Why are so many people having problems with school administration?

[Osteosaur]

Are problems with the administration really so common in medical school? I’ve noticed quite a few posts on that vein lately: People worried about dismissal, being put on notice, and whatnot.

1) Less mature students just being unrepentantly and habitually late, snipping at professors over exam questions, posting racist memes, and other stupidity?

2) Is it mostly during clerkships where people run into trouble? As in a bad first impression with an attending sours your rotation?

I’m a non-trad student and I like to think I carry myself professionally and get along with people, but it does have me worried. I feel like when you’re working, at the very least, if you have a good ethic someone will pick up on that and give you the benefit of a doubt on a bad day. Here, in a class of 150, I feel so invisible that a single bad interaction might snowball. It’s probably just nerves about starting but who knows.

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[mistafab]

No, problems with admin are not at all common. Maybe 1 or 2 per class (out of around 200) at my school.
1) yes, but in our school’s case it typically involves alcohol and poor decision making.
2) I think the people getting in trouble find ways to get on the radar earlier than clerkships. It is normal to get one or two attendings you dont click with, in a normal person this just leaves you with mediocre evals, not any type of professionalism issue.

Don’t worry about it.

 

[Treebeard]

I frequently find myself utterly shocked at the way my classmates are willing to act with regards to school. Between their hostile tone re: questions and skipping mandatory lectures to literally play video games in the lounge directly adjacent to the classroom, it's a wonder that more of them aren't in some form of trouble (or they are and I just don't know it, who knows).

The divide between students with / without full time work experience or other serious responsibility is immeasurable

 

[popopopop]

I frequently find myself utterly shocked at the way my classmates are willing to act with regards to school. Between their hostile tone re: questions and skipping mandatory lectures to literally play video games in the lounge directly adjacent to the classroom, it's a wonder that more of them aren't in some form of trouble (or they are and I just don't know it, who knows).

The divide between students will / without full time work experience or other serious responsibility is immeasurable

I can't believe this stuff doesn't stop at 3rd year either, at least here.

 

[Psai]

Some of it has to do with people who have had no adversity who need meaning in their life and find it by snitching on others for relatively innocuous things.

 

[Raney Schauer]

I’ve noticed quite a few posts on that vein lately:

Keep in mind this is an internet forum. All the stories get concentrated in one place, blown way out of proportion and you get half the story. The vast majority of medical students are not on this forum. Hence, the perception of a large problem from a very small sample size.

 

[VA Hopeful Dr]

Some of it has to do with people who have had no adversity who need meaning in their life and find it by snitching on others for relatively innocuous things.

In my 4 years, the only people who got in actual disciplinary trouble were the guy who showed up high on coke and broke his fist punching the anatomy lab wall and the guy who told a room full of OB/GYN residents that women shouldn't be doctors.

But yeah, totally due to innocuous tattling.

 

[NicMouse64]

In my 4 years, the only people who got in actual disciplinary trouble were the guy who showed up high on coke and broke his fist punching the anatomy lab wall and the guy who told a room full of OB/GYN residents that women shouldn't be doctors.

But yeah, totally due to innocuous tattling.

RIP Medical career Lmao.

 

[nimbus]

Keep in mind this is an internet forum. All the stories get concentrated in one place, blown way out of proportion and you get half the story. The vast majority of medical students are not on this forum. Hence, the perception of a large problem from a very small sample size.

Yep. That’s how a couple dozen people suddenly becomes a Twitter mob.

 

[atomi]

Medical schools are increasingly trying to push a social agenda and use subjective “professionalism” violations to try and make sure everyone falls in line. Some fight back and suffer. But it’s still relatively rare to get in trouble for politics compared to the more extreme divisions in the university. The medical school is usually the most conservative school.

But usually the people who get in big trouble do so due to laziness, mental illness, or simple incompetence.

