Feeling down

[fatefulfortuity]

How do you get over events where an attending makes you feel like crap? I've been feeling down the whole day because of a particular attending's reaction to things that were somewhat out of my control (combination of being at the end of shift, complicated diagnosis, being at a new hospital, and not knowing my exact role as a new resident on a non-traditional rotation). I've been feeling a combination of being depressed and somewhat angry, and after everything I've been through to get to where I am, and seeing that there are still many more years of training ahead, I really just feel like giving up.

I was well liked during my medical school rotations, got along with the residents as a student, did well academically, and was seen as a responsible, efficient, compassionate, and overall outstanding intern during my internship. I've dealt with all sorts of difficult personalities and situations from patients, family members, and other attendings/consultants. Usually I was able to compartmentalize the behavior from patients/family members and justify unprofessional behavior from attendings/consultants in my mind as they were either known to be dinguses by everyone else or that their behavior was prompted out of laziness. Even though it meant a harder time for me, I still went out of my comfort zone many many times and fought for patients under my care to get the services they needed. Of course these times weren't easy, but at least I knew in my mind that I had the higher moral ground. And rarely did it feel personal. It also helped that I became close with a lot of my fellow interns and we could trust each other to freely talk about these things.

Now I'm at a new hospital where I don't know anyone and I don't have my usual group of friends or people I could talk to. And worse is that this attending seems to be well liked as far as I can tell. What really did it was that at the end of the day the attending just stood up and left without saying a word or even acknowledging me, really making me feel like a piece of gum stuck on someone's shoe. The feeling was worsened due to the fact that I'm now in my chosen specialty and I got this reaction from what I felt was one of my own people, so it felt a lot more personal. Running things through in my head, I can't even say exactly what or how I could have done better unless I was already performing at a senior level, and even then I don't think the expectation of doing things in a shorter timeframe could have been met seeing how long the attending took to do the same thing afterwards. And now that I'm at my "real program," I feel that I can't even really talk to anyone and instead feel like I have to show the same happy front that everyone else seems to be showing. Now I'm just doubting myself in every way, my medical knowledge, my ability to study, my physical health, my willingness to keep this up for the next few years, my ability to fit in with the program, even my character as a person.

Edit: just wanted to clarify, there was no "mistake" made per say, since this is what some people here are assuming. No wrong order, no misdiagnosis, no wrong treatment given, no wrong information relayed to patient or other providers. I was literally 2-3 minutes into the patient's chart looking at things. The attending approached me and just starting acting bizarrely passive aggressive and asking me if I'd already done so and so and telling me that it was end of shift and I needed to be faster. Difficult to describe in words but the atmosphere was really tense/awkward. I think I just need to say this was out of my control and just keep doing what I'm doing regardless of being dismissed by one insignificant human being.

---

Members don't see this ad.

 

[TraumaLlamaMD]

How long did it take you to feel comfortable in med school, and again in your intern year? I'm sure you didn't feel (or perform) like a rock star two weeks in. If you've honestly evaluated what went wrong and how you can improve, and most importantly don't make the same mistakes next time, you've done all that can be asked of you at this point.

As to getting fussed at by your attending for things you can't control, remember that this person was once a resident too, probably getting reamed out for the same issues. Many of them remember. If there was truly no way you could have done better, it's not about you - they're frustrated with the system and you're the most available person to complain to. As you gain credibility and are seen as more competent, you may find you're given the benefit of the doubt more often when something goes awry. Getting things done on time in a hospital can take way more effort than really seems justified sometimes, but again, as you get used to your new hospital and role, it'll only get easier.

And make sure to leave time to bond with your coresidents - they're all going through the same thing right now, and I guarantee you're not the only newbie getting chewed out and doubting yourself on July 14.

 

[WheezyBaby]

Lacking some details, so I won't comment with much specifics. I'm assuming a mistake was made. Being able to actually make mistakes (at least, ones of any major significance) is one of the biggest changes in transitioning from a student to resident. Generally, mistakes are best looked at from a systems standpoint, they rarely fall solely on an individual. It seems like you've analyzed the event to some degree, but you should get additional perspective. Do you have a senior on service with you? If not, giving your staff some time to cool down and bringing the event up for further discussion could be beneficial, both to get their insight and to demonstrate that you've thought about what happened. If you still have concerns and aren't comfortable going to your peers to discuss this, you could ask to talk with one of your chiefs. Finally, you may have distance from friends and family, but continue to lean on them for support. You need support. The feelings you're having aren't unusual

 

[mvenus929]

During my intern year, about halfway through, I was in my clinic and saw a patient (two, actually), with asthma. During my history, the mom refused to look at me, barely acknowledged my questions, and essentially answered I don't know to those she did acknowledge. In essence, she had no clue what meds her kids were on, when they took them, what their triggers were, what they looked like with an exacerbation, etc.

