Issues with residents

[Rocknurse]

I am a third year AGACNP student in a clinical rotation in a surgical ICU team. The team is small and consists of the lead APRN, the attending, myself and perhaps one other NP student and lately a couple OBGYN residents who are doing a short rotation with our team to gain experience with surgical adults. I am having an issue with these two residents and their attitude towards me and I had such a bad day the other day that I really had to bite my tongue.

Right at start of shift we had a rapid response on the floor that my preceptor (the APRN) and I had to run to so the resident was asked to take report from the night NP and give us report on our return. When we came back we were sitting in the area where we work (a small area with 4 computers). We were all sitting in a circle and she rolled her chair in front of me and turned her back on me and started to give report in almost what I would describe as a whisper, speaking only to the attending. I asked if she wouldn't mind speak up a little so I could hear or perhaps move back so she didn't have her back to me. I actually had to ask her twice because she ignored me the first time. I couldn't hear what she was saying since she had her back to me, and my patients were extremely sick and complex and I really needed to know what was going on with them as I didn't know them at all. The second time I asked her she just told me I could "go and stand over there" and pointed to the other side of the desk. Then later, I was trying to help my preceptor place an order in Epic because we just went live with it and she doesn't know how to use it. The resident constantly talked over me and wagged her finger in my face, interrupted and said "just a minute" and stood right in front of me almost stepping on my toes so she could help the NP and look like the golden girl. I really wanted to tell her that I am actually a certified Epic analyst but I didn't want to start a scene.

All through rounds, no matter where I stood, she moved in front of me and turned her back, getting in between me and the attending multiple times, no matter where I moved. I kept trying to hear the attending but wherever I stood she pushed me out of the way. One time I tested it to make sure I wasn't crazy and stood right next to him and his computer and she almost trod on my toes trying to push me out of the way. The other resident treated me with the same disdain. We each were working off our own computers and I got up to check something on a patient and when I came back she said "I took your computer". No apology, no explanation. Apparently hers shut down and as she is much more important than me she just took mine and I guess I can just deal with it. I had to go work on the other side of the unit away from my preceptor who I am supposed to be working with.

I have never experienced anything like this before. It's so ridiculous. I really wanted to tell her that I've been a nurse, and in critical care, for longer than she's been alive but again, I'm in a rotation and I was on my best behavior, but I'll be darned if this precious millennial is going to disrespect me like this. It's absurd. I'm twice her age and know a thing or two. She may be a doctor but she's still green behind the gills, no matter if I'm a student or not. It was her first day in the unit, and I've been there for 3 months. The team is small and should be inclusive. I have my own patients and write my own notes, it's not like I'm helpless or clueless. How can I deal with this? If she wags her finger in my face one more time...

[Julius Seizure]

Rest assured, the rest of the team sees her behavior. She is building her own reputation. Good job being on YOUR best behavior during your time there. The team sees that, too.

If you felt that you needed to, you could speak privately and objectively with your preceptor about your concerns that the dynamic might be impacting your ability to get the most out of your clinical time there, and ask for your preceptors advice. However, I agree with what you said about that not being worthwhile since you won't be there much longer. Just get what you can out of your rotation. I, like you, am just too tired to deal with people like that.

As a side note, I was 100% sympathetic until I got to the words "precious millennial". While still mostly sympathetic to you, I found that last paragraph a bit off putting. I would definitely avoid that in any conversation that you might have with your preceptor about it - but I am very sure that you would never do that anyway!

Again, keep up being as professional as you possibly can - you can only control you!

[TriciaJ, RN]

She spent all day parking herself directly in front of you? After about the third time I'd have a hard time resisting pulling individual hairs out of her head. When she notices, just say "Sorry. I think you might have nits." That should be the last time you see the back of her head in such close proximity.