 

[atomi]

I frequently find myself utterly shocked at the way my classmates are willing to act with regards to school. Between their hostile tone re: questions

The divide between students will / without full time work experience or other serious responsibility is immeasurable

This. Many medical students are only a few years removed from high school and haven’t done anything else in their lives. Because medical school is more like high school than college, these kids frequently revert back to high school like behavior. I remember distinctly this cocky 22 year old losing his **** as an M1 when he missed a couple of points on a quiz and tried to argue with the transplant surgeon who gave it on a technicality in front of everyone. Reciting stuff out s textbook telling the surgeon he was wrong, You know, the transplant surgeon volunteering his time to be there. The guy literally looked over at the med school administrator and said “this is ridiculous” and shook his head. The student kept going, wasting everyone’s time because he couldn’t deal with not getting a 100. Happened over and over and over. It was always the 22 year olds.

 

[Goro]

Medical schools are increasingly trying to push a social agenda and use subjective “professionalism” violations to try and make sure everyone falls in line. Some fight back and suffer. But it’s still relatively rare to get in trouble for politics compared to the more extreme divisions in the university. The medical school is usually the most conservative school.

But usually the people who get in big trouble do so due to laziness, mental illness, or simple incompetence.

It's not a social agenda to want to train doctors to behave better towards patients. And it's not just medical schools, ACGME is all in as well:

https://knowledgeplus.nejm.org/blog/exploring-acgme-core-competencies/
Note that the majority of the domains are humanistic ones.

Agree 100% with the bold.

Professionalism issues are actually rare, based upon my school's experiecnes and what I see posted on SDN.

But you mention in the post just above this (which came in as I was writing this!) as a resident have a dog in this fight. For many med school graduates, residency is their first employment ever, and as such they come with poor work skills. So they think that they can simply go home at the end of the day because it's not busy, or go away to Cousin Joycie's wedding after only a week on the job, ...and make more work for you.

 

[atomi]

For many med school graduates, residency is their first employment ever, and as such they come with poor work skills. So they think that they can simply go home at the end of the day because it's not busy, or go away to Cousin Joycie's wedding after only a week on the job, ...and make more work for you.

Med students like this lack perspective. I was constantly annoyed by the ones who would say they “had to go to work” in referring to their rotations. Like it was a cute little thing for them. Hey guys look at this, “I’m actually going...snicker...to work!” You seeing this shi*? Hey ma, guess what I’m going TO WORK today. Talking to the cute undergrad at the bar , “yeah so there I was at work in the OR and had to take this gunshot wound to surgery...”

Sorry, you are not “going to work”, you are going to school. You do not do work as a med student. You make our lives harder and get in the way. You don’t just get to be involved in a procedure or something whenever it is convenient for you. It’s not playtime, these are people’s lives. You are not “doing” anything productive. We take time to try and teach you and give you advice. YOU ARE AN OBSERVER, A LEARNER. You don’t get to make decisions,

So I would say it’s not really about having work skills. It’s about lacking perspective and constantly thinking they are the center of the universe and everything revolves around them and their schedule.

Regarding pushing the social agenda, I was referring more to the social justice warriors trying to cram controversial topics down everyone’s throats as truth and calling you unprofessional if you disagree. Rather than actual professional issues with patients like wearing blue jeans and a t shirt to clinic or something,

 

[Goro]

Med students like this lack perspective. I was constantly annoyed by the ones who would say they “had to go to work” in referring to their rotations. Like it was a cute little thing for them. Hey guys look at this, “I’m actually going...snicker...to work!” You seeing this shi*? Hey ma, guess what I’m going TO WORK today. Talking to the cute undergrad at the bar , “yeah so there I was at work in the OR and had to take this gunshot wound to surgery...”

Sorry, you are not “going to work”, you are going to school. You do not do work as a med student. You make our lives harder and get in the way. You don’t just get to be involved in a procedure or something whenever it is convenient for you. It’s not playtime, these are people’s lives. You are not “doing” anything productive. We take time to try and teach you and give you advice. YOU ARE AN OBSERVER, A LEARNER. You don’t get to make decisions,

So I would say it’s not really about having work skills. It’s about lacking perspective and constantly thinking they are the center of the universe and everything revolves around them and their schedule.

