Should I RESIGN or be terminated & FIGHT?

[Shikima]

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What kind or ridiculous places did you guys train at?

Pretty darn ridiculous.

 

[Shikima]

So it is unprofessional to call someone unprofessional. Got it. Love our system.

Thanks, this made me laugh.

It's more like a case of the Princess Bride..

“You keep using that word, I do not think it means what you think it means”.

 

[DrT2202]

Please note that describing a female attending as "OLD AS DIRT", equating the age of 40 to "OLD AS DIRT" and describing a work colleague as "broadcasting promiscuity" because of the boots she wears is unprofessional.

I have to say that I've worked with a lot of middle aged female attendings/residents in my FM rotation and they were really really nice. The whole program had a great atmosphere and almost everybody dressed properly. Even the somehow younger residents who might wear short skirts didn't look or seem inappropriate. Learned a lot in FM.

One of the points I'm trying to make is that I got along well with faculty/residents/staff in all rotations so I'm not entirely a terrible person. I also have friendly positive relationships with people in my department. There's a lot of room for speculation on subjective issues and the human mind/psychology is really really complex. Sometimes non verbal communication, first impressions, racial/ethnic backgrounds can affect the person's perception of another person even subconsciously. Whatever the case is; the best anyone could wish for is that the individuals with power would have good intentions.

 

[Winged Scapula]

I am somewhat dubious that the students and residents here really know the difference between "hooker boots" and nice elegant boots.

Hookers do not wear knee length leather or suede boots. They wear these http://www.discountstripper.com/susieblk.aspx . Pleather or vinyl, over the knee boots.

"Old as dirt" women physicians wear things like this http://www.anntaylor.com/kamryn-leather-boots/315496?colorExplode=false&skuId=14151262&catid=cat660012&productPageType=fullPriceProducts&defaultColor=6600.

 

[deleted480308]

I am somewhat dubious that the students and residents here really know the difference between "hooker boots" and nice elegant boots.

Hookers do not wear knee length leather or suede boots. They wear these http://www.discountstripper.com/susieblk.aspx . Pleather or vinyl, over the knee boots.

"Old as dirt" women physicians wear things like this http://www.anntaylor.com/kamryn-lea...tPageType=fullPriceProducts&defaultColor=6600.

(Asks wife what size boot she wears) 😉

 

[MediCane2006]

I am somewhat dubious that the students and residents here really know the difference between "hooker boots" and nice elegant boots.

Hookers do not wear knee length leather or suede boots. They wear these http://www.discountstripper.com/susieblk.aspx . Pleather or vinyl, over the knee boots.

"Old as dirt" women physicians wear things like this http://www.anntaylor.com/kamryn-leather-boots/315496?colorExplode=false&skuId=14151262&catid=cat660012&productPageType=fullPriceProducts&defaultColor=6600.

Ooh those are nice.

 

[NotAProgDirector]

There's been quite a bit of action on this thread, so I missed some chances to comment.

I agree that the concept of "professionalism" is vague. I think there are some things we would all agree are unprofessional -- and they are very rare events. The problem is that there is a large grey area where people disagree. This is not completely unique to professionalism. Let's take medical knowledge -- as based on the USMLE. A passing score and a failing score are the difference of a single question, yet the two people (one who passes and one who fails) are really the same. It's completely arbitrary -- much like some of the professionalism examples above.

One interesting example is using cell phones on rounds. "More seasoned" physicians almost uniformly feel this is unprofessional. But if interns are looking some item up on their phone -- the right dose of voriconazole, or a study they remember reading about recently -- then perhaps it's actually just fine.

 

[Winged Scapula]

Ooh those are nice.

Which ones - the vinyl hooker boots that apparently female attendings are wearing around the country to the hospital or the elegant Ann Taylor ones? 😉

 

[DrT2202]

I am somewhat dubious that the students and residents here really know the difference between "hooker boots" and nice elegant boots.

Hookers do not wear knee length leather or suede boots. They wear these http://www.discountstripper.com/susieblk.aspx . Pleather or vinyl, over the knee boots.

