I’ve heard this saying a bunch of times, and it’s simply not true. They can not only stop the clock but can quite literally make the clock go backwards by repeating a year.
Valid point. I'm a little cushioned from this as a subspecialty resident, if they held me back one year our coverage would be absolutely fucked so they go to lengths to not do it. But those who put in the time and are competent surgeons despite all the bullshit usually don't run into this issue.
Can't you report it if they illegitimately fail you? You can prove you're taking a good care of your patients by clinical outcome measures. Unless you're risking someone's life seriously which again they need to have a proof for that, there is no legitimate ground they can fail you. No?
No. There are always ways to fuck you over. Mist made up one i saw was “not enough enthusiastic energy during morning rounds. Was cited as reason (among other equally bullshit ones) to terminate her contract (in reality, her attending and our boss is a misogynist and was just looking to replace her. Not in the US, residents can be terminated like any other employee)
>not enough enthusiastic energy during morning rounds
That is insane. I don't know what else they made up but if you go to the court with that report, I'm hopeful that there has to be a way to prove their corruption. That is no way near a legitimate reason to terminate someone's contract.
Hope we never have to find out through personal experience. But I know myself, I can't keep my mouth shut when there's injustice or disrespect. They will hate me already and I rather prefer that than following along their bs.
And for that matter, F all pseudodoctor NP’s! Quit thinking you all went to medical school! I have more respect for PA’s! Oh yeah I forgot, for the super gunner nurses, there’s the DNP!!! WTF?!?! Pretty soon there will be NNP’s (neurosurgeon nurse practitioners)!
I agree. I'm just a patient, but it scares me that in the majority of states, NPs, who are clearly unqualified, can practice independently as a physician, essentially. It should terrify everyone. At least PAs are better trained and know what they don't know.
I agree. I'm just a patient, but it scares me that in the majority of states, NPs, who are clearly unqualified, can practice independently as a physician, essentially. It should terrify everyone. At least PAs are better trained and know what they don't know.
I’m joking about the NNP. It wouldn’t surprise me though in the future. But the DNP I’m not joking. Where I’m from a lot of these DNP’s. NP with a doctorate. Want to be called doctors here. Never did the rigorous first 2 years of didactic study and definitely never did the painful last 2 years of clinical work! Never had to get yelled at by asshole attendings and nurses for that matter!
We are residents. The whole point is the hospital consumes out life. So we become competent physicians who know how to deal with shit when it hits the fan unlike mdielevels
Profound. Have you yet realized that your trainers insist upon your unique intellect so that you accept the inevitability of owing $800K to the federal government? No CRNAs believe themselves better to the physicians with whom they work. The system insists, however, that physicians believe that.
Random atteneings you encounter during residency can't make you repeat a year. They can complain to your PD and if your PD agrees THEN you repeat the year. As long as your PD, APD like you you're pretty much golden from a "run out the clock" standpoint.
This. As long as you do your job and maintain a level of competency roughly equivalent of your peers, you're in the clear. Be likeable and competent and they can't do shit as long as you're relatively professional.
PDs really do not want to do this. It reflects badly on the program just like it does on the resident. People will ask "why didn't they train them better?" or "why did they fall so far down the match list they ended up with a bad resident?"
Yeah, but this is just mythmaking. I’m a surgery resident, I spent 2 months doing required weekly in-person check ins with a psychiatrist (affiliated w/ my institution) due to active suicidal ideation with a plan and means (which I lied about)….while still going to work everyday and getting good evals. I just told people I was feeling more tired than usual.
There was literally no point in reporting the abuse because there had always witnesses who never spoke up.
All I’m saying is not crumbling publicly isn’t a skill it’s more like survival. Also, you can have “thick skin” and still be really suffering.
It’s really hard when you’re essentially kissing ass 24/7. I’m on rotations now and that’s essentially what I do day and night. It sucks that the few words of some careless attending can make or break your career. I hate that I’m made to feel like shit every other day. Can’t wait for all of this to end.
The key is to distinguish between 3 types of attendings: 1) The Worst: those who say they love to teach but actually only do it so they feel more knowledgeable or powerful over trainees. 2) The Best: those who are incredible teachers, give you good feedback, and want to see you succeed. And 3) Those who are chill smart people and don’t have an ego but also don’t go out of their way to help you learn. Kiss ass to 1. Be real with 2. Just be a hard worker and don’t ask too many questions for 3.
