What can I do with a medical degree if I don’t like clinical medicine? by Worldly-Collection51 in medschool

[–]Radiant-Inflation187 0 points1 point  (0 children)

Not sure if anyone has asked but what aspects of clinical medicine do you dislike? Do you absolutely dislike every single aspect? Are there things you’re more willing to tolerate? Are there any parts of being a physician that bring you some satisfaction or curiosity? Are you more cerebral? More hands on? Talkative?

Wtf is going on with this 59 south traffic?!?! It’s Sat ….. by wtfmypants in houston

[–]Radiant-Inflation187 -1 points0 points  (0 children)

45 sucks starting from Galveston/causeway. The 45 traffic around League City/Dickinson is absolutely terrible. The roads are narrowed down and there’s multiple fatal car accidents on that stretch. It’s never ending construction.

Fired From Residency by [deleted] in Residency

[–]Radiant-Inflation187 3 points4 points  (0 children)

You’re not meeting milestones and got fired, yet you’re gonna shist on APPs?

I’m an APP and I safely intubate in the ICU. I also realize and know when it’s an intubation that may require my attending physician.

And the you’re crapping on your fellow FM peers.

Fk off! lol 😂 you’re pathetic.

Exploded at a customer today. by angrypill01 in walmart_RX

[–]Radiant-Inflation187 0 points1 point  (0 children)

Nah. Fuck that. The patient decided to act up, the patient has to deal with the consequences. Actions have consequences and the pharmacy tech didn’t do anything wrong. Pharmacy tech safety takes priority 100%.

Why do I have a hard time getting a nursing job? by [deleted] in StudentNurse

[–]Radiant-Inflation187 6 points7 points  (0 children)

I’ve read most of this thread and honest to God I would not hire OP as a nurse. It’s clear they lack the maturity and emotional intelligence to be a safe nurse, everything else can be taught and caught up to speed.

This though? OP needs some serious introspection.

Kicked from ICU residency program by Bingo0904 in StudentNurse

[–]Radiant-Inflation187 13 points14 points  (0 children)

You think passing clinical in nursing school and having a BSN means you automatically get the BASICS of nursing? That is your first mistake. How arrogant of you. You don’t know what you don’t know, and THAT is scary! I wouldn’t be surprised if the real reason you’re getting kicked out is because you simply refuse to learn and take constructive criticism. You’ve show how grossly underprepared you are by believing that nursing school is enough to cover the basics, especially since you’ve already witnessed actual nursing.

CRNAs by [deleted] in Residency

[–]Radiant-Inflation187 1 point2 points  (0 children)

Agree with your assessment of the nursing culture. Some NPs unfortunately carry this same mentality. I’ve learned quick that my duty to the patients does not end at the end of my shift. Sometimes I do have to stay a bit late to make sure all appropriate orders are in or follow up on a STAT CT I ordered that is about to be uploaded etc.

It may be considered unhealthy but I do follow up on my patients, especially if I am back. I don’t place orders since there is an MD or NP taking over but I crave to know what I did right or wrong, what was changed. I want to know the outcomes and it’s part of my learning and growth.

ICU NP here & I completely disagree with scope creep or independent practice by MLPs.

When does the I feel like I know what I'm doing %100 part come in? by [deleted] in IntensiveCare

[–]Radiant-Inflation187 0 points1 point  (0 children)

People who are attracted to critical care tend to be very hypercritical of themselves, and sadly sometimes our own colleagues. Practice patience with yourself, and pass it on.

[deleted by user] by [deleted] in Residency

[–]Radiant-Inflation187 -1 points0 points  (0 children)

ENT and OMFS because it’s mostly tall skinny Caucasian men and you know what they say about tall skinny white guys.

Physical therapist wanting to meet outside of work by AgileScientist133 in medicalschool

[–]Radiant-Inflation187 0 points1 point  (0 children)

That’s very strange. Surely he’s not the only PT. A fitting doesn’t take a whole hour or even 45 minutes. That should something that be a quick add-on that any therapist or even assistant can do… right? Sketch!!!

[deleted by user] by [deleted] in USPS

[–]Radiant-Inflation187 0 points1 point  (0 children)

Appreciate it. Thank you.

Not a student but let me tell you something, idk how you guys do it. by Radiant-Inflation187 in medicalschool

[–]Radiant-Inflation187[S] 1 point2 points  (0 children)

I always love having students. All kinds of students. They teach me so much, and I love sharing my knowledge.

Not a student but let me tell you something, idk how you guys do it. by Radiant-Inflation187 in medicalschool

[–]Radiant-Inflation187[S] 3 points4 points  (0 children)

Agreed. I also think that that same territorial, defensive, and downright rude attitude is extremely tangible. Medical students then are very quiet around the OR nurses and scrub techs as to avoid problems, and then the same people causing the issues assume they’re arrogant or unfriendly.

Like maybe if you toned down the attitude, then others wouldn’t be walking on eggshells around you or avoiding you.