"Old as dirt" women physicians wear things like this http://www.anntaylor.com/kamryn-leather-boots/315496?colorExplode=false&skuId=14151262&catid=cat660012&productPageType=fullPriceProducts&defaultColor=6600.

Hahahaha thanks for sharing that

 

[Shikima]

I am somewhat dubious that the students and residents here really know the difference between "hooker boots" and nice elegant boots.

Hookers do not wear knee length leather or suede boots. They wear these http://www.discountstripper.com/susieblk.aspx . Pleather or vinyl, over the knee boots.

"Old as dirt" women physicians wear things like this http://www.anntaylor.com/kamryn-leather-boots/315496?colorExplode=false&skuId=14151262&catid=cat660012&productPageType=fullPriceProducts&defaultColor=6600.

You realize what this means?

There may be a public outcry for digital media to demonstrate which boots are made for you to walk in.....

Disclaimer: Yes, it was a bad nancy sinatra pun.

 

[ruralsurg4now]

Which ones - the vinyl hooker boots that apparently female attendings are wearing around the country to the hospital or the elegant Ann Taylor ones? 😉

OK, you got us. I don't think that they make stripper boots that are large enough for female attendings' thighs. HEEEEY OOOOOOO!! 😀

 

[ruralsurg4now]

One interesting example is using cell phones on rounds. "More seasoned" physicians almost uniformly feel this is unprofessional. But if interns are looking some item up on their phone -- the right dose of voriconazole, or a study they remember reading about recently -- then perhaps it's actually just fine.

No offense, but I don't know what you're talking about. Physicians of all ages will interrupt anyone to answer a random cell phone call or return a page. You can literally be talking to them and they'll look down at their pager and start dialing.

 

[Buzz Me]

(I've been a custodian, no shame in it, but a doctor is too expensive to the hospital to run a mop and give sponge baths)

I've picked up the mop before (usually in anger, when no one else will do it) when a floor just won't get cleaned. Once when there was vomit all over the floor at the VA and housekeeping just refused to show up, and people were slipping all over the place. Another time in the OR when the room just wasn't getting turned over fast enough for our (pending) emergent case.

 

[thefritz]

No offense, but I don't know what you're talking about. Physicians of all ages will interrupt anyone to answer a random cell phone call or return a page. You can literally be talking to them and they'll look down at their pager and start dialing.

As a med student. I have never given a single end of course presentation where an attending didn't get up in the middle of it and leave or procede to answer a call in the room. Whereas if you're in a presentation as a med student and your cellphone rings, you get the look of death from everyone in the room for simply not muting it. Even a buzz from a text message will get you dirty stares.

 

[thefritz]

One interesting example is using cell phones on rounds. "More seasoned" physicians almost uniformly feel this is unprofessional. But if interns are looking some item up on their phone -- the right dose of voriconazole, or a study they remember reading about recently -- then perhaps it's actually just fine.

By definition, using a smartphone to look up information on rounds is extremely professional. However, this goes back the point about the mis-use of the word. It has nothing to do with conducting your professional duties, it has do with image. I was reprimanded as an M4 (by a nurse no less) for pulling out my cellphone in clinic to look something. Apparently the clinic has a rule that you cannot have cellphones in public view in the hallway because it 'looks bad to the patients.' (you know, the patients who bring their 5 kids into the visit room with them all playing on their ipads and the patient is texting as you are trying to take a history...) You also are not allowed to be seen sitting down, so all physician workstations are standing pods. I'll give you one guess which specialty this was.

Cell phone = video game to old people.

 

[ruralsurg4now]

As a med student. I have never given a single end of course presentation where an attending didn't get up in the middle of it and leave or procede to answer a call in the room. Whereas if you're in a presentation as a med student and your cellphone rings, you get the look of death from everyone in the room for simply not muting it. Even a buzz from a text message will get you dirty stares.

I'd often look at students if their cell phones went off, but not because I was upset but because I was so freakin' bored that the sound got my attention.

