So I'm not trying to step on any toes here, but I am just a little shocked at two experiences I've recently had and I want to know if this is normal or just two bad cases...
First, I worked at a small critical access hospital and we had to call a rapid response on a patient. All of the nurses rushed in and worked their magic while I watched over the floor since I was the only PCT and all of the nurses were busy. 20 minutes after the rapid was over, the physician came calmly and slowly walking down the hall and asked our nurses about the rapid. She was two months pregnant and took frequent hour long naps throughout the day and really just didn't seem at all concerned about the rapid response (if being 20 minutes late didn't say enough, IMO).
Now I've transferred to another hospital in the same network but it's a bigger hospital with all of your expected units. So last night I was watching our telemetry monitor and a patients heart rate dropped to 40, 30, 17... I alerted my nurse and we ran in. The woman was gray, not breathing, and by that time had no pulse. We called a code blue and I started compressions while the nurse got her oxygen. In a matter of minutes the code team was there and took over and once again I found myself monitoring the floor because the nurses were in the room working on this patient. About 10 minutes after the code started, the physician came walking up like he had no care in the world, stopped outside of the room and looked in for a whole maybe 8 seconds, and then left! He didn't ask a single question, walk in the room, hell, he probably didn't even know the patients name!
I've just found myself really outraged both times that the physicians did NOTHING. Is this how it normally goes? To me it just seems like doctors prescribe the meds and the nurses do, well, everything.
I do not believe in letting someone dig his/her own grave. What is the point of doing so, other that getting feeling of self-satisfaction? Why not be a professional and be helpful? If the resident doesn't want the help, then fine, you've done what you could, but this idea of "I'm going to sit back and watch them drown" is petty, juvenile and unprofessional. Who knows...that resident/doctor who's a jerk could become your biggest ally, all because you chose to take the higher ground.
Don't get me started on bomb paging interns/residents at 0300 for Tylenol, Colace, etc.
I'm not being petty and unprofessional. By far. I sort of resent the implication.
I don't bomb page interns and I never will. That's just idiotic.
But if I'm treated with disrespect and like a handmaiden, and the resident is about to seriously infuriate an attending (note: NOT with anything THAT CAUSES HARM), I'm going to let them do it. I'm not going to suggest an alternate pathway, nor should I have to. Professionalism goes both ways. If I've tried to help, and they reject it, and/or treat me like I'm an idiot, I'm done. Here's your rope, dude. Pretied.
You mentioned this, and then jumped to the conclusion that I'm a jerk about it. Not in the least.
Sometimes taking the higher ground just makes you a pushover. In my almost 40 years on God's earth I've learned the difference. And there's a huge difference.
It is unfortunate that we as medical professionals are still having this debate in the 21st century. Allowing interns to fall on their face because they are "jerks" is petty and unprofessional and only reinforces the negative stereotype of nurses as proletariat. This is an 19th century mentality that has been perpetuated to the detriment of nurses, physicians, and patients.
We are supposed to be a team for heaven sakes, its not a competition. I think co-education of physicians and nurses would go a long way to fostering a sense of camaraderie, and a nurse who works with student physicians can go a long way in teaching them the appropriate ways to conduct themselves. Why not bail the jerk out, then take him/her aside and explain that the way you were treated is unacceptable behavior and that he/she should not treat you or any other nurse that way?
Why not teach the student instead of "eat the young"?
I'm not being petty and unprofessional. By far. I sort of resent the implication.
I don't bomb page interns and I never will. That's just idiotic.
But if I'm treated with disrespect and like a handmaiden, and the resident is about to seriously infuriate an attending (note: NOT with anything THAT CAUSES HARM), I'm going to let them do it. I'm not going to suggest an alternate pathway, nor should I have to. Professionalism goes both ways. If I've tried to help, and they reject it, and/or treat me like I'm an idiot, I'm done. Here's your rope, dude. Pretied.
You mentioned this, and then jumped to the conclusion that I'm a jerk about it. Not in the least.
Sometimes taking the higher ground just makes you a pushover. In my almost 40 years on God's earth I've learned the difference. And there's a huge difference.
It is unfortunate that we as medical professionals are still having this debate in the 21st century. Allowing interns to fall on their face because they are "jerks" is petty and unprofessional and only reinforces the negative stereotype of nurses as proletariat. This is an 19th century mentality that has been perpetuated to the detriment of nurses, physicians, and patients.
We are supposed to be a team for heaven sakes, its not a competition. I think co-education of physicians and nurses would go a long way to fostering a sense of camaraderie, and a nurse who works with student physicians can go a long way in teaching them the appropriate ways to conduct themselves. Why not bail the jerk out, then take him/her aside and explain that the way you were treated is unacceptable behavior and that he/she should not treat you or any other nurse that way?
Why not teach the student instead of "eat the young"?
