It's the 1st of July

BonnieSc · Jul 2, 2016

Kudos to your comment. Although July 1st is the first day for new interns/residents with all the accompanying issues, I find the other snarky comment offensive. In a perfect world, the OP wouldn't have to gave anyone directions. Don't feel sorry for you at all.

Offensive? Come on, we all know they need to learn, but that doesn't mean we can't commiserate. Our residents started a week early. This is a big challenge. And while some docs are eager to learn and just so cute and excited to be there, others seem to have a chip on their shoulders, not at all interested in the opinion of a twenty-year veteran nurse. (I'm not talking about myself.) A couple of nights ago a new intern wouldn't order a measly 5 mg of ambien "because she's a drug addict". That's not how we do things at my hospital. I spent at least half an hour trying to sort out my patient's labs last night, because most of them were ordered three times (transfusion services called me in irritation, asking why the patient needed a third type and screen). One patient was ordered for a holter monitor because the intern "couldn't find the order for telemetry".

I have sympathy for them, and for the most part I enjoy being part of a doctor's education, but it does create a lot of extra work!

missmollie, ADN, BSN, RN · Jul 2, 2016

Luckily I have the ability to discontinue orders regardless of who ordered them. If I see 3 orders for lab draws and they are the same order, I can dc two of them.

I also enjoy teaching what I know to pgy1s, and I love that they want to save the world. Sometimes they even teach me as well. I've had one draw me a diagram of how she thought through a disease process, and it was really helpful. A little part of me hates watching them change throughout their pgy experience from inquisitive and excited to the pgy4's or 5's who are stressed and have seen it all. Of course, the same can be said for me as well. I'm a completely different person now than when I started. I think that's the natural progression of knowledge in the medical field.

I had one last night who would not order a fleet enema. I was half tempted to just put the order in myself, but tried to digitally disimpact the poor guy. It didn't work, but hopefully the day team was able to order something. That's the most frustrating part of new doctors starting. They are either extremely hesitant in ordering anything, or they order inappropriate things because they can.

NanikRN · Jul 2, 2016

Advice i give the ones that ask and yes, we do get new docs smart enough to ask, : be nice to the nursing staff and always have a reason for what you do.

I love watching them grow from first years on

BonnieSc · Jul 2, 2016

Luckily I have the ability to discontinue orders regardless of who ordered them. If I see 3 orders for lab draws and they are the same order, I can dc two of them.

Sure, I can DC duplicate orders, too--it just takes time, especially when 20+ labs are ordered, some have been done and some haven't, some are legit repeats like a repeat CBC after treatment and some aren't, like an HbA1C (and were they ordering that again as a mistake or because they didn't trust the result?). Then you throw in order sets--you've DC'd some of those duplicate labs but oh, then the doc realizes she ordered the heparin gtt orderset by mistake and DCs that, along with the PTT the patient actually does need but the duplicate order had already been DCd so now there's no PTT scheduled at all... if the nurse isn't looking carefully there can be some serious delays in patient care, or worse.

nutella, MSN, RN · Jul 3, 2016

I worked in teaching hospital for most of my nursing career and actually enjoyed that environment. Sure, when they switch on the new ones come in it is a bit of an adjustment and take longer to get orders and such but there are also advantages. At least most of the teaching hospitals were really good and students as well as residents do a comprehensive review, patient interview and assessment. They prescribe according to latest knowledge. There are differences between the best teaching hospitals in the US and the "regular" ones. Students and residents in the first ones are usually top prepared, know all the answers when the attending or chief resident rounds with them and know their stuff. The "regular" ones are generally less perfectionists and I have seen attendings in desperation over residents with no clue on certain topics. I enjoyed the knowledge they brought and most of them had good manners.

In the community hospital it is different and to be honest, I miss the residents. At least they always called back and came to see a patient asap....

mmc51264, BSN, MSN, RN · Jul 3, 2016

Had a pt brought in admitted as outpatient step-down. We had some discussion about what that actually meant.

Fiona59 · Jul 3, 2016

Happy Canada Day!!!
Oh, you were thinking of something else?

what my first thought was as well! Finally somebody recognized our national holiday!

Mamanurse90 · Jul 3, 2016

Thank you for reminding me why I am soooo happy I just transferred from my Level I trauma hospital/University to their small community hospital with no residents!!!

mmc51264, BSN, MSN, RN · Jul 4, 2016

Had a mix of pts this weekend and pleasantly surprised at the new batch. It was a good day!!!!!

CeciBean, ASN, RN · Jul 6, 2016

Sure it's crazy, but thank God for their seniors, who are mostly really sharp and able to keep them in line! The last teaching hospital I worked at had great senior residents in my unit, and if I had a real problem, all I had to do for the most part was go find the senior in charge and explain it. Problem solved! Also, *some* medical schools these days seem to actually teach manners! I had a few pgy1s come to me with their orders and ask me to look at them and see if they'd forgotten anything. Not many, but some. On the other hand, there's that first overhead code call, when you see 19 newbies all headed in the same direction....I wouldn't want to be in THAT room!