how to deal with residents who don't treat you well

[Majorpain]

I just want to vent out here in the forums coz I've nowhere else to turn to. Had a bad day today with my resident scolding me in front of other people just because I didn't get the patient back to the nursing home, even though the family decided against it. I felt so humiliated in front of all the nurses and the social worker. Cried a river in the bathroom and tried to compose myself but I can't. Still feeling a little down till now. I miss my family and want to be with them during these times when I'm down. Despise him so much. I said to myself I won't let his attitude bother me and just do my job well. Why are some people like this, they don't care about your feelings and would even call you out in front of others? Other residents are really nice and not like him. Sorry for the long rant here, just wanted to express my feelings.

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[yaah]

Part of medicine is learning how to deal with difficult situations, which includes criticism. Unfortunately because of the nature of medicine, criticism often happens in public. I know it's small comfort but it will make you better in the future - in medicine we have to be able to handle uncomfortable situations and still keep our wits and our confidence.

In truth, lots of times residents and attendings don't consider your feelings because your feelings are not really the important thing - the important thing is the patient. But in many cases some residents and med students are just miserable people and it makes them feel better when others feel worse. All you can do is suck it up and try not to take it personal.

You're right, the appropriate response in the situation would be for the resident to talk to you in private and not in public. This is often a time when you talk to an attending about how you can avoid situations like this in the future - maybe you did something wrong that you didn't know was wrong?

 

[Top Gun]

I just want to vent out here in the forums coz I've nowhere else to turn to. Had a bad day today with my resident scolding me in front of other people just because I didn't get the patient back to the nursing home, even though the family decided against it. I felt so humiliated in front of all the nurses and the social worker. Cried a river in the bathroom and tried to compose myself but I can't. Still feeling a little down till now. I miss my family and want to be with them during these times when I'm down. Despise him so much. I said to myself I won't let his attitude bother me and just do my job well. Why are some people like this, they don't care about your feelings and would even call you out in front of others? Other residents are really nice and not like him. Sorry for the long rant here, just wanted to express my feelings.

If its any consolation, you're not the only one who has to deal with seniors like these. Most of the upper-level residents in my program are pretty nice, but there's this one guy I have to be on call with Tuesday who I am absolutely petrified of. He is the kind of resident who has no control over his temper and is very intimidating. I'm dreading call with him on Tuesday.

 

[lowbudget]

Part of medicine is learning how to deal with difficult situations, which includes criticism. Unfortunately because of the nature of medicine, criticism often happens in public. I know it's small comfort but it will make you better in the future - in medicine we have to be able to handle uncomfortable situations and still keep our wits and our confidence.

In truth, lots of times residents and attendings don't consider your feelings because your feelings are not really the important thing - the important thing is the patient. But in many cases some residents and med students are just miserable people and it makes them feel better when others feel worse. All you can do is suck it up and try not to take it personal.

I thought this was very thoughtful.

The only thing I would disagree with the sucking it up part. For many of us, residency is the first time any of us has had a real job with this much responsibility. And, it's also the first time many of us are managing people in this, sort of, middle manager position. So everyone's learning.

If your resident is half-way human, I'm sure he's embarrassed by the situation also, but he's just not talking about it. When you have settled down, just say to him that your feelings were hurt and that you didn't appreciate the way he talked to you and blamed you for something out of your control. You don't have to pull him aside and make it a "moment". Do it in public, if you're as confrontational as I am. Just say it as a matter of fact. Who knows? Maybe he'll respond, talk about it, apologize and have respect for you. And maybe you'll learn not to let people dictate how you feel, and how your day goes.

I've always believed that good managers don't act ridiculously like that. It's the bad ones, who aren't confident, who don't know what they're doing, who act out like that.

I say, forgive him for his inexperience in team work and managerial skills, but don't let him get away for his bad behavior. Like I said, everyone's learning... you... him... everyone.

 

[dragonfly99]

Disagree with confronting the resident. I don't see much to be gained there. Remember, they can always hurt you more.

Just to play devil's advocate a little, whether or not the family wants the patient to return to the nursing home may not be the point. You can't really keep a patient in the hospital longer than is medically indicated...lots of times the patient and/or family don't agree with the medicine team's decision that the patient is ready for discharge, but we (the docs and nurses) have to make that decision. Medicare and insurance companies won't pay for patients to be in the hospital if it isn't medically indicated. Not to say that you kick somebody to the curb just to save the hospital money, but dispo issues like this will come up constantly on the medicine service, and you can't just keep all the little old people on your service the entire month because you feel sorry for them or there is only 1 nursing home out of 7 in town that the family is willing to accept. They can always transfer their family member to a different nursing home later if they don't like the one they do to. This happens with rehab facilities as well...the family will have an idea of where they want the patient to go, but there are no beds, and then the family wants the patient boarded in the hospital until the rehab bed in the desired facility is available. At any rate, the social worker should be helping you with dispo issues like this. You have to work with her from day 1 on dispo issues on patients like this.

Perhaps the resident was angry with you because the attending had wanted the patient discharged that day, and he (resident) though it would get done, and it didn't. But I agree that berating you in public wasn't the greatest way to handle this. Dispo is one of the things the resident should be helping you out with also, this early in the year.