Regarding pushing the social agenda, I was referring more to the social justice warriors trying to cram controversial topics down everyone’s throats as truth and calling you unprofessional if you disagree. Rather than actual professional issues with patients like wearing blue jeans and a t shirt to clinic or something,

Perversely, some students still don't understand the concept that when you're on rotation, you have to treat it like a job, and for starters, show up on time, and leave when the work is done, and not because it's 5PM. I suspect we're both saying the same things, but in different ways.

Re: the bolded, at least my school seems to have avoided this!

 

[Oh_Gee]

Med students like this lack perspective. I was constantly annoyed by the ones who would say they “had to go to work” in referring to their rotations. Like it was a cute little thing for them. Hey guys look at this, “I’m actually going...snicker...to work!” You seeing this shi*? Hey ma, guess what I’m going TO WORK today. Talking to the cute undergrad at the bar , “yeah so there I was at work in the OR and had to take this gunshot wound to surgery...”

Sorry, you are not “going to work”, you are going to school. You do not do work as a med student. You make our lives harder and get in the way. You don’t just get to be involved in a procedure or something whenever it is convenient for you. It’s not playtime, these are people’s lives. You are not “doing” anything productive. We take time to try and teach you and give you advice. YOU ARE AN OBSERVER, A LEARNER. You don’t get to make decisions,

So I would say it’s not really about having work skills. It’s about lacking perspective and constantly thinking they are the center of the universe and everything revolves around them and their schedule.

Regarding pushing the social agenda, I was referring more to the social justice warriors trying to cram controversial topics down everyone’s throats as truth and calling you unprofessional if you disagree. Rather than actual professional issues with patients like wearing blue jeans and a t shirt to clinic or something,

Perversely, some students still don't understand the concept that when you're on rotation, you have to treat it like a job, and for starters, show up on time, and leave when the work is done, and not because it's 5PM. I suspect we're both saying the same things, but in different ways.

Re: the bolded, at least my school seems to have avoided this!

so do we call it job, work, or school? jorool?

 

[Raney Schauer]

so do we call it job, work, or school? jorool?

Training.

 

[Psai]

Med students like this lack perspective. I was constantly annoyed by the ones who would say they “had to go to work” in referring to their rotations. Like it was a cute little thing for them. Hey guys look at this, “I’m actually going...snicker...to work!” You seeing this shi*? Hey ma, guess what I’m going TO WORK today. Talking to the cute undergrad at the bar , “yeah so there I was at work in the OR and had to take this gunshot wound to surgery...”

Sorry, you are not “going to work”, you are going to school. You do not do work as a med student. You make our lives harder and get in the way. You don’t just get to be involved in a procedure or something whenever it is convenient for you. It’s not playtime, these are people’s lives. You are not “doing” anything productive. We take time to try and teach you and give you advice. YOU ARE AN OBSERVER, A LEARNER. You don’t get to make decisions,

So I would say it’s not really about having work skills. It’s about lacking perspective and constantly thinking they are the center of the universe and everything revolves around them and their schedule.

Regarding pushing the social agenda, I was referring more to the social justice warriors trying to cram controversial topics down everyone’s throats as truth and calling you unprofessional if you disagree. Rather than actual professional issues with patients like wearing blue jeans and a t shirt to clinic or something,

I disagree. I think medical students should be taking an active role in patient care including making decisions with assistance, actively learning about patient conditions, performing procedures, etc. Yeah they make our lives harder but we were there just a few months ago. Students shouldn't just be learners and observers but should be something more. Our education system is being bastardized by outsiders and yeah it would be nice if everyone could get the most highly trained and experienced person doing everything but then you're trading today's patients for tomorrow's.

I mean jesus we have NP "fellows" doing things they shouldn't like central lines and rounding in ICUs, why shouldn't a student who has worked 100x harder than those people ever did lose out on opportunities because they're being viewed as burdensome "observers"?

 

[Treebeard]

Med students like this lack perspective. I was constantly annoyed by the ones who would say they “had to go to work” in referring to their rotations. Like it was a cute little thing for them. Hey guys look at this, “I’m actually going...snicker...to work!” You seeing this shi*? Hey ma, guess what I’m going TO WORK today. Talking to the cute undergrad at the bar , “yeah so there I was at work in the OR and had to take this gunshot wound to surgery...”

