Rough first shift

[saintsfan180]

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I just had my first shift on Monday and it was pretty rough. Shift was actually going ok until this attending came on and everything just shot downhill. He's apparently known for being an ass, but I thought since it was my first shift and I've never used the EMR before that he'd cut me a little slack. Nope. I got completely reamed on my presentation style even. I had checked out a pt to the previous attending so I was just going to ask him about a small section of the patient after rounds and he ripped me a new one, so of course all of my subsequent presentations sucked because I was freaking nervous. Toward the end of the day I decided I just didn't care anymore and he almost seemed to ease up a bit. I feel like I'm fairly competent at least, but every time I'd say something he'd sigh loudly and rub his face like I was the dumbest person to ever grace this program. I mean, half the time my workup was right and he'd still act like I was ******ed and he came up with it. I'm not saying I didn't make stupid errors and forget some things, yeah duh it's my first shift of course I did, but the way he was acting was really making my work way worse. I was so worried about making mistakes that I probably made more than normal and I was afraid to ask him for help so I had to rely heavily on the nurses (who are awesome at my facility).
For instance, we had a low speed MVA come in, who was fine at the scene, ambulating/etc but EMS came and packaged her to be safe. He had no pain, nothing. I checked with the attending who was on at the time and we went over her Nexus criteria and he told me to remove the c-collar so I did. Well I then check out to jerkbag after attending A went off shift and he tells me "not to go randomly yanking c-collars off of people". WTF? How on earth do I deal with this guy for 4 years??? All the upper levels were pulling me aside telling me it was okay, I was doing alright. Apparently a couple cried on their first shift with him, others just stopped seeing patients so they could avoid him entirely. How is this good for patient care?
It's gotten a little better since then, other folks seem to be a bit nicer and more patient. Geeze I just hope I can avoid this guy as much as possible.

 

[Arcan57]

I just had my first shift on Monday and it was pretty rough. Shift was actually going ok until this attending came on and everything just shot downhill. He's apparently known for being an ass, but I thought since it was my first shift and I've never used the EMR before that he'd cut me a little slack. Nope. I got completely reamed on my presentation style even. I had checked out a pt to the previous attending so I was just going to ask him about a small section of the patient after rounds and he ripped me a new one, so of course all of my subsequent presentations sucked because I was freaking nervous. Toward the end of the day I decided I just didn't care anymore and he almost seemed to ease up a bit. I feel like I'm fairly competent at least, but every time I'd say something he'd sigh loudly and rub his face like I was the dumbest person to ever grace this program. I mean, half the time my workup was right and he'd still act like I was ******ed and he came up with it. I'm not saying I didn't make stupid errors and forget some things, yeah duh it's my first shift of course I did, but the way he was acting was really making my work way worse. I was so worried about making mistakes that I probably made more than normal and I was afraid to ask him for help so I had to rely heavily on the nurses (who are awesome at my facility).
For instance, we had a low speed MVA come in, who was fine at the scene, ambulating/etc but EMS came and packaged her to be safe. He had no pain, nothing. I checked with the attending who was on at the time and we went over her Nexus criteria and he told me to remove the c-collar so I did. Well I then check out to jerkbag after attending A went off shift and he tells me "not to go randomly yanking c-collars off of people". WTF? How on earth do I deal with this guy for 4 years??? All the upper levels were pulling me aside telling me it was okay, I was doing alright. Apparently a couple cried on their first shift with him, others just stopped seeing patients so they could avoid him entirely. How is this good for patient care?
It's gotten a little better since then, other folks seem to be a bit nicer and more patient. Geeze I just hope I can avoid this guy as much as possible.

Not everyone in academics is cut out to be in academics. I've heard anectdotally that being an academic attending in early July is extremely stressful, but it's also a part of the job. Are there multiple attendings to check out to (ie is being an ass his attempt at work avoidance)? If all the interns hate dealing with him, then it's almost assuredly him and not you that's the problem. So I'd not take anything he says personally, and I wouldn't look to him to try and evaluate how you are doing as an intern. Learn what you can from him but try and stay emotionally detached.

 

[shopsteward]

The main thing to remember with any colleague like this is that they can easily intimidate you into being in the wrong. For instance, if they make it unpleasant to talk to them, you avoid talking to them when you should be. That puts you in the wrong, and the bully has justification for being even more unpleasant. So be aware of your reactions to this man, and try not to let those reactions stop you from doing what you should be doing.

Be polite, be conscientious, do your best and try not to let his behaviour adversely affect yours. Try to create good working relationships with the other people around you - people who are well integrated into the workplace society are harder to isolate and to bully. If you carry on doing your best, and fitting well in the workplace, either you will gain his respect or you will be in a position to no longer need it.

Good luck.

 

[saintsfan180]

Yeah he was doing exactly that, intimidating me into not talking to him so he could yell more when I messed up. It's my fault for letting it get to me and I'm annoyed at myself for it but the first shift comes with a significant amount of stress as it is. About 8 hours into the shift I went down to the caf to decompress and gave myself a little pep talk about not being a pushover and I got it together a bit. That and I had like 4 patients out so I didn't pick up any new ones for a while. The problem is that he was the only staff there that night so I was forced to deal with him. It's just bad luck getting the biggest dick on your first day. Everyone else is really helpful and nice, so I so hopefully I can have as little interaction with this dude as possible because I sure don't give a crap about earning his respect. I just want to do my work and get by. I just don't get why you go into academics (unless you suck to bad to be private) if you are going to be that exasperated by interns. Of course we are going to be *****s at first. It's just poor patient care to be unapproachable to the point where we are having to figure everything out on our own.

