Stupid things I heard throughout residency

[TheLoneWolf]

Story 1

Had multiple attendings in the VA who pretty much treat them at parity with full picks in the schedule and pushing residents around. The most incompetent attendings would call these CRNAs 'doctor', buddy buddy always.

One favorite moment comes to memory, VA attending decades experience, No ABA certification, kicked out of her last group:

Attending when Im a CA-1 at the VA inbetween cases:

Attending : what is the correct dose of midazolam in a parkinsons patient?

Me: It depends

Attending: wrong, you must know just based on the disease process

Me: umm there are multiple factors which have not been looked at, I cant make a blanket statement about any drug without knowing age, weight, comorbidities, meds

Attending: wrong. you must know this. It is absolutely contraindicated in parkinsons patients, it will cause respiratory arrest at even 1 mg. You will kill someone if you do.

Me: stares in disbelief, looks at nearby computer, type keywords in, no hits or studies or case reports

Attending: red in face, shouting 'are you even listening' pay attention

Me: sorry I cant find anything related to this

Attending: Listen boy I am telling you about life, anesthesia is not about books or studies, its about experience. If you give even 1 mg versed to a parkinsons patient they will go apenic and code.

Me: umm thanks for the info

Attending proceeds to complain to the department and writes it in my daily eval

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[Psai]

Careful bro...

 

[TheLoneWolf]

Story 2 'Fire him now'

Hospital had reputation of slow turnovers so hired new consultants to change this. Now, fast turnovers (10-15 mins tops) for OR cases, only slower for robots. I push a patient out and cleaning and anesthesia techs are waiting to rush in. Drop off patient to PACU, signout, write orders, then run to holding for next patient. Pretty much everyone is rushing around like a bee outside of the OR. Everything is setup in the morning, techs can bring in a line central line setups and kits on short notice.

CA-1 Long case for gen surg. Get relieved by CRNA later in the day, militant type, thinks she knows better than any doctor. Give signout, about to leave and she looks at the a line bag and freaks out. "This is LR, not saline, which tech made this up?" I tell her so and so tech brought it in at the beginning of the case. She says " This is absolutely unacceptable, he needs to be fired NOW. You know he did this once before". I say the cuff readings are the same as these readings and its probably an innocent enough mistake. She kept insisting that LR cannot be used in an a-line as it will completely throw off your numbers. She wouldnt drop the thing over this tech and kept insisting that she would file a report and have him fired over it.

I went home thinking am I missing something here? Im pretty sure she is incorrect. Multiple literature searches with nothing to support this.

Could only find a paper from 1987 Hook Et al. where they used lactated ringers.
Comparison of the patency of arterial lines maintained with heparinized and nonheparinized infusions. The Cardiovascular Intensive Care Unit Nursing Research Committee of St. Luke's Hospital

I guess she was having a bad day or someone really likes that tech cause nothing came of it.

 

[Iso4ane]

Careful bro...

Why? I like working with all my attendings and I can’t pick a favorite as each is special in their own way.

 

[pgg]

Why? I like working with all my attendings and I can’t pick a favorite as each is special in their own way.

I think what Psai is getting at is these aren't necessarily stories a resident would speak in person to the program director or department chair, and that

1) posting them anonymously on the internet is about 2 degrees of Kevin Bacon away from doing just that

2) letting the justifiable irritation and disgust expressed here surface in one's daily resident life isn't likely to make life any better

Hence be careful. As our old friend Jet would say, bow your head, learn from the bad examples those people set, and resolve to never be like them.

 

[Twiggidy]

I think what Psai is getting at is these aren't necessarily stories a resident would speak in person to the program director or department chair, and that

1) posting them anonymously on the internet is about 2 degrees of Kevin Bacon away from doing just that

2) letting the justifiable irritation and disgust expressed here surface in one's daily resident life isn't likely to make life any better

Hence be careful. As our old friend Jet would say, bow your head, learn from the bad examples those people set, and resolve to never be like them.

