Anybody else disillusioned already?

[Winged Scapula]

Great idea. I think I'll get some La-z-boys for the exam rooms and waiting room.

LOL! Don't forget the pillows and blankies!!!

---

Members don't see this ad.

 

[fineline]

And for our illegal immigrant friends who still don't speak english

CC: TBD (total body dolor)

Speaking of our illegal friends, I like how, even if you inconvenience yourself by learning rudimentary Spanish a lot of them won't even attempt to talk to you. Like, I know enough Spanish to have a basic conversation, but some Hispanics will just sit there and go "NO. NO SPEAKA ENGLISH." until I get a translator. Which pisses me off because not only are they here illegally, they're using my taxes to pay for their social services, they don't learn the language, they force me to learn theirs, AND they're not even trying to understand me when I speak in broken Spanish. So one time this Hispanic lady does the "NO SPEAKA ENGLISH" thing to me and so I just shrugged and said, "perdon, no hablo espanol, senora" and just kept speaking English to her until she left in anger. And I didn't simplify the English, either, so that she would have a shot at understanding it. I was like, "so my understanding of the situation at hand is that you are suffering from ..." Ho ho ho, it was great. Since she left midway through the interview of her own accord, I didn't have to tell an attending about it, either. Double sweet.

 

[dynx]

Speaking of our illegal friends, I like how, even if you inconvenience yourself by learning rudimentary Spanish a lot of them won't even attempt to talk to you. Like, I know enough Spanish to have a basic conversation, but some Hispanics will just sit there and go "NO. NO SPEAKA ENGLISH." until I get a translator. Which pisses me off because not only are they here illegally, they're using my taxes to pay for their social services, they don't learn the language, they force me to learn theirs, AND they're not even trying to understand me when I speak in broken Spanish. So one time this Hispanic lady does the "NO SPEAKA ENGLISH" thing to me and so I just shrugged and said, "perdon, no hablo espanol, senora" and just kept speaking English to her until she left in anger. And I didn't simplify the English, either, so that she would have a shot at understanding it. I was like, "so my understanding of the situation at hand is that you are suffering from ..." Ho ho ho, it was great. Since she left midway through the interview of her own accord, I didn't have to tell an attending about it, either. Double sweet.

I too relish my inability to speak spanish. Once had a spanish only patient needed a chole, was originally scheduled that night when I did the admit with an interpreter. Later her case got bumped and put on the board for the next day. The nurse asked me if I was going to tell the lady her case wasn't going that night, my response: "I don't speak spanish and she won't understand in english, but I'm sure she'll figure it out when she sees the sun rising". I heard about that one the next day. Seriously, if you're too damn lazy to learn english Im too damn lazy to get you an interpreter past the initial eval. Im not going to f*ck up my schedule because you need an interpreter, you can just lay there in the dark and wonder what the hell is going on for hours on end...maybe with all that confusion learning the language will start to seem worth the effort. Or maybe I'm just a dick. Either way.

edit: and also, now that I think about it (this has nothing to do with the rest of the thread by the way) why the hell does everybody need a goddamn sleeping pill these days? I swear to god if you give me a pillow and a tile floor Im out like a light. How come every goddamn patient needs benadryl or an Ambien? I once had an old guy who, get this, fell asleep behind the wheel of his car on a freeway and caused a huge accident, almost killed some younger guy in another car. When I saw the guy when he got to the floor he told me "I need a sleeping pill for tonight or I'll just lay here awake, I can't sleep without it" MOTHER F*CKER YOU JUST FELL ASLEEP DRIVING A CAR! How about I come in here and honk a horn every couple of minutes? Will that make you feel drowsy? Idiots.

 

[fineline]

Im not going to f*ck up my schedule because you need an interpreter

Yeah, it's ******ed because even if all you want to do is say ONE sentence to them you have to get an interpreter. Screw that. This also happens to me, when you get a consult from the ER and it's clear that they didn't actually talk to the patient (they never do anyway, but with illegals it's even more clear) because the resident can't speak Spanish and there's no translator/translator phone around. Consequently, you have to do all the work (as usual).

Oh, and I never give people "sleeping pills." If they want to medicate themselves at home, that's their business. Last I checked, sleeping occurs naturally.

 

[Tired]

You don't know the cure for CFS? It's called "not filling in their disability form." At the minimum it'll get them to go somewhere else.

On a related note, I love the people who come in telling me they have "Reflex Sympathetic Dystrophy", for two reasons:

(1) When asked where they have it, they invariably say, "All over", which of course is impossible

(2) The phrase was replaced by Chronic Regional Pain Syndrome a hell of a long time ago, meaning they've been carrying this diagnosis for at least a decade

At least they're easy to deal with. I immediately stop the interview and ask, "What do you want?"

They say, "Morphine. 20mg."

I say, "I'll give you 5mg."

"But that won't work!"

"You get 5mg."

"Fine."

 

[Winged Scapula]

Iedit: and also, now that I think about it (this has nothing to do with the rest of the thread by the way) why the hell does everybody need a goddamn sleeping pill these days? I swear to god if you give me a pillow and a tile floor Im out like a light. How come every goddamn patient needs benadryl or an Ambien? I once had an old guy who, get this, fell asleep behind the wheel of his car on a freeway and caused a huge accident, almost killed some younger guy in another car. When I saw the guy when he got to the floor he told me "I need a sleeping pill for tonight or I'll just lay here awake, I can't sleep without it" MOTHER F*CKER YOU JUST FELL ASLEEP DRIVING A CAR! How about I come in here and honk a horn every couple of minutes? Will that make you feel drowsy? Idiots.

Hah! I was just thinking about this today when I saw an ad for Ambien. If you take a sleeping pill regularly at home, fine...I'll give it to you provided you aren't on a boatload of narcs or other benzos. But what is with all the phone calls for them at 0200? How about turning the lights out at 10pm and figuring out at 1130 you can't sleep?

I'm not a fan of them, especially for the elderly but I think nurses offer the meds to them rather than trying comfort measures like keeping things quiet on the ward and an extra blanket or pillow.