Cycle never ends - once saw a sub-I giving an MS3 on my service shit for missing something minute on rounds. Like actually berating the MS3. Needless to say, we did not rank him.
PGY-6 here. cannot even count the many many times I have been yelled at, called stupid, shamed & demoralized in front of colleagues, students, nurses, hospital staff. I have taken it all in stride.
Learned to just "heed the lesson" from all the verbal abuse I have had to endure. I remember crying during my junior years but now, not anymore.
I do my best to let what they say NOT get to my head (and my heart). There is no other way. If I crumble under the pressure I may not make it to end of the tunnel.
So I endure.
See this blows my mind because I’m currently doing volunteering at a major hospital to hopefully get into medical school one day and you’d never guess the abuse residents take while on the floor. I currently work on the orthopedic trauma floor and it’s rare we ever see the surgeons, and if we do it’s like them hanging out at a computer only to go back to wherever they came from. No one would ever know such crazy abuse or treatment goes on from the outside looking in. I really think more would get done about it if more people knew.
Haha he smiles because he knows one day it will end, the tables will turn, and he can criticize anyone who treats others so poorly. Rest assured he is keeping receipts….in the interim, he needs to play the game so as to not disadvantage himself. No point in pushing back at his stage
Sometimes, however, people recall their negative experiences as a Med student/resident and then vow to never treat any of the junior physicians/med students that way.
I wish this was the case - that he would treat his subordinates with respect they deserve, just like how wishes now. I am afraid he, like many before him, forget what it felt like and continue the trend. It's like the abused becomes the abuser.
This is the biggest thing I hope to keep in mind as an attending. Don’t perpetuate the abuse. Don’t be the guy you hated working with as a med student/resident
Remember those qs from psych/step 2.
"A resident berates a medical student after not presenting their preferred order of vital signs. Earlier that day the resident was told they were 'stupid' by their attending for being slower than usual in clinic.
The resident is demonstrating what type of ego defense?"
Displacement.
Projection is when you assume others do bad things cause you do bad things.
Displacement is taking your outwardly inflicted frustration out on someone else
Oh I get it. This is an anti CRNA thread, not a " shit that attending is a dick for yelling at the resident instead of using the opportunity to foster learning" thread.
Just wanted to know what I was reading
One NP I worked with was so bad/dangerous that my hospital revoked her privileges and reassigned her to a non-clinical job in the patient advocate office.
She told people she was leaving clinical practice to complete an "Advocacy Fellowship."
I clearly stated they weren’t being helpful they were being know-it-alls. While the attending is most definitely an asshole at least he actually DOES know what he’s yelling about. If he’s thinking “man this resident really sucks” he has the experience to think so. CRNA pushing propofol needs to STFU because she couldn’t even make an incision let alone perform a whole ass surgery.
This exactly! Critiquing his last surgery and going over all the shit he already got yelled at for like they know any better. Infuriates me. Meanwhile this resident is just smiling at this smug bitch. I couldn’t help but be impressed with his ability to tune the bullshit out.
I straight up offered the sticks to the CRNA one day. "Come scrub in and you will find yourself equally as frustrated as I am right now." *adhesions instensify*
Dude. No matter how bad or toxic shit gets, you shouldn’t participate in it too by calling staff “underlings” …you’re perpetuating a toxic culture, on a post about how much toxic culture sucks.
Poor guy. My cousin is a crna and the holier than thou bullshit is simply comical. She couldn’t get into med school twice. Lied about her mcat. During crna school, if you can call it that, I saw what she was studying and legit the chick couldn’t figure out basic acidosis vs alkalosis. Tbh, Id be scared shitless if that’s the person handling my care. But this person has no problem stating their income and how they know more than physicians.
It’s so bizarre. I get along great with the CRNAs here, I’ve never gotten that sort of attitude from them. But I know those people are out there. If only people really knew just how much residency separates physicians from everyone else
I could say healthcare worker instead. I was really only using the term as a catch all for people responsible for pt care. If I’m only referring to mid-levels, I’d say that
Avg 24% acceptance rate a makes it on par with most graduate programs. Learning is also fairly rigorous, as compared to other mid levels, or graduate programs in other fields.