Sorry, you are not “going to work”, you are going to school. You do not do work as a med student. You make our lives harder and get in the way. You don’t just get to be involved in a procedure or something whenever it is convenient for you. It’s not playtime, these are people’s lives. You are not “doing” anything productive. We take time to try and teach you and give you advice. YOU ARE AN OBSERVER, A LEARNER. You don’t get to make decisions,

So I would say it’s not really about having work skills. It’s about lacking perspective and constantly thinking they are the center of the universe and everything revolves around them and their schedule.

Regarding pushing the social agenda, I was referring more to the social justice warriors trying to cram controversial topics down everyone’s throats as truth and calling you unprofessional if you disagree. Rather than actual professional issues with patients like wearing blue jeans and a t shirt to clinic or something,

Hm idk, I frequently find myself referring to going into rotations as work. While I get why that isn't totally accurate, I really do strive to treat it as work - show up on time (read: early), do whatever I possibly can to help out, confirm and meet the expectations of my supervisors, etc. IMO this is the correct way to approach it.

 

[Goro]

so do we call it job, work, or school? jorool?

Apprenticeship

 

[RNthenDoc]

I disagree. I think medical students should be taking an active role in patient care including making decisions with assistance, actively learning about patient conditions, performing procedures, etc. Yeah they make our lives harder but we were there just a few months ago. Students shouldn't just be learners and observers but should be something more. Our education system is being bastardized by outsiders and yeah it would be nice if everyone could get the most highly trained and experienced person doing everything but then you're trading today's patients for tomorrow's.

I mean jesus we have NP "fellows" doing things they shouldn't like central lines and rounding in ICUs, why shouldn't a student who has worked 100x harder than those people ever did lose out on opportunities because they're being viewed as burdensome "observers"?

About every fourth post of yours bashes NPs in some way.

“Tell is where the midlevel touched you, this is a safe space.”

 

[DrMcCoyDO]

This. Many medical students are only a few years removed from high school and haven’t done anything else in their lives. Because medical school is more like high school than college, these kids frequently revert back to high school like behavior. I remember distinctly this cocky 22 year old losing his **** as an M1 when he missed a couple of points on a quiz and tried to argue with the transplant surgeon who gave it on a technicality in front of everyone. Reciting stuff out s textbook telling the surgeon he was wrong, You know, the transplant surgeon volunteering his time to be there. The guy literally looked over at the med school administrator and said “this is ridiculous” and shook his head. The student kept going, wasting everyone’s time because he couldn’t deal with not getting a 100. Happened over and over and over. It was always the 22 year olds.

I’d imagine this is why when I was in school, we had two main processes by which to air grievances about quizzes. First, we had class reps who would go through requests to recheck questions, filter out the BS, and submit the legit ones to the faculty. Then the reps would communicate back with us either the faculty’s decision to overturn a wrong answer or the faculty’s reasoning behind not. Second, for our clinical courses, we had a dedicated hour in our lecture hall, which was optional to attend, at which students could go over the test with the faculty and discuss issues or complaints. Outside of those two avenues, we were basically SOL unless we wanted to take time out of our day to make a one on one appointment. Worked out well for most, I think.

 

[DrMcCoyDO]

Sorry, you are not “going to work”, you are going to school. You do not do work as a med student. You make our lives harder and get in the way. You don’t just get to be involved in a procedure or something whenever it is convenient for you. It’s not playtime, these are people’s lives. You are not “doing” anything productive. We take time to try and teach you and give you advice. YOU ARE AN OBSERVER, A LEARNER. You don’t get to make decisions,

Eh, I went into med school after several years of working full time. Yeah, the first two years med school were just that: school. But I still considered the clinical years work in addition to school. I was expected to show up like it was a job; I was expected to put effort in like it was a job. Was I often a drain on the residents’ time? Definitely. Were their times that I was not the most productive? Of course! Doesn’t mean that I never did anything productive. That also doesn’t mean that it was any less a job that I was expected to show up for and work hard at.

