Attitude change with younger RTs

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evert1de101

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Anyone else find themselves working with a lot of gen Z/young millennial RTs that like to have opinions? I'm locums working at multiple sites and the RTs keep trending younger, the game now is apparently to talk the physician down from whatever intervention is requested. Patient needs a tube? Why not put them on bipap instead. Patient needs bipap? Why not put them on a nonrebreather for heart failure. Need deep suction for bronchiolitis? Why not try a bulb. Young people suck.
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Yeah, I experience this also. I got **** for using a bougie recently "that's a great way to put a hole in someone's lung."
 
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evert1de101 said:
Anyone else find themselves working with a lot of gen Z/young millennial RTs that like to have opinions? I'm locums working at multiple sites and the RTs keep trending younger, the game now is apparently to talk the physician down from whatever intervention is requested. Patient needs a tube? Why not put them on bipap instead. Patient needs bipap? Why not put them on a nonrebreather for heart failure. Need deep suction for bronchiolitis? Why not try a bulb. Young people suck.
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All the time…

My response is usually, because I’m the physician and this is what I’m doing.
When the patient is stable we can stop and talk about the why? Cool? Thanks!
 
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I am required do a lot of these online modules on promoting a non-hostile work environment and stuff like "speak up if you think something is wrong"

Not saying this is causing that attitude but it sure doesn't help
 
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I have said these words:

"Because I'm the attending and I said so."
 
A question for the older docs, were millennials this whiny about their viral URIs when they were the same age as the 18-25 year old gen Zs of today? Or are we as a society just becoming snowflakes 😅
 
cyanide12345678 said:
A question for the older docs, were millennials this whiny about their viral URIs when they were the same age as the 18-25 year old gen Zs of today? Or are we as a society just becoming snowflakes 😅
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It's getting worse.
I see far more "whiny 20 somethings" now then I did 10 years ago.

They act like a flu-like illness is a medical mystery.
 
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I used vid laryngoscopy on a fairly healthy young guy for trauma intubation in a collar. Would it have been an easy DL? Probably. Am I completely comfortable with DL? Yep. Did I have VL right there and just want it to be done? Yep. RT made the comment "why don't you use the skillful way instead of the easy way?" I said theres lots of data to show first pass is higher with VL. She responded "theres more data that says it isn't."

It was at this point that wareagle knew the conversation was over (Said in Morgan Freeman voice of course)
 
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wareagle726 said:
I used vid laryngoscopy on a fairly healthy young guy for trauma intubation in a collar. Would it have been an easy DL? Probably. Am I completely comfortable with DL? Yep. Did I have VL right there and just want it to be done? Yep. RT made the comment "why don't you use the skillful way instead of the easy way?" I said theres lots of data to show first pass is higher with VL. She responded "theres more data that says it isn't."

It was at this point that wareagle knew the conversation was over (Said in Morgan Freeman voice of course)
Click to expand...

Oh hell no. STFU.

Sit down with their boss. Reprimand. You need to cut insubordination and crap attitude off at the knees.
 
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cyanide12345678 said:
A question for the older docs, were millennials this whiny about their viral URIs when they were the same age as the 18-25 year old gen Zs of today? Or are we as a society just becoming snowflakes 😅
Click to expand...

The answer is yes. Every generation is always worse than the last, we are always 10-20 years away from complete moral decay, and yet somehow the world keeps turning and progress marches on.

This is a quote almost certainly misattributed to Socrates, but definitely at least 100 years old:
"The children now love luxury; they have bad manners, contempt for authority; they show disrespect for elders and love chatter in place of exercise. Children are now tyrants, not the servants of their households. They no longer rise when elders enter the room. They contradict their parents, chatter before company, gobble up dainties at the table, cross their legs, and tyrannize their teachers."

Even if the literal quote isn't 2,500 years old, the sentiment most certainly is. "Young people suck; am I right, or am I right, fellas?" is quite possibly one of the oldest memes.
 
