Ok so I am a family medicine doc wanting to become a hoapitalist. I signed a hospitalist offer in a medium sized city in Oklahoma. Pay is great, but my main reason why I chose the job was because I didnt have to do any procedures or run any codes ( codes run by ED physician) I had several offers with similiar perks but this one paid the most. I signed with them 3 months ago. Im supposed to start next month, however I got a call from one of the hospitists before I started about new updates to the program that we are now going to start running codes which I thought was B.S. reason why I chose this was so that I dont run codes. I know how to run a code but Im not going to lie I didnt have much experience in residency and Im not really comfortable. What should I do in this situation. Contract mentions nothing about running codes
Change in job description before starting Job
- Thread starter Cadet133
- Start date
- Joined
- Jan 24, 2017
- Messages
- 3,755
- Reaction score
- 4,326
It’s not hard, follow acls protocols. Take a refresher course if yours is expired.
I presume you’re running codes just for the floor? ICU? Are there any residents. Regardless, in a community hospital 1. Doesn’t happen that often. 2. If only floors, it happens even less. 3. Most dying patient “should” already have “the talk” with the family, so it shouldn’t happen often. 4. None of us are “comfortable” running codes, because, you guessed it, it doesn’t (shouldn’t) happen that often.
Take what I said with a little lightheartedness. It’s up to you what you want to do now. You can ask for more money, you can ask if you can back out of your contract, you can learn a new skill. TBH, most of the nurses should be ACLS/BLS certified. I have faith in your ability to run a code much better than they ever can.
Good luck, op.
I presume you’re running codes just for the floor? ICU? Are there any residents. Regardless, in a community hospital 1. Doesn’t happen that often. 2. If only floors, it happens even less. 3. Most dying patient “should” already have “the talk” with the family, so it shouldn’t happen often. 4. None of us are “comfortable” running codes, because, you guessed it, it doesn’t (shouldn’t) happen that often.
Take what I said with a little lightheartedness. It’s up to you what you want to do now. You can ask for more money, you can ask if you can back out of your contract, you can learn a new skill. TBH, most of the nurses should be ACLS/BLS certified. I have faith in your ability to run a code much better than they ever can.
Good luck, op.
- Joined
- Sep 20, 2004
- Messages
- 6,009
- Reaction score
- 6,721
Does your contract say you don’t do codes or makes no mention of codes? There is a difference...if it says you don’t do codes, you many have some ground to stand on, if it doesn’t t mentioned it, then if it’s considered to be a part of the regular duties then you are stuck unless you are willing to walk away from the job.
- Joined
- Jul 11, 2017
- Messages
- 244
- Reaction score
- 141
If it were procedures, yeah, I would be upset and frustrated as I don’t like doing lines and getting rage-paged by the ED for admissions. But codes, I would be ok with it, might be a chance to get a $5-10k bump if you ask for it as the ED renegotiated their contract with the hospital it sounds.
DolphInternist
New Member
- Joined
- May 25, 2019
- Messages
- 6
- Reaction score
- 1
There's nothing you can do. Hospitalists run codes, period.
What...did you think that FM or general IM 3 year residency stamp of approval was going to get you anything good? Did nobody tell you otherwise in a full 4 years of medical school and 3 years of residency?
Sorry to sound cynical but I'm just telling you how it is so that you finally understand. You are an employee, you will do what they ask, and that's all there is to it. If you don't like it, they will replace you with a new grad, immigrant, or mid level.
What...did you think that FM or general IM 3 year residency stamp of approval was going to get you anything good? Did nobody tell you otherwise in a full 4 years of medical school and 3 years of residency?
Sorry to sound cynical but I'm just telling you how it is so that you finally understand. You are an employee, you will do what they ask, and that's all there is to it. If you don't like it, they will replace you with a new grad, immigrant, or mid level.
- Joined
- Jan 24, 2017
- Messages
- 3,755
- Reaction score
- 4,326
Not sure why immigrant needs a separate category. Everyone go through a residency before they can practice. If we have enough doctors like you, who are pure American with great world view, committed to improve health and cure diseases, perhaps then everyone can be in better place.
You should start a thread with cap letters “DONT DO MEDICINE”. You sound angry and burned out. Or move to Caribbean or somewhere with better weather and food.
- Joined
- Dec 14, 2006
- Messages
- 69,368
- Reaction score
- 61,721
That is kind of crappy. Sorry to hear it man.
Unfortunately your only leverage here is walking.
Have you taken any sign on bonus or moving money? Already take out a loan on a home? That kind of thing? If you can get away with not moving or having to start without paying back money then consider that. I guess it all depends on how pissed you are about all of this.
I don’t agree that running codes is necessarily standard for hospitalists. There are plenty of places that have the intendivists or emergency physicians running codes in a hospital. Though it is in the hospitalist wheelhouse. You do get better at what you do. Maybe just bone up on the ACLS and see how it goes??
- Joined
- Feb 24, 2010
- Messages
- 3,415
- Reaction score
- 6,978
I hear in outpatient you don't run codes...
- Joined
- Mar 6, 2005
- Messages
- 22,254
- Reaction score
- 19,538
Unless somebody codes in your office.
- Joined
- Feb 24, 2010
- Messages
- 3,415
- Reaction score
- 6,978
That's just BLS, and 911 call.
