Should I RESIGN or be terminated & FIGHT?

[IlDestriero]

You need to replace the culture of laziness with the culture of safety.
When the hospital's reimbursement is tied to quality care these lazy dinosaurs will be out on their asses as well, and it won't take long.

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[ruralsurg4now]

No, I would have told the nurse to pull the Foley catheter, and they would have. I'm not sure where the breakdown in communication comes in. They say "are you sure, she's old, decrepit, dessicated, etc.". That's reasonable and appropriate to confirm and address their concerns. I would have listened and said "yes, please take it out" and probably mentioned the new policy and that the patient was mobile, or whatever.
When did you all give this power to the floor nurses? It's not a PRN order.

It's not a breakdown in communication. The nurse was lazy and didn't want to get the patient up if she needed to void. I found out after I joined that the hospital has a culture where, as long as things aren't viewed as egregious, attendings don't want to fight with the nurses. That's also why I didn't give a damn about it. I wrote the order and talked to the nurse and nurse manager. My conscience is clear. That's also why I didn't write a second order. It stopped being my problem three days prior.

I talked to the nurse manager because I figured that with our metrics, she'd be all over the nurse's ass, but apparently she also sucked.

 

[DrT2202]

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

As a FTD with only 1 year of residency I'm limited to licensure in 3 states only. I got a license already to 1 of them but I feel hurt. It's a hit to your pride and I feel back stabbed and judged. It's a humbling experience and now I want to prove to the whole world that I'm better than they think I am.

 

[DrT2202]

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

Ruralsurg has been a great help and source of relief for me along with other docs, attendings and def the progdirector. The anonymous nature of the website is amazing. Thank you everyone responsible and contributor in this thread.

 

[DrT2202]

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

I agree with you; I wasn't the most perfect fit. But it shouldn't be that easy and that subjective to get a RESIDENT out of the program like that. I was even told by the PD that "you have options" so it didn't really irk his/her sleep. The "favorite" snow flake residents were my friends at the beginning of the program and a common theme was them trying to get into a 2nd year of residency to gain licensure in much more states than you would with 1 year. they came to me for advice about licensure and applying to programs. They def had some jalousy that I was in my 2nd year and on my way to get licensure in cool states to live in. In the reasons presented against me were that residents think I'm opinionated and not a team player. how can they say that? and why wasn't I informed? and they mentioned that they didn't want to pair up with me on a practical exercise. Why is that my fault? Did I ever insult/fight or do anything bad to them? U don't like my opinion and suddenly one of the residents who was closest to me turns on me and takes the rest of her close friends from the same sex with her? and they're the favorites? Who's the judge of that? I'm not perfect and I made mistakes but not to the point of lying in reports (which happened) and getting me out without corrective action or clear warning. programs have so much power and the contracts and laws are written in a way that gives them all the advantage and you can't beat them. Too sad.

 

[ruralsurg4now]

Ruralsurg has been a great help and source of relief for me along with other docs, attendings and def the progdirector. The anonymous nature of the website is amazing. Thank you everyone responsible and contributor in this thread.

No problem, it's always good to help someone out.

 

[michaelrack]

and suddenly one of the residents who was closest to me turns on me and takes the rest of her close friends from the same sex with her.

Now were are starting to get to the bottom of your residency difficulties...who rejected who?

 

[Modeselektor]

This was a worthwhile thread to read, because of all the viewpoints, stories and info.
Cheers.

 

[DrT2202]

Now were are starting to get to the bottom of your residency difficulties...who rejected who?

It's not who rejected who. it's just a co-resident who I've been in touch with before the program. Had a small dis-agreement, became friends again then suddenly over a silly argument (like I'm talking and then he/she would say "let me tell you this, oh well never mind" then I was " come on, when ur talking to me, don't just quit mid sentence" afterwards we didn't talk again. I wasn't the most diplomatic person and that didn't help my popularity. I was too confident, too secure. This experience is humbling. Can't find a job so far. It's really tough.

 

[Modeselektor]

Outside of your job duties you have to do what you can to help maintain the smooth running of the facility as well as ensure patient and staff satisfaction, making sure your boss never has to step in or even think about you. Your job is NOT to judge anyone or express opinions about sex, religion, politics, or make ANYONE feel uncomfortable. This interferes with the normal functioning of the system and like a bad part in machine you will be ousted.

People may call it being PC, touchy-feely and a kiss-up, but if you're not sincerely concerned about the staff, customers and your boss, why should they care about you?