Agree. The key to residency is just to always be respectful. "Yes sir/ma'am" "No sir/ ma'am" "I'm not sure I'll read up on that tonight" and if someone is being ridiculous inform the PD. If the PD doesn't back you then just realize your program leadership is trash and keep a low profile, study, graduate, and don't look in the rearview.

 

[Twiggidy]

Quite frankly no program should have attendings that aren’t board certified teaching residents or else’ they’re told stupid stuff as described.

 

[TheLoneWolf]

Agree. The key to residency is just to always be respectful. "Yes sir/ma'am" "No sir/ ma'am" "I'm not sure I'll read up on that tonight" and if someone is being ridiculous inform the PD. If the PD doesn't back you then just realize your program leadership is trash and keep a low profile, study, graduate, and don't look in the rearview.

Been there and done that. Prior poster in other thread mentioned anywhere out of there was much greener grass. Very true. Occasionally nice to look in the rearview mirror and know I survived the dumpster fire intact.

 

[Shimmy8]

Based on posts in the last month alone, OP sounds like the resident who thinks he/she is better than his/her attendings.

Maybe it’s the truth, but I know that these complaints sounds like incessant residency whining that EVERYONE endures at one point or another.

Folks I worked with that acted/thought like this, well, frankly, weren’t people I’d want to be my colleagues.

Again. Be careful.

 

[Iso4ane]

I think what Psai is getting at is these aren't necessarily stories a resident would speak in person to the program director or department chair, and that

1) posting them anonymously on the internet is about 2 degrees of Kevin Bacon away from doing just that

2) letting the justifiable irritation and disgust expressed here surface in one's daily resident life isn't likely to make life any better

Hence be careful. As our old friend Jet would say, bow your head, learn from the bad examples those people set, and resolve to never be like them.

It really is hard to be sarcastic in text. But, I totally got the message the first time.

 

[woopedazz]

Sometimes I hear the sound of m own voice. The **** that comes out of my mouth...

 

[MoMoGesiologist]

I don't get what the big deal is. I think it's great stress relief to commiserate with people who are going through the same thing. When online, just make sure it's de-identified or anonymous enough.

Stupid thing that I hear that I have to shut my mouth about: "OMG LR is contraindicated in hyperkalema what are you doing!? Are you dumb!?"

Myth-busting: Lactated Ringers is safe in hyperkalemia, and is superior to NS.

 

[GravelRider]

The real question is this: did you learn the proper way to tape the tube?

Residency is all about saying “gee thanks, I never would have thought a counterclockwise swirl of tape around the tube would have made a difference, but that is a really great tip.” Play the game and move on.

 

[deleted162650]

The real question is this: did you learn the proper way to tape the tube?

Residency is all about saying “gee thanks, I never would have thought a counterclockwise swirl of tape around the tube would have made a difference, but that is a really great tip.” Play the game and move on.

Well to be fair, only a dipsh*t would tape it clockwise.

 

[acidbase1]

Quite frankly no program should have attendings that aren’t board certified teaching residents or else’ they’re told stupid stuff as described.

Some have residents sit cases with CRNAs

 

[anbuitachi]

Agree. The key to residency is just to always be respectful. "Yes sir/ma'am" "No sir/ ma'am" "I'm not sure I'll read up on that tonight" and if someone is being ridiculous inform the PD. If the PD doesn't back you then just realize your program leadership is trash and keep a low profile, study, graduate, and don't look in the rearview.

there are residents who actually say sir/maam to attendings? i've never heard of that one before

 

[MirrorTodd]

there are residents who actually say sir/maam to attendings? i've never heard of that one before

Why would you not?

 

[pgg]

The real question is this: did you learn the proper way to tape the tube?

Residency is all about saying “gee thanks, I never would have thought a counterclockwise swirl of tape around the tube would have made a difference, but that is a really great tip.” Play the game and move on.

 

[Shimmy8]

If you’re from the south or have military background, not uncommon to hear sir/ma’am.

And sir/ma’am >>>>> infinity >>>>> first names (unless specifically told to do so.)