 

[Blade28]

Oh don't get me started on yet ANOTHER rant!...

(1) Remember when hospitals were supposed to be quiet? Sometimes it's so loud at the nurses' station that I can't have a conversation with someone sitting next to me. Or I can't hear someone on the phone.
(2) All these prn meds? Really? When at home, do YOU take a prescription pill every time you have indigestion/mild nausea/hiccups/insomnia/mild headache/jittery nerves? Really?
(3) THE TREATMENT OF A FEVER IS NOT TYLENOL. Fever is NOT caused by a deficiency of acetaminophen! Let's find the cause, shall we?
(4) Yes, it's OK for a patient to be NPO overnight. Do YOU eat a midnight snack every single night?
(5) Yes, not every patient needs IV fluids running when NPO overnight. Do YOU drink all night long?
(6) PLEASE don't unnecessarily freak the patient/patient's family out by telling them erroneous information, like what vital signs to watch out for (otherwise they'll become obsessed with the monitor/Dyna-Mapp), how important the PCA button is (or the family members will push it even when the patient is ASLEEP), how incurable their metastatic cancer is, what day they'll be discharged (unless we've discussed it on rounds!), what time they'll be discharged (stop saying "first thing in the morning!"), etc.

 

[Coastie]

Deport!

Speaking of our illegal friends, I like how, even if you inconvenience yourself by learning rudimentary Spanish a lot of them won't even attempt to talk to you. Like, I know enough Spanish to have a basic conversation, but some Hispanics will just sit there and go "NO. NO SPEAKA ENGLISH." until I get a translator. Which pisses me off because not only are they here illegally, they're using my taxes to pay for their social services, they don't learn the language, they force me to learn theirs, AND they're not even trying to understand me when I speak in broken Spanish. So one time this Hispanic lady does the "NO SPEAKA ENGLISH" thing to me and so I just shrugged and said, "perdon, no hablo espanol, senora" and just kept speaking English to her until she left in anger. And I didn't simplify the English, either, so that she would have a shot at understanding it. I was like, "so my understanding of the situation at hand is that you are suffering from ..." Ho ho ho, it was great. Since she left midway through the interview of her own accord, I didn't have to tell an attending about it, either. Double sweet.

 

[Coastie]

Why sleeping pills? Because the nurses are too lazy to actually do their jobs, which includes meeting patient's needs overnight. See, that interferes with the blue bell/haagen daaz/breyer's to which they have become accustomed, and therefore, they want you to fix everything magically with sleeping pills. They WILL CALL non-stop unless you order them.

Yeah, and they are making anywhere from $30-50 an hour to do so while you slave away. Think that's bad? Just wait til you have socialized medicine where the incentive to work is even less..just wait!

Yeah, it's ******ed because even if all you want to do is say ONE sentence to them you have to get an interpreter. Screw that. This also happens to me, when you get a consult from the ER and it's clear that they didn't actually talk to the patient (they never do anyway, but with illegals it's even more clear) because the resident can't speak Spanish and there's no translator/translator phone around. Consequently, you have to do all the work (as usual).

Oh, and I never give people "sleeping pills." If they want to medicate themselves at home, that's their business. Last I checked, sleeping occurs naturally.

 

[Coastie]

1) There is a serious rise in a new disease amongst "the real workers of healthcare", nurses, and it's a frightening thing: Nursing Auditory Gastrophilic Syndrome, or NAGS for short. Increased adipose from the gastrophillic, or love of stomach portion of the syndrome, around the external auditory ear canals has led to decreased sensation of hearing, thus louder talking, and an increase in eating, which is sometimes the only thing a nurse can hear while chewing with her mouth open. As you can see, this all leads into a vicious cycle of talking loud, eating, talking loud, eating, which is non-stop...

2) Lawyers and scramble-to-beg-like-a-dog-to-the-whiny-patient committee. Oh, and lazy nurses.

3) Yes it is. If tylenol isn't the cure of fevers, then why did God make tylenol, hmm? Stupid doctor!

4) See #1. Obviously.

5) "Yes, there is plenty of water content in chicken supreme hot pockets."- Charge Nurse answering your question

6) You dare question what the nurses do? Looks like it's another stuck up MD resident who really is itching to get written up by the nursing committee, deserving of losing a license, or at the very least, a very nasty letter in your permanent record. Don't you know that nurses know just as much as doctors, and care 5x more?

Three real events in the past week regarding #6:

1) Oh crap, the blood pressure is 115/70? I thought it was supposed to be 120/80. Call the rapid response team!
2) The blood pressure was 240/120 6 hours ago (in a patient with previous MI x FIVE history and chest pain this whole time), and you didn't call me!?!??!!??!? Nurse: I was busy....
3) Why did you hold mr. so and so's clonidine (note mr. so and so has BP which is being attacked with tons of meds and is just now getting under control) which led to a very high reading and his discharge being held? Nurse: His pulse was 70, I was afraid giving clonidine would slow his heart down too much and even stop it.

Oh don't get me started on yet ANOTHER rant!...

(1) Remember when hospitals were supposed to be quiet? Sometimes it's so loud at the nurses' station that I can't have a conversation with someone sitting next to me. Or I can't hear someone on the phone.
(2) All these prn meds? Really? When at home, do YOU take a prescription pill every time you have indigestion/mild nausea/hiccups/insomnia/mild headache/jittery nerves? Really?
(3) THE TREATMENT OF A FEVER IS NOT TYLENOL. Fever is NOT caused by a deficiency of acetaminophen! Let's find the cause, shall we?
(4) Yes, it's OK for a patient to be NPO overnight. Do YOU eat a midnight snack every single night?
(5) Yes, not every patient needs IV fluids running when NPO overnight. Do YOU drink all night long?
(6) PLEASE don't unnecessarily freak the patient/patient's family out by telling them erroneous information, like what vital signs to watch out for (otherwise they'll become obsessed with the monitor/Dyna-Mapp), how important the PCA button is (or the family members will push it even when the patient is ASLEEP), how incurable their metastatic cancer is, what day they'll be discharged (unless we've discussed it on rounds!), what time they'll be discharged (stop saying "first thing in the morning!"), etc.