 

[Leforte]

To the OP:

What if you asked the program you could have a final 2-4 weeks to try to show improvement - and that this is what you propose to do.
1) With patient interactions in clinic, after you have introduced yourself to the patient and family, explain that you are a new doctor and are trying to improve communication skills - tell them that if they feel any areas for improvement, could they tell you either immediately or at the end of the visit and that you will have an evaluation form for them to complete that addresses issues like "friendliness", "explains well", "mannerisms", etc, etc.
2) These interactions will be reviewed at the end of each clinic with the attending and any issues will be immediately addressed
3) You will continue in psychotherapy and can address any particular issues brought up during that time
4) You will strive to demonstrate an improvement over the probationary 2-4 weeks
5) If you fail to improve in your communication skills, as demonstrated by multiple patient evaluations that you will resign

Perhaps aProgDirector can comment if that could be viable.

 

[core0]

Which ones - the vinyl hooker boots that apparently female attendings are wearing around the country to the hospital or the elegant Ann Taylor ones? 😉

I'm more curious why you know about the first website.

 

[ruralsurg4now]

To the OP:

What if you asked the program you could have a final 2-4 weeks to try to show improvement - and that this is what you propose to do.
1) With patient interactions in clinic, after you have introduced yourself to the patient and family, explain that you are a new doctor and are trying to improve communication skills - tell them that if they feel any areas for improvement, could they tell you either immediately or at the end of the visit and that you will have an evaluation form for them to complete that addresses issues like "friendliness", "explains well", "mannerisms", etc, etc.
2) These interactions will be reviewed at the end of each clinic with the attending and any issues will be immediately addressed
3) You will continue in psychotherapy and can address any particular issues brought up during that time
4) You will strive to demonstrate an improvement over the probationary 2-4 weeks
5) If you fail to improve in your communication skills, as demonstrated by multiple patient evaluations that you will resign

Perhaps aProgDirector can comment if that could be viable.

That doesn't necessarily seem unreasonable, except that when you're at the point of already discussing "resign versus get fired," they're past that. Basically, it's showdown time, where he has to figure out whether they have anything substantial or if they're just bluffing.

 

[IlDestriero]

Yeah, that ship sailed away the last time you met with the PD and didn't correct your actions.

 

[NotAProgDirector]

To the OP:

What if you asked the program you could have a final 2-4 weeks to try to show improvement - and that this is what you propose to do.
1) With patient interactions in clinic, after you have introduced yourself to the patient and family, explain that you are a new doctor and are trying to improve communication skills - tell them that if they feel any areas for improvement, could they tell you either immediately or at the end of the visit and that you will have an evaluation form for them to complete that addresses issues like "friendliness", "explains well", "mannerisms", etc, etc.
2) These interactions will be reviewed at the end of each clinic with the attending and any issues will be immediately addressed
3) You will continue in psychotherapy and can address any particular issues brought up during that time
4) You will strive to demonstrate an improvement over the probationary 2-4 weeks
5) If you fail to improve in your communication skills, as demonstrated by multiple patient evaluations that you will resign

Perhaps aProgDirector can comment if that could be viable.

Going to agree with the above. This is what the OP should have done after the first warnings. He/she can certainly ask, but it's probably much too late now.

 

[ruralsurg4now]

More like, walk in there and go:

MOOOOOORTAAAAAALLLL KOOOOOOMBAAAAAAAAT!!!

Duh-duh duh-duh duh-duh duh-duh duh duh
Duh-duh duh-duh duh-duh duh-duh duh duh
Duh-duh duh-duh duh-duh duh-duh duh duh
DUH DUH DUH DUH-DUH!

And rip out the PD's spine.

 

[deleted480308]

More like, walk in there and go:

MOOOOOORTAAAAAALLLL KOOOOOOMBAAAAAAAAT!!!

Duh-duh duh-duh duh-duh duh-duh duh duh
Duh-duh duh-duh duh-duh duh-duh duh duh
Duh-duh duh-duh duh-duh duh-duh duh duh
DUH DUH DUH DUH-DUH!

And rip out the PD's spine.

