discussion about whether the diet should be "regular" or "low fat" or 1800 cal versus 2000 calories--or whether we should give 3 cans of "boost" or "boost plus" is gripping and crucial.
 
Tired said:
Yes, it's crucial to get someone to the bedside to give oxygen, check vital signs, take an EKG, draw labs, and call the primary physician.

Of course, that "someone" used to be the bedside nurse(s). Fortunately for them there are now RRTs.

Now online shoe-shopping need not be interrupted for trivial things like changes in the patient's status.
Click to expand...

Outside of the ICU (I usually really like the ICU nurses), I often can't really figure out what the nurses do except for chart and change the occasional diaper or clean up vomit. Like my complaints about many doctors, they are also deferring a good deal of their skills to other people. RRT do what you mentioned above, assistants or LPNs do vitals. I often can't find anyone on a floor who knows how to take a manual BP or pulse (which is a little scary). They occasionally get meds together, which is 5% actually doing something and 95% charting the med or calling the doctor to complain about the med.
 
spicey said:
Im a Registered Respiratory Therapist on a Rapid Response Team at a Philly Trauma hospital. I take offense to the Insults. I like running around and scaring families. Don't take that away from me. Its the highlight of my day.I love bossing around Med students,nursing students, all students LOL. Well now that im about to become a med student..I hope karma doesn't come back and bite me in the butt. Last time i checked its not illegal to Scare people is it?
Click to expand...

Scaring people should be the most important part of your job. Keep up the good work.
 
Miami_med said:
Outside of the ICU (I usually really like the ICU nurses), I often can't really figure out what the nurses do except for chart and change the occasional diaper or clean up vomit. Like my complaints about many doctors, they are also deferring a good deal of their skills to other people. RRT do what you mentioned above, assistants or LPNs do vitals. I often can't find anyone on a floor who knows how to take a manual BP or pulse (which is a little scary). They occasionally get meds together, which is 5% actually doing something and 95% charting the med or calling the doctor to complain about the med.
Click to expand...

Here's what I can remember doing many years ago in a small hospital as a nurse...diathermy, electrical muscle stimulation, range of motion, IPPB treatments (they still have those green machines?) and God knows what else that would get me into trouble these days, if the mandated paperwork would allow me the time.
 
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