Conflicts with ancillary staff - impact on chances as chief resident?

[slam_dunka]

Hello - I need help here.

I am a second year resident. I would like to be a chief resident someday. I am a top-performing resident - attendings generally think this about me, based on rec letters and verbal feedback.

1. great assessments/diagnoses
2. great teaching of residents
3. sets an example for other residents
4. team player
5. hard worker
6. smart

I heard from one of the current chiefs that I am (or was?) under consideration for being a next chief, which I would like to do.

However, there is one problem that has increasingly been brought to my attention both by my attending and a resident friend when I asked her for feedback. More than one ancillary staff has complained about me at multiple locations where I have worked - that I use a sharp tone when I speak/raise my voice/I am rude/I make them uncomfortable. I had a talk with an attending about picking my battles wisely/taking the high road a few weeks ago, after the following incident:

An ancillary staff member had refused to do a task related to patient care that I tried to delegate to her (a task anyone can do but it was late and she was the first person I found, and that I could not do because my computer account was down). I scolded the staff member saying that we shouldn't have the attitude of "not my job" when we work in a system. She told me that it was not her job and that I should speak with her supervisor tomorrow. So I spoke with the supervisor the next day (in a collegial way), and the supervisor had expressed that she was frustrated with the system and the attitude that some of these staff had, and that it was partly some of the other supervisors' (not her) fault for promoting such an environment. My rudeness the night before did not come up in this conversation. She seemed willing to address some concrete issues that I brought up for the next staff meeting, so I left feeling like I accomplished something. But the next day an attending called me in stating that the same supervisor reported to him that I was rude to the staff member. He asked me for my side of the story, which I gave. He did not seem like he thought this was worth disciplining me over, state that these conflicts happen in the workplace and that he was frustrated with the system at times too, and suggested that I pick my battles wisely/take the high road. Which I accepted.

I asked a friend (in the same residency) for personality feedback today - and she told me that the word on the vine was that I was rude to ancillary staff. Plenty of ancillary staff had complained about me, even at the VA (or perhaps especially there). Even if my friend did not tell me this, I can tell when I have a sharp tone, and it is usually in response to the following scenarios: 1. People refuse to do what I ask (and what I think they are supposed to do), behaving like it is not their job 2. People don't follow through with what they agreed to such that I have to tell them a second time, 3. People don't have common sense, when I think they should know better. I was born with a quick temper and as I grew up I also developed a critical tongue. The same friend also told me that she thought I complained too much during the monthly resident meetings, and warned me that she didn't think attendings liked complainers, and that they see me as a complainer. I am actually not unhappy with the program, just that I have an opinion about most things, and feel compelled to state them. During my first year I thought I was rude to staff, and wanted to fix it, but it was difficult when I am tired/in a hurry. At the beginning of my first year I was not vocal at resident meetings but became more vocal as the year went on when I formed more opinions, but I was never rude at these. I am collegial with other residents at work generally and am collegial with ancillary staff 80% of the time.

Because I have been thinking about this problem for some time, I took an emotional intelligence test (about 300+ questions of various sorts, from ArchProfile) and scored in the 98th percentile overall. Generally I was average to top for all characteristics:

Emotional competencies (76th percentile)
- ability to identify emotions in self (98th percentile)
- comfort with emotional expression (67th percentile)
- comfort with emotional situations or people (80th percentile)
- emotional reflection (69th percentile)
- emotional regulation (53rd percentile)
- emotional integration (91st percentile)

Social competencies (83rd percentile)
- adaptable social skills (78th percentile)
- social insight (83rd percentile)
- conflict resolution knowledge (86th percentile)
- conflict resolution behavior (88th percentile)
- empathy (98th percentile)
- ability to read body language (68th percentile)
- flexibility (82nd percentile)

Drive (70th percentile)
- goal-setting (59th percentile)
- striving (82nd percentile)
- self-motivation (52nd percentile)
- self-awareness (80th percentile)

Stress management (79th percentile)
- coping skills (63rd percentile)
- emotional selectivity (magnitude) (100th percentile)
- emotional selectivity (precision) (89th percentile)
- resilience (73rd percentile)
- adaptability (83rd percentile)
- contentment (62nd percentile)
- positive mindset (71st percentile)
- extreme rumination (12th percentile)
- values congruence (68th percentile)

Self-regard (78th percentile)
- self-esteem (89th percentile)
- self-confidence (75th percentile)
- assertiveness (67th percentile)
- self-efficacy (87th percentile)
- need for approval (21st percentile)


Questions for you:
1. Should I specifically address these issues at my semi-annual evaluation, and give them my plans for improvement? Or am I just sticking my foot in my mouth?
2. I am thinking of ways to improve on this, but welcome your suggestions
3. Are my chances as chief over? - I get that this depends on who else is in the running - but in general would you prioritize someone who gets along with staff/vocalizes less at resident meetings, if they are not as good at teaching/helping other residents/hardworking?