Seriously, if you look at students as complete time wasters with no purpose other than to observe, I can draw only one of three conclusions. Either you have a supremely poor pool of students, you are not great at utilizing and/or precepting students, or I am completely misunderstanding your points.

 

[Psai]

About every fourth post of yours bashes NPs in some way.

“Tell is where the midlevel touched you, this is a safe space.”

If you don't like it, you're free to not read it. Part of the beauty of America is the ability to willfully ignore the truth and try to drown out views that don't match your own.

 

[Winged Scapula]

About every fourth post of yours bashes NPs in some way.

“Tell is where the midlevel touched you, this is a safe space.”

Its not bashing to speak the truth about the encroachment of MLPs into medical education and practice. You will see once you start medical school the difference in depth of knowledge and training, dedication, hours worked etc. and then come here and tell us that a MLP who did an on-line NP course and is working as your independent "hospitalist" in the ICU (replacing the physician because he/she was cheaper) isn't a problem.

 

[getdown]

The biggest part of medical education I hate is the medicolegal constraints that prohibits teaching. Medical students are no longer allowed to learn to place invasive lines or even pull out central lines anymore. It's a ****ing travesty. Obviously patient safety comes first but as long as they're being adequately supervised it shouldn't be an issue. But I remember putting in central lines and alines as a med student. We get interns now that don't know how to put a goddamn IV or how to simply take out a central line.

Furthermore, just to touch quickly on how midlevels vs resident training. For the first year of CA1 in my residency the attendings would be the one inducing the patient while the resident would tube. And SRNAs would be allowed to actually push the drugs themselves. I always thought this was ridiculous.

 

[UnoMas]

I tell people that I am going to work as a 3rd and 4th year, now that I am slightly more useful as a 4th year. I serve many roles: anesthesia tech, drug fetcher, family caller, pharmacy caller, patient comforter, on my surgery rotation- retractor and punching bag. Menial as it may sound, you do need an actual person to do it. As a medical student, you can be as involved as you want to be; if you want to be an observer, you will be treated as an observer

 

[UnoMas]

The biggest part of medical education I hate is the medicolegal constraints that prohibits teaching. Medical students are no longer allowed to learn to place invasive lines or even pull out central lines anymore. It's a ****ing travesty. Obviously patient safety comes first but as long as they're being adequately supervised it shouldn't be an issue. But I remember putting in central lines and alines as a med student. We get interns now that don't know how to put a goddamn IV or how to simply take out a central line.

Furthermore, just to touch quickly on how midlevels vs resident training. For the first year of CA1 in my residency the attendings would be the one inducing the patient while the resident would tube. And SRNAs would be allowed to actually push the drugs themselves. I always thought this was ridiculous.

I actually saw this conversation went down in real life, the attending's reasoning is "They'll be on their own next year. You'll have time" It's ridiculous!

 

[Psai]

I actually saw this conversation went down in real life, the attending's reasoning is "They'll be on their own next year. You'll have time" It's ridiculous!

They shouldn't be on their own. It's not our responsibility to make up for the deficiencies in their training or to train them ourselves. Their role should be to assist at best and yet I see them doing more and more clinically. Then we have bizarre pressure from people who have no idea what they're talking about to play nice because everyone is equal. Yea, no.

 

[Winged Scapula]

Hint: the issue with medical students not doing procedures isn’t all about medicolegalities.

The MLP will bill for it; the resident supervising you can’t.

But this is o/t.

 

[getdown]

How is this possible? I've done both already, placing IVs numerous times and I'm only a few months into third year.

I don't know. That's what makes this bewildering. My med school was in the east coast but did residency in the west coast. At least where I did residency the hospital was very risk adverse. I mean the med students had to get a ****ing presidential order to put in foleys and had only trained on manakins (didn't even know there was such a thing). A lot of it is probably patient dependent as well. Some of these patients think they're God's gift to mankind and wouldn't let any resident let alone med student do anything on them. You want attending only job? Then go to private practice not a teaching institution.