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wareagle726 said:
I used vid laryngoscopy on a fairly healthy young guy for trauma intubation in a collar. Would it have been an easy DL? Probably. Am I completely comfortable with DL? Yep. Did I have VL right there and just want it to be done? Yep. RT made the comment "why don't you use the skillful way instead of the easy way?" I said theres lots of data to show first pass is higher with VL. She responded "theres more data that says it isn't."

It was at this point that wareagle knew the conversation was over (Said in Morgan Freeman voice of course)
Click to expand...
“Ok, go get the data and show me. I’ll wait.”
 
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wareagle726 said:
I used vid laryngoscopy on a fairly healthy young guy for trauma intubation in a collar. Would it have been an easy DL? Probably. Am I completely comfortable with DL? Yep. Did I have VL right there and just want it to be done? Yep. RT made the comment "why don't you use the skillful way instead of the easy way?" I said theres lots of data to show first pass is higher with VL. She responded "theres more data that says it isn't."

It was at this point that wareagle knew the conversation was over (Said in Morgan Freeman voice of course)
Click to expand...
Must've been a Bammer RT
 
wareagle726 said:
I used vid laryngoscopy on a fairly healthy young guy for trauma intubation in a collar. Would it have been an easy DL? Probably. Am I completely comfortable with DL? Yep. Did I have VL right there and just want it to be done? Yep. RT made the comment "why don't you use the skillful way instead of the easy way?" I said theres lots of data to show first pass is higher with VL. She responded "theres more data that says it isn't."

It was at this point that wareagle knew the conversation was over (Said in Morgan Freeman voice of course)
Click to expand...

The NNT is around 17 to prevent a failed intubation. That's a better NNT than giving aspirin for NSTEMI. I use VL, a bougie, and a checklist for everyone as a matter of routine.

New grads are at the peak of Mount Stupid in terms confidence vs competence.

Bakhsh A, Ritchie M. Video laryngoscopy vs. direct laryngoscopy. Acad Emerg Med. 2019;26(2):259-260.
 
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wareagle726 said:
"why don't you use the skillful way instead of the easy way?"
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Yeah, that comment displays a clear intention to inflame. I'd love if I had the presence of mind to say something professional that would also and the message that it's not OK, like "I welcome you to raise any patient concerns in real time. However, if you would like to question my clinical judgement when there are not real-time patient safety issues then please contact my administrative assistant to find a time for you, your supervisor and myself to sit down and chat."
 
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**** I thought I was the only one! The amount of push back I get on ABGs, Vapotherm, and deep suction is insane.
 
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I married a respiratory therapist--I think this is something they teach them in school after neb day, vent setting day, suction day, and then how to do all the other stuff nobody wants to do like EKGs day
 
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Dr Mantis Toboggan said:
Lol. Shorthand for Volunteer (Tennessee)

Go Vawls! Etc
Click to expand...

Ahh. A phonetic spelling, as it is spoken by the local populace. How clever.

NCAA sports... Unnggh. I'll see my way out of this discussion.

Keep Universities for the pursuit of knowledge.

EDIT: Yeah, I said it. When your head sportsball coach is paid multimillions while your research departments grovel for money... let's just call it what it is: a sports franchise with a school attached. I'd rather not have had my western civ recitations polluted by Javon McSportsballer and the like.

I mean, that's amazing Sportsball research that the Vawls put out last year; really pushed the boundaries of the field. I'd say that I read the paper, but kek.
 
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RustedFox said:
It's getting worse.
I see far more "whiny 20 somethings" now then I did 10 years ago.

