Its not easy being green
Bambi. Newbie. What's another term for those warm and fuzzy interns? I mean no disrespect, honestly. But they're so cute!
June brought us a new batch of 'em from the family practice program. Plugging a post from Dr. A., I will admit that I do appreciate the family docs for many reasons. It is true, not everyone can know something about everything, and while a specialist is necessary at times, the down-and-dirty basics are still there.
What I find a entertaining is that the same dude who can manage a K+ of 6.7 with kayexalate, EKGs, O2, and IV push insulin with D5 50 without breaking a sweat - yes, this happened on our non-monitored unit - is the same guy who is hesitant to order an antifungal cream for yeasty skinfolds.
Early the other morning, Dr. Dearest comes to see his patient. I brought the gloves.
He does his physical assessment, tries to talk to her about how she is feeling, and generally ignores me. He mentions a few orders he will be writing, and I ask him if he would mind tossing in some nizoral lotion for her groin and abdominal folds. He wanted me to get her in to bed so he could see it. It happens every time, and each time I hope like crazy that it won't. This is why I brought the gloves. He looks interested, and I can sense the wheels turning in his mind. But does he write it, in the end? No! Mama Doc will be rounding with the whole group later in the day; he'd be back. At the end of their visit, I mention the skinfunk again. He says he examined it earlier. And? Mama Doc asked for his assessment. She said it sounded fungal. The patient is a morbidly obese diabetic. What is your plan? He writes for lotrimin cream. I ask if it can be a lotion, due to the area that needed coverage. He wrote for the nizoral lotion I previously requested. He shot me a look. Mama Doc smiles at me. It will be a long year.
I know docs have this status thing and granting requests from nurses might seem like we're undermining them, but really we're not. You can call it evidence-based practice, experience, or just trying to save you some precious time. I'm sorry I stepped on your ego.
So, she's reviewing their progress notes on their assignments, and periodically would quiz them.
And what are the indications for Abilify? How does the efficacy compare with the cost? Are there alternatives that might be available? Complements? What are the risks associated with antipsychotic drug therapy in the demented population?
Good times. Good times.
The PA students though - what a fun bunch those wacky kids are! I look forward to sharing counter space (and a phone) during dictation. Seriously though, this one guy looks like Doogie. I was listening to him the other day, and asked where he was from, (his accent seemed a bit weird). Utah, he tells me. He goes on to explain how he tends to pick up other people's accents, and he doesn't know why. I can empathize, being from Oklahoma, and living in Virginia for a decade, I can revert back to a southern drawl quite easily. My family used to think it was cute when we'd be visiting family up north and I'd pick up a slightly Canadian intonation. Back to Doogie. I asked him if he was from New Delhi, Utah. He laughed. Dr. Patel laughed. As time rolls on though, I find it distracting and strange. He got to do a rectal swab today though, so it all works out in the end. :-)
PS - this is one of those irreverent posts that someone might find offensive. All in a day's work, I say. All in a day's work. Lighten up, save the professionalism for the paycheck. Relax, and enjoy some snark. It's good for you.
June brought us a new batch of 'em from the family practice program. Plugging a post from Dr. A., I will admit that I do appreciate the family docs for many reasons. It is true, not everyone can know something about everything, and while a specialist is necessary at times, the down-and-dirty basics are still there.
What I find a entertaining is that the same dude who can manage a K+ of 6.7 with kayexalate, EKGs, O2, and IV push insulin with D5 50 without breaking a sweat - yes, this happened on our non-monitored unit - is the same guy who is hesitant to order an antifungal cream for yeasty skinfolds.
Early the other morning, Dr. Dearest comes to see his patient. I brought the gloves.
He does his physical assessment, tries to talk to her about how she is feeling, and generally ignores me. He mentions a few orders he will be writing, and I ask him if he would mind tossing in some nizoral lotion for her groin and abdominal folds. He wanted me to get her in to bed so he could see it. It happens every time, and each time I hope like crazy that it won't. This is why I brought the gloves. He looks interested, and I can sense the wheels turning in his mind. But does he write it, in the end? No! Mama Doc will be rounding with the whole group later in the day; he'd be back. At the end of their visit, I mention the skinfunk again. He says he examined it earlier. And? Mama Doc asked for his assessment. She said it sounded fungal. The patient is a morbidly obese diabetic. What is your plan? He writes for lotrimin cream. I ask if it can be a lotion, due to the area that needed coverage. He wrote for the nizoral lotion I previously requested. He shot me a look. Mama Doc smiles at me. It will be a long year.
I know docs have this status thing and granting requests from nurses might seem like we're undermining them, but really we're not. You can call it evidence-based practice, experience, or just trying to save you some precious time. I'm sorry I stepped on your ego.
So, she's reviewing their progress notes on their assignments, and periodically would quiz them.
And what are the indications for Abilify? How does the efficacy compare with the cost? Are there alternatives that might be available? Complements? What are the risks associated with antipsychotic drug therapy in the demented population?
Good times. Good times.
The PA students though - what a fun bunch those wacky kids are! I look forward to sharing counter space (and a phone) during dictation. Seriously though, this one guy looks like Doogie. I was listening to him the other day, and asked where he was from, (his accent seemed a bit weird). Utah, he tells me. He goes on to explain how he tends to pick up other people's accents, and he doesn't know why. I can empathize, being from Oklahoma, and living in Virginia for a decade, I can revert back to a southern drawl quite easily. My family used to think it was cute when we'd be visiting family up north and I'd pick up a slightly Canadian intonation. Back to Doogie. I asked him if he was from New Delhi, Utah. He laughed. Dr. Patel laughed. As time rolls on though, I find it distracting and strange. He got to do a rectal swab today though, so it all works out in the end. :-)
PS - this is one of those irreverent posts that someone might find offensive. All in a day's work, I say. All in a day's work. Lighten up, save the professionalism for the paycheck. Relax, and enjoy some snark. It's good for you.
posted by Julie, RN at 10/03/2006 09:03:00 PM
1 Comments:
Thanks for the plug. Shape up those interns/residents! They need it. I know I did. In fact when I finished residency and became what med students call a "big doc," it was again a sense of being green. And, learning from nurses in my new hospital happened all over again. So, thanks! Glad I'm not a resident anymore - those were painful years - sheesh!
Post a Comment
<< Home