New Residents, Eeek!

Nurses General Nursing

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The new interns have been at my hospital for one week now. I just worked the last 3 days and found myself catching lots of mistakes, some minor (ie forgetting to notify anesthesia that their services will be needed for CVL placement) to major (ie throwing parts of chart in shredder because he "changed his mind" about what he had wrote" or asking nurse if a PICC line is spelled "PICC" or "PICK".) One of my other pt's became so fluid overloaded from the exceptionally high rate they were running her NS that she gained 14lbs (in 4 days :eek: )

Sorry, just vening about these newbies. Hoping nurses out there are being supe rvigilant that work in teaching facilities and hoping these guys grow up quickly.

Specializes in stepdown RN.

I say give them a break you were new and just learning once right? Everyone cant be perfect like some of the nurses on here.

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Specializes in Oncology/Haemetology/HIV.

Oh residents!

The one that ordered two units of PRBCs on a pt with a 26% crit and a white count of over 200K in blast crisis.

The one that put in for 6 mg of IV Dilaudid Q1-2 hrs PRN, instead of morphine.

Or conversely orders a one time dose of 1-2 mg IV morphine, for a two hundred pound pt with a massive MI.

The one that didn't feel safe ordering "that much" of a standard heparin flush for a monthly portacath flush.

The one that actually ordered a neutropenic vegetarian, lactose free tyramine free, low sodium, diabetic diet - whereupon the Attending asked, "EXACTLY WHAT do you think that the pt would be able to eat on that?"

Thankfully, most of those that I work with are secure enough to ask the nurses about anything questionable, and give us some credit when we contradict them on issues that are specific to specialty.

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Specializes in NICU, PICU, PACU.

July...not exactly Christmas in July, that is for sure lol Sure, there is a learning curve and they are uncomfortable, in NICU,they get thrown to the wolves for the most part. But....when I am telling you I am not taking that order off because it is wayyyyyy wrong don't stand there and argue with me until I have to call the fellow, who told you what to write (the correct order) in the first place. Also, please look at the patient before you put orders in, a normal baby shouldn't be pasty white, making that cute singng noise when he breathes and be glassy eyed with a BP in the toilet...I don't really care about putting ointment in his eyes and a shot in the thigh. And if we have stuck a kid 8 times and can't get a line in, no I am not going to let you who have never put an IV in a baby do it, so don't cop an attitude with me. I am old enough to be your mom and don't make me use my mom voice! lol We have a few good ones this month, and a few that aren't going to get out of the unit with their behind intact.

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As a newly minted intern (or "baby MD" as some people in this thread called interns), I would like for you to think back to the time before you were a perfect healthcare professional, and you too were in training. Just think about the little "oops" moments you have had, and how you learned from these mistakes. Perhaps then you will have a greater deal of empathy for us, instead of being annoyed/laughing at our mistakes.

Fortunately, the hospital that I am interning at has AMAZING nurses who enjoy taking a moment out of their time to lend a helpful bit of teaching advice, or gives a heads up on a mistake that is being made. They do this in a professional, congenial, and friendly manner.

Also, please remember that your favorite MD that you worked with was once also merely a "baby M.D", and that learning in medicine is a lifelong growing process that is filled with many obstacles, but also many mentors.

I know that one day when I do have the skills to be an attending, I will reflect back on my training years, and remember all the kind, helpful people who really made a difference/impact on me.

As a sidenote to the nursing students in here with the criticisms, I find it highly hypocritical that you would feel the need to put down interns...we are all in one ship (haha hopefully not a sinking one). I am sure you too make mistakes, and how would you feel if the MD laughed at you about it. Conversely, imagine if you made a mistake, and the MD made a friendly correction. Which situation would prove to be a better learning experience? The latter, of course.

To all the kind, friendly, and supportive nurses...I thank you, as I am sure my fellow interns do. If we make a mistake, and it's an honest mistake, just tell us...we are EAGER to learn.

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Specializes in New PACU RN.

^Hello & good to side the 'other side' here :lol2: . Keep in the mind that the nature of a venting thread is to list all the negatives. I'm pretty sure if I went to a docs forum I would be seeing a lot of venting & criticism about nurses (student or otherwise).

Why don't you open a thread about your experiences with nurses or what you would like us to know etc. I think a lot of people would be interested to hear. Just a thought.

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Specializes in Intermediate care.

had a resident tell me to titrate a dobutamine drip to Blood Pressure. :uhoh3: and he wonders why patient wasn't responding. (Probably because dobutamine is used to increase contractility, not increase BP)

Kept telling resident that it wasn't correct- had to get attending in the room, who by the way adores his nurses more than life itself (yes they do infact exist) Attending says in his Peurto Rican accent "Listen to these Nurses. I tell you this over and over and you not get it."

Ahh i love that doctor :-)

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Specializes in Medical Assisting.
As a newly minted intern (or "baby MD" as some people in this thread called interns), I would like for you to think back to the time before you were a perfect healthcare professional, and you too were in training. Just think about the little "oops" moments you have had, and how you learned from these mistakes. Perhaps then you will have a greater deal of empathy for us, instead of being annoyed/laughing at our mistakes.

Fortunately, the hospital that I am interning at has AMAZING nurses who enjoy taking a moment out of their time to lend a helpful bit of teaching advice, or gives a heads up on a mistake that is being made. They do this in a professional, congenial, and friendly manner.

