As an intern, I was supposed to start my emergency medicine rotation on a Sunday. The schedule listed me as starting at 1PM, so I thought it would okay to make plans for the night before. Specifically, I bought tickets to a Green Day concert for Saturday night.
So you can imagine I wasn't thrilled when I got an email from the rotation director, saying that we were having an orientation Sunday morning at 7:30AM.
That totally sucked for me. But it sucks even worse for the two people who had Sunday as one of their days off. In fact, only one person was actually supposed to be working on Sunday morning, even though we all had to show up at 7:30AM. On a freaking Sunday.
I emailed the director and asked him how long the orientation was going to last because I made plans (to sleep). He replied:
My plan is to done by 900-930h, but we can do the computer training (without many questions) first which takes under an hour, tour the ED, and then do the practice on the computers part last. My experience in the past is that the people who are not beginning an AM shift spend a lot of time practicing on the computers rather than starting their shifts, and those with the day off leave quickly (strange how that works!)
My first thought was, "FUCK YOU!" He's making people come in on their day off and he has the nerve to make a sarcastic quip about how those people want to leave early? Days off are very rare in intern year. I assume this guy did a residency and went through the same shit we have to, but maybe he'd just forgotten. Or maybe he was just insensitive.
Anyway, it turned out that having me come in at 7:30AM then start my shift that afternoon and work all night violated some sort of ACGME rule, so he ended up switching me to the day shift on Sunday. I spent a very long time practicing on the computers.
You were such a passive aggressive intern, Fizzy. I always complied with whatever my program planned on my days off: board exam practice (half a day), ACLS training - two full days, orientatins, volunteering, anything. I frequently worked my afternoon clinic after having finished overnight ER shift and having slept just 2-3 hours. Did I mention that after clinic ended at 5 pm I had to start my next overnight shift at 7 pm? I agree with your feelings. I just never let myself feel that way. I wonder if feeling resentful all the time made (making) you more stressed out.
ReplyDeleteYou sound like such a goody-goody! If you told your co-interns this sort of thing I'll bet they all just LOVED you.
DeleteIf you don't complain, at least passive-aggressively, nothing will ever change for the better
DeleteIs it really "passive-aggressive" to be upset about having to come to work on your day off? I'd call it "justifiably upset". It's only passive-aggressive if I come in and then do a shitty job and act really bitchy to the director. I always complied, same as you did.
DeleteIf you truly didn't hate coming in on your days off, maybe it was because you didn't hate your internship as much as I did to begin with. When you already hate your work and then someone asks you to come in extra days, it's extra unpleasant.
Anonymous 1, while your commitment to your internship was, um, admirable, being sanctimonious about it seems a little uncalled for. If you can't complain about being an intern, what can you complain about? Complaining about stuff is what separates us from the animals!
Delete-Dr. Alice
Anon 1 would be violating duty hours if s/he adhered to the same practices in today's residency training environment. Smells like martyrdom to me, but feel happy for Anon 1 if it s/he was able to do all that without feeling taken advantage of at the time. At the same time, I'm pretty sure I'd hate this person in real life.
DeleteMy internship IM program encouraged residents to dictate from home to avoid adding to our duty hours as we often worked more than 80/week (tho' dictating from home DOES count toward duty hours). If residents recorded more than 80 hours they received a call from the program coordinator asking them pointedly if they had really meant to record those hours and instructions to change them to make them "accurate."
I should have notified the ACGME, but I worried the program would retaliate against me and wanted to finish internship so I could move on to residency. The program was sheer hell, but honestly, I learned a whole lot in part because of all the extra work.
Fizzy - what is passive aggressive is intentionally prolonging your computer training so you do not have to go straight to ER. To others - I was voted resident of the year, by overwhelming majority of my peers (my attending stated to my surprise - they all loved working with me: never complained, let people down, did my job the best I could no matter how tired, did not have tantrums at work, screamed at anybody etc). True, Fizzy, I did not let emotions ruin my internship. And it was harder before hour restriction rule. As I said in my first post I agree with your feelings but I did not let myself feel that way about something that is going to last a year.
DeleteThat last sentence was meant to be a joke, because he said that people who were working that day always spent extra long on the computers. Kind of "proved him right!" kind of thing.
DeleteI entirely believe everyone loved working with you as a resident. I also loved the people who were willing to do all the work everyone else didn't want to do. But don't believe your attitude is the most common one, or even possible for everyone. You can't just say to yourself, "I'm going to love my job" and then it's so. Do you tell your patients who are depressed "don't let yourself feel depressed" and then they're miraculously not depressed? Emotions don't work that way.
Anon: Did you advise your peers that you thought they should be more like you (that they complained too much and threw tantrums and let everyone down) as you just did with Fizzy? I'd imagine you had the sense not to, or else they wouldn't have liked you nearly as much. Speaking of silent resentment....
DeleteAlso, you must have worked with quite an interesting group if the compliment they gave you when they voted you resident of the year was that you "did not have tantrums at work, [never] screamed at anybody" etc. Pretty low bar.
"I always complied with whatever my program planned on my days off" - as a PD, I can tell you, sometimes we NEED a resident to let us know they are going to violate duty hours. In this warm & fuzzy age of medicine, we comply, but the onus is on the individual. If you 'comply' but violate, for shame.
DeleteTrue, lyssum. We need to remember the reason these work hour restrictions were put in place--for patient safety. Don't be proud of violating work hour rules. You may as well be proud of being drunk on the job.
DeleteNo wonder you hated your ER rotation, given that kind of start. Tricia
ReplyDeleteI wish you luck, even when things arent what we wanted... I just discover your blog... right now! Seems will be funny and instructive.
ReplyDelete(Sorry for my english, but i think is good enough for understand me, by now)... (Will try to improve my self next time). :-D
I'm sure you learned something absolutely necessary for your ER rotation, that you couldn't POSSIBLY have learned on Monday morning. I mean, IMAGINE having worked that one shift without the OFFICIAL tour of the ER. And there's, like, no WAY you could have done an independent tutorial to at least survive 1 shift - you'd have to be, like, a DOCTOR to be able to figure that out. No way.
ReplyDelete- Grace
Well, they clearly couldn't take the time out to do the training in two different groups or something. The only way to accomplish this was for people to come in on their days off.
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