- Joined
- Sep 5, 2018
- Messages
- 399
- Reaction score
- 240
Everyone codes everywhere. Your a doctor for gods sake. You should be able to handle some codes
- Joined
- Jan 24, 2017
- Messages
- 3,755
- Reaction score
- 4,326
Kid, please walk the walk before you comment.
- Joined
- Sep 20, 2004
- Messages
- 6,009
- Reaction score
- 6,721
Do you work as a hospitalist?...no they don’t...it’s not about ability per se...sure I can run a mini icu on a floor if I wanted to( well at least when I first finished residency) but just because I can doesn’t mean I should...more and more hospitalists can have quite the heavy census and push for early discharges , never mind all the non medical, social crap that they don’t tell you about in med school...even one code can consume a great deal of time and throw off your flow... it’s why you have residents or rapid response teams that run theses things in most hospitals.
- Joined
- Jul 15, 2012
- Messages
- 1,279
- Reaction score
- 1,188
No not all doctors can handle codes in my experience. I have yet to see a competent code started or run in radiology.
OP I think if you have to do this, just read up on your ACLS algorithm - it’s truly just an algorithm. The tougher part IMO is if you get them back what is the decision making - TTM? Cath lab? Thrombolytics for PE? Etc etc
- Joined
- Sep 20, 2004
- Messages
- 6,009
- Reaction score
- 6,721
Hopefully he has a closed icu...🙂
- Joined
- Jan 24, 2017
- Messages
- 3,755
- Reaction score
- 4,326
- Joined
- Nov 1, 2007
- Messages
- 1,581
- Reaction score
- 1,179
Quite honestly, running codes is the easy part...pull out the ACLS card and read the algorithm
It's all the stuff when they're really sick and haven't coded yet that is hard.
It's all the stuff when they're really sick and haven't coded yet that is hard.
- Joined
- Dec 14, 2006
- Messages
- 69,368
- Reaction score
- 61,721
You mean it’s not ok to give the ignorant a bit of a tongue lashing for being ignorant?
I think your message should have been to the complainer and reporter to *think* before posting and commenting about what they do not understand yet rather than chasten everyone else.
Look I get the kinder gentler SDN thing. I even agree to a point but there is also something to be said for letting thin skins know they need to be thicker. Negative feelings and dealing with them is part of growing up and becoming a professional.
- Joined
- Jul 15, 2012
- Messages
- 1,279
- Reaction score
- 1,188
Wait so that gets a reminder but not the dude saying that immigrantz are taking er jerbs?
- Joined
- Sep 30, 2008
- Messages
- 41,907
- Reaction score
- 26,453
I'm not sure that the post you think prompted my response is actually the one that was reported.
It's a fine line between giving tough but honest advice and being ruder than you need to be to get your point across, and without pointing to a particular user or post as crossing some line, I'm just giving a general reminder. Trying to redirect a thread that hasn't crossed any lines but might have the potential to shouldn't be seen as us wagging our fingers at anyone in particular.
- Joined
- Dec 14, 2006
- Messages
- 69,368
- Reaction score
- 61,721
Well. I might respectfully and humbly suggest your post wasn’t actually that helpful. Tell us who did the “bad thing” in the specific and we can all learn and recalibrate in here.
- Joined
- Sep 30, 2008
- Messages
- 41,907
- Reaction score
- 26,453
I get what you're going for here, and agree transparency is good. That said, while obviously a single post was reported that got this thread on our radar, I meant what I said about my post being general reminder rather than directed at anyone in particular.
Sorry if that's not "helpful." But I also don't really want to drag this thread further off topic than it already is.
- Joined
- Nov 16, 2009
- Messages
- 852
- Reaction score
- 284
Are you required to do central lines? If not, idk how you're going to be required to run a code. Hear me out, anyone can go through the algorithm, but sometimes you need a line to actually implement it, and that may fall on you. Maybe they can do an I/O during the code and circumvent that? Why is the ER no longer doing them? Unless your contract specifies it, you're kind of at the mercy of the hospital policies. Our hospital updates practice standards etc and we just have to adapt.
Keep the ACLS card in your pocket and just go through the algorithm. Believe it or not, the nurses are usually pretty good, at PEA. Your most critical intervention is good IV access, and that may be your biggest challenge.
Keep the ACLS card in your pocket and just go through the algorithm. Believe it or not, the nurses are usually pretty good, at PEA. Your most critical intervention is good IV access, and that may be your biggest challenge.
- Joined
- Dec 14, 2006
- Messages
- 69,368
- Reaction score
- 61,721
Why would you need a central line for ACLS?
- Joined
- Jul 15, 2012
- Messages
- 1,279
- Reaction score
- 1,188
If you are running a code you should not be the one getting IV access. I’ve seen a couple of boneheaded residents do that and it was disastrous. If your patient has a good IV you also don’t need central access
This is why a code team exists. You should not be delegating running the actual code to a nurse.
- Joined
- Nov 16, 2009
- Messages
- 852
- Reaction score
- 284
As a hospitalist, I put in crash femoral lines during codes. My partners do as well. Crash lines happen more often than I'd like, but when it has to happen, it has to happen. I don't see how someone can be proficient in ACLS theory and practice without being able to place a line, that's my only point, but it's just my opinion. That's what I'd say to the admin if I was OP and if they didn't have to do lines/ER did them.
- Joined
- Dec 14, 2006
- Messages
- 69,368
- Reaction score
- 61,721
A "crash femoral line" is completely unnecessary though regardless of what you or your partners do.
