Resident Expectations?

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gasresmd

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Hi all - I'm a CA-2 anesthesiology resident and I'm becoming more and more frustrated by my daily work... I'm wondering if anyone can tell me how much of my frustrations are institution/residency specific, and how much of this all is part of the downfall of our profession?

I'm tired of scrub techs, OR techs, and OR nurses talking down to me and not helping me in any way whatsoever. Case in point, I have a morbidly obese patient who needs a bit of ramp enhancement and I ask the OR nurse for more blankets to ramp the patient - the nurse refuses to get them, telling me what I can get them myself. Or I come into the OR with an 80 yr old half dead patient and the OR staff is blasting Ke$sha - then they refuse to turn it off when I tell them that we're in the room and to turn of the music / be profesional.

I'm also sick of frequenstly having to turn over my own room - wiping down my machine, making the bed, restocking my omnicell, and restocking my anesthesia supplies from the workroom (syringes, ET tubes, alaris pumps, etc). Don't we have techs for this kind of thing?

I also get so frustrated that CRNAs on 12 hour shifts need to "take a break" and I get called on my 20th hour of work to do an absurd lap chole so that the CRNA isn't overworked. Is it normal for residents to fluff CRNAs and keep them comfortable and happy?

It seems like the giant losers in the academic workflow are anesthesiology residents - CRNAs, techs, and even the janitors seem to be treated better. To what degree is this all simply the plight of physician anesthesiologists these days, and how much of this is program malignancy or residency frustration?

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At my school, they have anesthesia techs that turn over anything anesthesia related after every case.

Of course my n = 7, as far as different hospital ORs ive been in, but it sounds to me that you are describing the culture at your place. Which is probably not rare; but its not like that everywhere. Especially not in PP from what I hear.
 
If you are a current CA-2 that must mean you will be finishing in about 15 months. It sounds like you are in a typical academic hospital with a weak anesthesia department that allows their residents to be treated like crap. It sucks; its not right; but unfortunately that is the reality of being an anesthesia resident in a lot of programs. However, at this point in your life it is not worth it to fight any of those battles. My advice to you is to show up to work, work hard, get the best clinical training possible, let all of the B.S. glide off of you like water, pass your boards, and move on with your life. Five years from now you will likely be at a job where you will have much more respect, better pay, better hours, and more vacations. Those same lazy, miserable scrub techs and nurses will still probably be at their same job and all of the crap that you experienced as a resident will slowly fade from your memory.
 
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Hi all - I'm a CA-2 anesthesiology resident and I'm becoming more and more frustrated by my daily work... I'm wondering if anyone can tell me how much of my frustrations are institution/residency specific, and how much of this all is part of the downfall of our profession?

I'm tired of scrub techs, OR techs, and OR nurses talking down to me and not helping me in any way whatsoever. Case in point, I have a morbidly obese patient who needs a bit of ramp enhancement and I ask the OR nurse for more blankets to ramp the patient - the nurse refuses to get them, telling me what I can get them myself. Or I come into the OR with an 80 yr old half dead patient and the OR staff is blasting Ke$sha - then they refuse to turn it off when I tell them that we're in the room and to turn of the music / be profesional.

I'm also sick of frequenstly having to turn over my own room - wiping down my machine, making the bed, restocking my omnicell, and restocking my anesthesia supplies from the workroom (syringes, ET tubes, alaris pumps, etc). Don't we have techs for this kind of thing?

I also get so frustrated that CRNAs on 12 hour shifts need to "take a break" and I get called on my 20th hour of work to do an absurd lap chole so that the CRNA isn't overworked. Is it normal for residents to fluff CRNAs and keep them comfortable and happy?

It seems like the giant losers in the academic workflow are anesthesiology residents - CRNAs, techs, and even the janitors seem to be treated better. To what degree is this all simply the plight of physician anesthesiologists these days, and how much of this is program malignancy or residency frustration?

Is this a Manhattan program...
 
None of this is a problem at my academic children's hospital.
Except for the Crna thing. They are shift workers and we almost never pay them overtime. We will sit a faculty alone before we pay overtime. The late/call residents and fellows do all the work after 7.
Keep your head down and grind it out, don't sweat it, don't complain, get it done and reap the rewards in a few short years.
 