They act like a flu-like illness is a medical mystery.
Click to expand...
My area had a mini covid wave in the summer. That sub variant seemed to really like making young people feel like they got hit by a truck, while leaving the oldies unscathed.
I had countless 20-something’s with headache, fever , myalgias, runny nose, cough, nausea, the whole gamut
Ask me, wide eyed : what could it be !?!?!
:Shrug: it’s probably covid
But it can’t just be that !
:two hours later , after blood work, cxr, etc : well turns out it’s covid
Wide eyed again
🤦🏻‍♀️
 
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wareagle726 said:
I used vid laryngoscopy on a fairly healthy young guy for trauma intubation in a collar. Would it have been an easy DL? Probably. Am I completely comfortable with DL? Yep. Did I have VL right there and just want it to be done? Yep. RT made the comment "why don't you use the skillful way instead of the easy way?" I said theres lots of data to show first pass is higher with VL. She responded "theres more data that says it isn't."

It was at this point that wareagle knew the conversation was over (Said in Morgan Freeman voice of course)
Click to expand...

“Focus on the tube holder, sweetie “
 
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I don't think I've had an rt say much more than "what settings would you like doctor?" Can't believe some of these comments
 
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CoolDoc1729 said:
My area had a mini covid wave in the summer. That sub variant seemed to really like making young people feel like they got hit by a truck, while leaving the oldies unscathed.
I had countless 20-something’s with headache, fever , myalgias, runny nose, cough, nausea, the whole gamut
Ask me, wide eyed : what could it be !?!?!
:Shrug: it’s probably covid
But it can’t just be that !
:two hours later , after blood work, cxr, etc : well turns out it’s covid
Wide eyed again
🤦🏻‍♀️
Click to expand...

*Surprised Pikachu Face.gif*
 
Where I did my TY, I was expected to manage the vent, tell RT the settings, etc. Fast-forward to my categorical program. The first time I tubed someone, I gave them the settings I wanted and got "Yeah, no, we don't do that here" and proceeded to set the vent how they wanted. We were strictly forbidden to touch the vent and the RT's would file safety reports if we did. Only certain Pulm/CC docs could touch the vents without repercussions.

RustedFox said:
Ahh. A phonetic spelling, as it is spoken by the local populace. How clever.

NCAA sports... Unnggh. I'll see my way out of this discussion.

Keep Universities for the pursuit of knowledge.

EDIT: Yeah, I said it. When your head sportsball coach is paid multimillions while your research departments grovel for money... let's just call it what it is: a sports franchise with a school attached. I'd rather not have had my western civ recitations polluted by Javon McSportsballer and the like.

I mean, that's amazing Sportsball research that the Vawls put out last year; really pushed the boundaries of the field. I'd say that I read the paper, but kek.
Click to expand...

I went to LSU for undergrad, no one cares what happens on campus East of Tiger Stadium. The only way they got funding from the state one year was to threaten to close the school which would not allow them to have a football season. The money magically appeared. Had a class in the "Center for Student Athletics" with its marble floors and functioning A/C, while the library ceiling was falling in.

RustedFox said:
It's getting worse.
I see far more "whiny 20 somethings" now then I did 10 years ago.

They act like a flu-like illness is a medical mystery.
Click to expand...
lost count of how many of these I had last night. Recently I've had them come in for a muscle cramp, insect bites, heartburn, ad infinitum ad nauseam...
 
Haven't noticed this being a thing at all. But I will say that boomers are the worst ever. And everyone thinks every subsequent generation sucks. Don't worry, the gen X and boomer folks probably thought you were a big baby. Now you get to perpetuate the same thing because the only thing that has actually changed is that you are now older.
 
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carbonizedeyesockets said:
Haven't noticed this being a thing at all. But I will say that boomers are the worst ever. And everyone thinks every subsequent generation sucks. Don't worry, the gen X and boomer folks probably thought you were a big baby. Now you get to perpetuate the same thing because the only thing that has actually changed is that you are now older.
Click to expand...

Agree. They act like we are the keepers of all their medical needs and they need to be responsible for NOTHING.
After all: "It's all in the computer".
 