Best post of thread

 

[Shikima]

best post of thread

+1.

 

[danielmd06]

I am somewhat dubious that the students and residents here really know the difference between "hooker boots" and nice elegant boots.

Hookers do not wear knee length leather or suede boots. They wear these http://www.discountstripper.com/susieblk.aspx . Pleather or vinyl, over the knee boots.

"Old as dirt" women physicians wear things like this http://www.anntaylor.com/kamryn-leather-boots/315496?colorExplode=false&skuId=14151262&catid=cat660012&productPageType=fullPriceProducts&defaultColor=6600.

They're *all* hooker boots. That's why guys like me love them. They have another name, too...

Oh, wait. Professionalism? Huh? What were we talking about?

 

[dozitgetchahi]

While we're on the subject, I'd like to say that I agree that much of what I see women wearing on the wards borders on being 'unprofessional'. Often times their clothing isn't really 'dressy' - sometimes it's downright trashy - and the usual result is that the women end up looking 'underdressed' standing next to the men, who themselves are simply wearing business casual clothing.

 

[touchpause13]

While I very much like the Ann Tyler boots I probably would not consider them professional shoes.

Those would not be allowed at formal meeting at my sorority. IMO only ankle boots are okay in professional settings

 

[pgg]

I'm glad I can lounge around in scrubs all day and still be dressed professionally.

 

[DrT2202]

To the OP:

What if you asked the program you could have a final 2-4 weeks to try to show improvement - and that this is what you propose to do.
1) With patient interactions in clinic, after you have introduced yourself to the patient and family, explain that you are a new doctor and are trying to improve communication skills - tell them that if they feel any areas for improvement, could they tell you either immediately or at the end of the visit and that you will have an evaluation form for them to complete that addresses issues like "friendliness", "explains well", "mannerisms", etc, etc.
2) These interactions will be reviewed at the end of each clinic with the attending and any issues will be immediately addressed
3) You will continue in psychotherapy and can address any particular issues brought up during that time
4) You will strive to demonstrate an improvement over the probationary 2-4 weeks
5) If you fail to improve in your communication skills, as demonstrated by multiple patient evaluations that you will resign

Perhaps aProgDirector can comment if that could be viable.

This is a great idea and I wish I saw that before going to yesterday's meeting.

Unfortunately, the PD has committed to me not continuing the program to everybody. The HR has told me as well that no corretive actions can be offered to me as I'm considered on an executive level!

I will PM you more details and thanks for your feedback.

 

[DrT2202]

Yeah, that ship sailed away the last time you met with the PD and didn't correct your actions.

And that's the problem. The 2nd meeting with the PD was a friendly meeting that I was apologizing in for my crankiness during a training session not involving patients. I wasn't counseled properly that's a fact and the issues/reports I had were not considered serious till the physician complained from that patient survey that affected him.

 

[DrT2202]

More like, walk in there and go:

MOOOOOORTAAAAAALLLL KOOOOOOMBAAAAAAAAT!!!

Duh-duh duh-duh duh-duh duh-duh duh duh
Duh-duh duh-duh duh-duh duh-duh duh duh
Duh-duh duh-duh duh-duh duh-duh duh duh
DUH DUH DUH DUH-DUH!

And rip out the PD's spine.

I don't actually hate/dislike the PD. Up till now, I'm still baffled by this. Even they admitted that I was blindsided by this as well as some of my co-residents. A few people who know the details agree that i was not properly counseled and that the real motives are not clear.

 

[DrT2202]

I'm a foreign graduate, American citizen, excellent command of the language and passed all board exams (no scores for dentistry) but the cultural norms seem to be the biggest obstacle for me and the harder to change specially that nobody teaches it to you when you go directly to post-grad (residency). Common sense helps but really it is different when I was practicing abroad. Staff and patients really respect and appreciate your knowledge as a doctor to the point of non questioning and a lot of trust.

It's great that there is a standard of care in the US and the highest level of medicine and dentistry is taught and practiced in this country that's why licensure and board certification is very competitive for foreign grads.

