Malicious "pimping" in nursing / nurse practitioner school?

[RomaniGypsy]

I have been investigating both advanced practice nursing and medical training, and I get a bad feeling about medical training. I've mentioned attitude problems I've caught from doctors and medical students before, but now it's time to address one specific topic.

They say that in medical school, "pimping" is a common thing. Apparently there are two main types, each of which begins with a medical practitioner who is serving in the capacity of an instructor firing off a series of questions at a student or resident. The "beneficial" type is where the questions are legitimately related to something the student or resident should know because he/she will need to use it in practice, and if the student / resident gets to the point of saying "I don't know", the instructor will tell the student to look it up and perhaps do a brief presentation on it the next day they're together.

For the record, I consider this entirely acceptable. I teach (though not in a school) and I do the same thing to my students sometimes.

The second type is "malicious", where the point of the questioning is to humiliate and embarrass the student. As I've read, the questioning may or may not deal with relevant topics, but in either case when the student / resident reaches that "I don't know" point, the instructor will mock the person in front of his/her peers for not having that knowledge.

What makes it worse is that they seem to think that this is acceptable practice and that people should not rise up to stop it. (I suggested that they could rise up en masse to stop it if they wanted to, and some of them mocked me for that!!) Personally, I see no benefit in the mocking / humiliation / whatever you'd call it, because all that does is bring people down with no counterbalancing benefit.

So my question is: In nursing education, considering all levels from LPN up to DNP, how prevalent is the "malicious" form of "pimping"? And, if it happens at all, what is the likelihood of retaliation against someone who either returns fire at that moment (so as to save face if nothing else) or reports the abuse to the administration of the school or facility?

[Jedrnurse, BSN, RN]

And now, another exciting round of "every nurse younger and/or less experienced than me is a spoiled entitled snowflake."

All right, you've left me no choice...

"Beetlejuice! Beetlejuice! Beetlejuice!!"

[EDNURSE20, BSN]

I had a lecturer in nursing school that did this. It was so bad that even the nurses on floor of my last placement complained about her. She was just awful.

[JKL33]

And I have never been in favor of hazing. If you have to deal with unnecessary and harmful BS in order to get into their club, I'm the kind of person to walk the other way. I've never wanted to be in anyone's club that badly. So, from this angle anyway, it seems that I'm more cut out for nursing than medical school.

My (nursing school) experience was as follows with regard to your inquiry. I won't label it as anything, it just was what it was. It worked just fine for me.

The closest thing to what you are talking about would be "med cart interrogation." That is, we had reviewed our patient records and researched some aspects of their conditions and treatment prior to attending the week's clinical days. So when we met our instructor at the med cart to administer medications, there was a lot of "quizzing." You'd better know what you were talking about, from memory. They listened to our blurb about what we had researched, then started asking questions. If we appeared to know the information pertaining to that patient's meds, they would ask questions that didn't have to do with that med or that patient. I did okay with it because it wasn't totally random, they really just wanted to see if you understood the pharm enough to think about how that med might be useful for another type of patient, etc., etc.

However. If they got the inkling that people were trying to BS or didn't have a good handle on the information, watch out. They would ask questions, lack of preparation would be apparent, and people were sent to the library, which counted as an absence. Two absences, you were out. I did witness them being somewhat rougher on people whom they suspected hadn't prepared.

**

All that said, this would be the last thing I'd worry about if in the position to be accepted to medical school. Or nursing school. After all, IMO (as I think you have said, too), it is not unreasonable to expect people to be prepared and to be able to do a bit of critical thinking. So then you really only run into problems if you don't prepare yourself, OR (much more rarely) if you run across a true jerk. You can't make life decisions based upon the fact that you might run across a jerk. Because, you will.

With regard to quizzing/pimping etc., it all depends on the attitude of the instructor. If the goal is to humiliate and/or purposely disadvantage someone, that's not cool. If the goal is to expect people to absolutely know what they're talking about to the best of their ability when they wish to provide health care to sick people, I'm fine with that.

[RomaniGypsy]

My (nursing school) experience was as follows with regard to your inquiry. I won't label it as anything, it just was what it was. It worked just fine for me.

The closest thing to what you are talking about would be "med cart interrogation." That is, we had reviewed our patient records and researched some aspects of their conditions and treatment prior to attending the week's clinical days. So when we met our instructor at the med cart to administer medications, there was a lot of "quizzing." You'd better know what you were talking about, from memory. They listened to our blurb about what we had researched, then started asking questions. If we appeared to know the information pertaining to that patient's meds, they would ask questions that didn't have to do with that med or that patient. I did okay with it because it wasn't totally random, they really just wanted to see if you understood the pharm enough to think about how that med might be useful for another type of patient, etc., etc.

As long as it wasn't totally random and the information that was the subject of the quizzing was stuff that any nurse could be reasonably expected to have to know and use in the course of his/her work with at least some regularity, and the instructor wasn't specifically aiming to humiliate or embarrass the student, that'd be fine. It all comes down to this - we're only human, and even those of us who study everything may fail to recall one piece of information we thought was "esoterica" and really wasn't.

However. If they got the inkling that people were trying to BS or didn't have a good handle on the information, watch out. They would ask questions, lack of preparation would be apparent, and people were sent to the library, which counted as an absence. Two absences, you were out. I did witness them being somewhat rougher on people whom they suspected hadn't prepared.

