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Dear Prudence Advice to Female Ped Resident on Staff Relations

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  • Dear Prudence Advice to Female Ped Resident on Staff Relations

    So, the following was posted on Slate.com today. What do you think?

    Dear Prudence,
    I'm a young female doctor who's fairly new to the hospital where I'm doing my residency in pediatrics. Residency is brutally difficult, but I can handle it. What I'm having major difficulty with are the passive-aggressive nurses and secretaries who share my workspace. I'm barely 5 feet tall and look like a teenager. I’ve also never been good at dealing with the subtle drama that goes on between women. I find it really hard to do my job when the middle-aged nurses and secretaries question every order I give, force me to justify my orders, "forget" to do what I asked, or whisper among each other about whether or not I'm competent. They never do this to the staff doctors or male residents. They also do it to any young female who's starting out. They are not outwardly aggressive, so there is rarely a concrete incident I could document as proof. I should be able to talk to my program director about this, but she herself is a bully who delights in catching us making mistakes and in putting us down. I’ve got more than three years to go, but I cry for hours after every long, tiring shift. How do I deal with this?

    —Miserable Doc

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    Dear Doc,
    To find a diagnosis for you, I turned to my friend, emergency physician Kerry Foley. She said she doesn’t doubt your account that the nurses and other staff can be passive aggressive, and maybe even more so to other females. She says that even when one is experienced and rested, these relationships can be difficult. But add the resident’s burden of being overworked, underpaid, eating dinner from a vending machine, and dealing with sick children, and that’s a recipe for tears. Foley advises the therapeutic shift of trying to see the world from the perspective of these middle-aged women. Foley says imagine what it’s like to have years of experience, then have to face a yearly troupe of newly minted doctors who arrive acting like the boss. She says in every new work situation she encountered it took her a while to earn the respect of the nursing staff. She suggests doing the following: Be kind to patients and their families; answer the phone at the desk sometimes when everyone is busy; help a patient to the bathroom on occasion; ask the nurses’ opinions about a clinical situation. She also suggests scheduling an appointment with the head nurse on your floor and asking, "What can I do to be a more effective member of this patient care team?" Foley says that young doctors have had their noses in books for so long that they often need to work on their people skills—you pretty much acknowledge this yourself. So try these suggestions and see if things don’t improve. She adds it couldn’t hurt to show up at the beginning of your next night shift with a plate of brownies for the hard-working staff.

    —Prudie
    Wife and #1 Fan of Attending Adult & Geriatric Psychiatrist.

  • #2
    I bet its frustrating to have to deal with brand spankin new doctors who have only been out of med school a month every july simply because they are new to the job and the hospital. Not to mention on some floors they get new ones each month. For thay reason I always reminded DH to be appreciative of the staff because they know how things work and could make his job as an intern either smooth or rough.

    Wife to PGY3
    Loving wife of neurosurgeon

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    • #3
      I don't know about the advice given, but it's a pretty common experience for many female residents. Particularly petite and/or attractive ones. DH's program wasn't malignant at all, and several of his female co-residents experienced similar treatment from nurses. One such doc was a completely judgmental snatch to other women, so I kinda get why the nurses haaaated her, but the other petite and/or attractive docs were very nice, funny, competent practitioners.

      Seems like the disparate treatment was most noticeable in specific departments. I noticed it most with the labor/delivery nurses. I really liked almost all of them, but they didn't hide their disdain for anyone.

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      • #4
        I think her advice is a bit unrealistic, but then again my frame of reference is surgery and not peds or medicine so maybe it's different for those services. For some reason I had an almost guttural reaction to that last sentence... "it couldn’t hurt to show up at the beginning of your next night shift with a plate of brownies for the hard-working staff." This comes across... I'm not sure of the right word. Patronizing? It just rubs me the wrong way. Sure, DH has taken goodies in for the staff and other residents before when I make a big batch of sweets, but to suggest to a resident that she needs to bake brownies to win over the "hard-working staff", like she's groveling to them or something? I'm sure the resident is just as hard-working, or more hard-working, than the staff and I guarantee you she has less time to bake freakin brownies for all the other hard-working people.

