She really said that? Yep, it's gonna be a LOOOONG residency

[nursejohio, ASN, RN]

Just a *long* vent about our newest intern to rotate through... I feel like I'm going to explode. Management is aware, as are the upper residents, she's driving us all crazy!

The latest meltdown was over a patient in triage. All the classic c/o UTI, horrible UA and a temp. Her urine came back from lab with blood, leuks, nitrites, protein and epithelials. So the doc says the specimen was dirty, and she's not treating for a UTI unless we get a straight cath specimen? Really? Cause I wasn't aware the presence of epithelial cells completely negated the presence of all the other supporting s/s. Anyway, fussed back and forth over cathing the patient for no apparent reason and she was adamant about not giving abx until we had a cath sample. The 2nd year was at the desk, so we ran it by him and he said there was no reason to put the patient through that, and she needed to be treated regardless. So lil miss sunshine intern gets her scrubs in a bunch and says we (the nurses) are just like little kids "when mommy says no and you go running to daddy"

Hmm... I was under the impression that we are all educated and licensed professionals working together for the best interests of our patients. Apparently I was wrong. She is firmly of the mindset that her orders are law, and should be mindlessly followed. :bowingpur

Last week had an induction patient with borderline severe pressures. Hydralazine didn't do much, but mom was getting uncomfy and wanted an epidural. Anesthesia had already been called to come do the epidural, when she wrote an order for 40 of labetalol ivp. K, but lets see what the epidural does first maybe? Mom isn't rocking 200/110s, they were more like 150-160/80-90. Got the epidural, BPs dropped by a solid 30 points and doc is incredulous that we didn't push the labetalol beforehand. Seriously? I didn't go to med school or anything, but even I know epidurals can make blood pressure drop like a rock. As it was, baby didn't tolerate the drop anyway and mom got cut 30 minutes after for lates. If we'd given the labetalol it absolutely would have been a crash section. That was explained to her, "but I wrote the order, I just don't understand why these nurses aren't doing what I tell them to"

Her 3rd year has grabbed her by the hand and pulled her into a room multiple times because she's running her mouth in front of the totally wrong audience. FYI- the *nurses station* is probably not the best place to be complaining about how offended you are that we have the ability to think and are doing so before blindly following whatever drivil she came up with for an order, there's a *doctors lounge* for that crap. She's even been warned (by the other docs) that we'll be ones saving her behind next year when she's managing the high riskers and she needs to not make enemies, but she doesn't give a rip apparently...

[masonRN]

Interns sometimes need a good "breaking in." While I'd never advise someone to prank a new MD with a poor attitude, I'd have to plead the 5th if interrogated about my own past.

It sounds like there's a good team of docs there trying to set her straight. May I suggest that you and your colleagues make an effort to thank them for their efforts?

[Jean1313]

Geez, and I thought our Ortho PA was bad. I hope for the patients health, the RNs sanity, and for her own career, she wises up. That's horrible.

[Flare, ASN, BSN]

well - we're half way to july (and someone has gotten awfully big for their britches). It seems to me that putting patients through unnecessary procedures (uncomfortable ones too...) and ordering drugs for BP without first treating pain shows signs of a very narrow minded doctor. Oh Lord! I hope she's going to specialize in something like radiology where she can sit with a nice cup of tea and read films.

[Jolie, BSN]

I feel for you!

[TeleNurse2010]

I feel for you!

I feel for the patients! She needs to watch another film about mistakes being made in the hospital and the thousands of needless deaths that occur due to health provider errors. Doctors and nurses should work as a team for the good of the patient, not the good of their egos. I hope she learns her lesson soon, and not at the expense of a patient.

[HM2VikingRN, RN]

Ideally we should be trying to help each other get it right not wrong. We have a lot of med students come through our unit but our attedings have made a point of validating our skills/abilities to the students which has tamped down this silliness. Hopefully your docs will rein her in.

[Drakebrn]

I also work in a teaching hospital and have those same issues. Some residents have the attitiude " your just a nurse". Sometimes they just look at the patients as cases and not a real people. I know for young residents complicated cases are exciting, but when a resident breaks out in a smile and gets excited because a pt gets a 4th degree lac. I want to pull my hair out!!! As nurses we have to keep fighting the good fight for our pts and continuing to educate our residents, if that means going up the chain of command, so be it!

BTW, I have a resident who wants everyone with no medical complications to have elective cesarean sections. He feels it's so much easier on the pt and family to plan out exactly what day, when, not "suffer" through labor, and don't forget the all important perineal preservation!!! Ugh !!!

[PegRNBSN]

We had a very similar resident on our unit about 5 years ago. She pulled the same stuff but no one ever talked to her outside the heat of the moment. I along with another charge nurse had a meeting with her senior resident and her when she was not on duty (and neither were we). We brought coffee and sweets and talked about the issues. We started by first having the senior express his appreciation of nurses when they question or discuss orders as no one is above making a mistake or listening to another point of view. We then told her what we thought her strengths were ( this one was very smart) and then told her what we needed from her. We didn't say " you do this and this and we can't stand it!". We said "We need to be respected as professionals and colleagues. We are part of a team with the goal of providing excellent and safe patient care" We then asked what she needed from us. It turns out there were several nurses who knowing her reputation were quick to question or complain and even if justified didn't do it in a professional manner.

I or the other charge nurse met with her monthly for the rest of that year. She turned out to be an excellent physician and had great relationships with the nurses but it took alot of hard work on everyone's part.

Don't write her off yet!

[nursejohio, ASN, RN]

Oh, we do thank them every time we see it in action, but they aren't getting through to her... at least not yet.

The other residents have been known to prank an intern or 2, and I'm thinking she is in desperate need of it- whether it's them or us behind it? I don't much care.

Nope, she's an OB... which means we're stuck with her for 4 years unless she transfers mid program

Peg-that's an AWESOME idea. She's grating on everyones nerves just as much, I bet I can find a couple willing to have a sit down with her. She really does have potential, but right now she just can't see that there is a way other than hers everytime. Hopefully we can fix that before she flips to the dark side :chair:

[prmenrs, RN]

I like that it was 2 docs and 2 nurses, she was less likely to feel ganged up on. Neutral territory is a good thing, too.

Kind of a "come to Jesus" meeting.

[Sandwitch883RN]

I've never worked in a teaching facility until now. Nurses have far less autonomy where I work now and its frustrating. There is also far less respect for nurses. In a community hospital where there are no in house providers the docs seem to acknowledge or at least realize nurses can and will save their butts if they show respect and and support even minimally. Here....well... not so much. I had a resident ask me to dig through the trash for something that was inadvertently thrown away by myself and another nurse. I refused. I politely told her she was welcome to get it out of the trash but I would NOT be doing it. It wasnt something that was absolutely needed! It's going to take some getting used to working with residents and interns! I guess they think all we learn in nursing school is how to mindlessly follow orders and provide menial labor. God forbid we develop critical thinking skills!