It’s not med school (5.5% acceptance rate). And it’s certainly not on par with the training anesthesiologists receive. But there’s no reason to shit on CRNAs individually. They took a path that was offered, and work hard to become competent and do a good job. The idea of making fun of someone for struggling with acid/base disorders, something like half my class struggled with, is shitty.
Whether CRNAs should be able to independently practice, whether anesthesia needs more safe guards, and discussions of scope is a different issue. We can advocate for systemic change without being shitty to colleagues.
See, unlike you, I don’t call myself “well trained” or “anesthesia resident” or pretend to be something I’m not. If you’re going to start saying that shit, you better not be struggling with something medical students master well before residency.
Maybe the whole trope that ICU nursing prepares you for CRNA school is a whole load of bullshit if you don’t even master something as anole as acid-base disorders. Maybe there’s a reason why a proper pathway to practicing anesthesia exists (medical school → residency → attending) and nurses undercut that with some bullshit, which clealry underprepares them.
?? Did I say any of the above?
I’m an M4 student. Who knows their acid/base well enough for step 2 and working to integrate into clinical practice.
CRNAs also have what correlates to pre-clinical. They aren’t just thrown into an OR.
I’ve seen personal abuse hurled at CRNAs. There is rarely an excuse to scream at other ppl in the hospital regardless of your feelings of their pathway.
I don’t disagree that CRNAs in their current form are practicing with too large a scope. But there is a way to lobby for change without shitting on individuals
We all struggled with it... Usually as a MS2.. but then there were 2 more years.... Then, in my case, 6 more years of res and fell, and then finally independent practice....
Dude... If half of the class struggled with acid-base disorders..... I am really, really scared of what is going to happen when they grant them unsupervised practice.... they are in charge of acid-base during operations... Jesus take the ventilator...
Literally nothing is harder to get into than med school. Doubly so for residency. I’ll still congratulate people for getting into whatever they are applying to, and commiserate with their challenges
exactly! like the dude said in another thread, getting into CRNA has a 25% admit rate so getting in is still impressive, but MD med schools are anywhere from lows of <1% to 5% on average. add on the fact residency is another crapshoot process with ridiculous standards (like research when 90% of MDs will never touch research again)
Something I learned when I was a tech was to pick my battles. It was hard, especially when people were horribly condescending. But they want you to argue and feel bad about yourself, so the best thing to do is smile, nod, and say "thank you for letting me know". Unless of course they're wrong, or it's a serious problem.
Please keep on checking on these residents who keep up a smile in the face of adversity, because they more than likely are holding in a lot of pain and depression.
The gall of CRNAs to try to lecture residents. They probably think this is nursing school where they can bully student RNs and treat them like shit.
If it were me, I’d say, “sorry but I’m not allowed to receive instruction from non-physicians - it’s against ACGME rules” as a polite fuck you.
The key is to know it’s not about you it’s about them. Do what you can to learn from every experience and keep the mindset that people don’t handle stress well. If you let them get to you you’ve lost. Just be confident that you’ll be better than them someday
It took me a while to see that the ones who treated me most poorly were the ones who were more stressed and less trusted by their superiors. The shit often runs downcreek
Daughter dealing with this now. OB/GYN is so toxic it is CRAZY. Not just mid-levels but the residents forgot they are supposed to teach you and not make you constantly feel like a complete idiot. How is that helpful in the long run? Ego's are sky high for those people.
This is the main takeaway with all this.
The rot extends deeper and farther unfortunately.
What worked for me back then is to remember these people are generally unhappy, and focus on my own happiness. Easier said than done, but I guarantee it pays dividends even after you complete residency, only then you have more power.
Note: not advocating always turning the other cheek. By all means, defend yourself, but pick your battles.
This. This is a human decency issue- I don’t think it has anything to do with the roles.
We need to all treat each other better. Yelling at other adults is unprofessional and does not serve patients.