 

[fineline]

How about the classic "his BP was 105/68, so I held his morning metoprolol because I didn't want his pressure to drop"? Hey, if that's the case, don't call me when his pressure rises to ask me what to do -- apparently, you're smart enough to manage his meds. That's one of the basic problems. This is going to insult people who don't want to think about what I'm saying, but nurses are like children. It doesn't matter what their JOB is, they just do whatever interests them at the time. If they suddenly take it into their head to fiddle around with a medication, try and stop them. They'll do some stuff until they run into trouble and then call for help. Meanwhile, stuff they're SUPPOSED to be doing, why, that's boring so maybe I'll do it later or not at all if I don't think it's really "important." Things would be a lot less complicated in the hospital if nurses just came in, did their job, didn't do what wasn't their job, and acted like adults.

 

[Tired]

(1) Remember when hospitals were supposed to be quiet? Sometimes it's so loud at the nurses' station that I can't have a conversation with someone sitting next to me. Or I can't hear someone on the phone.

Conversation I overheard at the nurses station while I was in my 85yo patient's room.

Tech: I'm sick of all these old geezers. I hate cleaning up their ****.
RN: That's not very nice, someday you'll be old.
Tech: Take me out back and shoot me like a dog. That's what we should do with all these sick old patients.
RN: That's really not appropriate.
Tech: Whatever, I totally mean it. Totally.

 

[Venus21pam]

I'm loving this thread!! Hi-larious!

How about:
Doc (at 11pm checking up on a few selected patients): nurse, mr.'s so and so BP is really high (btw he came in with hypertensive urgency) - did he get his pm meds?
Nurse: oh, i held his clonidine and his metoprolol because his pulse was 58.
Doc: why didn't you call me to notify me/ask me what to do
Nurse: i just thought it was ok to hold it
Doc: never mind, just please give the meds now
half hour later: did mr. so and so get his meds?
Nurse: no
Doc: why not?
Nurse: i'm afraid he will get bradycardic!

are you freaking kidding me?
didn't I just say "give the meds now"?
since when do you just disregard the orders because "you though something might happen" - are you a freaking fortune teller or what??


Or how about a call at 1am:
nurse: ah, on pt in room 5 bed 2 - i just looked at her CAT scan and she has small bilat. pleural effusions - do you wanna start an antibiotic??

 

[Coastie]

That HTN Urgency story is about identical to mine, minus the metoprolol.

I'm loving this thread!! Hi-larious!

How about:
Doc (at 11pm checking up on a few selected patients): nurse, mr.'s so and so BP is really high (btw he came in with hypertensive urgency) - did he get his pm meds?
Nurse: oh, i held his clonidine and his metoprolol because his pulse was 58.
Doc: why didn't you call me to notify me/ask me what to do
Nurse: i just thought it was ok to hold it
Doc: never mind, just please give the meds now
half hour later: did mr. so and so get his meds?
Nurse: no
Doc: why not?
Nurse: i'm afraid he will get bradycardic!

are you freaking kidding me?
didn't I just say "give the meds now"?
since when do you just disregard the orders because "you though something might happen" - are you a freaking fortune teller or what??


Or how about a call at 1am:
nurse: ah, on pt in room 5 bed 2 - i just looked at her CAT scan and she has small bilat. pleural effusions - do you wanna start an antibiotic??

 

[Passthegas]

Internship at a top academic hospital is pure fricken hell. I'm going into anesthesia and happened to match at a place that doesnt allow you to choose your own intern year. Man, I had this sweet cush transitional year all set up, had the ins but now im stuck doing a "Clinical Base Year" which pretty much means "Scut monkey that gets **** on by Surgeons and Internal Medicine people Year". And I'm surrounded by a bunch of whiny uptight kiss ass gunners with no sense of humor. I'm routinely stuck at the hospital until 9 pm because this whiny uptight fugly internal medicine intern is constantly PMSing and refuses to take sign out from me. And I'm surrounded by a bunch of fat and ugly nurses whose only job is to page me with constant "FYIs" about **** I could care less about. "Patients temperature is 100.1, do you want to start antibiotics?" or on Cards in regards to a patient with NICM "FYI, patient had a three beat run of v-tach but is asleep, can you come see the patient". Or my goddamn favorite on my last call at 3 am on a crosscover patient, "Patient has a rash on his arm, can you come look at it and write for something". Do I look like a hot girl derm resident? No bitch, can I bring my foot to your fat ass? I'm so sick of the lack of respect nurses have for residents at academic hospitals. They constantly question orders with "why". Cause I said so, I'm the doctor, you're the nurse, deal with it. And I cant deal with the disrpespect patients have for doctors. Its bad at a a public academic hospital where ungrateful, fat, lazy, welfare people, illegal aliens get a million dollar workup and are pissed because they were discharged five minutes late. Lot of you are thinking, "wow this guy is an ass who doesn't belong in medicine" Well to be honest, I used to be so liberal and went into medicine like most people did, to use our knowledge to help sick people. But sadly in three months of internship i'm already so jaded and disillusioned by the whole health care system. I dont ever want to hear "I'm allergic to morphine but this drug that starts with a "D" is the only thing that works for me" Thank god its only a year of this **** then I'm off to doing what I always wanted to do "Putting these increasingly obese public hospital tubs of crap to sleep while IM residents get to deal with discharges and h and ps and social work rounds for another 3 years. There is nothing I hate more than social work, discharge planning, subacute blah blah blah rounds. And after residency off to private practice in the suburbs away from the nightmare that is socialized medicine at a big academic public hospital. To my bros in anesthesia, we chose wisely. To all you poor fellows stuck in IM or surgery, may god have mercy on your soul. Oh and to all the other programs at my hospital that we anesthesia folks are farmed out to in our internship do their dirty work, f*&k you all you b*&stards". To the EM program who makes us do 26 10 hour shifts in one month while their interns do 11 8 hour shifts and then tell me after I miss my last shift because I'm puking my guts out from food poisioning that I have to make up the shift during a day off on one of my other months, eat a fat "d83k.