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RustedFox said:
Agree. They act like we are the keepers of all their medical needs and they need to be responsible for NOTHING.
After all: "It's all in the computer".
Click to expand...
Responsible for nothing
Entitled to everything
I’m one of the nicer ones and they are destroying me
 
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The other day at new shop.

40s year old witnessed arrest unknown cause initially. Came in with a king. After the normal stuff I'm about to intubate (had to set my own **** up too and ask nurses for stuff since RT mia), RT shows up and says what are you doing? Why don't you wait? That doesn't need to be done.

I couldn't even imagine what the look I gave them looked like. Got rosc within 30 seconds of ETT. (Im aware of practice differences. I always put definitive airway unless a mega gomer or obviously beyond dead).
 
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I’m shocked by the attitude a few RTs are giving some of you. RTs where I’m at are only there to help me in a support role with whatever I need. I decide on breathing/airway interventions. I decide on vent settings. They aren’t the ones in charge and don’t make decisions. Some of them are weaker, which maybe is perhaps the flip side and why they aren’t overly confident with unnecessary attitude. I certainly empathize with some of you guys’ frustration.
 
Rekt said:
The other day at new shop.

40s year old witnessed arrest unknown cause initially. Came in with a king. After the normal stuff I'm about to intubate (had to set my own **** up too and ask nurses for stuff since RT mia), RT shows up and says what are you doing? Why don't you wait? That doesn't need to be done.

I couldn't even imagine what the look I gave them looked like. Got rosc within 30 seconds of ETT. (Im aware of practice differences. I always put definitive airway unless a mega gomer or obviously beyond dead).
Click to expand...

5q2zt0.png
 
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Yeah this is a bit crazy. The most I’ll get from RTs is maybe a politely asked question or two out of curiosity.
 
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CajunMedic said:
Where I did my TY, I was expected to manage the vent, tell RT the settings, etc. Fast-forward to my categorical program. The first time I tubed someone, I gave them the settings I wanted and got "Yeah, no, we don't do that here" and proceeded to set the vent how they wanted. We were strictly forbidden to touch the vent and the RT's would file safety reports if we did. Only certain Pulm/CC docs could touch the vents without repercussions.
Click to expand...


1. Put the order in for what you want and then safety report them back for not following the orders.

2. Hammer call the RT or the RT supervisor until it's changed or they stop complaining about you touching the vent.
 
Mount Asclepius said:
I’m shocked by the attitude a few RTs are giving some of you. RTs where I’m at are only there to help me in a support role with whatever I need. I decide on breathing/airway interventions. I decide on vent settings. They aren’t the ones in charge and don’t make decisions. Some of them are weaker, which maybe is perhaps the flip side and why they aren’t overly confident with unnecessary attitude. I certainly empathize with some of you guys’ frustration.
Click to expand...

Me too. All the RTs do as I ask them, they are helpful, we are a team. Very surprised.
 
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CajunMedic said:
Where I did my TY, I was expected to manage the vent, tell RT the settings, etc. Fast-forward to my categorical program. The first time I tubed someone, I gave them the settings I wanted and got "Yeah, no, we don't do that here" and proceeded to set the vent how they wanted. We were strictly forbidden to touch the vent and the RT's would file safety reports if we did. Only certain Pulm/CC docs could touch the vents without repercussions.



I went to LSU for undergrad, no one cares what happens on campus East of Tiger Stadium. The only way they got funding from the state one year was to threaten to close the school which would not allow them to have a football season. The money magically appeared. Had a class in the "Center for Student Athletics" with its marble floors and functioning A/C, while the library ceiling was falling in.


lost count of how many of these I had last night. Recently I've had them come in for a muscle cramp, insect bites, heartburn, ad infinitum ad nauseam...
Click to expand...
ahhh LSU - where they weren't allowed to spend money on a football stadium, the money was allocated towards dorms, so they turned the dorm into the base of the stadium during an expansion. Always had their priorties in order SMH
 
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