i'm not sure if it's just the service i'm on but i get the impression that the residents like to interject when i present a patient only to belittle me or to disagree; this has been the trend for a lot of the med students. as an example, during the hpi i mentioned how a patient had only one sick contact in the family and then immediately the senior resident said no, actually all family members had the illness recently; the attending later asked the parents who corroborated my story. i tend to keep my mouth shut during these situations, should I be arguing back or try to defend myself? i feel like i look like a complete idiot if i don't (unless the attending ends up asking to clarify) but a complete tool if i do. you really can't win.
venting frustrations during rounds
- Thread starter thetubes
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Depends on the resident. During a patient presentation last year I was speaking quickly and just loud enough for the attending to hear because we were in the ED and there were patients all over and I didn't want to announce a patient's entire story to everyone within earshot. The intern couldn't hear me very well because she was standing a little farther away and so she interrupted several times to tell me to say certain things, to which I replied politely, "I already told him, thanks." A short while later she told me that she enjoys teaching students, but if I'm not going to listen to what she says and take her advice and all the knowledge she so willingly shares on her own time 🙄, then she has no trouble throwing me under the bus every chance she gets. 😕 I explained that she hadn't heard what I said and I didn't want to ignore her comment and keep talking, which is why I said what I did. I had to grovel all afternoon in order to avoid spending the rest of the rotation on the intern's **** list, a list on which nobody wants to find themselves. This intern was known for yelling, having fits, shoving chairs, and throwing stuff at students. Worst. Month. Ever.
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No, I wouldn't try to argue or defend yourself. Even if you are 100 percent right. The residents a deuche and the attending can prolly see it, even if that's not the case arguing will only make it worse. Just grin and bear it.
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You have to remember that patients change their stories a lot. So the resident may not have been trying to make you look stupid and may have thought he/she was correcting an error you made.
At the end of the day, the patient is the resident's responsibility. You can screw up a history or miss a physical exam finding with relatively few consequences but that would be HUGE if a the resident did. Trust me, after you've left and gone home that resident is getting chewd out for missing something obvious or letting a "mistake" that the student made on their patient go uncorrected.
. So even if you end up being right, if they think they saw/heard something different from what you are presenting, they have to speak up. Maybe the delivery could be better but i feel like the intent is not malicious.
At the end of the day, the patient is the resident's responsibility. You can screw up a history or miss a physical exam finding with relatively few consequences but that would be HUGE if a the resident did. Trust me, after you've left and gone home that resident is getting chewd out for missing something obvious or letting a "mistake" that the student made on their patient go uncorrected.
. So even if you end up being right, if they think they saw/heard something different from what you are presenting, they have to speak up. Maybe the delivery could be better but i feel like the intent is not malicious.
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Agree. Is a "deuche" like a double-douche? Deuce + douche? Like it.
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I like it to--unfortunately I just misspelled it.
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da8s0859q
I'd leave it be. Tighten your presentation up if need be, but don't fight the resident. +1 to "if he's a douche, attending can see the douche-dom" comments.
There's always the option of tearing him/her a new assh*le when you have to do evaluations if it would make you feel better.
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Agree with this. If I correct a student (which happens only rarely), it is because I'm going to be the one held responsible for any incorrect information that gets perpetuated in the presentation or the chart.
I just finished my residency so if I may add a word or two. The residents are more stressed out than you so have pity on him. If they act like azzholes sometimes it's because they are frightened to their bones. Just let it pass and go on. And remember this: when and if the **** hits the fan and a patient starts to crash you're going to want that resident there to take over.
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Don't. That was a lose-lose thing to say. The attending knows you said it, which is really what matters.
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Exactly. Faculty just cares that students present the hpi clearly and share their medical knowledge. If the medical student gets a small piece of info wrong, faculty doesn't care. Patients routinely change their stories.
Good or bad - back up your resident. Unless your resident is doing something that will 120% sure hurt the patient, just go with it.
It's better to be wrong and a team player than right while upsetting your resident. The last thing a med student needs is poor resident evals of them.
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None of that excuses being an asshat.
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Hierarchy. You just have to deal with it. I'd only speak up if you're positive that you are correct and it will affect a patient outcome (Unless you know that resident really is not that great of a physician).
Can some sociologist do a study on the power interactions among house staff? heheh.
And yeah, pt's change stories all the time. I wish I had a penny for the number of times I've been in a room with the attending and the patient says something totally different than what they told me an hour earlier. It happens.
Can some sociologist do a study on the power interactions among house staff? heheh.
And yeah, pt's change stories all the time. I wish I had a penny for the number of times I've been in a room with the attending and the patient says something totally different than what they told me an hour earlier. It happens.
I remember a recent case where the patient told the attending the exact opposite of what they told me on a detail that totally changed teh plan. I was about to start blurting excuses, when I stopped and just said "oh ok, that's not what they told me when I asked". and the matter was settled without anything further. residents are most likely getting defensive about the info change and acting like an ass as a result.
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Is the Stanford prison experiment close enough?
wow this generated a lot more attention than i thought. admittedly, i posted this mostly out of frustration (i had an ongoing issue with this particular resident) and if you would have asked me on another day i wouldn't have questioned/doubted the way i handled it (ie by merely oh, right quietly). as for "revenge" in evals i'm not one to seek revenge out but i'm definitely going to be honest and comment on it but explain i was under the impression she was just stressed, i mean either way it looks bad on her part.
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I always do two things: 1) never make stuff up, because you will definitely get called out. 2) If information seems to be conflicting like your case, I usually just say something like "Ok, I was just repeating what I remembered them telling me, I can make sure to clarify it as soon as we're done meeting" etc. That way you're confirming you did not commit 1 (lying) while not really arguing or calling out the resident. Obviously you can't say it in a douche-bag way though, it has to be sincere (or at least sound like it).