Oh my dear LORD. I am completely being taken the wrong way.
What I said, restated: after a percentage of time, if i'm continuously treated like I'm some sort of third class idiot, I will not step in if a resident is about to screw himself over. The reasoning behind this is to teach this individual that occasionally you catch more flies with honey/can't treat people like crap regardless of what your title is/a bit of professionalism goes quite a long, long, long way.
Sometimes the best teaching moment is to let the person screw up.
Know who taught me this? MY PARENTS!!
And I daresay whoever raised ANY kid (or precepted a student, or worked with a stubborn MD/DO) has done the same thing: okay, sunshine, you're going to do it anyway, I tried to guide you differently - GO AHEAD. I'll be here to do the right thing for/with you when you come back. It was done to all of us at some point by someone; please don't try to pretend it hasn't been.
Every single time I've done this, the most amazing thing happens: it appears the doctor starts looking as us as though we just might know what in the blue blazes we're talking about!!!
Again, sometimes people need a kick in the pants. No one said this is competition. I use this when I see it going that way because I am sick to death of watching some nurses cower to MDs/take crap that they wouldn't take from their own spouses/get walked all over like we're doormats. I'm not.
Yet immediately people think I'm being a tool. Far from it.
Arrogance needs to be addressed. I don't stand for it. I didn't stand for it as a civilian and I won't stand for it now. It's disgusting. Is this a bit of a passive-aggressive stance? Maybe, but then again, so's being an obstinate twit with no grasp of the situation or the handle that the other person has on it - I'll show you how much smarter I am than you - I'll handle this, I'm a doctor, I know more than you. Uh, okay, good luck with that. I'll be here when you're done, and I'll probably have what we had already talked about ready for you when you get back.
I've gotten glowing performance reviews every year, civilian and military. I've never been disciplined and have had one complaint in six years, and the patient wasn't telling the truth - my boss knew me well enough to know that. Have I made mistakes? Yep, and they've been addressed. I've been written up. Wrote myself up, actually, on two separate occasions because I was the one who screwed up. I'm talking about disciplinary action, or being told I have 'attitude'. Not once. As a civilian I was recognized by the medical director of the entire cancer center twice for things I did. My guess is I'm not a problem.
One of them had to do with his own doctor (a RESIDENT, NOT an intern - we didn't have cross-cover interns on my unit after a couple of near misses on their part, so seeing a resident's name didn't seem odd to me because they all rotated through our unit) screaming at me into the phone when he was paged incorrectly - but it was his fault because he didn't check his pager out at the end of the day! I was calling the right number (cross-cover) but this tool didn't leave his pager at work. So he's screaming and CURSING at me into the phone (like a SAILOR), and I just let him go. The nurse sitting about four feet away from me heard every single word he said. When he paused for breath, I asked him, very politely, "Dr. X, was your pager turned in before you left the floor today? I think that's what happened." More cussing and then I was told that wasn't his problem, that I should know where the pager is. OMG - really? Then I told him once he'd stopped again, "Dr X, this has ceased to be a professional conversation and has turned abusive with your language. I am going to hang up the phone and call downstairs to get the name of the MD who is covering. I also want to tell you I have to report this to the Medical Director, Dr. Q, in the morning. Again, as I said before, I am sorry you were disturbed, but I was calling the correct pager number as noted in the order. Good night."
I wrote up the entire incident in an email I sent immediately to myself - both my personal and work emails. The RN who witnessed the whole disaster specifically told me to mention her in the email and that if questioned, she'd back me up.
I have a right to a harassment free workplace. I have a right to freedom from verbal abuse. THAT was verbal abuse. I didn't stop him - okay, genius, here's your rope, knot included. Then I stood up for myself, very professionally.
I should add that this MD had a reputation for embarrassing, belittling, and generally demeaning the RNs and occasionally a CNA. I worked mostly nights so I rarely had the misfortune of dealing with him, but I'd seen him in action more than once.
Next morning I told my boss - who told me I did exactly the right thing - and the medical director actually came looking for me. He listened to my story, said I made the right decision, and said he wished others would take a stand and stop people from - his exact words - 'treating staff, especially nurses, like doormats'. He told me the behavior was uncalled for and he would address it, that he would appreciate it if others would let him know when his staff was out of line, and thanked me for my professional approach.
Guess who walked onto the unit as we were speaking?
This guy got a needed attitude adjustment. I let him hang himself. Cuss at me because you're the idiot? Oh heck no. I found out I wasn't the first person he'd done that to. He didn't do a complete 180, but it took a lot of the edge off of him.
Please do not assume I'm a jackass about it; read the post for what it is. Again, I know the difference between taking the higher ground and being a pushover. As the med director said, there is absolutely no reason for me - for any of us - to be a doormat.