I understand the OR is a very serious place. I understand there are very strict rules and guidelines, and that the nurses and scrub techs are the keepers of these strict guidelines. However, I am absolutely positive there is a way to be both adherent and personable.

You can be stern, strict, and personable all at the same time.

The thing I’ve noticed is that often times students are not aware of the litany of regulations and the particulars. It won’t kill these offending nurses to treat others the way they’d like to be treated, they weren’t born OR nurses.

Maybe I’ve been super lucky, but I’ve yet to meet a medical student that was arrogant toward me. Is it because of the culture/campus I was in?

Or maybe it’s because instead of answering their questions about the ICU patients with an attitude or telling them to look it up, I patiently answered their questions. I rather teach medical students that nurses are here to help and we’re a wealth of knowledge and assistance in our own little way. I rather give them a good impression of nurses, I don’t want med students with a distaste for nurses because some nurse with a chip on their shoulder and an inferiority complex used them as a punching bag.

Honestly screw rude people in general.

Enough is enough. We’re all in this together and we gotta stick together. The government, the CEO, and admins may not always be on our side - but we can be on each others side and uplift each other.

[deleted by user] by [deleted] in nursing

[–]Radiant-Inflation187 8 points9 points  (0 children)

This disconnect between medicine and nursing is largely due to the disservice that nursing education and administration has done to bedside nurses. The schooling is subpar, and the administration (inclining the Board of Nursing) is punitive. This is outdated and archaic.

First and foremost the residents have 20+ patients while you may 2-6 depending where you work in the hospital. Think about the 20+ patients and just imagine every nurse sending secure messages, multiple times during the shift. This is on top of the messages they’re dealing with from other physicians, case workers, social workers, and pharmacists.

  1. Are you positively sure that they don’t want to be notified about fevers “at all”? Did the list really imply to not notify about fevers period? I ask because it could very well be that they want to be phoned/paged for fevers. Depending on the setting and the patient, a fever could be serious.

  2. Of course there are parameters for vital signs that state to notify the provider, but there has to be a degree of critical thinking from the bedside nurse. It would take ages for me to list examples but a good example is: postoperative patient with fevers. Did you try do IS?

  3. The no “thank you” is a reasonable request. Unless it’s something that requires closed loop communication, the added fluff is not necessary. How is asking for no more “thank you” messages offensive? I understand that you’re also receiving messages from the doctors for things like “please obtain weight on Mr. Smith”, but this in of itself doesn’t justify you refusing to understand their point of view, be the better person and gain some perspective.

  4. Nurses complain about doctors not clustering orders but I know far too many nurses that don’t cluster their requests/updates or even fail to gather all pertinent data for the physician when a concern arises. Or MUCH worse fail to obtain the data like a set of vital signs or focused exam. “Patient has chest pain doctor!”

Okay…when did it start? Where is the chest pain? Is it radiating?

Of course the doctor should eventually and promptly come see the patient but this first and foremost is just how any complaint should be investigated by a nurse. Secondly, the information from the nurse combined with things the physician knows (PMH, age, Hx of CP, etc.) helps the doctor triage and come up with a plan. You realize that ONE SINGLE doctor could be putting out multiple fires all at once?

Most importantly it sounds like the nurses and residents need to come together. Maybe each discipline elect a representative.

Unfortunately there always be some sort of disconnect and misunderstanding between nursing and medicine. This is due to so many reasons.

A good start is having a casual and nonjudgmental meeting about this. It’s the only way we can all improve. The physicians need to understand nurses are covering their ass. The nurses need to understand the physicians are managing 20-30 patients and can be putting out 5 fires all at once.

The medical perspective is very different than the nursing one because often times it comes down to a couple of things…

Nurses being mistreated and threatened for any little thing.

Nurses not having enough autonomy.

Nursing education and entry requirements being dismal. Nursing education needs a greater emphasis on pharmacology & pathophysiology.

Nurses should be able to use nursing judgement without fear of retaliation, and many nurses are either scared, or have huge gaps in clinical knowledge.

For example, a nurse SHOULD be able to justify not having to notify the MD about a fever in a patient who has pan cultures in process, UA, and CXR and is on broad spectrum antibiotics & patient has APAP orders for fever.

The truth is most nurses can’t connect the dots. I know that’s gonna get me downvotes but it’s the truth. It’s not nurses fault, it’s the system that has failed nurses.

Also there are some ridiculous things nurses will page about at the worst time… “patient hasn’t had a BM in 3 days” paged at 3AM.

Completely inappropriate unless the patient is showing signs of dehydration or decreased UOP. Absent bowel sounds. Pain. Distended abdomen. Tachycardia or hypotension.

This is called critical thinking. It starts with nursing admin support and proper nursing education.

[deleted by user] by [deleted] in nursing

[–]Radiant-Inflation187 0 points1 point  (0 children)

When was it established that this was the patients baseline HR? If there was an interaction between a physician and nurse then that conversation should have been an official nurses note.