 

[getdown]

How do we combat this? It is incredible how many of my fellow third years are apologetic and use the term "provider" ad nauseam. I've even heard numerous defend nps that unethically call themselves "doctors" to patients and go on to say we are all "a part of the team." blah blah. I feel as if the dumbing down of education is going to be the death of medicine, especially with the 20-30 crowd carrying the torch.

This is what happens when you've grown up force fed this safe space nonsense with a side of everyone is exceptional bull****.

Listen, as physicians we are part of a team since we can't do everything ourselves. We need the nurses, techs, LVNs, etc to get everything done otherwise we'd never leave the hospital or sleep or eat. However with every team there's a leader. Physicians should be the leader by virtue of not just knowledge-base but also because medicolegally we're still ultimately responsible for the patient. And that's the big ****ing kicker. Next time one of your friends spout this crap ask him/her/them this: when something goes wrong and the patient sues. Who do you think the courts will place the most blame on and will everyone on that team step up to take some of the blame? Watch them scurry back and on the "oh I'm ONLY a nurse/tech/midlevelXYZ and I only follow the doctor's orders. What a load of steaming hypocrites.

 

[CherryRedDracul]

In my 4 years, the only people who got in actual disciplinary trouble were the guy who showed up high on coke and broke his fist punching the anatomy lab wall and the guy who told a room full of OB/GYN residents that women shouldn't be doctors.

But yeah, totally due to innocuous tattling.

But in those two situations, they snitched on themselves essentially.

As a thoughtful Mr. Fantastik once put it:

Rap snitches, telling all their business
Sit in the court and be their own star witness
Do you see the perpetrator? Yeah, I'm right here
**** around, get the whole label sent up for years.

 

[VA Hopeful Dr]

The biggest part of medical education I hate is the medicolegal constraints that prohibits teaching. Medical students are no longer allowed to learn to place invasive lines or even pull out central lines anymore. It's a ****ing travesty. Obviously patient safety comes first but as long as they're being adequately supervised it shouldn't be an issue. But I remember putting in central lines and alines as a med student. We get interns now that don't know how to put a goddamn IV or how to simply take out a central line.

Furthermore, just to touch quickly on how midlevels vs resident training. For the first year of CA1 in my residency the attendings would be the one inducing the patient while the resident would tube. And SRNAs would be allowed to actually push the drugs themselves. I always thought this was ridiculous.

Why would an intern need to know how to put in an IV?

I did a fair number of procedures in med school but never had occasion to start an IV on a patient, and haven't needed to since then either come to think of it.

 

[nimbus]

Why would an intern need to know how to put in an IV?

I did a fair number of procedures in med school but never had occasion to start an IV on a patient, and haven't needed to since then either come to think of it.

Maybe when they respond to a code and the patient has an infiltrated IV which is common on the wards.

 

[getdown]

Why would an intern need to know how to put in an IV?

I did a fair number of procedures in med school but never had occasion to start an IV on a patient, and haven't needed to since then either come to think of it.

I guess some of my examples are Anesthesia specific. IVs are kind of our bread and butter thing. But I understand from a different services' perspective maybe that's not as important of a skill but with how often I get called for "difficult IV sticks" I swear it doesn't seem like a bad skill to have ... especially the OB floor 😉

 

[getdown]

Maybe when they respond to a code and the patient has an infiltrated IV which is common on the wards.

This has actually happened to me. I was the only resident in a very busy OB service and got called out of a c/s to place an IV in a coding OB pt on the postpartum floor. I was flabbergasted.

 

[nimbus]

This has actually happened to me. I was the only resident in a very busy OB service and got called out of a c/s to place an IV in a coding OB pt on the postpartum floor. I was flabbergasted.

Yep IV insertion is a simple lifesaving skill for anyone who works in a hospital.

 

[Psai]

I guess some of my examples are Anesthesia specific. IVs are kind of our bread and butter thing. But I understand from a different services' perspective maybe that's not as important of a skill but with how often I get called for "difficult IV sticks" I swear it doesn't seem like a bad skill to have ... especially the OB floor 😉

I've seen those nurses miss IVs on patients with veins the size of my thumb

 

[Giovanotto]

Med students like this lack perspective. I was constantly annoyed by the ones who would say they “had to go to work” in referring to their rotations. Like it was a cute little thing for them. Hey guys look at this, “I’m actually going...snicker...to work!” You seeing this shi*? Hey ma, guess what I’m going TO WORK today. Talking to the cute undergrad at the bar , “yeah so there I was at work in the OR and had to take this gunshot wound to surgery...”