Thanks for your input.

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[Gastrapathy]

You're asking the wrong question. You should be asking "is getting the reputation for being a jerk a threat to my livelihood?" Answer: yes.

You've ruined your rep at this place. You won't fix that. If you self-assess that you are rude 20% of the time to the support staff, that's in the "how did I get fired, I was totally screwed" thread range.

 

[Nephro critical care]

I have a colleague who is collegial 95 % of the time and boy she is a PITA to work with. Stay out of a chief year and spare humanity a year of torture.

 

[slam_dunka]

I also asked for suggestions on how to not be a jerk....and whether or not i should bring this up at a meeting....

 

[AdmiralChz]

Wow, this is a long and honestly pretty narcissistic post by the OP. You should aim to be professional to everyone you come in contact with, including the ancillary staff. A close mentor of mine once told me it takes minimal effort to be kind and professional to everyone, and you never know when it would be helpful to have those people go to bat/go the extra mile on your behalf. Don't make excuses for your actions as you spend two paragraphs doing in the OP, consider what the situation is and why some/many ancillary staff hold you in poor esteem.

Leave the emotional intelligence test out of this. You should aim to improve your everyday interactions - I wouldn't bring it up unless you are asked to by others. Make a mental note of how this interaction went bad and make adjustments to your behavior.

Being a chief resident isn't all that it's cracked up to be, trust me. You'll still be a board-certified/eligible X physician at the end of residency. At my program (a large, academic anesthesiology program), the chiefs were essentially the administrative/disciplinary arm of the program which made it a thankless and adversarial position. Since fellowships had largely already been decided by the time chiefs were named, I don't think it moves the needle all that much. Clearly it means a lot to you (again, watch for narcissism because if we notice it here who knows what face you put forward to your program), but you should aim to be a competent, professional physician first and foremost.

 

[mvenus929]

I assume you are IM based on your post--is that correct? Or are you in a specialty where the chiefs are residents as well rather than junior faculty?

Both during residency and now as a chief, the residents I like the best are those who are willing to go the extra mile for their colleagues--they readily switch schedules, they volunteer to help out at the various things we ask residents to staff, and are generally collegial people. One of those people is a bit adversarial when he gets frustrated, but is otherwise a good person and would have made a great chief had he been interested. Then, I look at the people who complain--complain that their schedules aren't fair, that we don't take into account their preferences, etc. Those people would be terrible chiefs. There are those who also approach us with suggestions--we had some concerns about our second year class as a whole, and a group of them approached us with 'we're concerned that these things are happening, and have some suggestions on how to make them better.' Those people show leadership potential, so while they complain, they also offer solutions and are willing to hear why we can or cannot adopt their solutions.

Then, we have residents who really don't have any insight. They are adversarial, don't approach others for help, and believe that nothing is their fault. When approached with ample evidence that there is a concern, they pull at the 90% of the time they don't have a problem. But that other 10% is serious enough that the leadership needs to step in. You don't want to be that resident.

Have you completely tanked the ability to become a chief? Probably not, but it will depend on the features of the rest of your class. One of the chiefs that was selected at our program in the recent past had a toxic personality, but she was still selected.

I think addressing the concerns head on is the best move for you regardless of whether it affects your chances at chief. Good luck.

 

[shopsteward]

I also asked for suggestions on how to not be a jerk....and whether or not i should bring this up at a meeting....

How not to be a jerk? Pretend everyone you interact with is either 1) your mother or 2) about to sit down for coffee with your mother. And by "everyone" I mean every staff member ("ancillary" or otherwise), every patient, every patient's relative and anyone at work who so much as holds a door open for you or lets a door slam in your face.

Should you bring this up at a meeting? Dear god, no. If it is brought up for you, say 1) you have recently realised this could be a problem 2) you asked around and got some useful feedback which you are putting into practice, and 3) you will be working hard to ensure that this is no longer an issue by the time of the next meeting.