 

[ruralsurg4now]

I'm a foreign graduate, American citizen, excellent command of the language and passed all board exams (no scores for dentistry) but the cultural norms seem to be the biggest obstacle for me and the harder to change specially that nobody teaches it to you when you go directly to post-grad (residency). Common sense helps but really it is different when I was practicing abroad. Staff and patients really respect and appreciate your knowledge as a doctor to the point of non questioning and a lot of trust.

See, this is the problem right here. This is sad, but that's not how it works in America, even if people won't admit it. I think a lot of foreign (and some native) physicians think that, as long as you have the training and licensure and credentials, then people must respect and appreciate you. But in America, it's more important that people like you. We've all run into physicians who are sub-par but whose patients love them, or vice versa. Same with nurses. Even though they like to think that they "understand" what's going on, more often than not the nursing staff merely decides whether you're a "good doc" or not based on whether they like you personally, which is pretty silly. But the trust isn't based on "I know he's knowledgeable." It's based on "he brings me food." I mean, that only gets you so far. I'm not saying that if you killed every patient you had, then a bon-bon makes it OK, but you could probably kill a couple. I'm not even joking.

 

[MediCane2006]

Which ones - the vinyl hooker boots that apparently female attendings are wearing around the country to the hospital or the elegant Ann Taylor ones? 😉

Haha. The Ann Taylor ones.

(I of course already own several pairs of the hooker boots😉)

 

[Arcan57]

See, this is the problem right here. This is sad, but that's not how it works in America, even if people won't admit it. I think a lot of foreign (and some native) physicians think that, as long as you have the training and licensure and credentials, then people must respect and appreciate you. But in America, it's more important that people like you. We've all run into physicians who are sub-par but whose patients love them, or vice versa. Same with nurses. Even though they like to think that they "understand" what's going on, more often than not the nursing staff merely decides whether you're a "good doc" or not based on whether they like you personally, which is pretty silly. But the trust isn't based on "I know he's knowledgeable." It's based on "he brings me food." I mean, that only gets you so far. I'm not saying that if you killed every patient you had, then a bon-bon makes it OK, but you could probably kill a couple. I'm not even joking.

Rigid hierarchies do very well at executing a fixed plan of action. They do less well at responding to constantly changing conditions because the flow of information is impeded at every level based on concern for the content of the message effecting one's place in the hierarchy. This leads to a form of CEO syndrome, which is bad for the patient (from a health standpoint) and bad for the doc (from a legal standpoint). Medicine is a team sport and the ability to be an effective part of the team is a prerequisite for having successful patient outcomes.

 

[ruralsurg4now]

Rigid hierarchies do very well at executing a fixed plan of action. They do less well at responding to constantly changing conditions because the flow of information is impeded at every level based on concern for the content of the message effecting one's place in the hierarchy. This leads to a form of CEO syndrome, which is bad for the patient (from a health standpoint) and bad for the doc (from a legal standpoint). Medicine is a team sport and the ability to be an effective part of the team is a prerequisite for having successful patient outcomes.

Two points:

First of all, you're right that rigid hierarchies don't respond to changing situations, but that's actually how hospitals run. Everything is about checklists and "chain of command." If I feel that a patient should be treated in a different way, then suddenly I get pounded from all sides.

Second of all, medicine isn't a team sport. When people say that, they mean that "you have to agree with us." For example, we had an Internist who was extremely old and consequently thought he knew everything. He was a good guy (but very egotistical), but sometimes he was wrong. He had a tendency to tell our group (the surgeons) when someone "needed an operation." And in fact that's what he would tell the patient. "I'll have the surgeons operate on you." (Probably because he wanted to sound like he was in charge.) And more than I few times I went in there and said "you don't need an operation." Well, after one or two times of this, he complained to my group and they'd come in and operate on a person even if I felt that they didn't need an operation, usually for chronic pain. (That's a big part of why I left the group, among other things.) Now, I was labeled as "not a team player" because I didn't just "go with the flow." That's what people mean by "team player." I'm proud to not be a team player.

