bring in the clowns!, er i mean residents! - page 3

Nurses far and wide, prepare to be amazed and astonished, yes that is right, july 1st is right around the corner, and that means new resident day!:eek: Well, here it comes, the day that a fresh... Read More

  1. by   NotReady4PrimeTime
    I worked nights last night. In the PICU. It was pretty quiet as things go. Our census included a Day 1 post heart transplant, three Day 1 post CV surgeries (one of whom had spent part of his first day in V-fib), a C4-5 spinal fusion post # and a very fresh post MVC with numerous facial #s. Our new Fellow started yesterday and his partner in crime was a green-as-grass resident. The new resident stopped by my bedside and introduced herself (how many do that!!). She then began telling me how overwhelming she was finding the unit. The monitors were intimidating, and she couldn't get over all the extra information we had to base our care plans on. Her theory isn't quite where she wants it, and she asked a lot of questions. The heart transplant started having frequent PVCs and if it weren't for the Fellow, I think she would have run screaming into the night! My little one had a slightly low K+ but had just had Lasix so I was observing. I told her about it, and that I was going to do another ABG in 30 minutes to see if it had come up. We run a fair number of high KCl infusions on our CVs and some other kids. That idea scared her. I then assured her that we had lots of other options before we pulled out the big gun. She relaxed visibly. So 0500 comes, all the 0400 ABG results are being examined and one of the kids has a K+ of 3.1, no KCl running anywhere and she says, "Should we start a KCl 1:1?" Boy she took that one to heart! Funny how a little sleep changes your perspective.
  2. by   petiteflower
    Gotta a new one this week---only one this time (we're pretty small) He has a problem with nurses--and seems to think that the prefix Dr makes you someone better than everyone else. Like that title magically changes you into a god, a master of all you survey and of course, more intelligent than any menial nurse you might come across. Well unfortunately (not) I had to show him the mighty student doctor the value of a menial nurse. Overheard him dictating on an ER patient we had just had---pt had a heart rate of 100-116 or so, ST. He dictated--pt was in mild ventricular tachycardia (HUH??????), I just turned around and said---excuse me----but don't you mean sinus tach??? He kind of mumbled around about a previous patient being in mild v tach and changed it What I want to know is what is mild V tach---would someone please enlighten me----isn't it kinda they are in vtach or not---or did I just sleep through the mild vtach portion of acls?

    I will say, though, that most of the time I really enjoy the students, I learn from them, and get to help teach them. Oh, and I do always, tell them---treat your nurses nice, and with respect, and you will have it returned. And, nurses can be bought with chocolate and lots of it. (lol)
  3. by   NICU_Nurse
    Wolfpax, ROFLMAO!!!! I have so been there.

    Are we the only ones who get a new round every thirty days? I thought all the doctors rotated like that; we get a new group every single month.

    This month, I have been sad to find out, we were woefully short of "good" docs; there was one in particular that was a complete angel, just loved her to death- if ever someone was meant for neonatology, it was her. However, for every light a dark, and we had another one who I am YIPPEEKIAIAAAAAAAAA to get the heck off our floor. She had a horrible attitude, obviously hated working with the babies (so beNEATH her, you know...), and just was out of her mind, spewing bad orders and bad suggestions all month long with half-*** interest.

    When they were doing final rounds the other day, it was her turn, and she got all flustered mid-rounds because our head neo was asking in depth questions of her. She became visibly agitated, and turned red, and had no answers for him. She was having to explain why a baby had come off the vent earlier that AM, and she said (right in front of a group of us), "Oh, that baby extubated at 0330 because the nurse picked him up by the ETT tube." We were like, WHAAAAA? And the nurse she pointed to looked at her like she was crazy and said, "Umm, yeah, that must have been right before I swung him over my head and flung him onto the floor..."

    This from the same doctor who, upon receiving an admit to the Level III that was mec covered but breathing fine and obviously just transitioning, said, "Intubate! He has to be INTUBATED! Get the cart!" We were all standing there, looking at this slimy but otherwise fine infant, who was looking right back at us and pinking up and rooting and satting 100% on room air, and we were just completely dumbfounded! So the admitting nurse was like, "Doctor, uhh, the baby is...appears to be...why do you want to INTUBATE?" and the doctor yelled, "Oh, you're RIGHT! I *MEANT* we need to start a UAC! Get the tray!" Uh, yeah.

    So, needless to say, happy to see them gone. She, along with the philandering doc caught with another team member making out in the conference room (the window was covered with paper that said "Parent Conference In Progress- Please Do Not Disturb"), and the one who refused to come from the call room despite all of our paging and calling and finally actually banging down the door trying to get her out because she hadn't had any sleep and refused to come out, well, I'm very, very happy to have a new group!!!

    These seem normal, so far...
  4. by   charissa
    Our regional burn center usually has its own resident on call. SInce this is july, we are now at the mercy of whatever surgical resident is stuck on call. And they hate being bothered with the burn center. An outpatient and a triage had to wait 2 hrs last night because we paged the guy3 times, and when we had him overhead paged he called back to ask hwy we were bothering him, he was doing something more interesting. Gotta love july . . .
    ALso, its kinda fun to see them wondering around with their hospital maps trying to find things. However, it was sasd to loose our last resident, he was one of the ones that learned a ton and really came a long way, and wasnt completely pissed off he had to take care of our poor burn victims!
  5. by   Dplear
    Hell, we have had our new residents for 2 weeks now. We get them in the middle of June. God help us they are getting dumber every year.