 

[24GaugeEJ]

What’s that written on your hand?!?

 

[Psai]

The real question is this: did you learn the proper way to tape the tube?

Residency is all about saying “gee thanks, I never would have thought a counterclockwise swirl of tape around the tube would have made a difference, but that is a really great tip.” Play the game and move on.

I just realised I always go counterclockwise and never questioned it until just now

 

[GravelRider]

Well to be fair, only a dipsh*t would tape it clockwise.

I prefer the clockwise swirl, but it’s not written in stone.

 

[anbuitachi]

Why would you not?

If you’re from the south or have military background, not uncommon to hear sir/ma’am.

And sir/ma’am >>>>> infinity >>>>> first names (unless specifically told to do so.)

guess military would make sense. it just never occured to me cause ive never heard of it. it also just sounds weird and seems not really necessary. do anesth residents call attendings in other fields sir/maam too in conversations?

 

[Twiggidy]

there are residents who actually say sir/maam to attendings? i've never heard of that one before

It’s being sarcastic and respectful at the same time.

 

[Twiggidy]

guess military would make sense. it just never occured to me cause ive never heard of it. it also just sounds weird and seems not really necessary. do anesth residents call attendings in other fields sir/maam too in conversations?

That’s the point of the effect. Im calling you sir in response to being chastised and you’ve never heard anyone call your sir. So not only does it sound strange but you know I’m possibly being an A hole. But what can anyone tell a PD? “This resident is a jerk because he called me “sir”? Well...okay

 

[Twiggidy]

I prefer the clockwise swirl, but it’s not written in stone.

I had an attending who wanted everyone to tape the tube on the left side for his case. Never really
had a good reason just wanted it that way.

 

[deleted547339]

guess military would make sense. it just never occured to me cause ive never heard of it. it also just sounds weird and seems not really necessary. do anesth residents call attendings in other fields sir/maam too in conversations?

I’m from the South. It was sir and ma’am all through residency and fellowships to staff of all specialties. It took me a good year to start calling the subset of attendings who went exclusively by their first name (with everyone) by their first name.

It’s how we were raised.

 

[neutro]

Even today, I call some of my senior attendings as "sir". Its just a reflex as thats how I was raised. I dont think twice about it. Its not meant to be insincere and they know that I am not below them, and in fact at times, have more qualifications -its hard to explain, I guess you can say that its a means to have respectful speech and conversation.

 

[neutro]

I had an attending who wanted everyone to tape the tube on the left side for his case. Never really
had a good reason just wanted it that way.

i cant tell you how many times as a CA-1 i forgot to turn the vent on after induction because instead of paying attention to the patient, i was so stressed because I couldnt remember which attending wanted me to use which tape to secure the tube in their preferred direction.

 

[Twiggidy]

I’m from the South. It was sir and ma’am all through residency and fellowships to staff of all specialties. It took me a good year to start calling the subset of attendings who went exclusively by their first name (with everyone) by their first name.

It’s how we were raised.

I mean that's the thing, the isn't anything wrong with being respectful.

 

[deleted547339]

I mean that's the thing, the isn't anything wrong with being respectful.

Honestly I cringe when I hear a med student say “yea” instead of “yes sir/ma’am.”

Southern + military = ma’am/sir

 

[sunshinefl]

Honestly I cringe when I hear a med student say “yea” instead of “yes sir/ma’am.”

Southern + military = ma’am/sir

I cringe when I hear myself say “yea” to my peers. I call everyone over 2 years old ma’am/sir. I’m a Florida baby so I don’t know if you count that as Southern or not. Some do and some don’t.

 

[coffeebythelake]

Quite frankly no program should have attendings that aren’t board certified teaching residents or else’ they’re told stupid stuff as described.

well many attendings just starting out aren't board certified.
i didn't get boarded until nearly 2 years out from residency.
didn't fail any exams though!

also, just because they are boarded doesn't mean they can't pull these stupid gems like the parkinsons-midazolam comment above

 

[deleted171991]

there are residents who actually say sir/maam to attendings? i've never heard of that one before

I did. Some of my residents still do. In most of the world, being polite is considered a marker of having been raised properly.

