so sick of being a "kid"

[justwondering]

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im sooo irritated with the fact that we work so darn hard, take on huge responsibilities, and yet we are not really treated like doctors by staff so much of the time.

for example, nurses/MA's who are not expected to do what they normally would for doctors out in the 'real world'... why am i calling in prescriptions? writing down their meds? faxing stuff?

or attendings who treat us like kids by checking back to make sure we (not me specifically) are getting lab results back to patients in a supra-timely manner or asking us to baby our patients when they don't do this stuff themselves.

or other staff actually making comments about us being young/inexperienced when they're not even in our field.

 

[Dejavu]

im sooo irritated with the fact that we work so darn hard, take on huge responsibilities, and yet we are not really treated like doctors by staff so much of the time.

for example, nurses/MA's who are not expected to do what they normally would for doctors out in the 'real world'... why am i calling in prescriptions? writing down their meds? faxing stuff?

or attendings who treat us like kids by checking back to make sure we (not me specifically) are getting lab results back to patients in a supra-timely manner or asking us to baby our patients when they don't do this stuff themselves.

or other staff actually making comments about us being young/inexperienced when they're not even in our field.

Honest, try and not take it personally. The ultimate responsibility lies with the attending, who has probably been burned once or twice, so it is natural for them to double check stuff. You will do it too, believe me.

Nurses know that you will be gone in a year or two, but they have to live with the attendings forever, so it is not surprising that they do more for them. Again, hard as it is, don't take it personally. Residency doesn't last forever.

Like they say in the Marine Corps...RHIP (rank hath its privileges). A fact of life at any level.

 

[xanthines]

Heh. From what I hear, BOHICA is a more applicable term...

-X

Like they say in the Marine Corps...RHIP (rank hath its privileges). A fact of life at any level.

 

[sunlioness]

Heh. I've been in my grown-up job for 4 days now and there's a good part of me that wants to run back to the "playground" and be a kid again. But having people to do stuff for me is nice . . .

 

[buckley]

I actually would like an attending who is extra paranoid to keep me from making some mistakes. It's been tough on me so far. I feel totally lost, but well, I'm learning. Hows everyone? Been so busy I haven't logged in for quite a while. Hope my fellow interns are doing waaaaay better! 🙂

 

[justwondering]

no, the attendings arent really doing anything to change patient outcomes(ie its not like they're double checking our work). theyre looking to see if we've gotten lab results back to patients in clinic (even normal ones) within a certain predefined time period, if we've returned phone calls quickly when patients call to ask us questions, etc. they do this at random times, so the purpose is only to make sure we are not slacking off and making patients wait. i dont think its the case that people ARE slacking, theyre just keeping tabs on us. some attendings are good about getting back to their own patients quickly, but many times i've noticed that they dont get any info back to them at times.

 

[BabyPsychDoc]

no, the attendings arent really doing anything to change patient outcomes(ie its not like they're double checking our work). theyre looking to see if we've gotten lab results back to patients in clinic (even normal ones) within a certain predefined time period, if we've returned phone calls quickly when patients call to ask us questions, etc. they do this at random times, so the purpose is only to make sure we are not slacking off and making patients wait. i dont think its the case that people ARE slacking, theyre just keeping tabs on us. some attendings are good about getting back to their own patients quickly, but many times i've noticed that they dont get any info back to them at times.

People of what age get most annoyed at "being treated like kids" and "not being trusted"?

 

[dragonfly99]

justwondering
I am with you
I look younger than my age so I get this more
I finished medicine residency recently
Do not expect respect from some hospital staff. BUT they will report you if they think you are "rude" in any way. Some of the nurses will not be nice. Do NOT take this personal it is just something they do because some people like to throw their authority around and also if you are female some nurses may resent you. STAY ABOVE IT. Do NOT let them draw you in to any argument.
As far as returning the patient phone calls, they (attendings) did this at our residency too. It is annoying. Realize that you will be held to a higher standard in this regard than attendings. It is unfair but it is reality. They are just trying to inculcate good habits at an early stage of your training. It is annoying if you are already conscientious. I would say document document whatever you do (i.e. "called patient back but no answer" or "phone was busy, no answer"). The resident clinic nurses likely will not return your calls because the residency thinks it's part of your training, and also they don't want to pay a nurse to do work that they can get you to do for no extra pay.

Don't worry, things get better with each year of residency. Also, people will treat you better when you are no longer a resident. Some nurses will still be rude, though. The trick as a resident is never let it get to you. Just smile at the nurses and attendings, learn to manipulate them a little (I only mean that in a good way....).

 

[me454555]

Inpatient medicine just sux. Plain and simple, it really is a babysitting service w/some medicine mixed in. Once the initial labs and plan is hashed out the rest of the stay is all about following up w/consultant so and so, checking on lab x, adjusting a med so that lab x is normal again, or figuring out how to move em out of the hospital.

