8.20.2011

"Just you wait...."

These words seem to be a running theme lately. If you are newish medical student, or just starting off resident, chances our you know what I'm talking about.

Are these words of warning? Are you trying to save us? What makes other, older, wiser nurses, residents, attendings want to deflate the bright-eyed and bushy-tailed Bambis' of their idealistic views? Why do you need to tell me it won't last? Why shouldn't we be as eager as a toddler to get a new toy?

Three examples:

-My friend Beth is one week from being done with her training and she has a job lined up to work as a PA in the ER. While rotating one day in her future ER, a nurse, and soon to be co-worker tells Beth that she will become like all the others soon enough, JADED. Beth denies this. The nurse insists. She has seen it happen, time and time again. It isn't clear why she is telling Beth this but it makes an impression.

-During my first week of surgery rotations I happened to work a long day. I arrived to the hospital around 4am and happened to talk to one of the nurses about a mutual patient of ours. The RN was working the night shift and remembered me,  so 18 hours later when I was back on the floor checking on a patient before I left for the day she made sure to tell me that my enthusiasm was temporary. She also told me I should go home. And while she was right and maybe I did need to go home I remember in that moment thinking to myself, I hope this lasts, I hope I always care this much about each patient I take care of, this is my job to be devoted.

A classmate started her rotations this week and she is on my FM team. When she got her first patient to admit she did a celebratory dance, complete with clapping and jumping up and down, right in the middle of the ER. I laughed (I can recall my own enthusiasm and the joy one feels when she is finally seeing a patient, by herself.) The resident gave her a funny look as she skipped  happily away. "What is up with her?" the resident asked me. "It is her FIRST patient!" I replied. The resident sighed, "I wish I was still so excited to admit a patient, I don't remember ever being that eager."

And yet, I am sure the resident was. At one time she was an idealistic, eager, enthusiastic doctor in training. Just like we all start out as... Bambis.

And I'm sure those nurses are right. Over time, in a few years, or maybe a decade my friend Beth may become jaded. The ER is a tough place to work. ER staff deals with sick, scared, patients. People can be at their worst and burnout in the ER field is real. But does that mean we have to try and take the idealism away before it wears off?

I did tire of 16 hour days. And note to self-seeing the same nurse separated by two shifts signals it is time to go home. But it will continue to happen. Even if I'm not always happy about it. And I should stay so devoted.

And yes, my classmate will stop dancing every time she gets assigned a new patient to admit. However my hope is that we continue to remember that feeling of enthusiasm from time to time.

Idealist, devoted, enthusiastic. Sure we all still Bambis but you know what, we wouldn't change it for the world, being a Bambi is a pretty cool thing! Go ahead, call me Bambi, I'm proud to be!



(Now where is my nurse like Carla?)

And because we all need some music in our day and not because this has ANYTHING to do with my post...

7 comments:

  1. Amen to everything you've written! I'm not sure if it's the burden of experience or if they're just trying to "warn" us. Either way it's annoying and I find myself tempering down my enthusiasm level just so I don't have to be told yet again that I wont always be this way.

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  2. warn of what? that one day we'll be tired and overworked and burnt out and bitter? maybe... but why can't we enjoy being new and eager while it lasts? and why can't they be happy for us?

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  3. yeah i know what you mean. I am 2 wks into obgyn (@NYM btw) and there is definitely an undercurrent of "don't be so into it, don't be so enthusiastic". It DOES seem to annoy some residents. I also had some nurses tell me I was only excited because I was new. And they all laughed.
    However, at least in my hospital (so far), the cynics seem to be outnumbered by those who are having fun and encouraging.
    This could all just be OBGYN (supposedly one of the most miserable specialties), but you know, people go into their specialty for different reasons, not always the best ones. And people can get frustrated with their job at a particular hospital/company/job etc. and end up taking that out on the people around them.

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  4. This theme of miserable people is not unique to certain specialties...it's not even unique to medicine. Every profession has it's naysayers and burnouts. You're not going to be able to change those people, but you can control the effect they have on you. It's hard to do. A huge part of training in medicine is based on modeling after those above you...unfortunately, it's one of the most efficient ways of learning. But that means you pick up the good, and the bad, and depending on your own underlying self-confidence and pathology (we all have some), how you end up after being spit out of med school, or residency, or fellowship, or even your early years of practice hinges on you're ability to separate the two.

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  5. I only have the patient perspective, but I am so happy to hear there are more docs out there who want to always be eager and accommodating.

    We have been lucky to find a pediatrician who has come full circle -- once he got out of the medical grind and opened his own practice, he got to make the decisions, call the shots, design the services. I can text our pediatrician at 9:30 at night and he writes back and ends it with a :) If it hadn't happened to me, I would have called it unheard of! He gives his home #, cell#, wife's cell # on the outgoing voicemail to his office.

    He has visitation rights at all the hospitals, which came in handy when my sister's baby was in ICU with RSV. He was there on a Sunday morning in a sweater and jeans just sitting with her, holding her, one morning when we showed up. He called Erin at midnight to say he had received lab results and didn't want to wait till morning to let her know.

    Of course, there's trade-offs -- his office is closed on Wednesdays, they don't open till 9:00 every day and usually close by 4:00, unless it's Friday, and then it's 3:00. They break for lunch from 12-1:30. But still, my biggest fear is that he'll retire for good before the kids are 18.

    So like I said, I don't have the perspective you do, but I do have an example of the doctor you sound like you're becoming, and I am so happy to watch you on this journey! You are doing so great and are such an inspiration.

    Lots of love, and hi to Jerry.

    Tara

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  6. I"m sorry to go on and on, but when we took Max to the ER for a febrile seizure (we didn't know what it was, just found him unconscious) I called him on his cell from the ER waiting room (where of course we were triaged WAY down the line), because when you're a parent in that situation, I HAD to talk to a doctor NOW. He talked me through it, made the diagnosis that the ER doc would eventually make 4 hours later, and checked his schedule for when I could bring him into the office the next day. Really -- unheard of among my mom friends.

    He has personally called us at home to find out how the kids are doing. His wife is his nurse and they are hilarious! They also take several weeks off each year to do mission trips. And if I need a pediatrician during that time, I completely trust his referrals.

    I'm sure he's had his share of burnout and I'd venture a guess that it has contributed to this wonderful practice that they now have. I know your work is tough but I am so thankful for people like you and our pediatrician :)

    Xo

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  7. Tara-
    Thank you for sharing your perspective and illustrating just how amazing your pediatrician is. It is nice to hear of such a wonderful physician running his practice in what sounds like the best possible way for himself and his patients. I hope that I can someday measure up.

    Thanks for reading and commenting. Please give Dana my regards too. And tell your beautiful boys that they are super lucky to have you as a mom!

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