 

[slam_dunka]

Generally the feedback I get from fellow residents is that the issues I bring up at those town hall meetings benefits residents as a whole (I never complain about being singled out for especially poor/unfair treatment - because I just don't think that is the case) - the warning I received from the friend has to do with me complaining/raising issues more than some of the other residents (probably attendings noticed too), although fellow residents think that my suggestions benefit them overall. Part of that has to do with me trying to be more vocal since I do want to be a chief resident. But since I got this feedback today, I will definitely tone it down next time at those meetings.

I wish that if the ancillary staff has a problem with me such that they want to report me, they would come to me first, and tell me that I am rude. Rather than report me to my boss - I don't report them to their boss when they do things sub-optimally (unless it was that one lady who told me to speak to her supervisor). Although I had wanted to change my interactions with the staff for a while, the first time an attending spoke to me about it was a few weeks ago (after above incident). There were no poor interactions with staff since then. So I will try to keep it that way.

Thanks for the suggestions - will try to put some of them into action.

 

[qxrt]

in general would you prioritize someone who gets along with staff/vocalizes less at resident meetings, if they are not as good at teaching/helping other residents/hardworking?

You're conflating desirable qualities in a chief resident with unrelated ones that don't have much bearing on being a chief. Being well-liked by everyone has nothing to do with vocalizing less at resident meetings, nor does being hardworking have anything to do with being good at teaching. In general, the resident who is well-liked by everyone (that means attendings, residents, AND ancillary services) but may not be clinically the best in class will be prioritized over the one who is clinically very competent, but has a reputation for being a complainer or rubs just a few key people the wrong way (even if he may be liked by most people). I'm currently the chief resident in my program, and last year, when I was the junior chief, I had some discussions with the prior chief about how the next chief was chosen.

Basically, if I had turned down the position of chief resident, the next resident to have been picked in my class was one who was well-liked by everyone, even though his clinical ability was considered below average for our class. I was a bit surprised by this at first, as we had another guy in my class whose clinical ability and knowledge was very strong, and yet, on discussion with my chief resident, he was absolutely NOT considered for the position, as he had a bit of a reputation as a complainer. By this, I don't mean that he was widely disliked; in fact, he got along very well with most of the attendings. However, his attitude did have the effect of rubbing some of the ancillary staff the wrong way (a part of it was the attitude of, "I'm doing my job, why aren't you doing yours?", which sounds somewhat similar to how you describe your interactions with ancillary staff), and my chief resident predecessor had a bit of a difficult time dealing with his complaints, even if they were geared towards trying to "improve the program."

Essentially, the gist of my anecdote is this: Great personal relationships and a good attitude are far more important characteristics in a chief resident than strong clinical ability or ability to teach residents. Obviously, both are important and desirable, but as the chief, your biggest responsibility is usually managing everyone's schedule and smoothing over disputes that may arise, and in that regard, you can see that good personal relationships are going to be a far more relevant and important trait to have than clinical ability or willingness to teach. What's important to note is not pointing at all the great relationships you have and all the people who like you, but rather, the percentage of people who DON'T have a great impression of you or don't like you all that much. It's easy to be friends with people who like you, but the more important question is, can you also deal well with people who you may not have the best relationship with?

 

[qxrt]

I wish that if the ancillary staff has a problem with me such that they want to report me, they would come to me first, and tell me that I am rude. Rather than report me to my boss - I don't report them to their boss when they do things sub-optimally (unless it was that one lady who told me to speak to her supervisor). Although I had wanted to change my interactions with the staff for a while, the first time an attending spoke to me about it was a few weeks ago (after above incident). There were no poor interactions with staff since then. So I will try to keep it that way.

Here's a tip -- the part I bolded is very unlikely to happen in any future career setting you'll end up in, so it's best not to expect it to ever happen on a regular basis in your future interactions. As a physician, you're considered to be in a position of leadership and relative high status, and it's a very difficult thing for ancillary staff to straight up tell you to your face that you're doing something wrong, especially given the perceived power differential, unless they're particularly outspoken or don't give a sh**. That's just not how society and human relationships, even without the perceived power differential, works. As humans, we are much more likely to b**** about our shi**y boss/manager or even manager/higher level from another unrelated department to our friends or coworkers, not straight up tell our boss to his face that he/she is doing something wrong. It's unreasonable to expect that they will do so.