Co-education of MDs and RNs would certainly go a long way. It might teach medical students we're not morons nor are we the hired help, and we do not need to be treated that way.
I remember once when I was in nursing school, a medical student came up to me to ask about a patient. At the time, we didn't wear a specific uniform and were easily mistaken as staff. I'd been in school about a semester and a half, and was terrified of the things he was asking me. I smiled and said, "I'm sorry, let me get the RN, I'm just the student."
The med student was with a group of others who were following their long-white coated instructor, a man whom I knew was the director of the cardiac floor I was doing my rotation on. In fact, he was head of cardiology. This man, who is nationally recognized for his research and his achievements, spoke to me above his students.
"Excuse me, miss? What was that you said?"
I thought - OMG. I'm about to get ripped by the local Cardiac God. Literally, I wanted to die, all of the students (who nearly trembled in his very presence, I'd seen it) turned and stared at me while I tried not to throw up.
"Oh, I'm sorry - I was only telling XXX here that I can't help him, that I'm just the student. I'll go get the nurse for you."
He shook his head at me. "That's what I thought you said. You are never, ever just the student - none of you. And when she [he read my badge and called me by name] graduates, she is never just the nurse. Don't ever say that - we are a team." Verbatim. I will never forget that.
So why not teach the student instead of eat the young - why not tell people, no, this is how it is, rather than letting young med students see us as hand towels to be wiped on?
Also in school, I was sent down to our ambulatory surgical unit for three days for OR observation time. My first day was great. Second day, not so much: the RN I was paired with told me I couldn't stand but so close, not to touch anything, 'you can't do this', 'don't even think about doing that' - I get it's her OR, but really, I'm not a moron. She actually took me by the shoulders and told me, "Don't move from here." Seriously? I thought, she's creating an example she doesn't want to make. I said nothing, kept a game face. She did this all day to me, in front of everyone. It was, to say the least, humiliating - but it's not my OR.
Finally in the middle of one surgery the doctor stops what he's doing (he was repairing a tendon of a guy who put a steak knife through his hand - he FOOSHed over the dishwasher) and looks at me. "You have papers to write, don't you, and you can't see from there." I nodded, gave a timid, "Yes, sir."
The RN goes, "Well, she'll contaminate the area. She'll touch things and get in the way." (I'm thinking, lady, I'm 33 years old with a 4.0 GPA. I know what I'm doing, you don't have to talk to me like I'm not here. I said nothing. Not my OR.)
MD: "She looks smart." To me, with friendly crinkled eyes (the only smile I'd seen in the room): "You're not going to touch anything, are you?"
Me: "No, of course not."
MD to RN: "Get her sterile gear. She's paying this place to observe. Let her observe." Verbatim.
And I got suited up and stood about a foot from the hand he was working on and got this amazing closeup of the surgery, which he talked me through the whole time. And then when he was closing up he sent me back to talk to the CRNA running the anesthesia - "hey, Joe, show her what you do". All because a doctor recognized that a student nurse was missing out. When he was done, the RN literally took me somewhere else and said, "I don't want you in my OR any more." Also verbatim. What did I DO, anyway? I get she may have been basing her actions on past experiences, which is why I said nothing, but she went further than that, consistently. Treated me like an object - even as though I were stupid and incapable of following simple instructions. Or tell me, "when I'm in the OR, I have students do XYZ (tell me what she expects). What is your assignment for this observation so we can see how best to meet your tasks?" Again, professionalism. I don't care if you want me five feet away. It's not my office. If you don't like students and think we're a nuisance (I get that), tell your boss you don't want them. Simple. But don't treat me like your frustration is somehow my fault. That's not fair.
I had a better day afterward with the other RN she put me with. And I got great comments on my 'learning experience' when I wrote the whole thing up in my journal entry for class.
Yeah - why not teach the student rather than eat the young?
Specializes in Oncology; medical specialty website.
It is unfortunate that we as medical professionals are still having this debate in the 21st century. Allowing interns to fall on their face because they are "jerks" is petty and unprofessional and only reinforces the negative stereotype of nurses as proletariat. This is an 19th century mentality that has been perpetuated to the detriment of nurses, physicians, and patients.
We are supposed to be a team for heaven sakes, its not a competition. I think co-education of physicians and nurses would go a long way to fostering a sense of camaraderie, and a nurse who works with student physicians can go a long way in teaching them the appropriate ways to conduct themselves. Why not bail the jerk out, then take him/her aside and explain that the way you were treated is unacceptable behavior and that he/she should not treat you or any other nurse that way?
Why not teach the student instead of "eat the young"?
That was a great example of how we can work together, maybe even get the "jerk" to straighten up and fly right. You are right, letting someone dig their grave because they irritate you is just another example of "eating our young."
Unprofessional. It's about the patient, not you. That kind of behavior is a great way to foster hostility. Suck it up and do the right thing.