It's really as easy as putting others before you in conversation, taking nothing personally, taking interest in how everyone is doing and doing what you can to bring them up. 90% of the time all you have to do is drop the ego for a second, listen and reiterate what they said before you speak.

Its like doctors who complain about nurses. Most of the time docs think they're better than the staff. That's childish. If you recognize everyone is important, make them feel so and value their input things will run much more smoothly, everyone will be happier, the patients will get better care and your boss will get less headaches.

 

[DrT2202]

Outside of your job duties you have to do what you can to help maintain the smooth running of the facility as well as ensure patient and staff satisfaction, making sure your boss never has to step in or even think about you. Your job is NOT to judge anyone or express opinions about sex, religion, politics, or make ANYONE feel uncomfortable. This interferes with the normal functioning of the system and like a bad part in machine you will be ousted.

People may call it being PC, touchy-feely and a kiss-up, but if you're not sincerely concerned about the staff, customers and your boss, why should they care about you?

It's really as easy as putting others before you in conversation, taking nothing personally, taking interest in how everyone is doing and doing what you can to bring them up. 90% of the time all you have to do is drop the ego for a second, listen and reiterate what they said before you speak.

Its like doctors who complain about nurses. Most of the time docs think they're better than the staff. That's childish. If you recognize everyone is important, make them feel so and value their input things will run much more smoothly, everyone will be happier, the patients will get better care and your boss will get less headaches.

Well said. However, I never judged anyone.

 

[Modeselektor]

I apologize for the assumption. Wish you the best of luck of course!

 

[ruralsurg4now]

Dude, that's horrible advice. I always laugh when people say stuff like "recognize that everyone is important, etc, etc." You see, people have no problem giving such advice to physicians, but you never see anyone giving that advice to anyone else. When they talk to other people, it's like "realize that you're equally important as doctors." It's basically socialism of hierarchy, where the key to harmony in the hospital is to undermine certain peoples' self-worth while building up other peoples' until everyone is equal.

 

[Modeselektor]

But they are important. I did not mean that being equally important meant impinging on a doctors jurisdiction and undermining him.

I meant as recognizing the part that a nurse plays and the part a doctor plays are both important in the care of a patient, and to not talk down to the staff like I've seen on occasion. That if someone has something to say, then listen.


The best attendings I've seen have a way about treating everyone decently and making them feel important and respected.

 

[ruralsurg4now]

Well, as long as you mean it in that manner, I can go along with that.

 

[jeffblue]

But they are important. I did not mean that being equally important meant impinging on a doctors jurisdiction and undermining him.

I meant as recognizing the part that a nurse plays and the part a doctor plays are both important in the care of a patient, and to not talk down to the staff like I've seen on occasion. That if someone has something to say, then listen.


The best attendings I've seen have a way about treating everyone decently and making them feel important and respected.

I don't know how long you have been in patient care.
Ruralsurg for now has outdone him/herself. I agree with him/her.

You can ask a nurse what the vitals are and she/he will interpret it as "talking down" to them.
Your goal/job/objective as a physician is safe patient care. your job is not to make every ancillary staff happy/ and feel important. If they feel slighted well so be it . Get another job. Get out of whatever they are doing because making them feel important is making me feel less important and uncomfortable. At the end of the day who do you want to be more comfortable and feel important? I agree with treat everyone with respect however.

 

[SouthernSurgeon]

Two points:

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

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

Urban legend has it that when a certain older endocrinologist in our area felt that a patient needed a referral to a surgeon, he would literally write on a prescription pad "Thyroidectomy" and give it to the patient to take with them to the surgeon.

 

[ruralsurg4now]

Urban legend has it that when a certain older endocrinologist in our area felt that a patient needed a referral to a surgeon, he would literally write on a prescription pad "Thyroidectomy" and give it to the patient to take with them to the surgeon.

That's actually not unreasonable, since there are clear reasons to perform those. It's pretty hard to get those wrong.

 

[Modeselektor]

I don't know how long you have been in patient care.
Ruralsurg for now has outdone him/herself. I agree with him/her.

You can ask a nurse what the vitals are and she/he will interpret it as "talking down" to them.
Your goal/job/objective as a physician is safe patient care. your job is not to make every ancillary staff happy/ and feel important. If they feel slighted well so be it . Get another job. Get out of whatever they are doing because making them feel important is making me feel less important and uncomfortable. At the end of the day who do you want to be more comfortable and feel important? I agree with treat everyone with respect however.

I take it what you mean is that certain staff members will simply take everything you say as talking down to them?

Sigh, I haven't encountered this where I practice. I would assume they would be reasonable elsewhere, but in those cases I would do as you say: Just being respectful.