It's kinda funny that on medicine most of what we do is non medical. Gotta love modern medicine

 

[Adcadet]

Do not expect respect from some hospital staff. BUT they will report you if they think you are "rude" in any way.

At your institution, to whom does one report to regarding resident rudeness? Chief Resident? The attending? Nursing manager? Physician administrator? Forgive my ignorance, but I've never heard of a specific example of this happening at the hospitals I've worked at.

Now, I've "reported" a few nurses before, but that was to the nurse manager of the unit to let him/her know of what a spectacular job the bedside nurse had been doing.

 

[dragonfly99]

Nurses and hospital staff "report" resident to whomever they want. That could be the chief resident, medicine attending, or a higher-up nurse administrator.
Most nurses are nice and do a great job, but some seem to get a charge out of showing their authority over residents. Luckily, this happened to me very seldom, but I know of other residents in my program who really got a number done on them, and it wasn't for being stupid or really obnoxious. A lot of it is random (i.e. resident A is actually short-temped and rude to someone, but the nurse he talks to never bothers to complain to anyone; resident B is on the phone with a nurse and the operator accidently cuts him off, and the nurse gets mad, thinking she was hung up on, and writes an angry letter to the medicine program director).

Luckily, I am not longer a resident. The dynamic really changes when you are no longer a resident - I get much more respect now and am treated like a physician and adult. My point was just to remind the resident that things DO get better. Keep slogging through!

 

[Top Gun]

Nurses and hospital staff "report" resident to whomever they want. That could be the chief resident, medicine attending, or a higher-up nurse administrator.
Most nurses are nice and do a great job, but some seem to get a charge out of showing their authority over residents.

This is very true. One of my pet peeves is how territorial nurses, ward clerks, and social workers get over workspaces and chairs, when, at the nursing stations in my hospital, workspace is already pretty limited, what with the stations being overcrowded with people. You see, the stations are pretty small, so finding enough space to do your work is at a premium. Not to mention the fact that sometimes you can't even get access to a computer terminal to check your labs.

 

[dragonfly99]

ditto Top Gun
Also we had a telemetry monitor lady who was notorious for not wanting to "allow" us to check the telemetry on patients, without her "permission". And it wasn't like I'd ever shove her out of the way...it's just that sometimes she was away from her desk, on the phone, reading a novel, whatever. She was super territorial about it, which made me mad because I wanted to scream, "I'm the freakin' doctor already!!! And it's MY patient. Don't tell me I need your permission to check the telemetry!".

 

[PediBoneDoc]

as a new resident in a hospital, whether it be intern or just new to the institution/facility, i think it is important to first get a "lay of the land." you need to figure out the politics. for most programs and hospitals, you are probably not the first resident to pass through. therefore, there is history. for most of the extended care providers, nurses, ma's and clerks, you will be given the stereotypical resident persona that has developed from previous experiences with residents. if you come in as a new doc, your respect will have to be earned; it will not be given. this isn't the old days of "the house of god." so best bet at first is to not take it personally. be a nice as possible until they get to know you and things will balance out. if you try to play the well i'm a doctor card, they will make you life miserable. they know how to use the system to get you into trouble. especially nurses. they are masters of incident reports. so don't take it personal. act like an adult and in time your due respect will be given.

as far as attending trust, that also must be earned. i tell my residents that there are assassins around every corner, that includes residents. example, i was talking to a family and informed them that a their child needed to be checked for endocrine abnormalities because she didn't fit the profile for patients with this problem. my chief resident tells me, "they have been done and are all normal." i say ok and move on. as i dictated the op note my resident didn't dictate, i took a look at the labs (my rule; if i don't scrub and you do the case, you dictate ... ok, just blowing off some steam). go figure the patients labs were very abnormal. hmm .... i told my chief about the labs, he said, "he was told they were normal." i didn't ask who told him, i just let him deal with it in what ever way he chose. again, assassins, trust no one.

as a "doctor in the real world", although you do get more respect from the staff, you are still have some of the same rules and bothersome ancillary staff and problematic nurses. you will be told how to dictate ( by CMS), your billing practices will be audited, you do have to obey the hospital rules. and in the end, in today's world having an MD or DO behind your name doesn't give special powers that cause people to bow down to you.

give respect and you will receive it. we are all human, and should treat everyone the same regardless of position.

 

[PeepshowJohnny]

Well I have my opinion for the RN's at least:

The average age of RNs climbed to 46.8 years in 2004, the highest average age since the first comparable report was published in 1980. Just over 41 percent of RNs were 50 years of age or older in 2004, a dramatic increase from 33 percent in 2000 and 25 percent in 1980. Only 8 percent of RNs were under the age of 30 in 2004, compared to 25 percent in 1980.

I'm in a town with a TON of nursing schools and I still work with so many nurses who are old enough to be my mother and then some.
So there's naturally a bias there where you're nervous with someone that junior. To be fair, a lot of older nurses seem to treat the nursing students with the same mind set that they have toward med students and new residents: that we're actively trying to kill their patients.

