Are hospitals deadlier in July?

marty6001, EdD, EMT-P, APRN · Jul 8, 2010

It is getting better for sure, but, there is an element of truth to that. hopefully we as nurses act as the patient advocate as well as intern advocate and prevent issues before they happen...

CNL2B · Jul 8, 2010

I actually think this has been studied and statistically proven. I will try to look around and find a link for you if I can.

Yep. The docs we have right now have been MDs for about 2 weeks, and most of them have that "deer in the headlights" look right now.

Actually I looked at your link to the CNN article and it links the study itself.

mamamerlee, LPN · Jul 8, 2010

I've been nursing since 1974, and that was being said long before. Seasoned nurses question many orders written in July and August, and are often met with new docs who just dig in their heels, rather than admit that a nurse may be correct.

When I worked in a very busy acute dialysis unit, the head of the dept told the new docs and fellows that they needed to listen to the nurses - many of us were doing this work for 5 years or more. We weren't trying to be difficult, but we were very familiar with 'usual' orders, and had already dealt with most situations.

Yes, I know that there are more issues with orders during July.

klone, MSN, RN · Jul 9, 2010

I worked with a LOVELY intern the other night who knew what she didn't know, wasn't afraid to ask for help, and thanked me at the end of the shift for my patience and for teaching her something.

If only all new residents could have such humility.

roser13, ASN, RN · Jul 9, 2010

No doubt in my mind.

marty6001, EdD, EMT-P, APRN · Jul 9, 2010

I forgot to add that I'm an APRN in a critical care unit, and the 3rd year residents parade all the first year interns by me to introduce them and tell them that if they are stuck they had better search me out for help. I think it's a nice tilt of the hat toward nursing that they utilize me in this way.

mskate · Jul 9, 2010

oh my goodness yes!

In the past week I have had:

A patient with a heart rate of 20 with the newbies not wanting to pace or medicate because "she still looks pink" - albiet, non-responsive.

A patient with a co2 of 70, a resp rate of 60 and an pao2 of 55, minimally responsive - who the newbie didnt want to call anyone to intubate.

A NSTEMI admission who was not ordered *any* medications. When paged for the orders and advised that she was still having chest pain - an order appears in the computer for tylenol. TYLENOL. and a resulting argument on what needed to be done for this patient and that tylenol was not the appropriate medication for a person experiencing chest pain who is having an MI.

An intern who tried to invent an "albumin replacement scale" for a low albumin level on the lab work, as if it was a K or Mag protocol and would not listen to us when we said that its really not how you go about that...

Arguments on why pushing someone who just starting vent weaning today, to go all day and all night, without an ABG checks and a high respiratory rate is not an OK way to vent wean someone and that you are inducing respiratory distress in an already sick patient.

Arguments on why if a patient was made NPO on admission because you were expecting the patient to be intubated, then 2 days later, the patient was made a DNR/DNI - keeping that patient NPO for several more days is silly. Your rationale is you don't want anything in the stomach in case you have to intubate, but you aren't going to intubate... sssooo...... you have a starving, crying patient who is dying and would just like some pudding.

..... I could go on and on. and this is only 8 days into the month. You get a spattering of people - you get the new ones that are super friendly, out going, excited to help out and willing to take suggestions and you get the others that do not want to listen to you at all, then get mad when you follow up the chain of command and go over their head to get things done. The lesson? - Never get sick in July, and if you do - you better hope you have a good nurse to back you up!!!

CNL2B · Jul 9, 2010

mskate -

I don't know if I should :lol2: or :bluecry1: about your post. It is sooooo true.

How about this? :banghead:

pielęgniarka, RN · Jul 9, 2010

(sarcasm) Hospitals are deadlier this month of July!!! THAT is why we have no admissions into our nursing home or rehab unit, they are all dying before they can get rehab. (/sarcasm)

In the 5 years I've been in LTC July is the month our census is the lowest, never fails. I always attributed it to no one wants to get elective surgery done during the beautiful summer weather and no one is slipping and breaking their hip or knee on ice.

PetiteOpRN · Jul 9, 2010

There must be some really evil nurse out there who is telling all of our interns to put their lead aprons on inside out and backwards, because 3 of them did this in front of me this week.

If this year's batch is really this clueless on their own, we're all in for a long year.

platon20 · Jul 9, 2010

Take it easy on the new docs, lets not pretend that this problem is unique to MDs. We all know that if it were NPs and PAs that all started working in July in a new job the death rate would also go up, probably even moreso because they have less than half the training of brand new MDs. Same thing with nurses. If you took all the experienced nurses out of the unit on July 1st and put 100% brand new RN grads on that day, the death rate would skyrocket for the same reasons.

I do think there should be a different system so that all the new MDs dont just hit the wards at the same time. Let some of them start in July, some in August, some in September, etc and gradually rotate them in throughout the year. That will minimize the effect on patient care. But at some point, you're gonna HAVE to have a newbie on the unit who doesnt know very much. How else are you going to train new doctors? There's no easy way around that.