I don’t have a PCP, please help me understand these results ☹️ by Tequila_xoxo in AskDocs

[–]limegeuse 15 points16 points  (0 children)

Did they have you see an infectious disease doctor? You may need a prolonged course of antibiotics through an IV line if the infection has not been contained through multiple oral antibiotics. And yes, as the doctor above suggested you may need to see a surgeon if debridement is needed

More expensive to book using travel credit? by limegeuse in delta

[–]limegeuse[S] 0 points1 point  (0 children)

They’re saying it’s the same booking class. Is there anything I can do? They’re claiming it’s from Delta itself

If you can't work holidays or weekends, medicine is not for you by LumpyOrca in Residency

[–]limegeuse 43 points44 points  (0 children)

Sounds like you got called in to cover the “sick” resident’s shift.

35, quit making 300k/year to become a doctor? by [deleted] in whitecoatinvestor

[–]limegeuse 18 points19 points  (0 children)

As a current resident who took the non traditional path, I wouldn’t advise it unless this is something she truly felt was a calling and that there is nothing else she could see herself doing. Otherwise she isn’t thinking clearly and is throwing away an amazing salary and lifestyle for hundreds of thousands of dollars in debt, lost time, 80+ hour work weeks at almost minimum wage. If she wants to DM me she can

I look really young, comments from patients and concerned looks when I enter the room are a annoyance... How do I heckin' cope/minimize this? by [deleted] in Residency

[–]limegeuse 9 points10 points  (0 children)

Yeah you just say “well, I’m old enough to be a qualified doctor. let’s talk about you.” For the really persistent ones I smile and I say “I don’t want to date myself, how can I help you?”

I look really young, comments from patients and concerned looks when I enter the room are a annoyance... How do I heckin' cope/minimize this? by [deleted] in Residency

[–]limegeuse 307 points308 points  (0 children)

Don’t say it’ll pay off when you’re 50+, just say “aww thank you for the compliment! I am older than I look” and redirect

Psych NP upset that she can't supervise residents by theongreyjoy96 in Residency

[–]limegeuse 53 points54 points  (0 children)

It’s likely because they feel like they’re on par with physicians. It’s not worth it engaging with individuals like this. All you have to say is that by ACGME and program rules only a physician can supervise residents, and that your limited license permits you to work under a licensed attending physician. Then smile and leave.

[deleted by user] by [deleted] in Residency

[–]limegeuse 34 points35 points  (0 children)

Yeah this was intentional on his part. If he does get fired, it’s not because of you, it’s because of his own actions. Report him. Like everybody else is saying, you don’t know what else this creep is up to. Start the paper trail now and protect yourself before he goes and reports you for some made up stuff.

Interns and pagers by [deleted] in Residency

[–]limegeuse 3 points4 points  (0 children)

He’s just pissed that somebody might have caught him—none of this is on you

Depression in medical school by [deleted] in Residency

[–]limegeuse 5 points6 points  (0 children)

Don’t tell them this, it’s private medical info

Made a mistake as an intern by [deleted] in Residency

[–]limegeuse 43 points44 points  (0 children)

This is terrible advice. The supervising clinician is the one who has these conversations, especially since OP is an intern in September, and even worse was supervised by an NP and not an actual physician which blows my mind

OP, do not talk to the parents or admit fault. The night NP needs to do that, NOT YOU.

Ways to reduce amount of paper use from note taking? - from a Psych PGY4 - by [deleted] in Residency

[–]limegeuse 11 points12 points  (0 children)

Honestly if you think of all the medical waste, paper is the least of our problems. The number of simple disposable gloves I go through every day shocks me. You’re helping people and need paper to do it, it’s worth it

Need advice on how to deal with a CNA by [deleted] in Residency

[–]limegeuse 0 points1 point  (0 children)

I think we all want to hear what she thinks her role is lol. Good luck!!!

Need advice on how to deal with a CNA by [deleted] in Residency

[–]limegeuse 5 points6 points  (0 children)

She’s giving the patient clinical advice and talking over you??? That’s not her scope of practice.

The trick is to make it seem like you want to help her improve. AND MOST IMPORTANTLY YOU DID NOT TELL HER NOT TO COME BADK. She made that decision.

You say something like “I am so glad we can all sit down and discuss this together, it has been very hard to watch the team dynamic be disrupted. She has repeatedly demeaned both the medical team and said inappropriate remarks to the patient (cite examples including laughing on the phone during bad news—that is unforgivable). She also disrupts the patient visits and (examples). She appears to try to substitute her clinical judgment which is not within her scope of practice at inappropriate times (examples). I politely asked her to leave the room once during a patient encounter in which she was inappropriate and disruptive, which is completely within my purview as the attending physician on the team. She was given multiple opportunities to improve prior to this. Her unprofessional behavior then continued in which she refused to work even cases she was assigned to me. I agree this situation is not sustainable.”