 

[Perrotfish]

nvm

 

[HomeSkool]

You're 100% out of line. Forget about being a chief resident; figure out how to stop being a jerk. Based on your original post, I'm guessing there's more to the anecdote than what you shared. I think it's likely you came off as demanding, entitled, and/or abrasive to whomever you were asking for a favor, so they told you to go screw yourself. You responded by ripping them a new one and then going to your own faculty to get a posse at your back. Even if your intentions were pure, you've clearly established a reputation that discourages your PD from taking your side on this. And your lengthy post about your emotional IQ results doesn't actually inspire confidence in your innocence. In the words of Steve Maraboli, "sometimes it seems that the louder someone claims sainthood, the bigger the horns they are hiding."

Like you, I was born with a fiery temper. Unlike you, I learned how to control it. The result is that I rarely bark, I almost never bite, and when I actually do bark, it's far enough out of character that people sit up and listen. As a result, I hear a lot more of "I saw we were working together and knew it would be a great day!" and less of "It's not my job."

In your interactions with others, remember that you're speaking with another person's husband/wife/dad/mom/brother/sister/whatever and treat them with the same respect you'd expect them to show your own loved ones. If my wife ever came home upset and tearful because of someone else's mistreatment, I'd kick that person's ass. Don't earn an ass-kicking by mistreating your co-workers. Have the integrity to take an honest look inside yourself - especially if doing so reveals things you don't like - and figure out how to fix your interpersonal interactions. That's much more important than becoming a chief resident.

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[calvnandhobbs68]

From your first little story, it sounds like you asked some staff member to do something he/she normally wouldn’t do and then got mad when he/she refused to do it....if that’s the case you should be extremely nice about ASKING someone to do something. Not telling them “we’re all part of a team here so you should just do what I say”.

Generally people will do things if you ask them nicely. If it’s outside of what they’d normally do and they still refuse, it’s unlikely they’re absolutely the only person around you can ask. Pick your battles buddy.

 

[Sam212]

What's the big deal about being a chief anyway? I'm a chief this year and it's a thankless job with a lot of babysitting (both residents and attendings) and navigating hospital politics.

In any case, remember, nurses and ancillary staff are like a herd, it's best to always be on good terms with them or they'll make it very difficult for you. You seem like you have a bit of a reputation but are still early in your residency, you can possibly bounce back. Whether you'll make a chief or not will largely depend on who else in your class is being considered. Chances are if you really are forward about your desire to be a chief, you likely won't be picked.

 

[Sam212]

Btw, you shouldn't have spoke to the supervisor the following day, it makes you look petty and a tool. Pick your battles wisely, who cares if the anciallary staff didn't do what you asked them to, just do it yourself, unless it was blatant violation of standard of care.

 

[Perrotfish]

What's the big deal about being a chief anyway? I'm a chief this year and it's a thankless job with a lot of babysitting (both residents and attendings) and navigating hospital politics.

If you're in a residency that leads to lucrative but competitive fellowships, like IM, then being appointed chief is potentially worth millions. It can be the difference between life as a 500K/year gastroenterologist and a 250K/year hospitalist.

If you're in a field where the fellowships are either not lucrative, not competitive, or both, then I agree with you that I don't get why anyone does it. I will never understand how Pediatrics programs get people to apply for chief, let alone how they get them to fight for the job.

 

[doc05]

(1) you've earned a reputation of being a jerk - you will NEVER be named chief resident.
(2) as another poster stated, you've ruined your reputation at this place.
(3) learn from this experience, stop being a jerk, and maintain good habits at your next job.

 

[Pes anserine]

(1) you've earned a reputation of being a jerk - you will NEVER be named chief resident.
(2) as another poster stated, you've ruined your reputation at this place.
(3) learn from this experience, stop being a jerk, and maintain good habits at your next job.

How is he/she being a jerk though? I find that physicians and nurses are held to such a different standard. So if the OP asks a nurse to do something and the nurse says "it's not my job" that's ok, but if OP said that, they would call him/her a non-team player, inappropriate, unprofessional, etc. Why are nurses allowed to be subpar and not team players? I feel for the OP.

 

[anonperson]

Hello - I need help here.

I am a second year resident. I would like to be a chief resident someday. I am a top-performing resident - attendings generally think this about me, based on rec letters and verbal feedback.