I know it might be too late for this instance, but if you see something like this again- offering some words of support to the resident after something like this can go a long way. Something like “good on you for taking that and staying positive, we are all learning here” or something more you lol
Please tell that resident your good thoughts... it's so high pressure and the support system can be sketchy due to rough schedules. That's so kind of you
Just remember, if you don’t value their opinion, it doesn’t hurt your feelings. So when some twice divorced toxic attending tries to lecture you on hours and work life balance, if you don’t value their experience in work life balance then their opinion isn’t worth anything. If some know it all crna wants to lecture you on surgical techniques, again probably not worth your time.
I am like this resident. For whatever reason, I do a good job at not taking things personally. Never really bothered me getting "yelled" at. No different than all the sports I played. Under all that anger, there is usually a teaching point, so I try to focus on that.
No need to feel bad for me. Worry about the people that can't handle it.
What really gets me are the boomer physicians who think they’re god. Like you got into this profession back when you could just waltz into a classroom. Humble yourselves.
I don’t understand the thought process of being rude to other people. We’re all over worked, we’re all (residents) underpaid, and undervalued (again, residents). Everyone is having a miserable time so why go out of your way to berate residents for trying their best? It’s quite literally not that hard to be a kind person
I can’t speak for the other Crna’s but I don’t want to be a doc. Y’all are so in debt it’s crazy! I came out of school with like 22k debt, paid off after one year, and make very good money now.
Where do you work that staff is like this? I’ve never encountered anything like this in any place I’ve worked (NYC area). By an attending sure but never CRNAs. They generally know their role and stick to it.
I disagree with both PA and NP being able to diagnose and treat independently. It’s not training or qualifications driven decisions but simply lobbying driven decisions. They are highly unqualified. And kudos to you for taking the MCAT and I hope you get into med school. We need more doctors and not more mid levels.
Honestly, I just think of CRNAs as “the help,” and the gall of the help trying to talk down to a surgery resident is farcical when they (at best) have a very superficial knowledge of anatomy, surgical technique, post-op care, etc.
Gave him some words of encouragement. He made a joke. Honestly still thinking about him. Maybe he is capable of brushing it off and already forgot about it but it’s wrong that he has to.
Fascinating to have surgical performance lecturing from a CRNA.
I believe an appropriate response, including said smile, is "what's your name again?".
Especially if working with them for years. Especially after using names of all your nursing staff all day to show it isn't a name memory issue.
The behavior of bullies is just projection. They’re miserable and inept so they must reflect that outwardly somehow. CRNA’s are incompetent at baseline, so don’t even engage with them since they don’t know shit anyway. They are not our equals, they’re lesser.
OP, you should also check on that guy because these are the types of guys who endure this abuse silently without showing any weakness, and when they reach a breaking point, they are more prone to committing suicide. So please check on him.
(CRNAs are prick all my homies hate them 😤)
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Overheard an attending once tell medical students that he was rounding with that “it doesn’t even matter what’s wrong with the patient anymore because at this point he has grown more weary than them by working with these students”. I was shook.
Overheard an attending once tell medical students that he was rounding with that “it doesn’t even matter what’s wrong with the patient anymore because at this point he has grown more weary than them by working with these students”. I was shook.
OR peeps are the chill peeps usually (or at least that was the case when i rotated) unless it messes up timing/schedule then whomever messed it up is screwed for the day. That CRNAs kid ain’t getting picked up on their own from day care ya know!
Haha, then you go home after that happens most days for a year, and you contemplate how you’re gonna kill yourself. Lol, so glad I always smile so people know I’m happy.
CRNAa scare me. They've messed up my mothers anesthesia twice now. I'm truly terrified at the autonomy nurses have to independently do what physicians do in the majority of US states. I'm not even a physician, just a patient, and it terrifies me.
CRNAa scare me. They've messed up my mothers anesthesia twice now. I'm truly terrified at the autonomy nurses have to independently do what physicians do in the majority of US states. I'm not even a physician, just a patient, and it terrifies me.
Residency in India: saw one Cardiac Surgeon scold his resident: “to go work in kitchen n then come n scrub with him.” I was devastated just listening to that.
I don’t know why I keep getting updates on this forum, mostly everytime Crnas are being brought up but who knows. As for your friend, it suck’s for sure. Sadly there’s dicks everywhere and within every profession, and it seems like medicine and healthcare have more than other careers. Furthermore, no anesthesia providers, md, do, or Crna, should be giving any tips to a surgery resident unless potentially asked. We know as much about the little intricacies of surgery as surgeons know of anesthesia.