"The most pissed off intern"

 

[Passthegas]

Deport!

HAHAAHAH. I love you man. Thats right, I'm not learning your language when you get healthcare for free, DEPORT!

 

[dynx]

Internship at a top academic hospital is pure fricken hell. I'm going into anesthesia and happened to match at a place that doesnt allow you to choose your own intern year. Man, I had this sweet cush transitional year all set up, had the ins but now im stuck doing a "Clinical Base Year" which pretty much means "Scut monkey that gets **** on by Surgeons and Internal Medicine people Year". And I'm surrounded by a bunch of whiny uptight kiss ass gunners with no sense of humor. I'm routinely stuck at the hospital until 9 pm because this whiny uptight fugly internal medicine intern is constantly PMSing and refuses to take sign out from me. And I'm surrounded by a bunch of fat and ugly nurses whose only job is to page me with constant "FYIs" about **** I could care less about. "Patients temperature is 100.1, do you want to start antibiotics?" or on Cards in regards to a patient with NICM "FYI, patient had a three beat run of v-tach but is asleep, can you come see the patient". Or my goddamn favorite on my last call at 3 am on a crosscover patient, "Patient has a rash on his arm, can you come look at it and write for something". Do I look like a hot girl derm resident? No bitch, can I bring my foot to your fat ass? I'm so sick of the lack of respect nurses have for residents at academic hospitals. They constantly question orders with "why". Cause I said so, I'm the doctor, you're the nurse, deal with it. And I cant deal with the disrpespect patients have for doctors. Its bad at a a public academic hospital where ungrateful, fat, lazy, welfare people, illegal aliens get a million dollar workup and are pissed because they were discharged five minutes late. Lot of you are thinking, "wow this guy is an ass who doesn't belong in medicine" Well to be honest, I used to be so liberal and went into medicine like most people did, to use our knowledge to help sick people. But sadly in three months of internship i'm already so jaded and disillusioned by the whole health care system. I dont ever want to hear "I'm allergic to morphine but this drug that starts with a "D" is the only thing that works for me" Thank god its only a year of this **** then I'm off to doing what I always wanted to do "Putting these increasingly obese public hospital tubs of crap to sleep while IM residents get to deal with discharges and h and ps and social work rounds for another 3 years. There is nothing I hate more than social work, discharge planning, subacute blah blah blah rounds. And after residency off to private practice in the suburbs away from the nightmare that is socialized medicine at a big academic public hospital. To my bros in anesthesia, we chose wisely. To all you poor fellows stuck in IM or surgery, may god have mercy on your soul. Oh and to all the other programs at my hospital that we anesthesia folks are farmed out to in our internship do their dirty work, f*&k you all you b*&stards". To the EM program who makes us do 26 10 hour shifts in one month while their interns do 11 8 hour shifts and then tell me after I miss my last shift because I'm puking my guts out from food poisioning that I have to make up the shift during a day off on one of my other months, eat a fat "d83k.

"The most pissed off intern"

This should be posted in the pre-allo forum. And to all you poor fellows stuck in Gas, may god have mercy on your soul...because when Im an attending surgeon, I won't.

 

[Derek Zoolander]

PTG,

While I don't have as much hate built up as you may, I almost wonder if we are at the same institution. I feel that we are the red headed step children who don't have a home, so why not abuse us and make us take the extra shifts and call. Man, 7 more months of non-anesthesia rotations. Really, 6 if you don't count ICU which I actually like. And as you said, "There is nothing I hate more than social work, discharge planning, subacute blah blah blah rounds."

I hear you bro, I hear you.

Internship at a top academic hospital is pure fricken hell. I'm going into anesthesia and happened to match at a place that doesnt allow you to choose your own intern year. Man, I had this sweet cush transitional year all set up, had the ins but now im stuck doing a "Clinical Base Year" which pretty much means "Scut monkey that gets **** on by Surgeons and Internal Medicine people Year". And I'm surrounded by a bunch of whiny uptight kiss ass gunners with no sense of humor. I'm routinely stuck at the hospital until 9 pm because this whiny uptight fugly internal medicine intern is constantly PMSing and refuses to take sign out from me. And I'm surrounded by a bunch of fat and ugly nurses whose only job is to page me with constant "FYIs" about **** I could care less about. "Patients temperature is 100.1, do you want to start antibiotics?" or on Cards in regards to a patient with NICM "FYI, patient had a three beat run of v-tach but is asleep, can you come see the patient". Or my goddamn favorite on my last call at 3 am on a crosscover patient, "Patient has a rash on his arm, can you come look at it and write for something". Do I look like a hot girl derm resident? No bitch, can I bring my foot to your fat ass? I'm so sick of the lack of respect nurses have for residents at academic hospitals. They constantly question orders with "why". Cause I said so, I'm the doctor, you're the nurse, deal with it. And I cant deal with the disrpespect patients have for doctors. Its bad at a a public academic hospital where ungrateful, fat, lazy, welfare people, illegal aliens get a million dollar workup and are pissed because they were discharged five minutes late. Lot of you are thinking, "wow this guy is an ass who doesn't belong in medicine" Well to be honest, I used to be so liberal and went into medicine like most people did, to use our knowledge to help sick people. But sadly in three months of internship i'm already so jaded and disillusioned by the whole health care system. I dont ever want to hear "I'm allergic to morphine but this drug that starts with a "D" is the only thing that works for me" Thank god its only a year of this **** then I'm off to doing what I always wanted to do "Putting these increasingly obese public hospital tubs of crap to sleep while IM residents get to deal with discharges and h and ps and social work rounds for another 3 years. There is nothing I hate more than social work, discharge planning, subacute blah blah blah rounds. And after residency off to private practice in the suburbs away from the nightmare that is socialized medicine at a big academic public hospital. To my bros in anesthesia, we chose wisely. To all you poor fellows stuck in IM or surgery, may god have mercy on your soul. Oh and to all the other programs at my hospital that we anesthesia folks are farmed out to in our internship do their dirty work, f*&k you all you b*&stards". To the EM program who makes us do 26 10 hour shifts in one month while their interns do 11 8 hour shifts and then tell me after I miss my last shift because I'm puking my guts out from food poisioning that I have to make up the shift during a day off on one of my other months, eat a fat "d83k.