        It also made me think of this:



        I think every hospital has one or two of these nurses that pick on the young female residents, and honestly I don't think there's anything she can do to win them over. They're pissed because she's them 20 years ago yet she gets to make the orders, so they've labelled her a bitch and that's what she's going to be to them until she leaves. I'm not saying the resident should be rude to them or even that she shouldn't be a little extra nice because I totally get how frustrating that would be to have a new, young boss every year, but I wouldn't go super far out of my way knowing it wasn't going to get me anywhere. I could also see some of that advice backfiring. Picking up the phone at the desk? "Bitch, why are you answering my phone?" I dunno, maybe Peds and medicine is different, but I can't imagine any surgical resident ever scheduling a meeting with the head nurse to ask "What can I do to be a more effective member of this patient care team?"
        Last edited by niener; 01-24-2013, 10:28 PM.
        Wife of a surgical fellow; Mom to a busy toddler girl and 5 furballs (2 cats, 3 dogs)

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        • #5
          I think that is all terrible advice. Basically, her advice is: to the nurse's (or frankly, a "patient sitter's") job to show that you are a team player. First, nurses are specially trained professionals with a separate skill set and different experience that doctors. If you start trying to do their job for them, you well could offend someone or, worse, make things less efficient or more dangerous. When was the last time a doc helped a patient to bed or to the bathroom...I mean, seriously? Rarely. You are likely to cause more chaos than help. I mean, yeah, grab the phone at the floor station if everyone else is busy AND it is OK with the nursing staff (it MAY be important for their system that THEY answer the phones...don't presume you are competent to do THEIR job just because you are a doctor), but don't try to be the nurse or administration. And bringing BROWNIES??? WTF? NO!! You bring in treats like that when people respect you--as a gesture of thanks for your collegial working relationship. You do not do this to grovel for respect. No one is going to respect you because you bring in brownies when they don't otherwise respect you professionally.

          Second, why is it the head nurse's job to explain to you how to earn the respect of the nurses and "fit it"? Grow up. The head nurse is incredibly busy and doesn't really have the time to explain to a young, naive, self-conscious doctor how to be a professional. Talk about a way to undermine yourself.

          Third, why are you letting a bunch of gossipy fishwives wreck your professional reputation. Grow a set of balls, conduct yourself and hold yourself out in a way that PRESUMES you will get the respect you deserve, and then hold people accountable when you don't get it. Stop being a freaking waif. I have know TONS of short, diminutive, delicate-looking, young female doctors (and nurses, and teachers, and lawyers, etc.) who have no problem getting the respect they deserve. And it starts by expecting it.

          And, for heaven's sakes, I don't know how this woman dresses, but my recommendation is be SUPER professional. DH sees young female med students and doctors dress in the most frightfully unprofessional attire. Hoodies under their lab coats, crocs, silly pink hair barretts, etc. DRESS LIKE YOU MEAN IT. If you are not in scrubs, then you should be in Ann Taylor-type professional attire EVERY.MINUTE you are at the hospital. Blouse or other appropriate professional tops, wool or other high-quality pants/skirt, and heels (don't have to be high or uncomfortable...but grow the heck up...if you wear unprofessional shoes, why should anyone treat you like a professional? And, get a professional haircut. Your bangs should not be sloppily pouring into your eyes and if you are a doctor, it is time to lose the yoga class sloppy pony tail. An uncomplicated, flattering, subtly stylish cut is appropriate.

          It may not be fair because guys generally can get away with a lot more, but this is really not the time to climb up on the women's lib bandwagon. Go that extra mile to look like a professional, act like a professional, and expect to be treated like a professional. The nurses are NOT responsible for fixing your problem (and they are not the cause of it--if they are treating you badly, it's time to consider what YOU can do to change).

          Speak to everyone politely, firmly, without giggling or wavering, and respectfully. But do not defer to false gestures of faux deference.
          Last edited by GrayMatterWife; 01-25-2013, 08:07 AM.

          Comment


          • #6
            What GMW said! Honestly, my tolerance for women who whine about being "liked and respected" is zero.
            Tara
            Married 20 years to MD/PhD in year 3 of MFM fellowship. SAHM to five wonderful children (#6 due in August), a sweet GSD named Bella, a black lab named Toby, and 1 guinea pig.

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            • #7
              Originally posted by Cassy
              We only roll our eyes at you if you give us stupid orders and/or don't even take our professional opinions into consideration when you're not quite sure and you're just winging it. At least go ask your senior if you don't want to listen to us.
              It may not be polite to roll your eyes, but...the doc probably deserves it! Nurses saved DH's butt several times, especially when he was a PGY1 and PGY2. LISTEN to them and RESPECT them without projecting insecurity. It may be hard to walk that line, but that is what being a professional grown-up is about.

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              • #8
                Originally posted by Cassy
                Will weigh in with my RN opinion later, I'm just on the go now. I agree with a lot of what has been said already. Though I do want to clarify that these interns/residents are NOT our bosses. They are our coworkers. Attendings aren't our bosses, either. Our bosses are our nurse managers, our unit directors, and our department managers. (all nurses)
                That was a slip on my part, I apologize. What I meant to say was someone with more permissions/authority as far as patient care goes, who sets the orders.


                And apparently it was okay that I couldn't come up with the words to explain why exactly her advice bothered me because GMW found them for me. Thanks LOL
                Wife of a surgical fellow; Mom to a busy toddler girl and 5 furballs (2 cats, 3 dogs)

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                • #9
                  The OP sounds like a whiny asshole. No wonder the nurses hate her.