Just keep trucking. You probably switch rotations soon anyway? Better to pick your battle and a battle that you were talked to "too harshly" isn't really a productive way to spend your time. The resident might be "in good" with your program director and/or attending, and if you mix it up with the resident you could end up getting hurt more, in terms of your evaluation(s) and/or the general work environment for the rest of the rotation. Just make like a duck and let it all roll off you.

p.s. there is a good thread on this topic on the anesthesiology form entitled "Bow your heads". I think it applies to this situation.

 

[TheWowEffect]

Tell them you are there to learn and thank them for their helpful scolding...errr...teaching. 😀

Seriously speaking, I agree with yaah. You will eventually learn to not let your feelings come in the way of doing your job. It may take more time for some but it ultimately comes with experience.

 

[Acherona]

**** flows downhill. The resident probably had someone down his back about getting the patient discharged. The intern/med student is a convenient scapegoat. This happens more often with nurses, but the point is not to take it personally. Definitely don't complain about it. If you want to get him to apologize to you, start by apologizing to him for messing up the discharge.

 

[roja]

This type of behavior is unfortunately a part of medicine... not a good one but its there. It is incredibly difficult for people to spontaneously learn that IF there is an issue that needs to be discussed, it should be discussed in private. (ie: praise in public, scold in private).

It is a shame that there is often no recourse when this is done. I have, on occasion, interfered when a consulting attending was trying to humiliate my jr resident, and I have pulled seniors aside when I have seen this happen. (fortunately, not often).

You will have to learn a little bit to not let this bother you. More importantly, hopefully you will learn from it and will not behave in a similar fashion when you are in a senior position.

IF you have an evaluation process for the rotation, you can mention it. (as the ACGME moves towards mandatory 360 evaluations, some places now have jr's and medical students evaluating seniors)

 

[3dtp]

This type of behavior is unfortunately a part of medicine... not a good one but its there. It is incredibly difficult for people to spontaneously learn that IF there is an issue that needs to be discussed, it should be discussed in private. (ie: praise in public, scold in private).

It is a shame that there is often no recourse when this is done. I have, on occasion, interfered when a consulting attending was trying to humiliate my jr resident, and I have pulled seniors aside when I have seen this happen. (fortunately, not often).

You will have to learn a little bit to not let this bother you. More importantly, hopefully you will learn from it and will not behave in a similar fashion when you are in a senior position.

IF you have an evaluation process for the rotation, you can mention it. (as the ACGME moves towards mandatory 360 evaluations, some places now have jr's and medical students evaluating seniors)

And it shouldn't be! Medicine or any other job. Other jobs have strong protections against that sort of behavior. A good employee can quit and get another job, usually paying more money, there are HR departments and labor laws to fall back on, etc. None of thes protections exist in medicine.

Donkeys exist in medicine. I came to the realization my second month in residency doing a TY that there is a junior high school mentality in residency, and along with that mentality, comes a few school yard bullies. The kind that get their kicks out of beating up on defenseless younger/smaller students, and that most of the rest of us avoided. Unfortunately in residency situations you can't avoid them, and you get your nose bloodied from time to time. It's not pleasant, it is not educational and builds resentment and the cycle of violence (verbal/mental) repeats.

I had a golden weekend, one of one that I had in that program in 12 months. I went to a friend's house some distance away, on the beach. When it looked like I was going to be delayed returning for weather, I had my buddy call the hospital and let them know the situation. It turns out that I was not only on time, but early getting in. Later, in front of a dozen people this donkey screamed at me for being late, not caring about my job, inconveniencing the world and pronounced me unfit for residency and medicine, using four letter words known only to drunken sailors on shore leave. None of this was true, and I had watched this jack-donkey do the same to a number of others, including reducing one resident to tears in a patient's room.

If you write someone like this up on a 360 evaluation, at least in that program, your evaluation will be a mirror image of it, and you can be screwed as well. It happened to me. Unfortunately, once severely burned you remember and all my subsequent 360 evaluations were precisely neutral. Not how it is, but there's little you can do. Until you are in charge.

Just remember that being anass is easy for insecure people given more responsibility than they are capable of handling. Try to remember when you get there this situation and try very hard not to pass on the abuse. All of medicine will be better for it.

 

[buckley]

in medicine we have to be able to handle uncomfortable situations and still keep our wits and our confidence.

In truth, lots of times residents and attendings don't consider your feelings because your feelings are not really the important thing - the important thing is the patient.

I despise these "truths" so much. Why do we always have to keep the facade that we know everything? And hence the stupid scripted dialogues, "Sounds good, " or "I believe so..."
True, you have to be a bit of a masochist to survive medicine.

 

[skypilot]

Part of medicine is learning how to deal with difficult situations, which includes criticism. Unfortunately because of the nature of medicine, criticism often happens in public. I know it's small comfort but it will make you better in the future - in medicine we have to be able to handle uncomfortable situations and still keep our wits and our confidence.

In truth, lots of times residents and attendings don't consider your feelings because your feelings are not really the important thing - the important thing is the patient. But in many cases some residents and med students are just miserable people and it makes them feel better when others feel worse. All you can do is suck it up and try not to take it personal.

I agree that it might make the med student tougher and more confident in uncomfortable situations in the future but at the moment that this type of behaviour occurs it contributes negatively to patient care.

The reason many docs are miserable and patients think doctors are A## is that is the way they behave. Even in the OR some degree of civility and restraint is important if the team is going to obtain the best outcome in an emergent situation.