"The most pissed off intern"

 

[Faebinder]

I truly hate the ER nurses... I think they are under the impression that just cause you are on call and they are awake.. well then the entire world should be awake as well. Yeah.. lets consult colorectal surgery, dermatology, psychiatry and the rest of the non-emergent services at 3 am in the morning... God forbid you should wait till 6 am.

 

[Passthegas]

This should be posted in the pre-allo forum. And to all you poor fellows stuck in Gas, may god have mercy on your soul...because when Im an attending surgeon, I won't.

And when I'm an attending anesthesiologist, we will refuse to work with you. Surgeons may be able to crap on anesthesiologists at academic places but in private practice we wont put up with your condescending crap.

 

[Coastie]

Long Live Anesthesiology!

Down with Socialized Medicine!

Vote Republican 08 or this will only spread to the suburbs and increase in severity 100X.

Nice way to sum up all the interns (especially the off-service guys) thoughts.

Internship at a top academic hospital is pure fricken hell. I'm going into anesthesia and happened to match at a place that doesnt allow you to choose your own intern year. Man, I had this sweet cush transitional year all set up, had the ins but now im stuck doing a "Clinical Base Year" which pretty much means "Scut monkey that gets **** on by Surgeons and Internal Medicine people Year". And I'm surrounded by a bunch of whiny uptight kiss ass gunners with no sense of humor. I'm routinely stuck at the hospital until 9 pm because this whiny uptight fugly internal medicine intern is constantly PMSing and refuses to take sign out from me. And I'm surrounded by a bunch of fat and ugly nurses whose only job is to page me with constant "FYIs" about **** I could care less about. "Patients temperature is 100.1, do you want to start antibiotics?" or on Cards in regards to a patient with NICM "FYI, patient had a three beat run of v-tach but is asleep, can you come see the patient". Or my goddamn favorite on my last call at 3 am on a crosscover patient, "Patient has a rash on his arm, can you come look at it and write for something". Do I look like a hot girl derm resident? No bitch, can I bring my foot to your fat ass? I'm so sick of the lack of respect nurses have for residents at academic hospitals. They constantly question orders with "why". Cause I said so, I'm the doctor, you're the nurse, deal with it. And I cant deal with the disrpespect patients have for doctors. Its bad at a a public academic hospital where ungrateful, fat, lazy, welfare people, illegal aliens get a million dollar workup and are pissed because they were discharged five minutes late. Lot of you are thinking, "wow this guy is an ass who doesn't belong in medicine" Well to be honest, I used to be so liberal and went into medicine like most people did, to use our knowledge to help sick people. But sadly in three months of internship i'm already so jaded and disillusioned by the whole health care system. I dont ever want to hear "I'm allergic to morphine but this drug that starts with a "D" is the only thing that works for me" Thank god its only a year of this **** then I'm off to doing what I always wanted to do "Putting these increasingly obese public hospital tubs of crap to sleep while IM residents get to deal with discharges and h and ps and social work rounds for another 3 years. There is nothing I hate more than social work, discharge planning, subacute blah blah blah rounds. And after residency off to private practice in the suburbs away from the nightmare that is socialized medicine at a big academic public hospital. To my bros in anesthesia, we chose wisely. To all you poor fellows stuck in IM or surgery, may god have mercy on your soul. Oh and to all the other programs at my hospital that we anesthesia folks are farmed out to in our internship do their dirty work, f*&k you all you b*&stards". To the EM program who makes us do 26 10 hour shifts in one month while their interns do 11 8 hour shifts and then tell me after I miss my last shift because I'm puking my guts out from food poisioning that I have to make up the shift during a day off on one of my other months, eat a fat "d83k.

"The most pissed off intern"

 

[Jimmy1]

ah, I love this thread. Makes me feel normal.

 

[Tired]

I truly hate the ER nurses... I think they are under the impression that just cause you are on call and they are awake.. well then the entire world should be awake as well. Yeah.. lets consult colorectal surgery, dermatology, psychiatry and the rest of the non-emergent services at 3 am in the morning... God forbid you should wait till 6 am.

That's not the nurse's fault though, that's the ER docs (ie - Kings of Turf).

One night I was covering for Urology, got a consult for balanitis in a 3 month old.

It was diaper rash.

 

[Apollyon]

A couple thoughts:

1. fibromyalgia = CFS = interstitial cystitis = depression. Somatic complaints for psychological problems. I told a patient this (with the FM dx), and that I was NOT saying that she was crazy, but it was somatic representations of psychological problems. She agreed with me.

2. Pain, from zero to 10, with 10 "not being the worst pain you've ever felt, but the worst you can imagine". Couple of things about that - I had a colleague in residency who would say, "so, if I punched you in the face right now, would that make the pain worse?", and there was a pain doc that I rotated with for 2 days on my anesthesia block, and his was "so, if 10/10 is one foot in boiling oil, would putting the other foot in boiling oil make it worse?"

3. Our financial people ask for $150 up front, less the copay. You know who pays, though? The Hispanic patients - some will pay THE ENTIRE BILL right there - with wads and wads of cash. Why? Bills --> collections --> immigration --> deport! The joke of "self-pay = no pay" isn't true with the Hispanic patients.

4. I apologize for sucky EDs and EM docs - dollars to doughnuts, they're not EM-trained, and that's why the ****ty consults come around. I'm really lucky where I'm at - there are primary care residencies, and, almost to a person, they're all happy-go-lucky. There's one IM resident whose judgment is horrible, and I actually admitted a patient to the hospitalists, telling the hospitalist - within earshot of this resident - that I do not trust his judgment, and that he would do the wrong thing. However, as another example, there was a patient one day I would have bet you $10 had perfed an ulcer, and one of the surgery residents was just itching to go to the OR. When the CT showed that he was not perfed, the resident said, "That's OK - right now, someone somewhere is hoisting a beer with his keys in his hands!"