 

[Cynic]

Eerily similar 3rd day of intern year...

 

[Daiphon]

This behavior is inappropriate... but to play devil's advocate, it may be less so if it's how you learn; I've had residents ask me to be a raging dick "because I do better when I have something to prove."

I try to tailor teaching to my resident's style... but this is very hard for me to pull off, as I'm a pretty easygoing guy.

Sounds like this guy, though, has a pattern... see if it gets better; if not, have a chat with your chief/PD as to avoid getting roasted on your evals.

Good luck!
-d

PS - not inappropriate to pull someone off a BB/CC if done correctly. CC aren't comfy, and pressure ulcers start in 30min or less.

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[danzman]

This behavior is inappropriate... but to play devil's advocate, it may be less so if it's how you learn; I've had residents ask me to be a raging dick "because I do better when I have something to prove."

I try to tailor teaching to my resident's style... but this is very hard for me to pull off, as I'm a pretty easygoing guy.

Sounds like this guy, though, has a pattern... see if it gets better; if not, have a chat with your chief/PD as to avoid getting roasted on your evals.

Good luck!
-d

PS - not inappropriate to pull someone off a BB/CC if done correctly. CC aren't comfy, and pressure ulcers start in 30min or less.

Sent from my DROID BIONIC using Tapatalk

That is a nutty resident!

I had a trauma surgeon spend a month yelling, screaming, and degrading me in front of anyone that would listen. I have to admit that it did make me work considerably harder for him. At the end of the month he sat me down and talked to me like a human for the first time. He said that "that's how I was taught, so that's just how I do it." Any time after that I had interactions with him he was very different, maybe not nice, but not an ass.

 

[Daiphon]

That is a nutty resident!

Concur. Became a helluva attending, and as a resident spent a lot of time teaching students & interns/juniors but never taught others in the manner he wanted me to teach him.

I guess ya go with what works for ya. d=)

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[The White Coat Investor]

Get your lovin' at home.

 

[AzEMMD]

I just had my first shift on Monday and it was pretty rough. Shift was actually going ok until this attending came on and everything just shot downhill. He's apparently known for being an ass, but I thought since it was my first shift and I've never used the EMR before that he'd cut me a little slack. Nope. I got completely reamed on my presentation style even. I had checked out a pt to the previous attending so I was just going to ask him about a small section of the patient after rounds and he ripped me a new one, so of course all of my subsequent presentations sucked because I was freaking nervous. Toward the end of the day I decided I just didn't care anymore and he almost seemed to ease up a bit. I feel like I'm fairly competent at least, but every time I'd say something he'd sigh loudly and rub his face like I was the dumbest person to ever grace this program. I mean, half the time my workup was right and he'd still act like I was ******ed and he came up with it. I'm not saying I didn't make stupid errors and forget some things, yeah duh it's my first shift of course I did, but the way he was acting was really making my work way worse. I was so worried about making mistakes that I probably made more than normal and I was afraid to ask him for help so I had to rely heavily on the nurses (who are awesome at my facility).
For instance, we had a low speed MVA come in, who was fine at the scene, ambulating/etc but EMS came and packaged her to be safe. He had no pain, nothing. I checked with the attending who was on at the time and we went over her Nexus criteria and he told me to remove the c-collar so I did. Well I then check out to jerkbag after attending A went off shift and he tells me "not to go randomly yanking c-collars off of people". WTF? How on earth do I deal with this guy for 4 years??? All the upper levels were pulling me aside telling me it was okay, I was doing alright. Apparently a couple cried on their first shift with him, others just stopped seeing patients so they could avoid him entirely. How is this good for patient care?
It's gotten a little better since then, other folks seem to be a bit nicer and more patient. Geeze I just hope I can avoid this guy as much as possible.

I had a nearly identical shift or two early in my intern year to what you're describing (being wrong no matter what I said, being looked at like I was an idiot, being intimidated to the point of not wanting to pick up any new patients). My advice would be just to stay systematic, professional, and keep contact with said attending to a minimum. Thankfully for me I didn't have many more shifts with that attending throughout the rest of the year. I don't at all advocate this method of teaching, but I will say that it definitely pushed me to try to be perfect every time.

 

[EMDoc0411]

I had a similar attending when I was an intern. Where I trained the interns weren't aloud to dictate patient charts. As a result, the attendings had to do the dictation. The day I became a second year, this attending turned into the nicest guy. To the OP, hang in there and before you know it, you might just end up being buddies.

 

[saintsfan180]

I get the mean teaching method, it just doesn't work for me. If you're a dick, I try to avoid you, not try harder. I guess I'll just have to wrap my mind around that and try to remember to be professional even if he's not gonna be. Yay!

 

[engineeredout]

Maybe this is just me, but the attendings that I feared the most didn't actually have to yell or raise their voice. I can think of one in particular who never raised his voice, and hardly showed any emotion. All he had to do was just stare at me and that was enough to make me think "Oh crap I am an idiot, I am going to check things over 20 times before coming back to him". He just had enough of a commanding presence that I wanted to work harder for him.


Then on the other hand, I've had the attendings/seniors who are just yelling constantly. Personally I tend to tune these people out more and thus have less of an incentive to work harder for them since I figure they're going to yell at me no matter what I do.