Weird thing is, most interactions I’ve seen have been nothing but positive. This might be a cultural thing at their hospital or within their residency or just with the douchey attending and the douchey Crna. Glad they have thick skin, it is needed in the hospital and as time progresses, and they become more experienced, they stand up for themselves.
I love all the comments about the CRNAs in this story but very little directed at the attending that was the real issue in the post. But, again, y’all will make such wonderful colleagues in the OR.
So he was reprimanded by both his attending and the CRNAs, and you .. praise the guy and bitch about the "wannabe doctors."
It sounds like he just sucks and your mid level hate is silly.
Yes, I praise him because he was doing a good job. Just because the Asshole attending wants him to do it HIS way doesn’t mean he sucks or was doing something incorrect. While I can understand the stress on the attending, yelling badgering and belittling the guy isn’t going to help the resident who is actually doing the surgery. He handled himself and managed his emotions better than the attending who has been doing this for years. The dialogue should have remained between the two of them. Why the dumbass glorified nurses thought they can comment on anything is beyond me. Just play on your phone and STFU. You don’t have an ounce of the training or knowledge he has especially in his specialty no matter how many years you’ve been doing your pretend doctor role. Until you physically scrub in and physically preform surgery STFU. “SoUnDs LiKe He SuCkS.” Just like a nurse to comment on something they know nothing about. Stop pretending. You’re not a doctor. Seriously. STFU
I think you need to work on yourself a little. The frenzied vitriol in re: nurses with advanced degrees- you seem a little unhinged. Doctors do deserve credit for all the knowledge they were exposed to and the tests they passed. However the lowest IQ possible to become a doctor is 115 pts. We both know many R.N.'s and P.A.'s that easily exceed that intellectual capacity. None of these types of healthcare workers has the right to behave like an abusive ass. I will treat a person with a higher level of training with general common respect but I will not assume that they have a superior level of clinical knowledge until it has been fully demonstrated. Respect is earned by proof of competence- not by having passed a test of minimal requirements to protect
They can always hurt you more, but they can't stop the clock. Props to that resident for not crumbling under the abuse.
I’ve heard this saying a bunch of times, and it’s simply not true. They can not only stop the clock but can quite literally make the clock go backwards by repeating a year.
Valid point. I'm a little cushioned from this as a subspecialty resident, if they held me back one year our coverage would be absolutely fucked so they go to lengths to not do it. But those who put in the time and are competent surgeons despite all the bullshit usually don't run into this issue.
Can't you report it if they illegitimately fail you? You can prove you're taking a good care of your patients by clinical outcome measures. Unless you're risking someone's life seriously which again they need to have a proof for that, there is no legitimate ground they can fail you. No?
No. There are always ways to fuck you over. Mist made up one i saw was “not enough enthusiastic energy during morning rounds. Was cited as reason (among other equally bullshit ones) to terminate her contract (in reality, her attending and our boss is a misogynist and was just looking to replace her. Not in the US, residents can be terminated like any other employee)
>not enough enthusiastic energy during morning rounds That is insane. I don't know what else they made up but if you go to the court with that report, I'm hopeful that there has to be a way to prove their corruption. That is no way near a legitimate reason to terminate someone's contract. Hope we never have to find out through personal experience. But I know myself, I can't keep my mouth shut when there's injustice or disrespect. They will hate me already and I rather prefer that than following along their bs.
The CRNA’s can’t but attendings can lol
F the CRNA’s
And for that matter, F all pseudodoctor NP’s! Quit thinking you all went to medical school! I have more respect for PA’s! Oh yeah I forgot, for the super gunner nurses, there’s the DNP!!! WTF?!?! Pretty soon there will be NNP’s (neurosurgeon nurse practitioners)!
I agree. I'm just a patient, but it scares me that in the majority of states, NPs, who are clearly unqualified, can practice independently as a physician, essentially. It should terrify everyone. At least PAs are better trained and know what they don't know.
Thank you! I agree with everything said in your comment!
Yes. They can hang out a shingle where PA’s can’t! Pisses me off!!