 

[Buzz Me]

(I of course already own several pairs of the hooker boots😉)

😀😎

 

[Winged Scapula]

While I very much like the Ann Tyler boots I probably would not consider them professional shoes.

Those would not be allowed at formal meeting at my sorority. IMO only ankle boots are okay in professional settings

Interesting. We will have to agree to disagree.
While the AT boots are not the nicest (ie, without straps), they would have been fine at my sorority, in the hospital or office and no one would blink an eye or call them unprofessional. I find it interesting that "shoe-ties" or ankle boots are acceptable but knee length leather or suede ones are not. I'm not sure I see the difference (disregarding the real hooker/FM types).

 

[touchpause13]

Interesting. We will have to agree to disagree.
While the AT boots are not the nicest (ie, without straps), they would have been fine at my sorority, in the hospital or office and no one would blink an eye or call them unprofessional. I find it interesting that "shoe-ties" or ankle boots are acceptable but knee length leather or suede ones are not. I'm not sure I see the difference (disregarding the real hooker/FM types).

Agree to disagree. Perhaps its just personal preference also one of our chapter presidents was a nazi about what was appropriate for chapter meeting so I'm probably more anal about it than the average person.

 

[chocomorsel]

You're the typical smarmy program director.. You know this is a trumped up charge based on bull****. Program directors use it to create a paper trail to soothe the people that are maknig the charges (nurses, techs ancillary staff..) to save face in front of them so their asses are not on the line. Its being yellow, less of a man. You know as the op stated sometimes when you are new and overwhelmed you come across one way when you did not intent to come across that way. ON top of that, nurses and nps and techs are incredibly jealous of medical professionals and moreover they are encouraged to report and write incident reports on any doctors. They relish in the demise of doctors. And the people who have to protect and stand up for doctors in training (residency program directors, chiefs of departments) fail miserably because they are too worried about their image. Leadership fails once again. This is NOT a popularity contest.

If the op was in the residents union this would NEVER happen!!!! and the program director would not have a leg to stand on.

Actually, this is not entirely the case. I went to a program with a residents union and new a couple of people who got fired. One I think was done dirty and I believe I have mentioned it on here before because she rubbed some people the wrong way and had some inconsistencies in some of her story but they tried to label her a druggie and got rid of her. The other had some serious issues. I myself had some somewhat similar issues as the OP, strong personality, opinionated and was put thru the ringer i.e remediation, probation, extension of residency.
The UNION however did SAVE MY ASS on the extension of residency part and I graduated on time thankfully. I am now working without any issues in a place where ancillary staff and other docs are respectful and nice and no one is throwing me under the bus but are supportive. Just passed boards and my old program and especially the PD can kiss my skinny black ass. Residency sucks and if you have a strong personality, stand up for yourself and are misunderstood you then you are screwed. Attendings don't stand up for you and program directors will throw you under the bus and run you over twice to look good. Cultural differences aren't even explored or recognized in many if not most places so if you are of a different culture, background and don't fit it with the norm, then it's much easier for your mistakes to be easily noticed compared to your Caucasian American counterparts and you end treated poorly. Very sad. Soo glad it's over and I can move the heck on with my life.
OP don't fight it unless you have no other options. If you could set up shop and work as a dentist or find another program that will take you do that as it's not worth it in my opinion.

 

[DrT2202]

Actually, this is not entirely the case. I went to a program with a residents union and new a couple of people who got fired. One I think was done dirty and I believe I have mentioned it on here before because she rubbed some people the wrong way and had some inconsistencies in some of her story but they tried to label her a druggie and got rid of her. The other had some serious issues. I myself had some somewhat similar issues as the OP, strong personality, opinionated and was put thru the ringer i.e remediation, probation, extension of residency.
The UNION however did SAVE MY ASS on the extension of residency part and I graduated on time thankfully. I am now working without any issues in a place where ancillary staff and other docs are respectful and nice and no one is throwing me under the bus but are supportive. Just passed boards and my old program and especially the PD can kiss my skinny black ass. Residency sucks and if you have a strong personality, stand up for yourself and are misunderstood you then you are screwed. Attendings don't stand up for you and program directors will throw you under the bus and run you over twice to look good. Cultural differences aren't even explored or recognized in many if not most places so if you are of a different culture, background and don't fit it with the norm, then it's much easier for your mistakes to be easily noticed compared to your Caucasian American counterparts and you end treated poorly. Very sad. Soo glad it's over and I can move the heck on with my life.
OP don't fight it unless you have no other options. If you could set up shop and work as a dentist or find another program that will take you do that as it's not worth it in my opinion.