Also, there's the issue that a lot of nurses don't understand what we're taught in medical school. These are broad generalizations but nursing school has more of an emphasis on the process of caring for disease, less on pathophysiology. Our school is just the opposite. And so when we hit the floor not knowing how to get stuff done but more background, we seem incompetent to nurses.

 

[dragonfly99]

peepshowjohnny
I totally agree w/you about the different methods of education in nursing school vs. med school, and the use of symptom-driven or protocol-driven methods of treatment, vs. really understanding the pathophysiology of what is going on.

I agree that respect must be earned, but I think it's unfortunate that blatant rudeness and unpleasantness has become so common in hospitals. I NEVER "pulled the doctor card"/expected special status just because of being a doctor. I only ever expected to get treated with the basic courtesy I would afford to any other person, including nurses. I found I didn't get that as an intern.

Don't worry, it gets better w/each year of residency. It gets much better if you are an attending, but still some nurses will dump on you and argue with your treatment plan in front of patients, even if they are totally medically wrong. For some reason, I almost never get this from pharmacists or other hospital staff. Still, some nurses are awesome, so I don't want to turn this in to a "bash the nurse" post.

 

[MSHell]

This is very true. One of my pet peeves is how territorial nurses, ward clerks, and social workers get over workspaces and chairs, when, at the nursing stations in my hospital, workspace is already pretty limited, what with the stations being overcrowded with people. You see, the stations are pretty small, so finding enough space to do your work is at a premium. Not to mention the fact that sometimes you can't even get access to a computer terminal to check your labs.

I wouldn't have believed it until it happened to me. There was nobody sitting at the nursing station so I sat down on one of the 3 available chairs. The nurse comes 30 seconds later and yells at me that I'm in the way! WTF? I'm not Jabba the Hut!

 

[dragonfly99]

MSHell
do NOT take it personal
it is not
the person may just fear losing a place to sit at "her" work area...
or some people on the hospital staff just relish the chance to put the med student and/or intern or resident "in their place" while they still can, as their perception is that later we will be rich and bossy...

 

[Winged Scapula]

Every hospital has THAT person who is territorial over THEIR chair.

We had a SICU nurse when I was in residency with legs shorter than a Corgis. She had a chair, HERS, which practically sat on the ground apparently so her feet wouldn't dangle. She would have a fit if anyone sat in it despite the fact that we all hated that chair and only chose it if there was nothing else available and we couldn't possibly stand anymore.

It gets better as an attending; I haven't had anyone yell at me about sitting in their chair in months!😛

 

[MSHell]

MSHell
do NOT take it personal
it is not
the person may just fear losing a place to sit at "her" work area...
or some people on the hospital staff just relish the chance to put the med student and/or intern or resident "in their place" while they still can, as their perception is that later we will be rich and bossy...

No worries. The nice nurse came in the next day and put the bitchy nurse in her place. Sweet. Bitchy nurse then tried to make up for it by asking the attending why I wasn't getting a "lunch break". At the end of the rotation, bitchy nurse told me she was so happy to get to know me and work with me (again in front of the attending) 🙄

 

[caroladybelle]

MSHell
do NOT take it personal
it is not
the person may just fear losing a place to sit at "her" work area...
or some people on the hospital staff just relish the chance to put the med student and/or intern or resident "in their place" while they still can, as their perception is that later we will be rich and bossy...

I hate to tell you, but it often has nothing to do with being an intern/MD. Such individuals will act like that if anyone - regardless of position "takes their space".....ask any agency nurse. The regulars are just as ugly to any "temp" taking the spot, no matter if they be intern, resident, nurse or HUC.

It has to do with the person, not the age, or the position/profession. Some people are just possessive of trivial things, figure that they have their issues and move on.

 

[caroladybelle]

MSHell
do NOT take it personal
it is not
the person may just fear losing a place to sit at "her" work area...
or some people on the hospital staff just relish the chance to put the med student and/or intern or resident "in their place" while they still can, as their perception is that later we will be rich and bossy...

I hate to tell you, but it often has nothing to do with being an intern/MD. Such individuals will act like that if anyone - regardless of position "takes their space".....ask any agency nurse. The regulars are just as ugly to any "temp" taking the spot, no matter if they be intern, resident, nurse or HUC.

It has to do with the person, not the age, or the position/profession. Some people are just possessive of trivial things or have their issues -I figure that they have their psych issues and move on.

I helped out an intern/resident and she called me "her good girl" (I am mid 40s) in front of the pt and fellow staff. One of the senior male house staff called her out on it...I was going to let it pass, though it was a tacky and rude comment....especially when I assisted her as a matter of politeness and not as a duty.

Try to respect everyone, from dietary to the CEO...it stands you in good stead. Rise above bad behavior.