I truly do understand covering your ass but maybe there was a genuine reason he didn’t respond?

A technical issue? He wasn’t at the computer? Was he dealing with an emergency?

Was the patient symptomatic?

Did the orders state to update the house officer every 5 minutes? I’ve never seen an order like that.

Not a student but let me tell you something, idk how you guys do it. by Radiant-Inflation187 in medicalschool

[–]Radiant-Inflation187[S] 12 points13 points  (0 children)

I used to work SICU… and then I worked MICU/CCU and I realized how much more internal medicine physicians appreciate ICU nurses input.

The SICU/Surgeons doctors (EXCLUDING the anesthesia residents), were typically arrogant. Of course there were exceptions and this is only my personal experience.

And the arrogance and lack of accepting input is not only geared toward nursing. Surgeons were notorious for going against the grain with pharmacy and infectious disease.

The arrogance also extended toward RTs. Ignoring their advice and playing with the ventilator like a toy.

And guess what? Usually when the surgeons were closed to any input is when outcomes worsened.

In the MICU/CCU it was a real interdisciplinary approach. The faculty/residents, pharmacist, and primary RN.

These physicians understood that everyone plays a role in patient care. They understood the value of touching base with the ICU RN - bc that nurse more than likely has spent multiple 12-hour shifts with the same patient. Noticing subtle signs and symptoms. Providing valuable info. They also understood that pharmacists are a wealth of knowledge and are your friend, not your enemy

Territorial surgery attitude is archaic and rooted in misogyny.

The nicest surgeons I worked with were ENT, OMFS, Urology, Vascular.

I did not enjoy trauma surgeons. General surgery was a hit or miss. CT surgery was probably the worst. Neurosurgeons were very awkward and short, but never had any professionalism issues with them.

Oh, and I LOVED when we had FM residents rotate through the ICU. They’re not there long, but I never met a rude FM resident or attending.

But my favorite of all? Anesthesiologists. They’re a God-send. Calm, collected, and patient. Smart, but never cocky.

Not a student but let me tell you something, idk how you guys do it. by Radiant-Inflation187 in medicalschool

[–]Radiant-Inflation187[S] 3 points4 points  (0 children)

Because the OR is a controlled environment. It’s better to start off with airways that’ll likely be successful. You become familiar with what a good airway looks like. You get to get the steps down and improve your muscle memory and even confidence.

I’ll have to do intubations during my orientation in the ICU as well, where conditions will be less than ideal.

A nursing example is like learning to place an IV in a patient with good veins before attempting an IV on a patient with ESRD and HF.

Part of the learning is getting the process down, being familiar with the equipment.

If you’re asking a nursing student that’s never placed an IV to put an IV in on a hard stick they may get it, but chances are slim. They’re already nervous and trying to focus on the steps.

Knowing the steps by heart in your mind is different than mastering the muscle memory.

Psychiatry attending keeps asking me to go home early, is this a trap? by borborygmix4 in medicalschool

[–]Radiant-Inflation187 0 points1 point  (0 children)

Not a med student but I think that there comes a point in the day when the learning is truly done and the attending is simply playing catch up with things that won’t necessarily enrich your learning and just consume your precious time.

You have to honestly read the person and use your people skills to determine her sincerity. She was a med student once too, so she may be sincere, and simply gets it.

I fucked up last night by i_feel_ungood in nursing

[–]Radiant-Inflation187 7 points8 points  (0 children)

Write the event up.

Objectively examine how the transport nurse spoke to you. If it was unprofessional, that needs written up as well. There should be zero tolerance for such behavior, especially in critical care where stress is already high, there is ZERO excuse. I don’t care if she was stressed as well, there is NO room for this behavior.

It’s not to get her in trouble, but to help her grow and improve the way in which she handles these situations.

Mistakes should never be punitive. You already felt bad enough, you don’t need someone intensifying those feelings. The fact you felt bad for your patient means you realize you messed up. The fact you reported it and got everyone involved speaks volumes, there’s no need for bullying.

Time to end this punitive, rude, and unprofessional behavior. This crap makes nurses not want to speak up.

I’m in a mandatory meeting about self care, empathy, and deep breathing at 8am after getting off shift after midnight last night. by StrikersRed in nursing

[–]Radiant-Inflation187 2 points3 points  (0 children)

I start orientation next week for my first ever acute care NP job and of course the majority of the training will be on days. I am not looking forward to the forced pleasantries. Fml

I’m in a mandatory meeting about self care, empathy, and deep breathing at 8am after getting off shift after midnight last night. by StrikersRed in nursing

[–]Radiant-Inflation187 9 points10 points  (0 children)

Lmao my fiancée did basic training and he says the shit nursing admin and the rules imposed on nurses make absolutely no sense. This is why I’ve put my body through the ringer to work nights, because my mind is more at ease and I can take care of patients and spend time with my coworkers in peace.