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we occasionally get attitude from nurses about getting things yourself too - if it's pre induction I let it slide ... doesn't effect patient safety.

if music is distracting you or impairing communication with the patient or your assistant however - I would not induce until the music was turned off... does effect patient safety
 
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When I get frustrated by situations largely outside of my control, I try and focus on the things I CAN control that might swing things into my favor. For example, getting people to *want* to work for you is an art, and starts with very little things: remembering people's names, smiling, inquiring about what's going on in the other persons life, and then following up in a few days to see if things have gotten better. If someone is not being cooperative or friendly, I like to ask point-blank "Everything ok? Seems like youre having a bad day." Oftentimes I find people dont realize the face theyre showing the world. It of course isnt going to work every time, or turn every cantankerous scrub nurse into a carebear, but it will at least give you something to focus on while you weather the remainder of your training.
 
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I've said before and I'll say again, it would be wonderful if there were a way to name and shame these types of programs (via submission to a mod who could post this type of feedback anonymously) within the private forum.

This type of inside perspective would be a huge help to those applying in the future.

OP, I'm sorry things are going this way for you.
 
Keep your head low and survive. I came from a very similar program, but can assure you, there is a light at the end of the tunnel. As long as it doesn't interfere with patient safety, I wouldn't make a big deal out of most things. Just keep in mind that in 15 months, contrary to the doom and gloomers, you will be a full fledged attending, making 6 figures, doing what you love day in and day out, and hopefully surrounded by people who feel similarly. Meanwhile, the disgruntled workers at your institution will continue being miserable and find new patsy residents to undermine...
 
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Your situation is likely the extreme situation. Most residencies will have instances of what you describe, but it is not the norm. There will always be people who will disrespect you, but you need to just do your work and not cause a stink. The satisfaction will come in knowing that you will graduate and move on and they will still be stuck there in their dead end job. It is okay demand that they do their job, but you need to do it respectfully. Get them on your team by saying, "Hey, this patient is really nervous and very sick. I need the radio off so that they don't feel worse and so that we can focus our attention on them." Or, "Hey, I am sorry to bother you but I really need about 10 sheets so that we can raise this patient up to help with intubation." Hopefully, this would get them on your team and asking like this will likely get a better response than just demanding that they do it. If they still say no, say, "It looks like we may need to page overhead to see if someone can come in to help us then." Okay, maybe that might be a little passive aggressive, depending on the tone. But it is not rude and you will have gotten the point across.
These are really things that the attendings should address if they are out of control and not doing their jobs.
 
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not at an ivy league program, we still have techs who drag their feet or miss stuff, but generally they will turnover the room. May need more involvement from me on outside locations like OB, IR, GI lab, etc. Some circulators love to help out, want to learn how to do it, and are interested in learning medical tidbits too. One of my ortho nurses loves to bag the patient, and especially loves if i point out juicy veins for her so she can keep up to scratch on IV placement. She helps with alot of stuff I do in return. Some circulators drag their asses and only care about online shopping and lunch break. I don't think wiping down your own machines is a norm. If you know how to do it, I'm sure people may like that when you do your job interviews. If that's something you don't want to do, join a prctice that won't make you do it. Overall, lazy and non-proactive employees hurt hospital and dept bottom line and waste everyone's time, they are a part of every organization (medical or not) that doesn't either pay top dollar for more motivation or take time to hire selectively. They're a part of life, and it's best to try not to let them get your blood pressure up when you can avoid it. power thru residency and eventually you can be in a position that decides which techs to hire and what they do, and influence which circs to keep around.
 
Sounds like my old program. Except for the routine cleaning of equipment. My department didn't give a crap. I was abused by everyone from attendings to secretaries and when I talked back and got smart with these folks (not the attendings, except for one bitch of a vascular surgeon), guess who was in the principals office?

Keep your head down and mouth shut. That is sadly the best way to get thru residency without red flags in your file that you will constantly have to explain. Private practice is like a 180 let me tell you. People more than eager to listen to you, to help you and help facilitate proper patient care. It is such a breath of fresh air.

Remember, these unhappy bastards cannot stop the clock.
 
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There's always those nurses that are on a power trip and flex their muscles with residents...different ways to handle it...i always found that swallowing my pride and playing their game worked the best...let then think theyre the boss...it's residency, do youre work, make each case worthwhile in some way and know ur life becomes way better in 1-2 years
 
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Thanks for the feedback everyone... for the most part I am indeed just keeping my head down and hoping (praying) that I make it through unscathed. My program is one of those that regularly holds back a resident or two each year, so I try not to make too much noise. I'm just glad to hear that there's hope out there after I finish!
 
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