Okay, so I'm probably going to get a lot of crap for this, but I have to say this latest crop of med students is . . . kind of dumb. Or lazy. Or both.
Admittedly, I don't know that much about what's involved in med students' rotations through our ED, but I do know that they are there as part of their education, and maybe they should take a little interest in what's going on?
I understand that they are tired and stressed out and sometimes freaked out and miserable. Believe me, most of the residents are, too. But past students haven't acted quite as strange as this bunch.
They seem to spend a lot of time lurking around: near the doctors' station, in corners, in the trauma room staring at the cabinets. "Do you need to find something?" I always ask, thinking their resident sent them over to get supplies. "No..." comes the answer. "Okay, just ask if you need something."
One refused to do the infamous DRE (digital rectal exam) that most med students are sent to do--to get some stool to smear on a guiac card to see if there's blood in it. He presented me with the card and said, "Dr. So-and-So needs some stool on this." I told him to go ahead and get it, and he told me "I don't need to do that, since I'm going to be an anesthesiologist." Not if this behavior continues! Apparently, the resident he's with is very frustrated with him, because he doesn't want to do anything; she thinks it's a cultural thing and that he has a problem taking instructions from a woman. Great.
I'm just not used to the way these students are kind of dragging ass all over the place. Ask them to do something and they roll their eyes. I've overheard several presentations, and when they forget something and their supervising doctor asks them to go back and clarify it with the patient, it's as if you asked them to stick their whole arm up their own assholes.
One of them came up to me and said, "Dr. Blah Blah wants you to give 2 Percocets to the guy in the asthma chair area." Since there were like four men in that area, I asked, "What is the patient's name?" She responded, "Dr. didn't give me a name. She just said, 'Tell GuitarGirlRN to give the guy in the chairs 2 Percocets.' " I said, "Ok, but I need a name. Could you find out for me? Or point him out?" She sucked her teeth and said, "I don't know which one! I'm just telling you what Dr. said to me!" and walked away.
Even in interesting situations like a code, or a trauma notification, they're hanging back, lurking around doorways--not jumping in like previous classes. I understand being shy or unsure, but when people are asking you, "Hey, come on over here and do some chest compressions," or "Spike this bag of fluids," or "Come look at this x-ray, what do you see?" and you're looking around like "Who, me? Uh, my laundry is done, gotta go..." I just don't see it as a good thing.
If you're lost, I'll help you and tell you where to go. If you don't know what supplies you need to start an IV, I'll show you. Need gauze? Okeydoke. Need to find a urinal so you can get a specimen? Right over here. Even if I'm busy I'll help you or find someone who can. I'm not mean. I'm happy to show you how to put in a Foley or start an IV. But you need to shake a leg and show some interest--or just pretend! Fake it til you make it, med student!
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19 comments:
Oh just give 'em their MD already so they can get over the distastful part and start earning money. Sheesh!
eye roll
The sense of entitlement knows no bounds! It's really nice of you to remain so helpful in the face of disinterest.
The sense of entitlement knows no bounds! It's really nice of you to remain so helpful in the face of disinterest.
I think guiac card dude should be on enema duty at least for a couple weeks. All enemas all the time. Nothing else.
Out of curiosity is it annoying when you have the opposite? Say you have a medical assistant following a pace behind you as you place an IV. Does it bug you if they insist on sticking close and sponging knowledge off you?
(Sorry, not overly topical, but as a pre-med student it's tough to find a medium place of eagerly learning and letting people do their job uninterrupted)
Zach,
Thanks for asking! Sometimes it's a little annoying when you're very busy and have to work fast, but it comes with working in a teaching hospital. I don't really mind, and I have no problem politely asking someone to wait outside the curtain, and if the patient is not comfortable with lots of people at their bedside, I'll insist that people step out.
Right now I'm precepting a new nurse (new to the ED, not new to nursing), and it's a little exhausting for me to slow down and explain. But it comes with the territory.
Believe me, you'll be able to quickly figure out who enjoys teaching and who doesn't. I often have a trail of paramedic students following me around, which I really like--because when I get really busy, it's great to have someone around who can start IVs and draw blood for me while I'm doing other things!
xoxo
GGRN
There is one group every year that has no motivation. No one knows why this is.
The next group will be better.
In the good old days, a nurse's letter could make or break a med student's grade.