                  Yeah, some nurses are mean, but some people are mean, regardless of occupation.
                  I'm just trying to make it out alive!

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                  • #10
                    I agree with everything that was already said. Personally, I think that if you can't figure out how to be respected without bribing the nurses with brownies there are probably bigger issues at play than your gender. That brownie comment really rubbed me the wrong way. Residents already have so little time and money (if they choose to go the store-bought route), and yet THEY're expected to bring in the treats for the hard-working nurses? Screw that! Coming from a doctor, that answer seems terribly one-sided. Even the admission that the nurses may be in the wrong was sugar-coated and followed by excuses over excuses. There are no excuses as far as I'm concerned. Roll your eyes internally if you must, but be professional to everyone.

                    What do YOU think, MrsK? You never did share your thoughts after posting this.
                    Cristina
                    IM PGY-2

                    Comment


                    • #11
                      We took in copious quantities of treats and frequently ordered dinner at various times. Usually, during rough shifts or crazy rotations -- not to kiss ass, though. It usually happened in the child birth unit during fellowship when they would get nailed and no one could get out to get dinner.

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                      • #12
                        I agree with what GMW and others have said. The brownies comment especially rubbed me the wrong way and I wondered if they'd suggest a male resident bring in brownies. When I began practicing law, I ran into some of the problems that the OP described. Part of it was because I was naieve and didn't know how to work with subordinates. Part of it was because thee staff all knew that I had been a legal assistant and I had clerked there before so it pissed them off when I asked them to, for instance, enter my billing when they knew that I knew how to do that myself nevermind that I had new, billable, responsibilities and entering time was no longer my job. They never would have expexted the men to type their own letters or file their own records. Part of it was also how the senior lawyers treated me. I was on the bottom of the heap so the staff treated me accordingly. Part of it was a mean girl clique that had formed among the staff. One of the parelegals told me that it wasn't that I asked them to do anything that the men asked them to do, it just sounded different coming from me. One 6' tall 200lb secretary even had a tantrum and threw a stapler at me when I asked her to send out an overnight package.

                        It took me years to gain their respect, mostly by working my ss off and not fraternizing with or confiding in the staff. I hate it when female bosses feel like they have to go to happy hour with their secretaries and talk about their personal lives. And I hated it when my male partners lumped me in with "the girls" (staff) all the time. It seemed like forever before the men figured that out.

                        When we all moved to a larger firm, the stapler secretary was assigned to me. I overheard her telling the paralegals in our new firm that they shouldn't give me grief because although I looked like a little girl, I knew my stuff and was a damn good lawyer.
                        Wife and #1 Fan of Attending Adult & Geriatric Psychiatrist.

                        Comment


                        • #13
                          My first reaction was-- how did she have 2 hours or whatever of free time to be crying?

                          Dh was all about asking floor nurses their opinions-- especially during intern year. He never had a problem with a nurse, but he's super diplomatic also. And he's a big guy who a lot of nurses like to mother for some reason-- prob bc they know his wife (me) doesn't have it together enough to send in brownies or baked anything!! Dh has been sent home with food for us from nurses several times lol!!
                          Peggy

                          Aloha from paradise! And the other side of training!

                          Comment


                          • #14
                            Originally posted by MrsK View Post
                            I hate it when female bosses feel like they have to go to happy hour with their secretaries and talk about their personal lives. And I hated it when my male partners lumped me in with "the girls" (staff) all the time.
                            This. Do not fraternize with the staff. The nursing staff, the admin staff, whomever. You are not staff. You are a doctor. Be very professional and RESPECT the staff, but do not pal around...if you are a woman, you will be "one of the girls" (read: one of the staff). And, RESPECT the staff's time, by the way. Many are paid by the hour. When their shift is over, LET THEM GO HOME. And no period talk, dating talk, or "what brand of tampon do you use" kind of stuff. They are not your girlfriends. And, if you are their boss, they really don't want to know this about you, anyway.

                            I used to work with partners who were absolutely oblivious to the fact that their secretaries' days were over at 5:00PM. It made me NUTS, because the secretaries would stay, out of fear for their jobs. They do not earn your paycheck and do not carry your responsibilities. And do not get paid overtime. Respect boundaries and treat their time as valuable, not a commodity for your to exploit. Recognizing their day ends before yours both protects their time and is a respectful way of making a clear delineation between your job and theirs.

                            Comment


                            • #15
                              Originally posted by GrayMatterWife View Post
                              This. Do not fraternize with the staff. The nursing staff, the admin staff, whomever. You are not staff. You are a doctor.
                              I disagree. I see nothing wrong with being friends with staff. Some of our favorite people are nursing and/or other support peeps and we socialize(d) with them frequently. Our residency peeps (whether they were docs, spouses, nurses, techs, or whatever) fucking rocked.

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