When I was an intern rotating in the ICU, I happened to be in a room with a third year ICU resident named Jill and her attending. And they were having a conversation like I wasn't in the room.
Jill started complaining to the attending about her resident Max. Max was an intelligent guy, very nice and conscientious, and mature beyond his years. I'd worked with him several times and he was always someone I felt like I could rely on. But I gathered from this conversation that Jill and Max were not getting along.
Max was interested in doing critical care as a career and Jill was complaining about the number of mistakes Max had made that month. Jill was going on and on about how he didn't pay enough attention to details and that he didn't know the patient's meds (so I guess I wasn't the only one). And the attending was agreeing with her. Max apparently also did something bad in terms of having some important code discussion with the family without including the attending.
I felt really bothered by the conversation that Jill was having with this attending (especially the fact that it was right in front of me). I went home feeling conflicted, wondering if I should warn Max that Jill had been dissing him so that he could do damage control.
Ultimately, I ended up not saying anything. Max already knew Jill didn't like him, and I didn't want to be the bearer of bad news. But I always wondered if I did the right thing.
I had a similar situation like this recently. One of my R3s and the NP were openly talking shit about one of the new interns, saying how much she sucked and all the things she was doing wrong. They weren't even trying to be quiet about it either, they were just talking about it out loud when we were rounding. I felt really bad for the intern, because she had no idea they even felt this way or what she was doing wrong. I tried to figure out if I should tell her, and I wanted to, but ultimately, I decided not to because I didn't know her that well and I wasn't sure how she would take it coming from me.
ReplyDeleteIt's a tricky situation, because if I were that intern, I think I'd be devastated to find that out. Yet I wouldn't want to keep doing things wrong.
DeleteI'm probably a little over direct (it has gotten me in trouble in the past). I wouldn't have said directly that Jill was bad mouthing him but I would probably have told Max that he should be careful and that he should try to do some damage control. And I would have probably tried to work into conversation with the attending that I thought Max was doing well (with hopefully a concrete example).
ReplyDeleteI wish I had the nerve to speak up during that conversation. But it's not like I was Miss Intern of the Year myself and I felt like I didn't have the right.
DeleteTo tell or not to tell..
ReplyDeletewell, I think it's Jill that should ask herself "to tell or not to tell"
She could directly talk to Max
also she could complain to the attending when Max was present there
Well, I think Jill did say things to Max. He definitely knew she didn't like him. It always amazed me because he was one of those diligent workers who I assumed *any* resident would have to like.
DeleteI had a very similar situation happen recently. On my very first rotation, I was working in the ICU with a few fellow interns. One of us was definitely struggling with the transition a bit more than the rest, but still getting the work done. I was pretty horrified to over hear one of the nurses complain to a senior resident that this intern made her fear for the patients. I didn't say anything to them or the intern, because I just thought it would make the situation worse and more stressful. Plus everyone was adjusting to new roles and would be getting better as time went on. Even so, I really think talking behind peoples backs (especially if fellow interns are within ear shot) is bad for morale.
ReplyDeleteIn these situations I think you're best off keeping quiet. Be Switzerland.
ReplyDeleteI adopted a policy of always telling staff about a particularly good resident or fellow. I will only bring up a "bad" resident or student if I feel it is really bad (like, say, a final year medical student who shows up consistently 3 hours late because she "doesn't want to be there").
ReplyDeleteThis way, if someone is dissing someone, in the back of their mind, they will also have some positive thoughts. "Dr Smith, I gotta say, one of your residents taught us EMGs last week and he was pretty amazing. It was a super helpful teaching session. Thanks for letting him miss clinic to help us learn this stuff!" inevitably, the staff feel pleased that they taught their resident so well, and there are good feelings all around. And if the resident messed up big time somewhere else, fine. At least the staff can have a more well-rounded opinion of the resident.