I suppose it depends upon how severe the lack of preparation is. For example, I took a biology class last semester and it was "in person", so I was able to see who was on the ball and who wasn't. There were at least three people who were on top of things. Yet, the two guys who sat to my right were total space cadets. They didn't pay attention, they spent the entirety of class on their phones, they failed pretty much every test and quiz... I had no idea why they were there. People like that, who don't even try to disguise the fact that they don't care - I could see the instructor being hard on those people, but still, not to the point of mocking. There's a difference between saying "You're a total space cadet in my class, you don't give a $&^@ about anything I've taught, you don't study, you don't do your homework; you don't belong here" in front of everyone, and pulling the student aside at the end of the session after a missed question or two, for a much more serious conversation potentially including some of the above phrases, when nobody else is around. The instructional effect would be the same, without the unnecessary mockery and embarrassment.

As far as "being sent to the library, which counts as an absence" - how is that tolerated? If you only get one absence before being kicked out on the second, that immediately takes away any leeway you had for a personal emergency. If the student were to say "no, I have to stay here so I don't get an absence on my record", what would happen?

So then you really only run into problems if you don't prepare yourself, OR (much more rarely) if you run across a true jerk. You can't make life decisions based upon the fact that you might run across a jerk. Because, you will.

As long as it's "very rare", and there is robust support for those who report truly jerk-like actions, that's fine. As long as "nurses eat their young" is largely a myth, or at least a relic of history, that's fine. I can deal with a jerk when I have recourse.

With regard to quizzing/pimping etc., it all depends on the attitude of the instructor. If the goal is to humiliate and/or purposely disadvantage someone, that's not cool. If the goal is to expect people to absolutely know what they're talking about to the best of their ability when they wish to provide health care to sick people, I'm fine with that.

As am I. Like I said before, I've had tough teachers, but most of them were actually nice people whose main concern was teaching you. Do what you're supposed to do as a student and they'll be fine with you.

[BostonFNP, APRN]

In clinic at the graduate level I absolutely push my students to answer questions, put them on the spot, develop answer to questions they may or may not know the answers to. I have limited time to get them from student to provider and they need to be able to answer tough questions, think on their feet, apply what they know to something they don't know, and ultimately, be able to say "I don't know but I know where to look or who to talk to". In my opinion, we make better providers by challenging students.

That being said, I would never berate a student or belittle a student, and all my students know that it's definitely ok not to know everything.

[2BS Nurse, BSN]

Attending nursing school is basically like going to boot camp. Once you get into the working world you can just use common sense to do your job.

Yes, I've heard my MD colleagues talk about "pimping". It's definitely a term used in this field.

[Lady_Leijing, BSN]

Oh, that kind of pimping... Wouldn't have realized that was an actual term, except ZDogg MD talked about it a while back ;-)

I had a clinical instructor that was like that. Every week, she would catch me on the way out of pre-conference and demand to know everything there was to know about my patient's condition, medications, etc. It didn't stop at the basic of what to watch for in their asssessment; she wanted me to basically recite the entirety of the side effects and mechanism of action of every medication that patient was taking. I felt cornered (once I was actually cornered in the conference room), and I would panic and stumble my way through the answers, If I didn't recall what she deemed to be sufficient information, she talked down to me like I was an idiot and treated me like I was a waste of time to teach. I thought I was going to fail clinicals until we rotated instructors, and I was working with a different professor--one that didn't treat me like an idiot and actually worked with me to learn skills or explained why what she was asking was important.

[kara_t]

I am currently a 3rd semester nursing student and I have never had an instructor be malicious in such a way you've described. Yes I've had instructors push for information but that was to get myself and others to use critical thinking skills to come to an answer. sometimes it may seem like they are being mean but in reality they are just trying to help us. Yes I've been told and have witnessed others be told to look something up but I feel that was just to get us to use resources and not rely on answers being handed to us.

[NurseBlaq]

Please look up the definition of "pimping".

Seriously

I promise I made it to the very first reply and you already covered exactly what I was going to say. Kudos!

Now let me go back and read the rest. This should be interesting. LOL

[Corlionie]

the hashtag!!! LOL

[Rocknurse, MSN, APRN, NP]

I'm in the final year of NP school and I have not had this experience....yet...although I am always fearing its emergence. In my last clinical rotation the attending liked to ask questions of the students but most often than not I was able to answer him, but on the occasions that I couldn't it was fine to stay silent or to state I don't know. He used it as a teaching method and I thought it was fine as it made me think. I was then able to apply it and look up stuff after the shift. I do not agree with any kind of maliciousness in medicine, and although I know it exists, thankfully it has not happened to me. I am always worried that it might happen at my next rotation but I think I'm mature enough to not let it get to me. I am practising in my head how to deal with it if it does occur. I will simply stay calm and say "I don't know the answer to that but I will go and look it up". That's all you can do. There are always going to unsavory characters wherever you go. I don't respond well to unkindness. I find it intimidating and harmful. I'd much rather be an environment where superiors teach in such a way as to inspire. Luckily I know the preceptor I am doing my next ICU rotation with and I chose her because she's awesome....enthusiastic, kind and knowledgeable. The professors in my school are seasoned, mature professionals and they have no need of this infantile behavior. We are all adults.

[BostonFNP, APRN]

I had a clinical instructor that was like that. Every week, she would catch me on the way out of pre-conference and demand to know everything there was to know about my patient's condition, medications, etc. It didn't stop at the basic of what to watch for in their asssessment; she wanted me to basically recite the entirety of the side effects and mechanism of action of every medication that patient was taking.

We do agree that this part of it is a good thing right?