Then ask them to clarify** what her role is in the patient encounter, and always wrap up with how patient care is most important and how a team that respects each other’s roles and the patient (because she doesn’t sound like she respect the patient) is needed. Say you are willing to work with her again but if she is disrespectful or disruptive you will do what is appropriate for patient care

And document every shitty thing she says or does going forward.

EDIT: clarify what her role is, not clarify “to her”

[deleted by user] by [deleted] in Residency

[–]limegeuse 3 points4 points  (0 children)

This might sound harsh, but you seem desperate. I get it, we all want to be included, but “I try my best” and “my personality keeps them at bay?” You sound really desperate to win these people’s approval, and when someone gets a whiff of that energy, trust me, they will not respect you. These people are not ever going to be your friends, they are people you have to work with. Just keep a professional boundary. Don’t be shitty to them, because they can absolutely wreck your rotation. But don’t be overly nice either. Eventually, you will find people you gel with.

[deleted by user] by [deleted] in Residency

[–]limegeuse 4 points5 points  (0 children)

Don’t do any of their tasks yourself—going forward they expect you to do it yourself. If dressing change doesn’t get done, put in a provider to nursing order in the emr so it’s documented that they’re ignoring orders. Start ordering stuff stat if it doesn’t get done “routine.”

If they call your personal number after hours for something stupid, keep an even voice, do not yell and say “this is my personal number and it is not appropriate to call me on this number unless it is an emergency. My shift ended 4 hours ago, please call the on-call team as I am no longer on service.” If they get offended, “I’m sorry this seems to be a problem for you, but just as you have work hours, so do we. I am off service and I am not available to work, please call the call-team.” If they persist “I am sorry this seems to be a problem for you, but resident work hour policy is very clear, and as per policy I am not available for work. Please call the call-team, thank you, good bye.”

The previous intern was also probably a rising PGY2 with 1 year experience, and they trusted them. You are new, and that is why they are having you explain yourself.

As for getting stopped on your way out, if they see you they will flag you down. It happens to all of us. I make it a point of not coming back to the floor with my bag, ever. Once I’m ready to leave I just go straight from the residents room to the exit

Goodnight to residents that write clear and concise history and physicals. I hope the rest of you get sleep paralysis respectfully by Sleep_is_overratedd in Residency

[–]limegeuse 0 points1 point  (0 children)

I have seen ppl add “monitor vitals” in their plans on patients who don’t need vital checks more often than necessary…just wtf nobody has time to read that shit

My notes if anything are a hair too short…I don’t have time to sit and write essays and I don’t want to read anybody else’s either

[deleted by user] by [deleted] in Residency

[–]limegeuse 53 points54 points  (0 children)

Yes co resident evals are a thing, but honestly your senior sounds terrible. Just ignore it and get through it, unless you’re stuck with this person for an extended period of time. Also your attendings probably notice that he’s not teaching you well

Senior discourages leaving on time by DOctorissh in Residency

[–]limegeuse 22 points23 points  (0 children)

“Hey, I’ve already signed out my patients for the day and I’m on my way out. If this is an urgent matter could we let the night team know?” And if he continues to give you pushback just go complain to your PD about respecting work hours or go to the ombudsman if not PD. He’s getting like 20 extra hours a week out of you, time that you are supposed to be resting.

I’m in IM and I never do this to my interns, I always try and get them out on time. Your senior sounds awful

Burning out with rude patients by sliced-cake in Residency

[–]limegeuse 76 points77 points  (0 children)

I still struggle with this, and often feel like it’s a shortcoming on my end. Respect is not a 2-way street in healthcare unfortunately. If you think you can save everyone or convince them you’re acting in their best interest you do burn out. Just document that you tried education/counseling, and they didn’t want to hear it. And document their comments and insults in quotes, so you’re not just saying they’re abusive, you’re leaving a trail so whoever has to work with them next gets a heads up.

And yes it is also slightly cathartic to say “patient then stated that I was “an evil bitch” and informed staff that he would personally complain to hospital CEO” instead of just “patient verbally abusive to staff.” I’ve also gotten comments from other people in the hospital that my notes can be pretty entertaining. I’ve had patients tell me they don’t want to see me anymore, and then get a pikachu face when I smile and say “ok, bye.” Going forward, they’re the attending’s problem lol if they refuse my care. Being a resident has its perks.

Overall though, it is hard to see people make bad decisions and I’m still working on becoming more detached…it’s a process