One of the problems with health care is somewhere in recent history that changed. We'd have better docs if med students listend to experienced nurses.
Of course some of these kids who just graduated nursing school - oy do they need an apprenticeship!
We've had a mixed bag with medical students in the OR lately. Some students are very polite, introduce themselves, and take direction well. Others will come late, see the surgeons at the scrub sink, and then walk in the room with their arms soaking wet expecting to have a gown and gloves magically waiting. These are the same students that will start grabbing instruments off the mayo stand during surgery so they can hand them up to the surgeon. (Oddly, the biggest "problem child" students we get in the OR are actually PA students, not MD students.)
This is just typical American/western attitude. And industry (many industries) encourages this by only hiring the people who will accept the lowest pay. You get what you pay for.
With every recession it seems the pay scale in many industries lowers. And that means hiring people who are more clueless/lazy/unmotivated than ever.
Tell him that you have done your fair share of DRE's and wouldn't want to to deprive him of the educational opportunity to do it himself, anesthesiology or no. How lazy can you get. He seems like the type that won't do anything cause its the "nurses job"
Aww...send Mr. No DRE to a spinal cord unit and force him to do bowel routines for a week. We do dig stim, we do suppositories, and we do enemas.
He'll be able to learn how to start IVs there, too, since he'll need to know that as an anesthesiologist, too.
God I hate primadonnas! That Perc idiot will probably end up going into pain management. With a flippant attitude like that, she'll have lots of customers, and maybe lose her license pretty quick handing out the "candy" to just anyone.
chuckr44, Med students aren't employees, they are students. They pay a LOT of money to get into med school. It has nothing to do with recessions or western laziness.
Apparently you are too lazy and clueless to understand what you're reading.
GGRN, just remind them that it's a teaching hospital for Doctors and Med Students, not RNs.
As a current med student (and occasional reader of your wonderful blog), I am embarrassed to hear that there are students out there giving the rest of us a bad name. However, to be honest, I'm not too surprised. I'll just say that I'll keep all this in mind when I start my rotations!
Alli
I'm a second-degree nursing student, and I'm BEGGING to start doing IVs and caths! They tell me i'll "learn on the job", but i'd like a head start...before they sic me on poor helpless patients! :-p
On the one hand they do sound like the dozens of doctors I have seen. So is one promoted to specialist based solely on arrogence or are there any other criteria (like, say, 'hands on' medical practice). To Mr. anesthesiologist; um, no you are not. Most Anesthesiologists if not all that I have met or worked with (been put out by) realize that they hold the life of the patient in their hands - bring them back alive. And that means knowing the patient, being patient, getting all sorts of weird things said to you when you begin light sedation and never getting thanked. So drop out now becuase if a little fecal matter is "too much" then you don't have what it take to me my or many other complex medical conditions person to help bring us BACK alive. Thanks for the great stories.
I've seen this in droves with nursing students over the last few years also. What kind of generation have parents over the last 20 years raised? Egads!
You might explain to the anesthesiologist wanna-be, that he should explain to his resident that anesthesiologists don't do that. Since he some day expects to be an anesthesiologist, he is just too good for this.
Or you could send him over to Frank Drackman for some commiseration.
Maybe they've read your blog and seen how you bad-mouth others that make mistakes or don't behave just the way you think they should. I would be hesitant and/or hostile to someone like that as well.
Anonymous,
Maybe they've read your blog and seen how you bad-mouth others that make mistakes or don't behave just the way you think they should. I would be hesitant and/or hostile to someone like that as well.
These students are not people who have any idea about who Guitar Girl is.
If these students are worried about being anonymously criticized on a blog, they really are overly sensitive and should consider a job somewhere else. Somewhere where their incompetence is less likely to kill people. Perhaps collecting garbage.
These students are there to learn - not to be baby sat.
Do you have any idea how insignificant this anonymous criticism is compared to the verbal criticism in front of their so called peers by attending physicians? If this is upsetting to them, how will they deal with patients dying? Perhaps you will be there to hold their hands and tell them it is OK, when they do not know what to do when dealing with an emergency. Perhaps you will tell them it is OK when their inaction leads to the death of patients.
You appear to have no idea about what is important in medical care. Being politically correct is dangerous to patients. The criticism of people who are dangerous is not a bad thing. This blog helps others to see where misbehavior can lead.
You are hostile, but you do not appear to have a clue. You defend those, who are dangerous to patients.
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