1. great assessments/diagnoses
2. great teaching of residents
3. sets an example for other residents
4. team player
5. hard worker
6. smart

I heard from one of the current chiefs that I am (or was?) under consideration for being a next chief, which I would like to do.

However, there is one problem that has increasingly been brought to my attention both by my attending and a resident friend when I asked her for feedback. More than one ancillary staff has complained about me at multiple locations where I have worked - that I use a sharp tone when I speak/raise my voice/I am rude/I make them uncomfortable. I had a talk with an attending about picking my battles wisely/taking the high road a few weeks ago, after the following incident:

An ancillary staff member had refused to do a task related to patient care that I tried to delegate to her (a task anyone can do but it was late and she was the first person I found, and that I could not do because my computer account was down). I scolded the staff member saying that we shouldn't have the attitude of "not my job" when we work in a system. She told me that it was not her job and that I should speak with her supervisor tomorrow. So I spoke with the supervisor the next day (in a collegial way), and the supervisor had expressed that she was frustrated with the system and the attitude that some of these staff had, and that it was partly some of the other supervisors' (not her) fault for promoting such an environment. My rudeness the night before did not come up in this conversation. She seemed willing to address some concrete issues that I brought up for the next staff meeting, so I left feeling like I accomplished something. But the next day an attending called me in stating that the same supervisor reported to him that I was rude to the staff member. He asked me for my side of the story, which I gave. He did not seem like he thought this was worth disciplining me over, state that these conflicts happen in the workplace and that he was frustrated with the system at times too, and suggested that I pick my battles wisely/take the high road. Which I accepted.

I asked a friend (in the same residency) for personality feedback today - and she told me that the word on the vine was that I was rude to ancillary staff. Plenty of ancillary staff had complained about me, even at the VA (or perhaps especially there). Even if my friend did not tell me this, I can tell when I have a sharp tone, and it is usually in response to the following scenarios: 1. People refuse to do what I ask (and what I think they are supposed to do), behaving like it is not their job 2. People don't follow through with what they agreed to such that I have to tell them a second time, 3. People don't have common sense, when I think they should know better. I was born with a quick temper and as I grew up I also developed a critical tongue. The same friend also told me that she thought I complained too much during the monthly resident meetings, and warned me that she didn't think attendings liked complainers, and that they see me as a complainer. I am actually not unhappy with the program, just that I have an opinion about most things, and feel compelled to state them. During my first year I thought I was rude to staff, and wanted to fix it, but it was difficult when I am tired/in a hurry. At the beginning of my first year I was not vocal at resident meetings but became more vocal as the year went on when I formed more opinions, but I was never rude at these. I am collegial with other residents at work generally and am collegial with ancillary staff 80% of the time.

Sorry to say, but you sound like a tool.

You sound like a good doctor in general but interacting with ancillary staff is important. The days of physicians throwing tantrums and getting $hit done that way are over. Not saying you threw a tantrum, but when there is a pattern of speaking rudely/sharp tone/whatever and it is noted among multiple staff members at multiple sites, you have a problem.

At least for me, residents who have very vocal opinions are generally annoying. Sure you can chime in from time to time but nothing is more irritating than a resident who runs their mouth non stop, especially at various meetings.

In your post you mentioned that people refused to do what you asked of them. What exactly does this mean? Are nurses refusing to perform an order that you placed or is it something more benign. That can encompass a lot of different things some of which impact patient safety and it is reasonable to get pissed while others don't.

At the end of the day, no one here can tell you if this will impact your ability to become chief. If your leadership likes you a lot, then you may be fine but most places are now doing 360 degree evaluations so this will probably bite you in the butt at some point.

A kind tone/being nice will get you more success in your professional life. People will look out for you when you make a mistake and will be willing to help you out when you are in need which will happen regardless of how good of a physician one is.

Another caveat, I am not sure if you are a male or female. Unfortunately, women are held to a different standard especially when interacting with ancillary staff and this could be playing a role.

 

[Rendar5]

How is he/she being a jerk though? I find that physicians and nurses are held to such a different standard. So if the OP asks a nurse to do something and the nurse says "it's not my job" that's ok, but if OP said that, they would call him/her a non-team player, inappropriate, unprofessional, etc. Why are nurses allowed to be subpar and not team players? I feel for the OP.

If a nurse asks me to do something and it’s not my job (and I have a reason I don’t feel it is appropriate to help out) I will say so, and they would never say the above.

