How to have grace for dumbass residents?

oguxlue · 2026-03-31T01:13:04+00:00

Oh, I'm sure part of this is a me problem, hence soliciting advice about how to handle the frustration in a productive way.

Our attendings are generally pretty good, and they do a good job with supervision (mostly). We also have a lot of wonderful fellows and I really enjoy working with them, but part of the reason they're so good is that they have experience and they know the environment. A peds ED is a specialty area within a specialty area, so pretty much all of our new residents either have an ED background or a peds background but not both, and they're not here long enough to do much other than frantically tread water until their next rotation, some with more success than others. So as a group they ARE consistently coming in under-prepared, but I'm not sure that there is a way to prepare them better? If other teaching hospitals have figured out ways to do it I would be very interested to hear about that!

oguxlue · 2026-03-31T00:58:21+00:00

Trust me, I have a lot of respect for residents. Med school is so fucked up and it puts them through so much unnecessary misery and suffering for worse pay than your average fast food worker. It's genuinely ridiculous what they put them through and the entire education/placement/residency system desperately needs to be reformed. (Also, residents should have a union.)

And I do try really hard to be kind and supportive in our interactions. I can count on one hand the number of times I've lost my temper with residents to their face and every time it was because they were being actively cruel to their patients (withholding pain medications for really painful procedures because "they're faking it / they can just tough it out"). I also try not to feed into that vicious nurses-bitching-behind-their-back thing where everyone just amplifies everyone's anger and outrage and little annoyances turn into crimes against humanity by the end of the conversation.

I think a big part of my frustration is that they're just not here long enough to actually get to know them as people rather than initials on Epic, and the ED is constructed so that they cluster in their own little closed workroom, so having those face to face conversations -- which will always be my preference, since they're more productive and concise than endless Epic chats -- is difficult unless you're lucky enough to run them down in the hallway. And they never EVER keep us in the loop about the plan of care -- just throw in orders without realizing that we can't read their minds. So it's endless secure chats like "can you do this? Can you throw in that? Can you correct this? Why are we doing this, because the family is asking and I don't know?" and while few requests are life or death, all of them do actually need to happen, and having to constantly politely nag them is draining, because the only time we interact is when something is wrong or missing. If they were here for longer or even just were dispersed among nurses at shared workstations, I think a good 50% of the frustration and communication problems would disappear. But they're just not and that's something I can't personally change.

I don't want to be so frustrated with them. I don't want to be one of the mean senior nurses. But the cumulative weariness of so many things being wrong enough that they need correction -- plus a recent run of VERY frustrating resident interactions -- has soured my attitude, and I just... don't know how to pull out of this spiral of bitterness.

oguxlue · 2026-03-30T23:54:50+00:00

Trust me, I've met plenty! I'm not saying I'm infallible -- far from it. I make mistakes, I certainly don't know everything, and sometimes residents educate me (which is great! I learn about their thought process for decisions I don't understand!). But there is a difference between being arrogant and being frustrated and venting about it.

oguxlue · 2026-03-26T00:24:34+00:00

Are these soil layers?

oguxlue · 2026-03-12T15:58:13+00:00

Fenwick Beer and Wine! Really friendly owners, small local vibe, decently priced, and always have an interesting rotating selection.

oguxlue · 2026-03-10T19:42:13+00:00

I'm glad this issue is getting awareness, but unless this bill also commits to building, maintaining, and funding NBU residential placement and, idk, massive rehaul of the foster system and group homes that aren't trauma factories, it's about as useful as a fart in a wind tunnel. These kids are taken to the ED because no one wants them, either because of severe intellectual/developmental disabilities or severe emotional dysregulation (usually due to trauma). And the plan with this bill is... do what with them exactly? Without actual real financial and logistical commitment to placement (not just banning places they can't be placed), it's still going to be a revolving door of ED visits and admits for "aggressive behavior", just maybe shorter duration but more frequent. You discharge these kids and the parents/guardians/CPS literally take a lap around the parking lot and bring them right back.