Also, please remember that your favorite MD that you worked with was once also merely a "baby M.D", and that learning in medicine is a lifelong growing process that is filled with many obstacles, but also many mentors.

I know that one day when I do have the skills to be an attending, I will reflect back on my training years, and remember all the kind, helpful people who really made a difference/impact on me.

As a sidenote to the nursing students in here with the criticisms, I find it highly hypocritical that you would feel the need to put down interns...we are all in one ship (haha hopefully not a sinking one). I am sure you too make mistakes, and how would you feel if the MD laughed at you about it. Conversely, imagine if you made a mistake, and the MD made a friendly correction. Which situation would prove to be a better learning experience? The latter, of course.

To all the kind, friendly, and supportive nurses...I thank you, as I am sure my fellow interns do. If we make a mistake, and it's an honest mistake, just tell us...we are EAGER to learn.

I just :redbeathe'd your post! Kudos to you! :yeah: Hopefully, when I'm a "baby :nurse:" I get to work w/ a Dr (or "baby M.D.) w/ a similar mindset as yours. (now could you pass along this attitude to some others, perhaps? That would be AWESOME. ;) Just my :twocents:, for what that's worth anymore.)

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Specializes in NICU.

It's bothersome, but as others have said, they are learning too.

As a nurse, I am the one that carries out most of the orders and you can be sure that I question anything I don't feel is right. Common sense has to come from the nurse as well to not carry out non-sensical orders.

If I get a particular persnickety resident and I know I'm right, I'll just call my fellow and/or the charge nurse. We all have our "oops" moments and the goal should be to work together and teach each other.

I suppose I'm in a unique situation because most of the residents in the NICU are more on the nervous side and will ask me for advice on what to order so I don't deal with too much top-down politics. I suppose it would be different on a med-surg floor, not to mention that you have 4-6 patients. I have 1-3 max depending on acuity...

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Specializes in Neuro ICU and Med Surg.
AAAAGH! a new resident ordered a saline bolus for my 25 year old patient with a head bleed. :eek: (Isotonic)

Questioned him about it and he didn't get what the big deal was.

Sometimes in our SAH patients we give a saline bolus for fluid balance or CVP to prevent vasospasam or if they are in spasam. Along with 3%NaCl depending on Sodium goal.

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Specializes in Oncology/Haemetology/HIV.
As a newly minted intern (or "baby MD" as some people in this thread called interns), I would like for you to think back to the time before you were a perfect healthcare professional, and you too were in training. Just think about the little "oops" moments you have had, and how you learned from these mistakes. Perhaps then you will have a greater deal of empathy for us, instead of being annoyed/laughing at our mistakes.

As a sidenote to the nursing students in here with the criticisms, I find it highly hypocritical that you would feel the need to put down interns...we are all in one ship (haha hopefully not a sinking one). I am sure you too make mistakes, and how would you feel if the MD laughed at you about it.

Be aware, that in many cases, new nurses has learned this behavior from MDs that treated them like trash when they were new on the floor, and behave with very little/no kindness to nursing mistakes. I had plenty of MDs laugh at me and dismiss me when I was a new nurse, not on an anonymous BB, but publically. Not to mention had them curse and throw things.

Does this make it right? No. But should nurses not be permitted to vent on an anonymous BB regarding the increase in their workload, and the amount of surveillance required, so that they blow off this steam and can go back to the unit tomorrow with smile on their face and go on as a helpful professional.

In addition, what you will find during your intern year, is that many interns/residents will start out a bit lost, and will appreciate the help that we give them. In a few monthes, that wears off a bit, and they believe themselves to be more "expert" than nurses and above them, even in specialty departments where things may be drastically different. Then they butt heads a bit. And by the end of the year, they have less/little tolerance for what the nurses' opinion, right or wrong.

I have Attendings that expect me and the rest of the staff to help interns/residents but also to keep the pts safe from them at times. If I do not carry out a questionable order, the intern/resident will give me hell - if I carry it out, the Attendings will have my butt. During the mid to latter part of the year, this can cause a great deal of friction.

Many of us are adapting to the "turnaround" in attitude that occurs at this time of the year. And it can be stressful.

And if you think that the opinions expressed here are harsh, may I suggest reading the dismissive comments about nurses over on SDN. They are in most cases, worse than what is here. They too need to vent, so that when they go back to work, they can put a smile on their face and continue to work with other HCWers that may have been silly/rude/dismissive/mistaken...and go on from it.

There was a rather well known, "What was the dumbest thing a nurse paged you for?" thread (or something like that,) that went on for pages.

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Where is the supervision of these newbies? Maybe its just me..but shouldn't the attending (or at least the more seasoned baby md.s) be monitoring what these interns are ordering?

I think that's just offensive. Saying seasoned resident wouldn't be so bad, would it?

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Specializes in Peds/outpatient FP,derm,allergy/private duty.
This.

Yep . . .

It's the old battleaxe nurses that normally keep them out of major trouble those first few weeks out of the gate. If you think about it the way we relate to them could actually set the tone for how they view nurses for the rest of their careers. I always found the difference in their personalities interesting. You could almost tell who was going to end up being really good and who would end up being nyeehhh . .wouldn't take my pet guppy to see them even if they are smart as a whip.

Clueless is OK, arrogant will get you in beeg trouble eventually . . .one of my fondest memories was of my petite nurse manager giving "Know-it-All Harvey" his primer on exactly what type of behavior would not be happening anymore on her unit. :cool::nurse:

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