 

[Southpaw]

If you don’t even occasionally use ‘sir or maam’ to your attending then I can pinpoint your geography and tell you I’ve got little to no interest in working there.

And any attending who gives AF about how to tape a tube, provided it’s safe for the patient, is probably useless. Completely useless. My favorite attendings in residency taught me everything I know. Both knowledge and tricks of the trade. But they couldn’t care less how a ETT was taped.

 

[deleted547339]

I cringe when I hear myself say “yea” to my peers. I call everyone over 2 years old ma’am/sir. I’m a Florida baby so I don’t know if you count that as Southern or not. Some do and some don’t.

Depends on which side of I4 you’re in.

 

[Consigliere]

That’s the point of the effect. Im calling you sir in response to being chastised and you’ve never heard anyone call your sir. So not only does it sound strange but you know I’m possibly being an A hole. But what can anyone tell a PD? “This resident is a jerk because he called me “sir”? Well...okay

Where I've traveled there are a lot of Phillipino nurses and the running joke was "how do you say 'fuc_k you' in Tagalog?" Answer? "Yes doctor."

 

[JOHNBROCHILL]

See now calling an attending sir/ma'am in the northeast sounds overly formal and insincere to me. I have only heard a few people do this and while respectful it sounds odd and kissass imo.

 

[Twiggidy]

Where I've traveled there are a lot of Phillipino nurses and the running joke was "how do you say 'fuc_k you' in Tagalog?" Answer? "Yes doctor."

Yep. Same concept

 

[TheLoneWolf]

Based on posts in the last month alone, OP sounds like the resident who thinks he/she is better than his/her attendings.

Maybe it’s the truth, but I know that these complaints sounds like incessant residency whining that EVERYONE endures at one point or another.

Folks I worked with that acted/thought like this, well, frankly, weren’t people I’d want to be my colleagues.

Again. Be careful.

Not a resident. Never said I was better than my attendings. The entire point of the post is that no one is infallable, not even my attendings.

Incessant residency whining..what? I'm sharing parts of my past that may be entertaining or useful to others on this forum. We all endure bullsh*t at work, sharing some of the memorable ones may be educational or informative to others, even if you don't find it so. There are 350 pages of threads here and many have nothing to do with anesthesia.

Worked and acted with people that thought like this? You don't me and I don't know you. Nor do I appreciate you painting me with a wide brush with what little info you can glean from a few posts. Unnecessary presumptuous.

I have learned much from the replies on this forum including better approaches to every day patient care and for tighter situations. That comes from people on here sharing their experiences...like me.

Let's be professional here. Or at least courteous of potentially opposing viewpoints.

 

[anbuitachi]

If you don’t even occasionally use ‘sir or maam’ to your attending then I can pinpoint your geography and tell you I’ve got little to no interest in working there.

I cringe when I hear myself say “yea” to my peers. I call everyone over 2 years old ma’am/sir. I’m a Florida baby so I don’t know if you count that as Southern or not. Some do and some don’t.

i can maybe understand a resident calling attending sir/maam. but attending calling other attendings sir/maam? unless he's the chair or something, then no way. id definitely would not want to work in a place like that. way too formal/hierarchical. attendings are all colleagues, it's very unneccessary in my opnion. but hey i see where people are coming from. if they were raised that way i guess it would seem normal

 

[jthedestroyr]

The real question is this: did you learn the proper way to tape the tube?

Residency is all about saying “gee thanks, I never would have thought a counterclockwise swirl of tape around the tube would have made a difference, but that is a really great tip.” Play the game and move on.

You mean cutting the tape in half, and putting one strip on the side then candy caning it up on the tube isnt the the most superior way, wait i thought it was only pink tape > cloth tape but on fridays in ortho rooms.

 

[chocomorsel]

It’s being sarcastic and respectful at the same time.

Not if you are in the Deep South as already stated. Everyone calls everyone Sir or Ma’am. I like it.