I agree. I'm just a patient, but it scares me that in the majority of states, NPs, who are clearly unqualified, can practice independently as a physician, essentially. It should terrify everyone. At least PAs are better trained and know what they don't know.
That’s not true. I currently have a NP and she’s awesome. I’ve had 3 previous PAs that were horrible.
No NP’s here. Only MD’s and/or PA’s.
What will they do? Perform brain surgery?
My fellow organism in Christ, please tell me this is a joke. What even is an NNP 🥺
I’m joking about the NNP. It wouldn’t surprise me though in the future. But the DNP I’m not joking. Where I’m from a lot of these DNP’s. NP with a doctorate. Want to be called doctors here. Never did the rigorous first 2 years of didactic study and definitely never did the painful last 2 years of clinical work! Never had to get yelled at by asshole attendings and nurses for that matter!
DNP??
Yes DNP
Definition?
Doctor of Nurse Practitioner
Or Doctors of Practical Nursing. Or whatever the F!
Why do you care that much what other people are doing? Sorry that the hospital consumes your whole life.
We are residents. The whole point is the hospital consumes out life. So we become competent physicians who know how to deal with shit when it hits the fan unlike mdielevels
Because they’re directly killing people with unsupervised practice. Edit: changed indirectly to directly
Would you mind providing evidence of this?
Says a person that requires direct supervision to not kill people.
They’re still in training.
Profound. Have you yet realized that your trainers insist upon your unique intellect so that you accept the inevitability of owing $800K to the federal government? No CRNAs believe themselves better to the physicians with whom they work. The system insists, however, that physicians believe that.
You are too!!
Random atteneings you encounter during residency can't make you repeat a year. They can complain to your PD and if your PD agrees THEN you repeat the year. As long as your PD, APD like you you're pretty much golden from a "run out the clock" standpoint.
This. As long as you do your job and maintain a level of competency roughly equivalent of your peers, you're in the clear. Be likeable and competent and they can't do shit as long as you're relatively professional.
The assumption is that they are older than you and therefore will reach old age and die before you.
"You'll be repeating for the rest of your life, kid. Just quit!" "For the rest of *your* life, old man."
PDs really do not want to do this. It reflects badly on the program just like it does on the resident. People will ask "why didn't they train them better?" or "why did they fall so far down the match list they ended up with a bad resident?"
Yeah, but this is just mythmaking. I’m a surgery resident, I spent 2 months doing required weekly in-person check ins with a psychiatrist (affiliated w/ my institution) due to active suicidal ideation with a plan and means (which I lied about)….while still going to work everyday and getting good evals. I just told people I was feeling more tired than usual. There was literally no point in reporting the abuse because there had always witnesses who never spoke up. All I’m saying is not crumbling publicly isn’t a skill it’s more like survival. Also, you can have “thick skin” and still be really suffering.
They can add a pound of pain to the scale but not one grain to the clock
I was a surgery resident 30 years ago and ...this is the saying we used too!
Yea. I tell med students and junior residents. Don't let medicine turn you into a bad person.
Too late!
Haha right! Fuck you too buddy! Also mind taking a look at this chart here...
It’s really hard when you’re essentially kissing ass 24/7. I’m on rotations now and that’s essentially what I do day and night. It sucks that the few words of some careless attending can make or break your career. I hate that I’m made to feel like shit every other day. Can’t wait for all of this to end.
The key is to distinguish between 3 types of attendings: 1) The Worst: those who say they love to teach but actually only do it so they feel more knowledgeable or powerful over trainees. 2) The Best: those who are incredible teachers, give you good feedback, and want to see you succeed. And 3) Those who are chill smart people and don’t have an ego but also don’t go out of their way to help you learn. Kiss ass to 1. Be real with 2. Just be a hard worker and don’t ask too many questions for 3.
I can’t agree enough
Good thing I️ was already a bad person 🗿
Now I want to be a bad person 🗿
Cycle never ends - once saw a sub-I giving an MS3 on my service shit for missing something minute on rounds. Like actually berating the MS3. Needless to say, we did not rank him.
haha what a tool
PGY-6 here. cannot even count the many many times I have been yelled at, called stupid, shamed & demoralized in front of colleagues, students, nurses, hospital staff. I have taken it all in stride. Learned to just "heed the lesson" from all the verbal abuse I have had to endure. I remember crying during my junior years but now, not anymore. I do my best to let what they say NOT get to my head (and my heart). There is no other way. If I crumble under the pressure I may not make it to end of the tunnel. So I endure.
