It's the first of July, the traditional day when new interns start their internship, interns become residents and residents become fellows. July is well known to be the most dangerous month to be hospitalized, not because the hospital isn't air conditioned but because of the plethora of doctors new to their role and perhaps not as competent in that role as they will be next June. Or as they were just a week ago, in their previous role.
July is tough for seasoned nurses, not only because of the medical staff but because of the plethora of new nurses who have just gotten off orientation, will soon get off orientation or who firmly believe that they're too smart and too knowledgable to even need orientation. It's difficult to reason with — or teach — someone who is convinced they already know everything, and that goes for both the medical staff and the nursing staff.
If you work in a teaching hospital, part of your role is to teach the doctors. Their view of nurses for their entire career is based on the interactions they have with nursing staff in their formative years†in the teaching hospital, and most of the nurses who work in a teaching hospital are fully cognizant of this. We know we're going to be called upon to teach when we take our jobs in the teaching hospital, and most of us take it seriously. It' just as easy to teach†the residents to look upon nursing as colleagues and team members as it is to teach them to look upon nursing as antagonizers, aggressors or obstructionists.
In July, you're going to find physicians who are doing it wrong.†It's part of our job to teach them to do it right.†And it's our job to do it in such a way that they learn from the nursing staff rather than hate us.
Almost everyone (except the patients) knows that the experienced ICU nurse who asks pointedly Are you sure you really want to do that DOCTOR?†is really saying You REALLY don't want to do that, you ignorant moron!†I've seen attending bring their herds of newbies around to meet the ICU staff and actually explain this to them. This is Ruby. She's an experienced ICU nurse, and she can teach you a lot. I don't ever want to hear about you disrespecting her, and if she ever calls you doctor†it means you're screwing up. Stop what you're doing and call your Fellow to ask for advice.†Most of them learn from that, but there is one new resident every year who insists that his first name is Doctor†and thinks that he knows more than the experienced ICU nurse. Few of them go on to be respected, successful practitioners. It's the MDs who know (or learn) how to listen and to learn from the nursing staff who become expert and well respected practitioners.
So welcome to July. If you're fortunate enough to have new interns and residents to teach, teach them to value and respect their nursing colleagues. Future generations of nurses will thank you.
Specializes in Nurse Leader specializing in Labor & Delivery.
I would be curious if they differentiate between University teaching hospitals and non-teaching hospitals? The rotation of Residents only happens in teaching hospitals.
Yes, I'm pretty sure the studies are only looking at hospitals that have residency programs, because they're looking specifically at the changeover that takes place in late June/early July.
In teaching hospitals, a nurse's daily job is to mitigate the July effect. However long it lingers into the other months of the year, if you catch my drift.
If there is no statistically significant increase in adverse outcomes (at least those with defined codes, which facilitate data collection for research ) resulting from hordes of newbies all arriving at the same time - we have done our job spectacularly well.
) resulting from hordes of newbies all arriving at the same time - we have done our job spectacularly well.
klone, MSN, RN
14,857 Posts
Yes, I'm pretty sure the studies are only looking at hospitals that have residency programs, because they're looking specifically at the changeover that takes place in late June/early July.