Of course it's about the patient, something residents and interns rarely understand. I advocate very strongly for my patients. I've basically told a resident "over my dead body" when they wanted to do a speculum exam on a woman because the med student "hadn't got to do one yet." My letting them drown was more in the way of letting them flounder in front of the attendings and their upper levels. If I'm just a nurse in their eyes, then so be it, they don't have to have the benefit of my experience and knowledge. As far as fostering hostility, well, if we'd gotten to that point in a relationship they had fostered a huge amount of hostility in me. I've been a great resource and friend for many residents and students, but for those that know it all, well, who am I to argue with them?
There are many ways of doing the right thing by the patient and allowing a resident to dig his or her own grave.
Yep. Hey, if they know it all, and I'm "just a nurse," I'm certainly not going to burden them with my experience. And usually when you get to this point with a resident, you've tried to help them and rebuffed many times.
Specializes in Oncology; medical specialty website.
carolina, I'm not going to quote your exhaustive post, but how you went from someone "digging a hole" to the verbal abuse incidents you describe, I'm sure I don't know. To me there's a big difference between an intern/resident who refuses input from nursing that would help the patient vs someone screaming about a pager issue. I never said we should tolerate abuse, and I can guarantee you I am no doormat.
I'm glad for you that you are so highly esteemed at your facility.
Oh my dear LORD. I am completely being taken the wrong way.
Yeah - why not teach the student rather than eat the young?
How many ways can I say I love this?!?! :up:Thank you, you said a lot of what I feel. I'm there to help, to teach, to contribute, but I am NOT your dang servant, and treat me like that at your peril.
carolina, I'm not going to quote your exhaustive post, but how you went from someone "digging a hole" to the verbal abuse incidents you describe, I'm sure I don't know. To me there's a big difference between an intern/resident who refuses input from nursing that would help the patient vs someone screaming about a pager issue. I never said we should tolerate abuse, and I can guarantee you I am no doormat.
I'm glad for you that you are so highly esteemed at your facility.
The mere fact that I give the impression of being 'esteemed' at my former place of employment seems sad to me, when all I ever did was make it clear that I won't be trod upon. People took that as some sort of radical move (the charge RN the night of the phone call incident was HORRIFIED by what I told that doctor). OMG. Why? Why was it viewed that way? Why was expecting to be treated with a bit of respect and dignity seen as so - unusual??
My point was this: when you're treated like crap, you reach a certain point where enough is enough, and you no longer deserve my assistance - or anyone's, for that matter. So I don't give it.
I also don't put up with abuse. That's nothing more than abuse - interns treating nurses like handmaidens, hired help, and complete morons who are there to wipe butts and fetch bedpans IS ABUSE - and plenty of RNs take it. WHY?? Why allow yourself to be walked on?? (That's the 'royal' you, not a specific you.) Uh, no thank you. Secretaries don't put up with it, teachers don't put up with it, computer programmers don't put up with it, and neither should I. Neither WILL I.
And RNs do it to each other as quickly as doctors do it to RNs. Either way, it's lateral violence (since there's not a doctor on this earth that I work for, other than my now hospital commander), and it's crap.
Sometimes being the bigger person proves nothing except confirm, at least in the other person's eyes, that you can be pushed around, that you have no self-respect, and very little self esteem (whether any of those things are true or not), and that's bogus as far as I'm concerned.
I get sick of RNs being told to sit down and take it, either implicitly or explicitly. "Oh, help them, even if they're jerks, be the bigger person" - as my British husband says, bollocks - helping someone who treats you like dirt tells them you're open to it, and there's not one RN in the world (or LPN, or CNA, or housekeeper) who needs to bow down to that sort of garbage.
I'm rather pleased my post was found to be exhaustive. It's equally exhausting watching people put up with that sort of disgusting behavior on a daily basis - or at least it was. It's much, much rarer in the military.
Yep. Hey, if they know it all, and I'm "just a nurse," I'm certainly not going to burden them with my experience. And usually when you get to this point with a resident, you've tried to help them and rebuffed many times.
Exactly. So why should we be expected to kiss their behinds, ingratiate ourselves to them, and keep pandering to their every whim?
Apparently it's OK for THEM to be unprofessional and treat us like idiot children, but if WE say, hell no, WE'RE unprofessional and we're the ones who need to meter our behavior.
Specializes in PICU, NICU, L&D, Public Health, Hospice.
What do doctors do? I wonder how many Americans are wondering WHERE WERE THE MDs when that woman in Oklahoma was laboring in the middle of an EF5 TORNADO and her attendants were FOUR INCREDIBLE NURSES!?
WELL DONE, LADIES!!!
(Back to the thread - I've just been almost desperate to post that somewhere!)
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OCNRN63, RN
5,979 Posts
I don't agree, based on my experience.