 

[Saddleshoes]

If you don't work well with the staff I'd rather not have you on my team.
(I will be here long after you are gone and so will the staff.)

 

[Pes anserine]

Sorry to say, but you sound like a tool.

You sound like a good doctor in general but interacting with ancillary staff is important. The days of physicians throwing tantrums and getting $hit done that way are over. Not saying you threw a tantrum, but when there is a pattern of speaking rudely/sharp tone/whatever and it is noted among multiple staff members at multiple sites, you have a problem.

At least for me, residents who have very vocal opinions are generally annoying. Sure you can chime in from time to time but nothing is more irritating than a resident who runs their mouth non stop, especially at various meetings.

In your post you mentioned that people refused to do what you asked of them. What exactly does this mean? Are nurses refusing to perform an order that you placed or is it something more benign. That can encompass a lot of different things some of which impact patient safety and it is reasonable to get pissed while others don't.

At the end of the day, no one here can tell you if this will impact your ability to become chief. If your leadership likes you a lot, then you may be fine but most places are now doing 360 degree evaluations so this will probably bite you in the butt at some point.

A kind tone/being nice will get you more success in your professional life. People will look out for you when you make a mistake and will be willing to help you out when you are in need which will happen regardless of how good of a physician one is.

Another caveat, I am not sure if you are a male or female. Unfortunately, women are held to a different standard especially when interacting with ancillary staff and this could be playing a role.

I agree a lot with the comment that women are held to a different standard. I have been there. Particularly if you are moderately attractive and/or have other reasonable attributes, nurses will hate you.

 

[slam_dunka]

So are males allowed to be more mean than females??

 

[Pes anserine]

If you don't work well with the staff I'd rather not have you on my team.
(I will be here long after you are gone and so will the staff.)

Why is it always the physician's fault? Why do we never assign fault to nurses, when we all know that many many many nurses and staff are subpar at best?

 

[Pes anserine]

So are males allowed to be more mean than females??

Absolutely. It's "normal" for men to be more "assertive" not to mention that many ancillary staff is female so lots of nurses/techs, etc like male docs. If you are a female and if you are attractive it's much much harder to get good 360 evals - regardless of what one does. Lots of jealousies and envy towards female physicians, again especially if attractive, or well off, etc.

It was sad, last holiday season as a sign of good will/niceness I bought coffee and these awesome yummy french pastries from a nearby bakery that i love for the nurses/techs, etc as it was my last ever inpatient rotation. Instead of most nurses being like oh that's nice of you, I was told by my male colleague that I got trash talked about how "well off" I must be being able to buy the pastries (somehow french = wealth?), and how I must never eat because I'm so thin, so I get pastries for the staff so they get fat.

I was like what????

Needless to say, I never bought anything else for anyone else.

 

[Rendar5]

Why is it always the physician's fault? Why do we never assign fault to nurses, when we all know that many many many nurses and staff are subpar at best?

Don’t know where you got this from. It’s the nurse’s fault plenty of times too. But if there are multiple people with the same complaint against the physician it’s usually he fault of the physician. If there are multiple people with the same complaint against the nurse, then it’s usually the fault of the nurse.

Pretty clear here who the one with multiple complaints is.

 

[AdmiralChz]

So are males allowed to be more mean than females??

... tell me you’ve taken more away from these posts than this. Please.

 

[Pes anserine]

Don’t know where you got this from. It’s the nurse’s fault plenty of times too. But if there are multiple people with the same complaint against the physician it’s usually he fault of the physician. If there are multiple people with the same complaint against the nurse, then it’s usually the fault of the nurse.

Pretty clear here who the one with multiple complaints is.

I personally disagree with this. I had a similar issue in the past, and I was ever told by one of my attendings - you might have had something happen with one nurse, and given that nurses are friends, one nurse becomes all nurses. Nurses are petty. I totally feel the OP's pain.

 

[Rendar5]

I personally disagree with this. I had a similar issue in the past, and I was ever told by one of my attendings - you might have had something happen with one nurse, and given that nurses are friends, one nurse becomes all nurses. Nurses are petty. I totally feel the OP's pain.

These are ancillary staff at multiple hospitals,not at the same institution (he mentioned it occurs also at the VA which implies multiple sites). He himself admits he is not collegial with staff 20% of the time. This is not one nurse complaining about him and spreading rumors. It sounds like you’re assuming his issues are the same issues as your issues where you were treated unfairly and projecting these circumstances onto him.