 

[2Fast2Des]

What about when brand new attendings who ask to be called Dr so and so to the CA3 or fellow, I'm like dude, you just graduated a couple of months ago...

I also remember reading a thread somewhere here a while ago and it rang absolutely true. We are all mature adults who went through enough schooling, achieving remarkable academic accomplishments, and working to a noble goal, apparently devolve into acting like children needing approval from their parents and act like subservient beings to the all great attendings. I mean seriously, if a negatively behaving individual talked to you in the chewing out fashion out of the work setting, wouldn't you think about clocking them in the face?
I think we all should behave like normal human beings, stop letting "egos" run the ship and just get the job done. I hate sucking up and having to have a stupid grin of excitement to show enthusiasm. Lets just work together like a team and teach/learn together rather than be fearful of Dear Leader attending chewing you out over dumb things

 

[deleted480308]

What about when brand new attendings who ask to be called Dr so and so to the CA3 or fellow, I'm like dude, you just graduated a couple of months ago...

I also remember reading a thread somewhere here a while ago and it rang absolutely true. We are all mature adults who went through enough schooling, achieving remarkable academic accomplishments, and working to a noble goal, apparently devolve into acting like children needing approval from their parents and act like subservient beings to the all great attendings. I mean seriously, if a negatively behaving individual talked to you in the chewing out fashion out of the work setting, wouldn't you think about clocking them in the face?
I think we all should behave like normal human beings, stop letting "egos" run the ship and just get the job done. I hate sucking up and having to have a stupid grin of excitement to show enthusiasm. Lets just work together like a team and teach/learn together rather than be fearful of Dear Leader attending chewing you out over dumb things

No. I don’t think about punching everyone who talks down to me

 

[MirrorTodd]

No. I don’t think about punching everyone who talks down to me

Lol maybe when I was a teenager.

 

[anbuitachi]

What about when brand new attendings who ask to be called Dr so and so to the CA3 or fellow, I'm like dude, you just graduated a couple of months ago...

I also remember reading a thread somewhere here a while ago and it rang absolutely true. We are all mature adults who went through enough schooling, achieving remarkable academic accomplishments, and working to a noble goal, apparently devolve into acting like children needing approval from their parents and act like subservient beings to the all great attendings. I mean seriously, if a negatively behaving individual talked to you in the chewing out fashion out of the work setting, wouldn't you think about clocking them in the face?
I think we all should behave like normal human beings, stop letting "egos" run the ship and just get the job done. I hate sucking up and having to have a stupid grin of excitement to show enthusiasm. Lets just work together like a team and teach/learn together rather than be fearful of Dear Leader attending chewing you out over dumb things

we had a few new attendings who introduced themselves as dr. xyz to residents then realized no one does that in this part of town and stopped

 

[deleted171991]

See now calling an attending sir/ma'am in the northeast sounds overly formal and insincere to me. I have only heard a few people do this and while respectful it sounds odd and kissass imo.

They can be as insincere as they want, as long as they do what they're told, without the usual 5 year-old Millennial debate ("Whyyyyy?").

 

[deleted171991]

we had a few new attendings who introduced themselves as dr. xyz to residents then realized no one does that in this part of town and stopped

I still do. I have achieved too many things in my life to let a greenhorn underling treat me like his buddy. One thing I can't stand in the US is this completely inappropriate egalitarianism, especially at work. It comes from our societal anti-intellectualism, I guess.

The residents at my current job are 10 times more spoiled than we ever were. And it hasn't been 10 years since my graduation.

 

[anbuitachi]

I still do. I have achieved too many things in my life to let a greenhorn underling treat me like his buddy. One thing I can't stand in the US is this completely inappropriate egalitarianism, especially at work. It comes from our societal anti-intellectualism, I guess.

The residents at my current job are 10 times more spoiled than we ever were. And it hasn't been 10 years since my graduation.

what do you do to peers? do you introduce yourself as dr ffp to other attendings? Once your resident is hired as an attending in your institution, do you still want them to call you Dr FFP? just curious