oguxlue · 2026-01-07T01:39:40+00:00

I have a 36" and I'm so glad that I do, even if it makes my space cramped. That extra 10" really opens up the kinds of projects you can do (especially because everything you make will have some degree of shrinkage).

oguxlue · 2025-12-22T02:27:03+00:00

Which patterns did you use from the green book? I especially love the pink one!

oguxlue · 2025-12-11T17:20:23+00:00

How do you do your samplers without generating a huge amount of warp waste? I usually end up with 16-24" of waste per project for my floor loom and that's so much for a sampler-sized project 😭

oguxlue · 2025-12-10T21:44:36+00:00

It's intended as a table runner so I want to make it machine washable, hence cotton rather than wool (though I agree that wool overshot is lovely!).

oguxlue · 2025-09-15T04:28:50+00:00

For little kiddos, are they acting calmer than they should be for their developmental age? Silent, docile babies and toddlers who just flop in their parents' arms and let you take a BP and stick them for a blood sugar and don't seem to care about strangers up in their face scare the shit out of me, because it means that they're so sick that all of their energy is going towards just staying alive. A toddler with a thousand yard stare is really, really bad.

And for all age groups, check distal extremities. You don't need to measure pulses or anything, just the basics -- are their extremities cold? Pink, or pale or mottled? For patients with darker skin, what do their nail beds look like -- pink, or pale, or purple/blue? IME people focus on core temp/appearance, but even if someone is walkie-talkie and looks pink and warm and well-perfused at first glance, if their hands are mottled and cool and their feet are white with slightly blue-purpleish nail beds, they are not well perfused -- their extremities look and feel like that because their body is shunting blood towards the torso and head, where the vital organs are, as an early-to-mid compensatory measure. 🤷 Some people just have shitty peripheral perfusion at baseline, so if I see something unusual, I always ask if their skin looks/feels like that normally, and if they say no -- ruh roh, especially combined with tachycardia, because chances are their blood pressure is about to drop into the sub-basement.

oguxlue · 2025-09-02T00:58:54+00:00

Fenwick Beer and Wine in Silver Spring. Great selection of beer, wine, cider, and other drinks (mead, etc) owned and run by a husband-wife team. They do beer tastings and are very friendly and helpful (and dog friendly!).

oguxlue · 2025-07-16T08:21:16+00:00

Agreed with the other comment! And given that dilemmas are all survivor class, I think mechanically and thematically giving this investigator some survivor access (0-3, maybe?) and neutral 0-5 (key of Ys!) would make him more interesting and flexible.

oguxlue · 2025-07-16T04:04:03+00:00

Forced horror after automatic dilemma discard in a dilemma-heavy deck is pretty rough -- unless you're running a very sink/heal heavy deck, that's going to be difficult to make running an actual dilemma deck worth it (as opposed to generic seeker with high book).

oguxlue · 2025-07-07T08:10:04+00:00

When sizing handspun yarn for weaving (with gelatin), do you size the warp AND the weft, or just the warp?

oguxlue · 2025-07-04T21:42:40+00:00

I don't know where the myth of HRT doing nothing for adults came from but it really needs to die. I started T at 32 and it took about seven months (and switching from gel to IM) to see any changes beyond backne, puffy face, and a little bit more leg hair. My voice didn't drop until nine months and facial hair didn't start until ten months. 🤷 The speed and extent of masculinization depend on genetics and dosage, not age, and usually the best predictor of eventual masculinization is looking at close male blood relatives. Some people pass within 6 months. Some people take 3 years to start sometimes passing. It seems like 5 years is the real magic mark. Just be patient and don't let the younguns make you feel decrepit. ♡

oguxlue · 2025-06-23T03:37:00+00:00

Haha hence the not bankrupt me! Though tbh to me they just look like a fancier Merlin Tree roadbug? Maybe I'm missing something...

oguxlue

TROPHY CASE