I’m sorry you may have had bad experiences with nurses but this doesn’t sound like that for this guy. I can at least assure you that I’ve seen plenty of times nurses on the losing end of physician-nurse interactions when they are inappropriate and not doing what they should. I have also seen a few exceptions where residents do make enemies out of certain nurses (not being the resident’s fault) and the resultant consequences of these things; I do have their backs when this happens so I don’t discount your own person experiences.

 

[FrkyBgStok]

Maybe I am in the minority or maybe it is my style, but as the physician, you are the leader and decision maker. There is never a reason to treat the ancillary staff poorly. If they are bad or don’t agree with you, explain to them why you are right. If they say that someone is doing poorly, go look at that person. If they are doing well, explain parameters on why you think they are doing well and what you are looking for in order to come back. If they ask you to explain something to the patient, go explain it to the patient. When you put in a new order that changes the patient care, call the nurse and tell her.

I’ve dealt with bad nurses that are incredibly frustrating, but short of almost killing someone, losing your cool only looks poorly on you. It doesn’t come across as being assertive, it is downtalking the nurse.

When I work with junior residents, I explain to them that showing the nurses that their job is important and that you appreciate them will come back to you tenfold. It seems to be true. Again, you are the team leader.

So yes. Poor relations with ancillary staff will affect your chief chances.

 

[evilbooyaa]

I agree a lot with the comment that women are held to a different standard. I have been there. Particularly if you are moderately attractive and/or have other reasonable attributes, nurses will hate you.

What? This trope about nurses hating women doctors is old.

Lost_in_space, is that you?

 

[AdmiralChz]

What? This trope about nurses hating women doctors is old.

Lost_in_space, is that you?

Or Light at the end of the tunnel? Or the many like mimics that poster has made. High probability.

 

[gutonc]

Ding, ding, ding...we have a winner

 

[deleted859535]

Or Light at the end of the tunnel? Or the many like mimics that poster has made. High probability.

Not disagreeing -- but most importantly, who gives a ****? Threads like this should just be locked right off the bat. Not worth any time.

 

[WingedOx]

So are males allowed to be more mean than females??

Why does it seem to be that more and more SDN threads seem to be about deficiencies in social skills?

 

[Psai]

Why does it seem to be that more and more SDN threads seem to be about deficiencies in social skills?

Trolls

 

[WingedOx]

Trolls

Unfortunately I don't think a lack of sincerity is the problem.

 

[neoexile]

Hello - I need help here.

I am a second year resident. I would like to be a chief resident someday. I am a top-performing resident - attendings generally think this about me, based on rec letters and verbal feedback.

1. great assessments/diagnoses
2. great teaching of residents
3. sets an example for other residents
4. team player
5. hard worker
6. smart

I heard from one of the current chiefs that I am (or was?) under consideration for being a next chief, which I would like to do.

However, there is one problem that has increasingly been brought to my attention both by my attending and a resident friend when I asked her for feedback. More than one ancillary staff has complained about me at multiple locations where I have worked - that I use a sharp tone when I speak/raise my voice/I am rude/I make them uncomfortable. I had a talk with an attending about picking my battles wisely/taking the high road a few weeks ago, after the following incident:

An ancillary staff member had refused to do a task related to patient care that I tried to delegate to her (a task anyone can do but it was late and she was the first person I found, and that I could not do because my computer account was down). I scolded the staff member saying that we shouldn't have the attitude of "not my job" when we work in a system. She told me that it was not her job and that I should speak with her supervisor tomorrow. So I spoke with the supervisor the next day (in a collegial way), and the supervisor had expressed that she was frustrated with the system and the attitude that some of these staff had, and that it was partly some of the other supervisors' (not her) fault for promoting such an environment. My rudeness the night before did not come up in this conversation. She seemed willing to address some concrete issues that I brought up for the next staff meeting, so I left feeling like I accomplished something. But the next day an attending called me in stating that the same supervisor reported to him that I was rude to the staff member. He asked me for my side of the story, which I gave. He did not seem like he thought this was worth disciplining me over, state that these conflicts happen in the workplace and that he was frustrated with the system at times too, and suggested that I pick my battles wisely/take the high road. Which I accepted.