I went to present to my attending. She proceeded to ask me questions in a way that I couldn't figure out what she was asking for, and then berated me when I didn't know the answers (not because I didn't ask... because the mom didn't know). This was in front of my entire clinic. It subsequently led to an evaluation stating that I didn't understand 'basic' pathophysiology like asthma, despite being halfway through my intern year.

I was livid. Me and this attending didn't really get along that well to start, though some people loved her. It was my only bad evaluation to date, and I felt that my entire rotation evaluation was skewed because of that one encounter.

Flash forward year and a half to my graduation. I had followed those two kids through the rest of my residency, and had developed some sort of rapport with mom (though I think she just hated my attending and found me much nicer). I'm now being praised for successfully managing complex patients.

Bottom line, don't let this color your view of the residency. The attending was probably having a bad day and took it out on you. Move on and keep learning.

 

[HooliganSnail]

How do you get over events where an attending makes you feel like crap? I've been feeling down the whole day because of a particular attending's reaction to things that were somewhat out of my control (combination of being at the end of shift, complicated diagnosis, being at a new hospital, and not knowing my exact role as a new resident on a non-traditional rotation). I've been feeling a combination of being depressed and somewhat angry, and after everything I've been through to get to where I am, and seeing that there are still many more years of training ahead, I really just feel like giving up.

I was well liked during my medical school rotations, got along with the residents as a student, did well academically, and was seen as a responsible, efficient, compassionate, and overall outstanding intern during my internship. I've dealt with all sorts of difficult personalities and situations from patients, family members, and other attendings/consultants. Usually I was able to compartmentalize the behavior from patients/family members and justify unprofessional behavior from attendings/consultants in my mind as they were either known to be dinguses by everyone else or that their behavior was prompted out of laziness. Even though it meant a harder time for me, I still went out of my comfort zone many many times and fought for patients under my care to get the services they needed. Of course these times weren't easy, but at least I knew in my mind that I had the higher moral ground. And rarely did it feel personal. It also helped that I became close with a lot of my fellow interns and we could trust each other to freely talk about these things.

Now I'm at a new hospital where I don't know anyone and I don't have my usual group of friends or people I could talk to. And worse is that this attending seems to be well liked as far as I can tell. What really did it was that at the end of the day the attending just stood up and left without saying a word or even acknowledging me, really making me feel like a piece of gum stuck on someone's shoe. The feeling was worsened due to the fact that I'm now in my chosen specialty and I got this reaction from what I felt was one of my own people, so it felt a lot more personal. Running things through in my head, I can't even say exactly what or how I could have done better unless I was already performing at a senior level, and even then I don't think the expectation of doing things in a shorter timeframe could have been met seeing how long the attending took to do the same thing afterwards. And now that I'm at my "real program," I feel that I can't even really talk to anyone and instead feel like I have to show the same happy front that everyone else seems to be showing. Now I'm just doubting myself in every way, my medical knowledge, my ability to study, my physical health, my willingness to keep this up for the next few years, my ability to fit in with the program, even my character as a person.

Edit: just wanted to clarify, there was no "mistake" made per say, since this is what some people here are assuming. No wrong order, no misdiagnosis, no wrong treatment given, no wrong information relayed to patient or other providers. I was literally 2-3 minutes into the patient's chart looking at things. The attending approached me and just starting acting bizarrely passive aggressive and asking me if I'd already done so and so and telling me that it was end of shift and I needed to be faster. Difficult to describe in words but the atmosphere was really tense/awkward. I think I just need to say this was out of my control and just keep doing what I'm doing regardless of being dismissed by one insignificant human being.

So......it seems like you are going to let this get to you....obviously, as you have already written a thread about it, but really you shouldn't. Without knowing details, I bet dollars to doughnuts that you picked up a patient he wanted to dispo fast at the end of the shift, and he thought "o great, the intern has this patient", so he got super snarky and aggressive with you, talked to you like you know nothing, and now your feelings are hurt, and you feel like everyone hates you.

Stop that.

This guy clearly just wanted to leave on time, and had other things he was worrying about

A few things about teaching:

1. July is exhausting. Teaching is fun......until it's not. July means that you have to do sooooooo much extra work because the interns just don't know the system or the medicine yet. We were all there once, so you really do get a pass, but tensions can boil over.

2. Not all attendings are good teachers, not all attendings want to teach. It takes a truly patient hand to guide interns through July/August.

3. When you start somewhere new, it may seem like everyone "likes" somebody at first, but chances are if they have treated you like garbage, they have done it to others. Wait like 4 months, and you will get a real feel for how everyone feels about all the attendings. I think you will find that their behavior has not gone unnoticed.

 

[LUCPM]

It's absurd for someone who is 10-20 years ahead of you to expect the same efficiency.

I once had an eval from one of the senior residents stating I need to improve my time management when I didn't finish a note before noon because of an admission and a pt that was crashing. To my own defense, I always get to hospital an hour early to chart round and start my note because I don't like to rush things and that note happened to be the only note I signed after lunch time in my entire intern year.

