Dealing with MDs (residents)

Hi, I would like help with this subject. For the most part, I don't have problems with residents. But there have been instances when I felt my concerns were not listened to, or when I needed their help and didn't get it. We have (as is everywhere it seems) an understaffed unit with the underserved population (and the whole host of issues that brings with it).

I think this issue has come up mostly with first year residents, it seems. I am very vocal, and will say something if I feel it isn't helpful, is negative, ect. I am not able to 'blow it off' as most of my coworkers are.

Between this, the understaffing, and the sometimes difficult patient population, I am burning out.

How can I help this situation?
Does the Attending have any input? Do you guys give performance reviews of the Medical Staff? i.e. Fellows and Residents.

No, we don't get to give input. the attendings are nice, but not around on nights.

Residents can be a pain. They're somewhere between scared to death and competent...some further along than others With 'full' doctors (beyond residency), I've asked them who I need to call if they're not interested in helping. I've also called the nursing supervisor to cover MY butt when I can't get decent orders (from 'full' docs as well).

That is odd. I have worked with lots of "residents" in my career and have never encountered one who was not interested in what you have to say. Or one who refused to help. Since you are responsible for your patient's care, just call your supervisor, charge nurse, or whoever your superior is, if you need help and can't get it. I find it strange that a resident would not/could not provide medical help when you need it. If it is simply nursing help that you need, that would be understandable. Have you tried to suggest to the residents just what you need or expect from them?

Quote from applewhiternThat is odd. I have worked with lots of "residents" in my career and have never encountered one who was not interested in what you have to say. Or one who refused to help. Since you are responsible for your patient's care, just call your supervisor, charge nurse, or whoever your superior is, if you need help and can't get it. I find it strange that a resident would not/could not provide medical help when you need it. If it is simply nursing help that you need, that would be understandable. Have you tried to suggest to the residents just what you need or expect from them?

Quote from beebleI am very vocal, and will say something if I feel it isn't helpful, is negative, ect. I am not able to 'blow it off' as most of my coworkers are.Between this, the understaffing, and the sometimes difficult patient population, I am burning out.How can I help this situation?

Well, I only talk to them re a patients issue. I dont bother them otherwise. They are part of an elite group and don't tend to socialize outside of that (sarcasm). it's when I don't get help with the issue, the issue is dismissed without discussion and/or the resident dosen't bother to treat me as part of the 'team' caring for the patient (but more of a waitress) that irks me.

I worked at one particular hospital where alot of the residents seemed particularly dense about wanting to listen to the nurses. I would document, document, document, as well as page the seniors and/or attendings when ever necessary.

Oh yes. I once had a first year resident write an order for MS04. I called to ask him to change the order, because the pt was allergic. This allergy was listed on the MAR, on the front of the chart, and on the H&P. The resident didn't change the order. Instead he said, "Oh, it's unlikely that the pt has a TRUE allergy. She probably just gets nauseated or itchy or something. Go ahead and give it." Of course I refused, and he acted like it was SUCH an inconvenience for me to bother him with such a trifling thing like pt safety and all...so I went over his head directly to his chief, told her what was going on and she changed the order. I heard that the first year got quite the reaming from her. Documentation and communication are your best friends when dealing with new docs that are stubborn for no reason. These types (thankfully, they are rare) will usually have their butts handed to them at some time by either their chief or the attending. Just make sure you cover your own turd cutter by documenting everything factually and in a timely manner. Although it is very hard to deal with the "know-it-all" attitude from this population, know that they are learning, and but sooner or later, they will recognize that our input as nurses IS valuable. The ones that don't listen to other members of the multi-disciplinary team are also the ones that the rest of their peers can't stand.

Quote from beebleWell, I only talk to them re a patients issue. I dont bother them otherwise. They are part of an elite group and don't tend to socialize outside of that (sarcasm).

Quote from AltraDoes intransigence go both ways?

Just remember this" God made residents because he was disappointed with the apes." I had one that played around with a body when the family was outside the room. One that was more interested in hind quarters of the female staff then he was with a dying patient.Some of them are good and some are morons. That's life in the big city. Do the best you can with the good ones and put the bad ones back in their cages.