Sorry, you are not “going to work”, you are going to school. You do not do work as a med student. You make our lives harder and get in the way. You don’t just get to be involved in a procedure or something whenever it is convenient for you. It’s not playtime, these are people’s lives. You are not “doing” anything productive. We take time to try and teach you and give you advice. YOU ARE AN OBSERVER, A LEARNER. You don’t get to make decisions,

So I would say it’s not really about having work skills. It’s about lacking perspective and constantly thinking they are the center of the universe and everything revolves around them and their schedule.

Regarding pushing the social agenda, I was referring more to the social justice warriors trying to cram controversial topics down everyone’s throats as truth and calling you unprofessional if you disagree. Rather than actual professional issues with patients like wearing blue jeans and a t shirt to clinic or something,

I've worked 50+ hours per week for 2+ years with maybe 6 days off in total during that time (holidays included) and I still consider my clerkship years work. I've many a times have said to friends who are not in medicine that "I have work on Monday, I can't". Hope I don't trigger you too badly.

Bonus: I'm currently in a clerkship that is textbook shadowing, and I still call it work :O

 

[getdown]

I've seen those nurses miss IVs on patients with veins the size of my thumb

Yep, I have too. A lot of it stems from them not putting the tourniquet tight enough. They don't want to hurt the patient so they put this loose ass tourniquet that doesn't hold anything and then the vein just flattens and the needle goes right through the other end.

 

[Winged Scapula]

Why would an intern need to know how to put in an IV?

I did a fair number of procedures in med school but never had occasion to start an IV on a patient, and haven't needed to since then either come to think of it.

A week didn't go by for me as a surgical resident without being asked to come and start an IV. Usually a transplant patient, IV drug user, post chemo, etc. difficult ones, but nonetheless hospital based specialties are often asked (because the nurses assume we have more practice).

 

[NicMouse64]

A week didn't go by for me as a surgical resident without being asked to come and start an IV. Usually a transplant patient, IV drug user, post chemo, etc. difficult ones, but nonetheless hospital based specialties are often asked (because the nurses assume we have more practice).

How often is a US guided IV actually used in these situations?

 

[Goro]

Back on topic, professionalism issues are rare. And most commonly, a slap on the wrist is all that one needs.

Students who get severely sanctioned for professionalism are not merely repeat offenders, but multiple repeat offenders. Savvy SDNers know that when someone posts "About to be dismissed!" threads, it's like an iceberg, with only the tip of the problems showing, and tons that are not seen (or rather, left out of the OP) underwater.

In thinking of my own students who were either dismissed, or narrowly missed getting dismissed, the major causes were pathological cluelessness, personality issues, or outright mental illness. I don't know if any of the people who had the second criteria had "you can't tell me what to do!" mindsets, but it wouldn't surprise me. I'm sure you guys have seen these in action at times.

 

[RNthenDoc]

Its not bashing to speak the truth about the encroachment of MLPs into medical education and practice. You will see once you start medical school the difference in depth of knowledge and training, dedication, hours worked etc. and then come here and tell us that a MLP who did an on-line NP course and is working as your independent "hospitalist" in the ICU (replacing the physician because he/she was cheaper) isn't a problem.

I *have* started Med school.

I didn’t say it wasn’t a problem.

But this is a topic about professionalism and all it took was one observation about how permeated this board is with anti-nurse bias to devolve the thread into an us-vs-them phallus measuring contest. Not exactly what I’d call interdisciplinary respect. Which by the way... is considered a professionalism issue in modern healthcare.

Let me be clear: I think NP education is not up to snuff, and I think wildly expanding scopes of practice is bad.

I also think American physicians do a **** job of advocating for positive change in healthcare in general.

Our poor outcomes compared to our peers speak for themselves.

Maybe instead of jumping all over each other we should pragmatically find ways of coexisting harmoniously, pushing for the betterment of patient care?

 

[Goro]

I *have* started Med school.

I didn’t say it wasn’t a problem.

But this is a topic about professionalism and all it took was one observation about how permeated this board is with anti-nurse bias to devolve the thread into an us-vs-them phallus measuring contest. Not exactly what I’d call interdisciplinary respect. Which by the way... is considered a professionalism issue in modern healthcare.

Let me be clear: I think NP education is not up to snuff, and I think wildly expanding scopes of practice is bad.

I also think American physicians do a **** job of advocating for positive change in healthcare in general.

Our poor outcomes compared to our peers speak for themselves.

Maybe instead of jumping all over each other we should pragmatically find ways of coexisting harmoniously, pushing for the betterment of patient care?

You radical, you!!!

 

[RNthenDoc]

You radical, you!!!

I know, I’m going to be the worst doctor ever.

Provided anatomy doesn’t do me in.

In which case I’ll do an online DNP program just to troll everyone on SDN.

 

[Psai]

I *have* started Med school.

I didn’t say it wasn’t a problem.

But this is a topic about professionalism and all it took was one observation about how permeated this board is with anti-nurse bias to devolve the thread into an us-vs-them phallus measuring contest. Not exactly what I’d call interdisciplinary respect. Which by the way... is considered a professionalism issue in modern healthcare.

Let me be clear: I think NP education is not up to snuff, and I think wildly expanding scopes of practice is bad.

I also think American physicians do a **** job of advocating for positive change in healthcare in general.

Our poor outcomes compared to our peers speak for themselves.

Maybe instead of jumping all over each other we should pragmatically find ways of coexisting harmoniously, pushing for the betterment of patient care?

The real professionalism issue is everyone pretending to be something they're not. Medical school is tough and stressful; make one mistake and you have a horde of people including your own ready to try to stomp all over you. Be happy with what you have and stop trying to police the people whose work allows for the system to function while paying your salary.

 

[getdown]

I *have* started Med school.

I didn’t say it wasn’t a problem.

But this is a topic about professionalism and all it took was one observation about how permeated this board is with anti-nurse bias to devolve the thread into an us-vs-them phallus measuring contest. Not exactly what I’d call interdisciplinary respect. Which by the way... is considered a professionalism issue in modern healthcare.

Let me be clear: I think NP education is not up to snuff, and I think wildly expanding scopes of practice is bad.

I also think American physicians do a **** job of advocating for positive change in healthcare in general.

Our poor outcomes compared to our peers speak for themselves.

Maybe instead of jumping all over each other we should pragmatically find ways of coexisting harmoniously, pushing for the betterment of patient care?

I agree that everyone should be able to work together. And I'll be the first to say that plenty of doctors have bigger egos than actual clinical skills. However, the bolded statement above you should better direct towards the different nursing groups pushing for more autonomy. The physicians have always been here, we're not trying to encroach in other fields. Let me ask you this question. How would you feel if LVNs and nursing assistants start telling you they can do the same if not better job in doing nursing duties than you? Would you feel they are clinically up to snuff and would you let them do so? Then you may know how physicians feel about this subject.

 

[hardpecs]

Just to add another angle to this, I think some of the issues are to do with the price we pay for our education and whats at stake. It increases the pressure when issues do arise. When you as a student are fully aware of the massive debt you're taking on for the cost of your education, you hope
there is some quality to the product, or that basic tasks like lesson and exam scheduling wont be a recurring issue.

Thats not to say there arent some people with really poor attitudes, but its certainly not the whole story.

 

[VA Hopeful Dr]

I guess some of my examples are Anesthesia specific. IVs are kind of our bread and butter thing. But I understand from a different services' perspective maybe that's not as important of a skill but with how often I get called for "difficult IV sticks" I swear it doesn't seem like a bad skill to have ... especially the OB floor 😉

Ah, that makes sense.

I must have just been lucky in residency, we had a nurse IV team that did all tough sticks and PICC lines. I never called anesthesia for a tough stick and only surgery for a central line once.