[hppygr8ful, ASN, RN, EMT-I]

Well

I was faced with a similar situation several years ago while on a clinical rotation - A Sr RN who was not my preceptor decided to pontificate on how Psych Nurses are not "Real Nurses" actually putting on a little show of someone running away from a patient with chest pain. Everyone there knew I was a psych nurse. I took it all in good humor until I was asked to start an IV which I proceeded to do and this nurse steps in and says "Here honey I got that." I declined started the IV with no difficulty then found this nurse in the nurses station. I said in front of everyone there including a physician "Look honey, I have been a nurse from as long as you have and done many specialties. I will put my skills up against yours any day so treat me with respect and I will do the same." As karma would have our next admit was a 56 y/o man with chest pain who a congruent diagnosis of Bi-polar with psychotic features. Not a single nurse on the unit wanted to go near him. I Doctor I had known for years suggested that I go attend the patient and do the initial nursing assessment. Once I had the patient sorted out and comfort able everyone there had a new Idea about psych nurses.

Hppy

[audreysmagic, RN]

I've been blessed that most of my experiences with residents have been great - my main issues are adolescent psych patients trying to scam them by getting orders from them for things that are not allowed on the unit (so they can then howl, "But I have a doctor's order!")... But once I talk to them they're cool. My Extra Special folks have usually been techs or fellow nurses. You seem to find a few more of those in psych, too. But...wow. I'd probably have to pick my battles on this one if I was almost out of the rotation, but I'd still stew over it. My favorite Extra Special Nurse was an older lady, who didn't even earn proper COB status (as the COBs are usually efficient, whereas this lady was anything but), who was always preaching to me, "I've been a nurse 34 years and if someone shows me a better way, by God, I'll do it..." Thing was, we did try to show her better ways, several times, and she firmly rejected them for Her Way. Quickly figured out that speech was, basically, an attempt for us to start doing things Her Way. Which was...not happening. Fortunately, she's no longer at my hospital. She needed a nice, quiet job in a tiny office somewhere that fit her pace. :)

While doing research for a paper this week, though, I did happen upon what seems to be the med student/resident version of AN, and...wow, there was a thread where it was just EVERYONE kvetching about NP's and making fun of them and even referencing AN as "wow go over there and look at how special they think they are." It was like finding a high school burn book, and most of them just seemed bitter about the money and time they were spending. (But when I clicked to see more of their posts, because I am nothing if not petty, I found that most of them are like third year students who still don't even know their basics firmly...) Maybe your resident is a denizen there. ;-D

[audreysmagic, RN]

Well

I was faced with a similar situation several years ago while on a clinical rotation - A Sr RN who was not my preceptor decided to pontificate on how Psych Nurses are not "Real Nurses" actually putting on a little show of someone running away from a patient with chest pain. Everyone there knew I was a psych nurse. I took it all in good humor until I was asked to start an IV which I proceeded to do and this nurse steps in and says "Here honey I got that." I declined started the IV with no difficulty then found this nurse in the nurses station. I said in front of everyone there including a physician "Look honey, I have been a nurse from as long as you have and done many specialties. I will put my skills up against yours any day so treat me with respect and I will do the same." As karma would have our next admit was a 56 y/o man with chest pain who a congruent diagnosis of Bi-polar with psychotic features. Not a single nurse on the unit wanted to go near him. I Doctor I had known for years suggested that I go attend the patient and do the initial nursing assessment. Once I had the patient sorted out and comfort able everyone there had a new Idea about psych nurses.

Hppy

Oh, nothing burns me like the assumption that psych nurses couldn't hack it in medical... Granted, there are a few, but usually, they're not great psych nurses either. Carve on my grave, "Psych patients can and do have medical problems!" There's a vast difference between a nurse in a freestanding psych facility not having the resources or equipment to deal with a medical emergency and not having the knowledge...a battle I often have with EMS when I have to call them and they give me That Look like "this isn't an emergency." Well, it is here, when I can't properly manage it before it becomes one. Usually a good solid report and a reminder of our lack of higher-level medical capabilities wipes that look away, and I've been known to casually mention I used to be an EMT to some of them... #pettyforlife But usually I have to just sigh and let it go.

[3ringnursing, BSN]

UNCOOL!

The princess sounds fabulous - I bet all the RN's that have to work with HRH are all having to reinvent the wheel on a daily basis.

One good bite to that index finger should do the trick I would think.

