Friday, October 26, 2012

Differences in opinion

There is always a bit of tension between a few staff members. It's present in any large organization and hospitals are no exception. This holds even more true in the ER, where the usual interpersonal relationships and disagreements are set against a backdrop of tragedy, loss, pain, crisis, and high emotion. So when differences in opinion migrate towards verbal disagreement or actual arguments, no one is too surprised - this isn't condoning the disagreements, just acknowledging that sometimes shit gets real.

So imagine my surprise the other night when shit got reeeaall.

An on-call resident pitched an absolute fit when he was dragged out of bed at 0400 to consult on a perfectly legitimate patient. He whined over the phone for a few minutes and then said he would be in shortly - I thought the story ended here. No, sir. It did not. When he showed up thirty minutes later he went absolutely ballistic in front of the patient, yelling at the ER attending for what he considered a BS consult and how it was the epitome of all things awful to have called the consult in the first place. The attending took it pretty well. He maneuvered the resident into the hallway for some privacy, and then proceeded to tear apart the resident for thinking himself so arrogant.

A few highlights of the new asshole-ripping the resident received:
"I've been an ER attending for 18 years. You've been a resident for two. Come back to me and decline a consult when you're actually a real doctor."

"I'm friends with your attending. I'll be sure to mention this gross absence of professionalism when I see him next week."

"If you ever, ever act that way again in front of a patient of mine, I will see to it that you are out of this residency program so fast you'll wonder what the hell happened to your life. Are we clear?"

I'm telling you folks, it was one of the most epic things I've ever witnessed.

**I should note that this is probably not an unusual scene to those who have worked at a teaching hospital before, but I've never worked with residents before this assignment. Thus, epic.


EMTErica said...

Is it bad that I LOVE when shit gets real like that? I hate a lot of things, but a false sense of entitlement is toward the top of my list. I witnessed something similar in my ICU, and it was a glorious sight to see.

court said...

this isn't exactly the same thing, but I got treated to some residents getting told when I was in the ICU after my second surgery to clear up the havoc peritonitis wreaked on my insides.

my awesome Chief-of-Surgery doctor came by with a group of residents on rounds. he asked them what they thought should be done with me, & they were all like, "she needs her catheter pulled; it's been more than 24 hours, & we should do another CT scan today to see how successful the operation was."

then he turned to me (a lucid 27-year-old who'd been perfectly healthy until another doctor failed to note that she had appendicitis a couple weeks earlier). & I was like, "uh, I don't want a UTI, but I also really don't feel strong enough to use the bathroom right now. & CT scans are actually really physically taxing too, so is there any way we could defer it 'til I've healed a bit more? or maybe we could do an ultrasound or mobile Xray instead?" (I'd had a really rough couple of days because they'd forgotten to up my pain med order after my surgery, which led to a horrible sleepless night during which I'd messed up my back on top of everything else.)

some of the residents started to argue, & the doc turned them saying, "here's your first lesson: always pay attention to what the patient is telling you, & if it seems reasonable, listen to them. her Foley can stay in another day; it'll be fine. she doesn't need a CT scan yet. what she needs is rest."

it was pretty awesome to witness. & he was a really phenomenal doctor/person.

Kathy said...

So did the resident shape up after that?
It's been a long while since I worked with cocky residents! Thanks for making me smile! You are a very entertaining writer, keep the stories coming...