 

[fineline]

That's not the nurse's fault though, that's the ER docs (ie - Kings of Turf).

One night I was covering for Urology, got a consult for balanitis in a 3 month old.

It was diaper rash.

Got you beat. I was consulted for cellulitis and it was an ischemic leg. And, yes, these were EM physicians at an EM-training program, not FPs covering or ER PAs.

 

[Apollyon]

Got you beat. I was consulted for cellulitis and it was an ischemic leg. And, yes, these were EM physicians at an EM-training program, not FPs covering or ER PAs.

Hmm...I call BS for a few reasons. 1. you've told your story about why you got canned ad infinitum, but never told this one before. 2. You were an intern when you got canned, so you wouldn't get the consult. 3. Ischemic leg? Pale, white, pulseless - cellulitis, red, beefy, tender. Cellulitis and DVT are often indistinguishable, but even a lay person could look at an ischemic leg and a cellulitic leg and tell the difference.

No matter what, you will always one-up when it comes to EM - since you won't say where, your stories are unverifiable, and, on the Internet, no one knows you're a dog. In other words, if it's not non-EM people, it's EM. If it's not residents, it's EM-trained attendings. If it's not EM-trained attendings, it's the department chair. Likewise, the problem becomes more minimal and absurd. "I got you beat - I got consulted for a diabetic foot, but it was gangrene and fell off in my hand" (<-- that is a true story, modified at one of our community hospitals - guy says, "my foot has been hurting, so I put my leg into a plastic bag" - when they took the bag away, his gangrenous self-BKA came with it).

 

[Jimmy1]

Woah- let's not turn this into a EM-bashing thread. We all know that everyone thinks everyone outside their chosen specialty is stupid.

 

[Blade28]

Woah- let's not turn this into a EM-bashing thread. We all know that everyone thinks everyone outside their chosen specialty is stupid.

Yeah, but only us surgeons are actually right.

 

[Winged Scapula]

You were an intern when you got canned, so you wouldn't get the consult.

Why not? Wherever I've worked its the intern who carries the service pager that gets all the consults...its service dependent as to whether or not the intern actually sees the consults, sees them with the Chief or attending, or passes them on to someone more senior.

That's why I was always amused at some "what do you think" consults...as if the fresh intern knew more than the senior ED resident or attending.

Whether or not the story is true, there is no reason to publically bash the poster.

 

[Tired]

Whether or not the story is true, there is no reason to publically bash the poster.

Publicly bashing posters is the new du jour here, hadn't you heard?

Now if only you would let Genetics come back . . .

 

[fineline]

Hmm...I call ...

Typical EM physician, he's calling someone. LOL. (That's the joke before the ripping begins.) Dude, you're wrong about everything -- don't blame me because you made some false conclusions. I wasn't an intern, I also didn't time-stamp this post, you don't even know what specialty I was in, and you don't know if this happened in med school or residency. That being said, great leap of failure you showed there.

I don't LIKE bashing EM physicians, but neither do I LIKE the way EM physicians act. You think if I could get rid of these ******s in exchange for never having to complain about it I wouldn't jump on that ride PRONTO? You're going to blame ME for talking about it, rather than THEM for acting like it just because it's YOUR specialty? Please, dude. You've gotta be joking. You know what's the best? I tell this attending that it's an ischemic leg and she doesn't care. All she cares about is moving the patient onto our service. She does one of these:

"Oh, ischemia? Huh! That's horrible! You guys are going to take her, right?" Actually, we talked with her family and since she has so many co-morbidities, they opted not to undergo a procedure. "Ah, good choice. So who do you think would be appropriate for her to go to?"

Are you kidding me? Is that what it's come to? I mean, she told me the patient had "some weird cellulitis going on" and turns out it's ischemia and she doesn't even care about where she missed the boat? Or that she didn't really examine the patient? And if you think nobody other than me has ever had one of those conversations, then you're naive.

You know what, sorry if you take these things personally, but unfortunately it's my experience and I know it's a lot of other peoples'. So tough.

 

[fineline]

Whether or not the story is true, there is no reason to publically bash the poster.

I welcome all bashing. I only stipulate that the person can take their public whipping like a man. (Or, if it's a wimmen, that she return humbly to the kitchen and MAKE ME SOME PAH!!)

 

[Apollyon]

you don't even know what specialty I was in

Yeah I do - remember, you told me?

I may still have the PM.

 

[fineline]

Uh oh. This could be trouble!!! Run!!!

 

[Faebinder]

The intern on our service always gets the consult call... The attending and the chief see the consult after the intern sees it first.

 

[Pekoe]

Edited later-- that sounds like athletic burnout. The only thing is, athletes have an off season and can recover while you have to adapt. No tips, other than that I wish you well.

 

[dynx]

And now for something completely different:

I used to be a pretty decent figure skater at my state level. I was going out and suddenly, I just didn't want to be there any more. My dad was furious, "What happened out there? You skated like you had lead in your skates!" I did have lead, but it was in my mind. Years of work fizzled. I was never able to get out there again and perform. I didn't know what happened. My parents had dollar signs flashing before their eyes.

My brother was a hockey player and he played all over the country.
One day it happened to him, but he knew of the burn-out and he called me a lot. He couldn't admit it to his team mates, but he was just feeling terrible.

I think that what doctors go through is a lot like athletic training. You are saturated for years learning, then you are being treated like excrement even though you have made it so far and there are still people better than you who flaunt it and there is nothing you can do about it, and the main event is happening and in spite of being here for a while and knowing what it would be like, your are fatigued from the heavy mental and physical work that you do. The greatest challenge to MD's is that you don't have the end of season that athletes have.