[Needneedle]

I know that we should all be nice to each other always, but the reality is that sometimes there is not time to be nice, and there is a rank structure. Yes, in an operation, the resident is more important than you. Get used to it. As a prior attorney, I was always nice to paralegals. But if we were in the middle of a trial and my pen stops working, I am taking my paralegal's pen. I am the attorney with the law license, and the paralegal is not. I am the one who will be asking questions of witnesses, not the paralegal. While I would be civil about it, I would not stop or delay whatever needed to be done in order to explain things to the paralegal in the middle of a trial. I suggest that you go to the resident after an operation, and try to find out or learn whatever you missed during the procedure, and all you can say is that you didn't hear the resident at times. If the resident is decent, he will speak louder the next time, if he is a jerk he won't, but you can not stop people from being jerks. You can also ask the resident why the resident moved you around, but ask it in the sense of wanting to improve yourself for next time, not as Hey, you touched me! From what it sounds, the resident was nervous and compensated for his nervousness by throwing his weight around.

[Rocknurse, MSN, APRN, NP]

I know that we should all be nice to each other always, but the reality is that sometimes there is not time to be nice, and there is a rank structure. Yes, in an operation, the resident is more important than you. Get used to it. As a prior attorney, I was always nice to paralegals. But if we were in the middle of a trial and my pen stops working, I am taking my paralegal's pen. I am the attorney with the law license, and the paralegal is not. I am the one who will be asking questions of witnesses, not the paralegal. While I would be civil about it, I would not stop or delay whatever needed to be done in order to explain things to the paralegal in the middle of a trial. I suggest that you go to the resident after an operation, and try to find out or learn whatever you missed during the procedure, and all you can say is that you didn't hear the resident at times. If the resident is decent, he will speak louder the next time, if he is a jerk he won't, but you can not stop people from being jerks. You can also ask the resident why the resident moved you around, but ask it in the sense of wanting to improve yourself for next time, not as Hey, you touched me! From what it sounds, the resident was nervous and compensated for his nervousness by throwing his weight around.

Are you kidding me? Firstly, the resident has absolutely no jurisdiction over me. Secondly, this is my major rotation and she is just traveling through...she's in OBGYN, I'm a critical care major and a veteran of the ICU for many, many years, and I've been on this rotation for three months. It was her first day! Thirdly, I didn't do anything wrong nor miss anything as I've been in this business longer than she's been alive, so there's nothing that she needs to tell me nor does she need to pull rank on me. I am part of the team and I have my own patients and write my own notes that she has absolutely no input in. I don't bow to her. I'd save that respect for the attending and the lead APRN. What a ridiculous statement.

And an update to the other that I mentioned...the one who kicked me off of my computer, who I thought was a resident but actually turned out to be a new NP grad who had just been hired and is on orientation. She didn't show up for work 4 times and is now in a lot of hot water, the ripples of which went all the way up to the critical care medical director. I guess my instincts were right about her, but I'm not wading into those waters. I guess I'm just amazed at the attitude of some people.

[hogger]

people aren't always nice to me and when they are mean I make sure to post on internet forums so people give me E-sympathy.

Sort of took the OP serious until he/she starting throwing around all this nursing experience and precious millennial stuff. People can be rude, welcome to Earth. Something tells me this is not the whole story lmao.

[WKShadowNP, DNP, APRN]

The OP is definitely not a millenial.

[Rocknurse, MSN, APRN, NP]

people aren't always nice to me and when they are mean I make sure to post on internet forums so people give me E-sympathy.

Sort of took the OP serious until he/she starting throwing around all this nursing experience and precious millennial stuff. People can be rude, welcome to Earth. Something tells me this is not the whole story lmao.

Yes, people can be rude...just as you are demonstrating.

[TicTok411]

As a student I would try to take the high road and not let these residents see they are bothering me. I would not give them the satisfaction. I worked in the ICUs a long time as an RN and residents come and go. There are always a few who think their poo don't stink and a few that just want to try and put you in you place. Over the years you learn how to deal with these types. Fortunately, the attending knew us better than the residents and if it was a particular problem we would pass it up the chain and it would be handled. I have seen many a resident required to apologize to an RN he/she was rude to and that is delightful to witness.

I work as an NP in a non-teaching facility and so very thankful I do not have to deal with residents. Many were great and it was always somehow satisfying to see them grow over their residency. I always tried to help them out anyway I could unless they wanted to have a chip on their shoulder then I would let them flounder. The ones we liked we took care of and they appreciated it and worked well with us. The nasty ones, well the unit secretary would call every 10 minutes at 0200 to clarify every order one by one.