I asked a friend (in the same residency) for personality feedback today - and she told me that the word on the vine was that I was rude to ancillary staff. Plenty of ancillary staff had complained about me, even at the VA (or perhaps especially there). Even if my friend did not tell me this, I can tell when I have a sharp tone, and it is usually in response to the following scenarios: 1. People refuse to do what I ask (and what I think they are supposed to do), behaving like it is not their job 2. People don't follow through with what they agreed to such that I have to tell them a second time, 3. People don't have common sense, when I think they should know better. I was born with a quick temper and as I grew up I also developed a critical tongue. The same friend also told me that she thought I complained too much during the monthly resident meetings, and warned me that she didn't think attendings liked complainers, and that they see me as a complainer. I am actually not unhappy with the program, just that I have an opinion about most things, and feel compelled to state them. During my first year I thought I was rude to staff, and wanted to fix it, but it was difficult when I am tired/in a hurry. At the beginning of my first year I was not vocal at resident meetings but became more vocal as the year went on when I formed more opinions, but I was never rude at these. I am collegial with other residents at work generally and am collegial with ancillary staff 80% of the time.

Because I have been thinking about this problem for some time, I took an emotional intelligence test (about 300+ questions of various sorts, from ArchProfile) and scored in the 98th percentile overall. Generally I was average to top for all characteristics:

Emotional competencies (76th percentile)
- ability to identify emotions in self (98th percentile)
- comfort with emotional expression (67th percentile)
- comfort with emotional situations or people (80th percentile)
- emotional reflection (69th percentile)
- emotional regulation (53rd percentile)
- emotional integration (91st percentile)

Social competencies (83rd percentile)
- adaptable social skills (78th percentile)
- social insight (83rd percentile)
- conflict resolution knowledge (86th percentile)
- conflict resolution behavior (88th percentile)
- empathy (98th percentile)
- ability to read body language (68th percentile)
- flexibility (82nd percentile)

Drive (70th percentile)
- goal-setting (59th percentile)
- striving (82nd percentile)
- self-motivation (52nd percentile)
- self-awareness (80th percentile)

Stress management (79th percentile)
- coping skills (63rd percentile)
- emotional selectivity (magnitude) (100th percentile)
- emotional selectivity (precision) (89th percentile)
- resilience (73rd percentile)
- adaptability (83rd percentile)
- contentment (62nd percentile)
- positive mindset (71st percentile)
- extreme rumination (12th percentile)
- values congruence (68th percentile)

Self-regard (78th percentile)
- self-esteem (89th percentile)
- self-confidence (75th percentile)
- assertiveness (67th percentile)
- self-efficacy (87th percentile)
- need for approval (21st percentile)


Questions for you:
1. Should I specifically address these issues at my semi-annual evaluation, and give them my plans for improvement? Or am I just sticking my foot in my mouth?
2. I am thinking of ways to improve on this, but welcome your suggestions
3. Are my chances as chief over? - I get that this depends on who else is in the running - but in general would you prioritize someone who gets along with staff/vocalizes less at resident meetings, if they are not as good at teaching/helping other residents/hardworking?

Thanks for your input.

Not really a resident, but I feel like the bolded is worrisome for lack of insight. =/

There has to be more to the story here and I feel like this could get bad something doesnt get fixed.

 

[WingedOx]

Not really a resident, but I feel like the bolded is worrisome for lack of insight. =/

There has to be more to the story here and I feel like this could get bad something doesnt get fixed.

There are a lot of problems with his story though my program had a 4 year (probably ongoing) streak of loud complainers becoming chief, myself included. Part of the job for me was calming the junior residents down about stuff because we'd been in the same frustrated position before.

 

[jhamaican]

to be honest:

the very fact that you felt the need to take an "emotional intelligence test" and post the breakdown raises red flags. It is pretty bizarre.

Residencies need multiple chiefs and the personalities have to balance each other. Not saying you shouldn't be selected as a chief, but I hope your co-chief is on the opposite end of the neurotic spectrum to balance things out at your program.

 

[Mass Effect]

I'm a Chief Resident. I'm not the smartest, not the most talented, not the quickest, I don't have the highest test scores or the best assessments/diagnoses (two of my classmates are brilliant in this regard). You know why I'm chief? Because I get along with everyone. I know how to handle criticism, how to be a liaison between residents and faculty, how to act during meetings, how to approach the situation if there's a conflict with two residents or a resident and nurse. I can advocate without being a pain in the ass. That's what being Chief is about. If you're having conflicts as an MS 2, you're destroying your chances.