Didn't fight it, got a positive letter from the PD. Unfortunately; I wasn't offered ANY corrective action or even a clear warning. Just 2 meetings and you're out. A bunch of subjective reports and minor minor incidents that hurt nobody. Hopefully I can find a job soon. Thanks for your empathy.

 

[chocomorsel]

See, this is the problem right here. This is sad, but that's not how it works in America, even if people won't admit it. I think a lot of foreign (and some native) physicians think that, as long as you have the training and licensure and credentials, then people must respect and appreciate you. But in America, it's more important that people like you. We've all run into physicians who are sub-par but whose patients love them, or vice versa. Same with nurses. Even though they like to think that they "understand" what's going on, more often than not the nursing staff merely decides whether you're a "good doc" or not based on whether they like you personally, which is pretty silly. But the trust isn't based on "I know he's knowledgeable." It's based on "he brings me food." I mean, that only gets you so far. I'm not saying that if you killed every patient you had, then a bon-bon makes it OK, but you could probably kill a couple. I'm not even joking.

Agreed and its such bull****! I mean is this a pageant? That was my problem in residency. I spoke my mind most of the time like I always did, defended myself, pissed off a few people and got a really bad reputation. At the end of the day, as long as I am good to the patients and treat people fairly what difference does it make? I don't need to be anyone's BFF. I don't take being shat on well, learned that after a couple of years of being picked on and bullied for being different looking as a kid. Came out fighting after that.

 

[chocomorsel]

Didn't fight it, got a positive letter from the PD. Unfortunately; I wasn't offered ANY corrective action or even a clear warning. Just 2 meetings and you're out. A bunch of subjective reports and minor minor incidents that hurt nobody. Hopefully I can find a job soon. Thanks for your empathy.

No worries. Don't get bogged down by the holier than thou attitude that tends to run on this website. We are humans and we make mistakes. Seems that sometimes people want you to be "their" idea of perfect. We are all guilty of it in certain respects. Expectations of how others should behave, what's appropriate and what's not. Problem is we all come from all walks of life and cultural differences need to be acknowledged and accepted.
Good luck on the job search. Look into moving to a non desirable state/area where licensing is likely easier and try to set up shop working for someone or on your own. You got 50 states to choose from and licensing is different in everyone of those states. At least in medicine it is. What about going back abroad? Do you absolutely have to stay in the US? I personally would not mind moving out of the country but I am a foreigner to begin with.

 

[chocomorsel]

Thanks, but that's not actually what I said, was it?



That's true, but I would point out that the vast majority of these people did navigate their way through life up until residency without leaving this "trail of pissed off people behind them." True?

Ruralsurg where did u come from? You keep hitting the nail on the head each time.

 

[ruralsurg4now]

I don't generally give out identifying information. I'm just more honest about how things are.

 

[chocomorsel]

What kind of ridiculous places did you guys train at?

I hope you are being facetious.

 

[chocomorsel]

I don't generally give out identifying information. I'm just more honest about how things are.

It was actually kinda a rhetorical question. Don't need to know your personal details. Just that I like your honesty. In some places, forward honesty is viewed as "unprofessional".

 

[IlDestriero]

I hope you are being facetious.