This is hard, but make sure you are getting live food (fruits and vegetables, not aquarium fish) and hang on. See a psychologist if you think you need it-- I suggest a sports psychologist because they are not interested in feelings so much as getting you out to play again and be in top form.

 

[deleted87716]

And now for something completely different:

You mean, something on-topic? It's nice to know that some people actually read the OP.

 

[dynx]

You mean, something on-topic? It's nice to know that some people actually read the OP.

touche

 

[Jimmy1]

Typical EM physician, he's calling someone. LOL. (That's the joke before the ripping begins.) Dude, you're wrong about everything -- don't blame me because you made some false conclusions. I wasn't an intern, I also didn't time-stamp this post, you don't even know what specialty I was in, and you don't know if this happened in med school or residency. That being said, great leap of failure you showed there.

I don't LIKE bashing EM physicians, but neither do I LIKE the way EM physicians act. You think if I could get rid of these ******s in exchange for never having to complain about it I wouldn't jump on that ride PRONTO? You're going to blame ME for talking about it, rather than THEM for acting like it just because it's YOUR specialty? Please, dude. You've gotta be joking. You know what's the best? I tell this attending that it's an ischemic leg and she doesn't care. All she cares about is moving the patient onto our service. She does one of these:

"Oh, ischemia? Huh! That's horrible! You guys are going to take her, right?" Actually, we talked with her family and since she has so many co-morbidities, they opted not to undergo a procedure. "Ah, good choice. So who do you think would be appropriate for her to go to?"

Are you kidding me? Is that what it's come to? I mean, she told me the patient had "some weird cellulitis going on" and turns out it's ischemia and she doesn't even care about where she missed the boat? Or that she didn't really examine the patient? And if you think nobody other than me has ever had one of those conversations, then you're naive.

You know what, sorry if you take these things personally, but unfortunately it's my experience and I know it's a lot of other peoples'. So tough.

Everyone can tell a story about some dumb comment a physician in another field has made, or some clinical judgement that was way off. Please. I have seen docs in every specialty do/say some pretty idiotic things. No physician is perfect, and no doctor knows everything. We all make mistakes. That is why we have a residency and we continue to practice medicine. So get off your EM-bashing train.

 

[fineline]

Everyone can tell a story about some dumb comment a physician in another field has made, or some clinical judgement that was way off. Please. I have seen docs in every specialty do/say some pretty idiotic things. No physician is perfect, and no doctor knows everything. We all make mistakes. That is why we have a residency and we continue to practice medicine. So get off your EM-bashing train.

Agreed, everyone makes mistakes and often huge ones that are ridiculous. That's whether you're in training or after training. What I'm DON'T buy and will NEVER buy is that I'm supposed to accept the EM mode of practice as a physician. It's one thing to make a mistake, it's another to have a complete lack of interest in a patient as a physician. If a person comes into the ER with CC "RLQ pain," the diagnosis instantly becomes "appendicitis." And that's FINE because it'll probably be right or else something that can be worked up later, except that this is the end of the road -- there's usually no accurate history or physicial other than "Abd: RLQ tender to palp."

Now, did I just describe to you something that seems acceptable as a physician? If so, why did you go to medical school? Anyone can go "chest pain = MI until proven otherwise" "RLQ = appendicitis," "RUQ = cholecystitis." Like I said, you can defend that all by saying, "my business is to find out what's going to kill them." OK, but then most times I don't get an accurate story or exam. "It's not my job to diagnose." OK, so your job is to make a diagnostic guess and call someone who will actually perform the duties that we were all taught in medical school? And I'm supposed to not make fun of that because you also have a medical degree like me? Forget that.

EDIT: And before anyone says I'm "off topic," I most certainly am not. The field of EM has caused my disillusionment with the medical field more than anything else could or would. Everyone I knew from my medical school who went into EM was smart (book-smart, but lazy), but guess what? Now they're just triage nurses who don't think, don't diagnose, and are clinically sloppy despite having trained at some excellent institutions. You know how dispiriting that is? Or how frustrating it is to get called by someone who is supposed to be at your level of training and it's like getting called by a medical student? Before they started their ward months?

 

[deleted87716]

Everyone I knew from my medical school who went into EM was smart (book-smart, but lazy), but guess what? Now they're just triage nurses who don't think, don't diagnose, and are clinically sloppy despite having trained at some excellent institutions. You know how dispiriting that is? Or how frustrating it is to get called by someone who is supposed to be at your level of training and it's like getting called by a medical student? Before they started their ward months?

God, grant me the serenity
to accept the things I cannot change;
the courage to change the things I can;
and the wisdom to know the difference. - Reinhold Niebuhr

 

[turkleton]

Man, this makes me feel normal. I felt guilty about how angry I got at the absolute asinine behavior of some staff. At our hospital, nursing will routinely page you to a phone they're no where close to so you stand for five minutes, waiting for to answer an absolutely ridiculous question ["Dr. pt's BP (perfectly healthy SLEEPING 19 yo is 89/60, do you want to do something) "Dr. pt is NPO for the procedure, but can I give him some breakfast?" ] while you stand in front of you pager crying because it wont stop blowing up.

The worst is when nursing ignore, or just don't fill out your orders, and you get reemed about it on rounds. Or when they constantly barrage you with pages to give some one narcotics for pain- everyone does NOT NEED MORPHINE, particularly not alcoholic cirrhotics- until you yield, give them narcs and then get it handed to you during morning rounds.

I'll admit I was initially intimated by nursing during the first few weeks of internship and impressed with their command of medical knowledge. That passed quickly. Although, I will say the ICU nurses are fantastic, most probably could have been doctors.

Oh and I get pissed about ER all the time. Although, I know with absolute certainty, other services get upset at the way we do things. This just seems like standard hospital protocol- when things go wrong, take the easy way out and blame the guy before. When you're tucked away in your own niche, you don't know how hard it is to see 20 ER pts in an hour, spend 10 hours doing an operation, or agonize over forgotten important aspects of patient care (IM). Most fields are staffed with bright people, struggling to survive just like you.