    Dave
  6. by   grneyes676
    We rotate residents every month too, they are on each service a few times thru the year. This is my first "July", I started as a nurse last August. I have already had some pretty funny orders. Last night I recieved an order to change a pt's linens....at 0100. The pt had a spot on his sheet from his incison oozing....
  7. by   shayraquelle
    I just started working as a healthcaretech/student nurse at a teaching hospital. I've been there for about a month. It's obvious that these new docs are overwhelmed. I worked 4-12 yesterday in a intermediate care unit. We had 5pts come back from procedures with no new diet orders, still NPO. Food services closes at 7pm. The RN paged and paged intern II, then intern I. Intern I called back after two hrs, saying she was aware that we tried to page intern II b/c they were eating dinner together. 30mins later the other intern called back saying, he hadn't gotten any pages. Anyway, 5pts did not get diet orders until 9pm. But the interns were eating their dinners!! It was getting old trying to calm them down, since they hadnt eaten in 24hrs. The RN called the nursing superviser and report was filed. I hope it does some good!
  8. by   Ruby Vee
    About 20 years (or more!) ago, I was working in a step-down unit on the east coast. One of the residents was a real arrogant jerk -- the kind who tells you his first name is "doctor." We all had a lot of problems with him, but I remember one night in particular. The patient was dying -- he had some sort of leukemia, but I don't remember which kind. He had a DNAR, but his family freaked and brought him to the hospital because he wouldn't take his pain meds. "Doctor" ordered morphine 2 mg. SC every hour. The patient refused. "I've had a long life, honey, and I only get to die once. I want to know what it's like, and the morphine makes me foggy." Seemed like a good rationale to me!

    "Doctor" flew into a rage when informed that the patient wasn't getting his morphine injections. "Tie him down and give them to him, then," was his answer to the "problem" of the patient refusing his morphine. I refused, and tried to explain the patient's views to him. He went into the room and bullied the patient into agreeing to the morphine, but when I went to give it, the patient says, "He doesn't understand, honey. He's young. I'm his first patient to die. But you understand."

    "Doctor" wrote me up, and I had to explain my self to a totally unsympathetic manager who operated on the principle that the MD is always right. I had black marks on my record for refusing to follow an order, and management rode me for the rest of my stay at that hospital.

    Fast forward 18 years. I'm working in an ICU on the west coast, and "Doctor" is brought in as the new chief of cardiology. On July 1, he brings a herd of new residents through our ICU and does a double take as he recognizes me (20 years and 40 pounds later). Then he introduced me to his residents.

    "This is Ruby. We go WAYYYY back. She'll do everything you say." (Laughs) "Seriously, guys. Ruby saved my butt a few times when I was an R-1, and she'll save yours, too. You could learn a lot from her." And as he walked away, I could hear him saying, "If the experienced ICU nurse asks you if you're sure you really want to do that, what they mean is "You really don't want to do that, you moron." " He never apologized, but I guess he did learn!

    Ruby.
  9. by   NicuGal
    Oh, we had a good one....we got called to the antepartum floor for a mom delivering in bed. Lots of green docs with the seasoned ones. I was standing there waiting to catch and as the baby is crowning the new OB doc next to me says...

    OMG, there is something wrong with that baby's head...it has a split and a hole...

    I looked at him and said, well, that would be because it is a BUTT!

    He was like...oh, uh,......

    We all, including the doc, had a good laugh after
  10. by   NotReady4PrimeTime
    [QUOTE]Originally posted by Ruby Vee " And as he walked away, I could hear him saying, "If the experienced ICU nurse asks you if you're sure you really want to do that, what they mean is "You really don't want to do that, you moron." "

    Good on you, Ruby Vee... Looks like they can be taught after all. Gives me hope for some of the loons I've seen over the years.

    P.S. I'm glad that you listened to your patient all those years ago and not to the order. After all, it really

    is about the patient, right?


    Oh, and NICU Gal, I nearly wet myself when I read your post... guess that Baby OB flunked anatomy.
  11. by   Nurse Ratched
    Originally posted by Ruby Vee
    "This is Ruby. We go WAYYYY back. She'll do everything you say." (Laughs) "Seriously, guys. Ruby saved my butt a few times when I was an R-1, and she'll save yours, too. You could learn a lot from her." And as he walked away, I could hear him saying, "If the experienced ICU nurse asks you if you're sure you really want to do that, what they mean is "You really don't want to do that, you moron." " He never apologized, but I guess he did learn!
    Ruby, that is quite possibly the coolest story I've ever heard here - and that's saying a LOT!
  12. by   kcrnsue
    I have never worked in a teaching hospital, but this thread reminded me of being in nursing school. I had just started and was scared to death. Our class had been split into groups, and the other group had already been to a nursing home to do blood pressure checks. One of the students explained how she kept pumping up the cuff and looking at her watch. She didn't even have a stethescope on! I didn't feel so nervous after that.
    :chuckle
  13. by   Peeps Mcarthur
    By Wolfpax
    "Oh, oh, hmm, just put down natural causes", my mouth droped and he repeated it, I reported to the desk seargent that he said natural causes the desk seargent replied"Ask him if he thinks the rope around her neck had anything to do with it?"
    :roll Thanks for that one!!

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