Hardly. Nurses ganging up on physicians, program directors picking on random residents and crushing their careers for fun, arbitrary extensions, and much of the other nonsense posted in this thread is ridiculous. It certainly didn't happen where I've been. People that had problems had legitimate issues, often completely unrecognized and definitely not corrected. Every rant thread on SDN about getting railroaded out of residency has the same theme. The more they post about the situation the clearer it is.
If you're charismatic people will like you and listen to you. Maybe you'll be the PDs favorite special snow flake and they will cut you some slack and give you additional opportunities, deep select for Chief, fellowship, etc. That's certainly true. It's also true of everything in the world. The squeaky wheel that's difficult to work with and has a bad attitude doesn't get the grease in the real world, they don't make partner and take a walk, or they get fired. In the academic community they don't get promoted or fail to be reappointed to the faculty. You can be a solid clinician, but if you're not a good fit for the group, I don't want you as a partner. There's enough drama at a big hospital without problem partners.

 

[ruralsurg4now]

The squeaky wheel that's difficult to work with and has a bad attitude doesn't get the grease in the real world, they don't make partner and take a walk, or they get fired. In the academic community they don't get promoted or fail to be reappointed to the faculty. You can be a solid clinician, but if you're not a good fit for the group, I don't want you as a partner. There's enough drama at a big hospital without problem partners.

Sure, but in all of that, all you seem to understand is "status quo good." Let me give you an example. At my old hospital (and I'm sure at most people's), there was a new initiative to remove Foleys after 24 hours. Now, I didn't mind because I was already doing that. Well, some patient of my group had a Foley and didn't need it, so I wrote an order to remove it. The nurse didn't remove it, which I found out later when I came back (i.e., she didn't even feel like telling me, I had to discover it). So I asked her what happened with the Foley. She said "the patient is old, you're just being mean to her." I told her that it wasn't mean, there was a risk for UTI and having the patient ambulate was beneficial. The nurse refused, so I went to the nurse manager. (I've also been known to just take out the Foley myself, because nurses seem to think that you are unable to do so.) The nurse manager comes back to me and says "we talked to the patient and the patient refuses." Which is, of course, ridiculous because you don't ask a patient if they want their Foley out any more than you ask them if they want their peripheral IVs changed. So I said "fine with me." Three days later, the nurse manager comes back to me and says "we need a written order from you to remove the Foley. It's been in too long." I told her I didn't really care, since I wrote the order three days ago and had been ignored, so she could find another physician to write it. See, the point is, if the patient chart is reviewed, then all of a sudden I'm the one who left the Foley in for three days and gets dinged, not the nurse.

Now, if I ask YOU, I'm quite sure that you think that I was harrassing the nurse or "having bad attitude." Which is why you don't recognize the issues we're discussing. True?

 

[IlDestriero]

No, I would have told the nurse to pull the Foley catheter, and they would have. I'm not sure where the breakdown in communication comes in. They say "are you sure, she's old, decrepit, dessicated, etc.". That's reasonable and appropriate to confirm and address their concerns. I would have listened and said "yes, please take it out" and probably mentioned the new policy and that the patient was mobile, or whatever.
When did you all give this power to the floor nurses? It's not a PRN order.
We have a nice relationship with our Pre and Post OP nurses. We work together to provide quality care. We don't get into pissing matches about when to place and pull Foleys. They don't like starting Vanco or any number of things pre op, but it's not open to discussion. If they call about adding a Tylenol order etc. I give it to them. It's a two way street.
The fact that they would even want to leave a Foley in a patient when it was no longer indicated proves they don't have the capacity to participate in an informed discussion on the subject.
The fact that you would knowingly leave one in unnecessarily is concerning as well. You defer to the nurse knowing she's doing something detrimental to patient care? When they get urosepsis and go to the ICU maybe they'll die and you can blame the nurse? Sounds like a good plan. I guess you're in charge of the OR, but not on the ward? Where you really are the sole responsible physician.
I'm hoping this was just a bad example. If this happened during training, it's the kind of thing the attending needs to follow up on and deal with. I don't want my residents dealing with disruptive nurses that disobey orders and ignore protocol any more than I want them to deal with a disruptive surgeon in the OR.
I should add another question. What kind of ridiculous places to you guys work?
It's funny you would note the catheter as an example because we track UTIs as religiously as CLABSIs. That nursing team would have been crucified for not following that order at my shop.