 

[fineline]

God, grant me the serenity
to accept the things I cannot change;
the courage to change the things I can;
and the wisdom to know the difference. - Reinhold Niebuhr

God didn't give me none of those things! I wuz robbed!!

 

[Pekoe]

You mean, something on-topic? It's nice to know that some people actually read the OP.

The OP was talking about I thought was burn out. I meant to relate it to that with athletics. You don't miss practices. You don't decide to walk out on a game or a competition. It the same with training to do anything that matters. You may want to stop because it gets to be so much, but you can't because you put so much into it.

I am finding as I get back into school, it's the same thing and in order to make the best grades possible for how I do things, I just don't slow down. Studying is my life now just as skating was when I was a teenager. I wonder if in a few years I will get burnt out and it scares me. I thought that I related it to that. FAIL

 

[divinemsm]

..dude..in all seriousness..I think we have been co-interns this year..LMFAO!!!..I wonder...

Internship at a top academic hospital is pure fricken hell. I'm going into anesthesia and happened to match at a place that doesnt allow you to choose your own intern year. Man, I had this sweet cush transitional year all set up, had the ins but now im stuck doing a "Clinical Base Year" which pretty much means "Scut monkey that gets **** on by Surgeons and Internal Medicine people Year". And I'm surrounded by a bunch of whiny uptight kiss ass gunners with no sense of humor. I'm routinely stuck at the hospital until 9 pm because this whiny uptight fugly internal medicine intern is constantly PMSing and refuses to take sign out from me. And I'm surrounded by a bunch of fat and ugly nurses whose only job is to page me with constant "FYIs" about **** I could care less about. "Patients temperature is 100.1, do you want to start antibiotics?" or on Cards in regards to a patient with NICM "FYI, patient had a three beat run of v-tach but is asleep, can you come see the patient". Or my goddamn favorite on my last call at 3 am on a crosscover patient, "Patient has a rash on his arm, can you come look at it and write for something". Do I look like a hot girl derm resident? No bitch, can I bring my foot to your fat ass? I'm so sick of the lack of respect nurses have for residents at academic hospitals. They constantly question orders with "why". Cause I said so, I'm the doctor, you're the nurse, deal with it. And I cant deal with the disrpespect patients have for doctors. Its bad at a a public academic hospital where ungrateful, fat, lazy, welfare people, illegal aliens get a million dollar workup and are pissed because they were discharged five minutes late. Lot of you are thinking, "wow this guy is an ass who doesn't belong in medicine" Well to be honest, I used to be so liberal and went into medicine like most people did, to use our knowledge to help sick people. But sadly in three months of internship i'm already so jaded and disillusioned by the whole health care system. I dont ever want to hear "I'm allergic to morphine but this drug that starts with a "D" is the only thing that works for me" Thank god its only a year of this **** then I'm off to doing what I always wanted to do "Putting these increasingly obese public hospital tubs of crap to sleep while IM residents get to deal with discharges and h and ps and social work rounds for another 3 years. There is nothing I hate more than social work, discharge planning, subacute blah blah blah rounds. And after residency off to private practice in the suburbs away from the nightmare that is socialized medicine at a big academic public hospital. To my bros in anesthesia, we chose wisely. To all you poor fellows stuck in IM or surgery, may god have mercy on your soul. Oh and to all the other programs at my hospital that we anesthesia folks are farmed out to in our internship do their dirty work, f*&k you all you b*&stards". To the EM program who makes us do 26 10 hour shifts in one month while their interns do 11 8 hour shifts and then tell me after I miss my last shift because I'm puking my guts out from food poisioning that I have to make up the shift during a day off on one of my other months, eat a fat "d83k.

"The most pissed off intern"

 

[fineline]

I just want to mention that it's hilarious that he used to be ultra-liberal and for socialized medicine. Everyone who is ******ed like that should be required MANDATORY to be primary care physicians and put their money where their mouth is. It's pretty cheap to be all for socialized medicine and then get to where you have to provide it and wimp out and go, "uh ...Anesthesiology, here I come!!!"

 

[lfcdoc]

How ironic. I was just sitting next to a 4th year med student in some conference the other day and told her the exact same thing. I think I'm actually getting dumber with regards to medicine knowledge. I couldn't even remember subarachnoid hemorrhage and temporal arteritis on my headache differential the other day in the ER. I mean, I graduated with honors--I'm not an idiot but those are big things to miss. I'm too busy figuiring out how to get an urgent IR procedure done and trying to get patients into clinics and dealing with obnoxious clerks (lots of people seem to like to complain about the nurses but IMHO, it's the clerks that make my life miserable). Actually learning medicine seesm way down on the priority list when it comes to patient care.

I too often feel that in regrads to my "fund of knowledge" I am loosing ground as a intern. As a student I had time to study and the motivation to do so but know I feel so often I'm not really learning medicine at work that I find it harder to find the time and motivation to keep reading etc. I haven't seemed to be able to fix this yet so no great advice to offer, just that I can relate. I have been told though that you really don't start to learn much untill aroudn Nov. or Dec. so perhpas once we get more and more efficient with the paperwork etc. we will have more time to dive into the medicine. That's my hope. I know I really miss having the time to go to noon coferences etc. as I always enjoyed those.

 

[jonnylingo]

:I wonder if in a few years I will get burnt out and it scares me. I thought that I related it to that.

I'm feeling the burn now as an intern, especially when talking to friends now making serious bank in business, pharm, banking, public health, etc.

I'm pushing 30 and I have yet to bring home a decent paycheck for my wife and two kids. Feels like I'm a renter for life, living from paycheck to paycheck, praying my car doesn't completely break down tomorrow. In what other field are you mid 30's before you make a living? Not to mention the 120,000lb gorilla you carry in student loans till retirement.

Done venting...

 

[coffeebeing]

Now halfway through internship, I am even more disillusioned. Things have not gotten better. I dread going to work everyday andcan't stop thinking about putting myself out of this misery, that is to say leave medicine altogether. I just might quit after this year and go start a business or something. I've had enough.:cry: