Hospitalist - problems with nurses

[Osteoth]

Nurses have gone rogue. I guess they are emboldened by admin. Amazingly, I noticed nurses in academic center where I did residency were more disciplined than nurses at these community hospitals.

Me too. I wonder why.

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[Splenda88]

Me too. I wonder why.

I am not sure why... At my place, it might be the small city atmosphere where almost everyone attended the same school and they know each other and some people in the leadership.

 

[The kitchen sink]

Nurses have gone rogue. I guess they are emboldened by admin. Amazingly, I noticed nurses in academic center where I did residency were more disciplined than nurses at these community hospitals.

They are emboldened by admin and their unions, and their ability to jump ship to another higher paying job, or strike without issue compared to physicians.

In comparison to above, what do we have?

A liability sponge of a license, anything else?

Go ahead, i’ll wait

 

[end stage fibro]

Nurses have gone rogue. I guess they are emboldened by admin. Amazingly, I noticed nurses in academic center where I did residency were more disciplined than nurses at these community hospitals.

Interesting to read this. I have had the same feeling, especially over the last few years. the inmates are running the asylum. Some of the newer nurses (and NPs) spend so much time debating the treatment plan. Frequently, what they are suggesting is batsh*t crazy - willy nilly adjustment of pulm HTN meds, stopping DAPT in fresh stents due to "bleeding risk," bizarre antibiotic regimens . It is especially bad in the SNF I go to.

I live in a big city, too. Lots of hospital systems, nursing schools, residencies. I don't think is geographically limited. Combined with newer residents being more soft (or I'm becoming more of a hoary attending...no, it is the kids who are wrong),I feel like non-procedural physician jobs will be at risk. Makes me feel bad for people that don't have physicians in their family to review the treatmen plan.

 

[dozitgetchahi]

Until the liability is actually spread to someone other than the physician, then it is an order and has to be followed. Unfortunately, it’s on us to enforce this through multiple barriers.

Yes. This.

Despite the realities of working in a health system, the medical boards still view the doc as the “captain of the ship” and will treat you as such when the **** hits the fan. Why didn’t you act to stop this? Etc etc.

At the end of the day, you are renting your labor to a hospital and your license is yours to protect. (Rest assured that they won’t help you do so.) Act accordingly.

 

[The kitchen sink]

Yes. This.

Despite the realities of working in a health system, the medical boards still view the doc as the “captain of the ship” and will treat you as such when the **** hits the fan. Why didn’t you act to stop this? Etc etc.

At the end of the day, you are renting your labor to a hospital and your license is yours to protect. (Rest assured that they won’t help you do so.) Act accordingly.

Employed physicians should unionize.

 

[sloh]

. It is especially bad in the SNF I go to.

lol tell me about it man. Kafkaesque

 

[Osteoth]

They are emboldened by admin and their unions, and their ability to jump ship to another higher paying job, or strike without issue compared to physicians.

In comparison to above, what do we have?

A liability sponge of a license, anything else?

Go ahead, i’ll wait

We still have money. We all make at least double what everyone on the team makes except if you’re in a poor market, and that’s your choice.

 

[The kitchen sink]

We still have money. We all make at least double what everyone on the team makes except if you’re in a poor market, and that’s your choice.

We do. However it is still a pittance compared to the upstream revenue the hospitals generate for our labor.

 

[Osteoth]

We do. However it is still a pittance compared to the upstream revenue the hospitals generate for our labor.

It’s criminal doctors can’t own hospitals.

 

[VA Hopeful Dr]

Yes. This.

Despite the realities of working in a health system, the medical boards still view the doc as the “captain of the ship” and will treat you as such when the **** hits the fan. Why didn’t you act to stop this? Etc etc.

At the end of the day, you are renting your labor to a hospital and your license is yours to protect. (Rest assured that they won’t help you do so.) Act accordingly.

I've got a board complaint in the works now. Hospital is paying for the lawyer 100%.

 

[Meerkatology]

how did the relationship get to this point?
maybe ive just been lucky, that i've never had any issues with nurses so far.

like i definitely dont consider myself a people person.
i generally dont even remember people's names or converse anything more than
the absolute minimum needed to do the work.

whenever i'm in the hospital i just want to get outta there asap

 

[BillBill1219]

Lol.

Like the aggressive message I got from a nurse a few days ago.

"Patient BUN went from 20 yesterday to 30 today, what are you going to do about it?"

Creatinine was 0.7 and BUN was 20 the day before; creatine 0.9 and BUN 30 when she messaged me..

I went and talked to patient and ask her a few questions, then started her on IVF at 75cc/hr for 6 hrs. RN is happy. Win-win... Lol

I really don’t understand how they can get away with having that attitude and yet, if our tone is even slightly off while talking to them, we are the villain.

 

[Osteoth]

I really don’t understand how they can get away with having that attitude and yet, if our tone is even slightly off while talking to them, we are the villain.

I always wonder if it’s a man vs woman thing. The male doctors tend to get a lot more complaints than the female ones…

 

[BillBill1219]

I always wonder if it’s a man vs woman thing. The male doctors tend to get a lot more complaints than the female ones…

I think the threshold to complain against men is probably much lower. I recently worked with an intern who screeched “sexism! misogyny!” every time a man spoke to her. It was unbearable. She saw injustice in everything except for her own absurd behavior. It’s very easy to believe that the nurses are trying to shift some perceived power dynamic in their favor…

 

[ShuperNewbie]

Makes me feel bad for people that don't have physicians in their family to review the treatment plan.

Oh my gosh... this is exactly what I've said to my wife on a few occasions. I've had a few instances where I've reviewed an oncologic treatment plan and thought to myself in horror "this person is actually being actively harmed". And the average Joe doesn't have the technical knowledge required to judge when something's off. This is a reflection of deep brokenness; the healthcare system is neither free nor equitable when the only way to ensure you're receiving quality care is to have a connection to someone who knows what they're talking about.

 

[anonperson]

Oh my gosh... this is exactly what I've said to my wife on a few occasions. I've had a few instances where I've reviewed an oncologic treatment plan and thought to myself in horror "this person is actually being actively harmed". And the average Joe doesn't have the technical knowledge required to judge when something's off. This is a reflection of deep brokenness; the healthcare system is neither free nor equitable when the only way to ensure you're receiving quality care is to have a connection to someone who knows what they're talking about.

That's a lot of things in life.

I'm sure building contractors are cutting corners etc unless you actually know the business and what to look for.

Same for car repair industry. I'm generally at the mercy of the mechanic when they make a recommendation.

Don't get me started on dentists... How many cavities and root canals are done that are likely questionable...