Most people like to view things from their own view. A few people go even further and becomes a real d*ck when things don't go the way they want, like a small child. Other people will yell at you because you happen to be the lowest of the lowest. There are all kinds of people and we just can't expexct everyone to be level-headed.


Sent from my SM-G935R4 using Tapatalk

 

[J ROD]

Most folks are dinguses on some days. I just do my best and forget the rest.

 

[dienekes88]

How do you get over events where an attending makes you feel like crap? I've been feeling down the whole day because of a particular attending's reaction to things that were somewhat out of my control (combination of being at the end of shift, complicated diagnosis, being at a new hospital, and not knowing my exact role as a new resident on a non-traditional rotation). I've been feeling a combination of being depressed and somewhat angry, and after everything I've been through to get to where I am, and seeing that there are still many more years of training ahead, I really just feel like giving up.

I was well liked during my medical school rotations, got along with the residents as a student, did well academically, and was seen as a responsible, efficient, compassionate, and overall outstanding intern during my internship. I've dealt with all sorts of difficult personalities and situations from patients, family members, and other attendings/consultants. Usually I was able to compartmentalize the behavior from patients/family members and justify unprofessional behavior from attendings/consultants in my mind as they were either known to be dinguses by everyone else or that their behavior was prompted out of laziness. Even though it meant a harder time for me, I still went out of my comfort zone many many times and fought for patients under my care to get the services they needed. Of course these times weren't easy, but at least I knew in my mind that I had the higher moral ground. And rarely did it feel personal. It also helped that I became close with a lot of my fellow interns and we could trust each other to freely talk about these things.

Now I'm at a new hospital where I don't know anyone and I don't have my usual group of friends or people I could talk to. And worse is that this attending seems to be well liked as far as I can tell. What really did it was that at the end of the day the attending just stood up and left without saying a word or even acknowledging me, really making me feel like a piece of gum stuck on someone's shoe. The feeling was worsened due to the fact that I'm now in my chosen specialty and I got this reaction from what I felt was one of my own people, so it felt a lot more personal. Running things through in my head, I can't even say exactly what or how I could have done better unless I was already performing at a senior level, and even then I don't think the expectation of doing things in a shorter timeframe could have been met seeing how long the attending took to do the same thing afterwards. And now that I'm at my "real program," I feel that I can't even really talk to anyone and instead feel like I have to show the same happy front that everyone else seems to be showing. Now I'm just doubting myself in every way, my medical knowledge, my ability to study, my physical health, my willingness to keep this up for the next few years, my ability to fit in with the program, even my character as a person.

Edit: just wanted to clarify, there was no "mistake" made per say, since this is what some people here are assuming. No wrong order, no misdiagnosis, no wrong treatment given, no wrong information relayed to patient or other providers. I was literally 2-3 minutes into the patient's chart looking at things. The attending approached me and just starting acting bizarrely passive aggressive and asking me if I'd already done so and so and telling me that it was end of shift and I needed to be faster. Difficult to describe in words but the atmosphere was really tense/awkward. I think I just need to say this was out of my control and just keep doing what I'm doing regardless of being dismissed by one insignificant human being.

If you provide consistent solid reasonable care, you're going to be fine. Just keep going.

On a personal note, I've changed the minds of several attendings who thought I was a piece of **** at the beginning of a rotation for no other reason than that I am generally an awkward dude who has a somewhat odd sense of humor. In fact, I didn't always have glowing evaluations in medical school, because sometimes I just don't connect with people. Just put your head down and keep going. Always look to be improving your efficiency and your timing. You have something to learn from everybody, so turn it into an opportunity to get better.

No matter who you are or what you do, somebody's going to try to make you out to be a piece of ****.

During my intern year, about halfway through, I was in my clinic and saw a patient (two, actually), with asthma. During my history, the mom refused to look at me, barely acknowledged my questions, and essentially answered I don't know to those she did acknowledge. In essence, she had no clue what meds her kids were on, when they took them, what their triggers were, what they looked like with an exacerbation, etc.

I went to present to my attending. She proceeded to ask me questions in a way that I couldn't figure out what she was asking for, and then berated me when I didn't know the answers (not because I didn't ask... because the mom didn't know). This was in front of my entire clinic. It subsequently led to an evaluation stating that I didn't understand 'basic' pathophysiology like asthma, despite being halfway through my intern year.

I was livid. Me and this attending didn't really get along that well to start, though some people loved her. It was my only bad evaluation to date, and I felt that my entire rotation evaluation was skewed because of that one encounter.

Flash forward year and a half to my graduation. I had followed those two kids through the rest of my residency, and had developed some sort of rapport with mom (though I think she just hated my attending and found me much nicer). I'm now being praised for successfully managing complex patients.

Bottom line, don't let this color your view of the residency. The attending was probably having a bad day and took it out on you. Move on and keep learning.

Exactly.

Most folks are dinguses on some days. I just do my best and forget the rest.

Well put.

 

[chicagochildpsych]

An attending physician in academia berated someone who couldn't talk back and acted smug, I can't imagine....


Sent from my iPhone using SDN mobile app