Wednesday, May 9, 2007

Team Player

***Warning: severe bitching and whining in this post.***

A couple weeks ago I had a student moment. I lost it on some of my “colleagues” because they’d not been on time to round on patients for a week and we had a patient that wasn’t seen. 15 minutes before rounds my friend and I quickly obtained the information and saw the patient for rounds, but did not write a note. During rounds I explained this, telling the other students (in the presence of the resident) that I would not write the note. There were enough students to see at least one patient and these 3 students had not seen anyone in a week.

This week I was taken aside by the resident who was present during my tirade. She explained that she understood me being upset, but that I was in the wrong for not writing a note on a patient I’d seen. My job was not to monitor other students. I was supposed to ensure that I was seeing patients and covering where it needs to be done. In essence, be a team player.

I find it extremely absurd that when people who have been victimized by parasites and suffer from it are expected to remain stoic. Apparently my expression of frustration showed “weakness” to this resident and showed her that I was a potential “problem student”. Hmmm, what about those who don’t even do their damn work? Aren’t they more of a concern? What about the fact that they’re going to get a very similar evaluation because no one has paid attention to the fact that they aren’t presenting during rounds? Am I just supposed to accept this chronic and habitual laziness while I work longer and harder? And if so, why?

I’ve heard of people talking about letting “gunners” do the work while they slack. I joked about letting other students who were interested in OB/GYN perform all the deliveries, but when it comes down to it I have a work ethic. I’m in no way a gunner on this rotation (perhaps on surgery I was, but certainly not here), but I still feel that when there is a requirement for students to see postpartum patients then everyone needs to be getting here on time and getting their notes written. If there’s a paucity of patients for a couple days and not everyone gets a chance to present at rounds then you can read. Not showing up till morning rounds start is not an option.

It’s just shows a general character flaw in some people who feel they’ll get away with as much as they can whenever they can. It shows a general lack of concern for patients and poor medicine in general. My problem is that I’ll get the same evaluation they do when they clearly don’t deserve it.


Raveen said...

I definitely agree with what your saying but in the end like she said its not your job to decide what they should or should not be doing. Granted it unfair that you have to pick up the slack for there laziness but I feel as though the world has a way of righting itself in the end.

You just have to keep working hard and know that in the end things will work out.

Old MD Girl said...

If you DO pick up the slack without bitching, she will probably notice. Or maybe she'll just notice how lazy everyone else is. I've always wanted them to take me aside, and say something like, "OMDG, I am really impressed that you did all this work this morning, and am irritated by your lazy colleagues. I wish all students could be as fantastic as you." But once I realized that scenario was unlikely I became a much happier person. In the end your colleagues' shitty work ethic will bite them in their asses. There is no need to bite their asses for them.

It's also likely that your hatred for this rotation is showing through -- unless you are the BEST actor in the world, how could it not. Maybe it's time to play, "Pretend to love OB/Gyn." Sometimes if I pretend hard enough, I actually start to like things a bit better.

Parcho said...

Oh there's an easy way to fix this. You guys have to just pick up patients. And if nobody volunteers--you started volunteering for people.

For instance: tomorrow we have 4 patients to round on. I've got W. YOu go see X. You see Y. You see Z. That good? K. Thanks. See you at rounds in the morning.

If it's post-partum patients from the night before--someone HAS to get in touch with the night team to find out how many patients to see. Use your pagers. That's what we did.

pinkie said...

I suffered through the exact same thing during Ob/Gyn. Sure, I may have inadvertently snarled at some people greeting me "good morning" because of my anger, but I kept my mouth shut and presented my patients. In time, the resident herself commented on how obvious my being upset was, but advised that I keep doing what I was doing nonetheless. She then promised that she and the attendings *know* who's carrying their weight, and come eval time, people would get crucified. That gave me some joy. =)

#1 Dinosaur said...

Just to offer some perspective on this kind of thing from another context:

A certain insurance requires the ORDERING physician to obtain precertification for certain procedures. A given (assole of a) specialist categorically refuses to do the precert, even though he's the one ordering the tests, is the only one who can answer the nonsensical questions in order to get it approved, etc.

The problem is that if I stick to my guns and refuse to do it, the one who suffers is the patient, who really needs the test. So I go ahead -- bitching and moaning -- and did the precert.

A thought: keep your eye on the ball: do what's best for the patient. Let the excess work load, lazy students, evaluation BS roll off your back as best you can. If you get in the habit now of always putting the patient first, you'll never go wrong.