See this blows my mind because I’m currently doing volunteering at a major hospital to hopefully get into medical school one day and you’d never guess the abuse residents take while on the floor. I currently work on the orthopedic trauma floor and it’s rare we ever see the surgeons, and if we do it’s like them hanging out at a computer only to go back to wherever they came from. No one would ever know such crazy abuse or treatment goes on from the outside looking in. I really think more would get done about it if more people knew.
I think it’s helpful to remember these threads are a concentration of people’s difficult experiences. It’s not all bad all the time :)
Haha he smiles because he knows one day it will end, the tables will turn, and he can criticize anyone who treats others so poorly. Rest assured he is keeping receipts….in the interim, he needs to play the game so as to not disadvantage himself. No point in pushing back at his stage
Sometimes, however, people recall their negative experiences as a Med student/resident and then vow to never treat any of the junior physicians/med students that way.
This is what I meant
Yep, sorry I misread that initially.
I wish this was the case - that he would treat his subordinates with respect they deserve, just like how wishes now. I am afraid he, like many before him, forget what it felt like and continue the trend. It's like the abused becomes the abuser.
This is the biggest thing I hope to keep in mind as an attending. Don’t perpetuate the abuse. Don’t be the guy you hated working with as a med student/resident
Remember those qs from psych/step 2. "A resident berates a medical student after not presenting their preferred order of vital signs. Earlier that day the resident was told they were 'stupid' by their attending for being slower than usual in clinic. The resident is demonstrating what type of ego defense?"
Displacement ?
Projection?
Displacement. Projection is when you assume others do bad things cause you do bad things. Displacement is taking your outwardly inflicted frustration out on someone else
Lol CRNA acting like they are so great
Easy to be overly confident when you don’t have to deal with the repercussions lol
Oh I get it. This is an anti CRNA thread, not a " shit that attending is a dick for yelling at the resident instead of using the opportunity to foster learning" thread. Just wanted to know what I was reading
There’s the “heart of a nurse” I keep hearing about
I don't browse the nursing subs and interject there, why do you browse the residency subs and comment here?
They call themselves residents now didn't you know?
They really do and it’s comical lol. They even talk of “fellowships”
One NP I worked with was so bad/dangerous that my hospital revoked her privileges and reassigned her to a non-clinical job in the patient advocate office. She told people she was leaving clinical practice to complete an "Advocacy Fellowship."
Sounds like nepotism / cronyism if they were that committed to keeping them.
The military... impossible to fire people.
That's so hilarious.. talk about thick skin and no shame
I clearly stated they weren’t being helpful they were being know-it-alls. While the attending is most definitely an asshole at least he actually DOES know what he’s yelling about. If he’s thinking “man this resident really sucks” he has the experience to think so. CRNA pushing propofol needs to STFU because she couldn’t even make an incision let alone perform a whole ass surgery.
Yes. We’re anti CRNA. Why are you nurses so shocked that we don’t like you when all you do is minimize the education and training of physicians?
Spot the crna creeping the residency sub
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This exactly! Critiquing his last surgery and going over all the shit he already got yelled at for like they know any better. Infuriates me. Meanwhile this resident is just smiling at this smug bitch. I couldn’t help but be impressed with his ability to tune the bullshit out.
What gall these nurses have. Lol Like if I were a corporate cost cutting measure I would keep my mouth shut.
I straight up offered the sticks to the CRNA one day. "Come scrub in and you will find yourself equally as frustrated as I am right now." *adhesions instensify*
Nice one!! Shut those underlings up!
Dude. No matter how bad or toxic shit gets, you shouldn’t participate in it too by calling staff “underlings” …you’re perpetuating a toxic culture, on a post about how much toxic culture sucks.
Oh ok! Let’s make them our equals! Get real DA! Toxic culture….! They have their job, I have mine. Stay out of mine!
Name and shame
Poor guy. My cousin is a crna and the holier than thou bullshit is simply comical. She couldn’t get into med school twice. Lied about her mcat. During crna school, if you can call it that, I saw what she was studying and legit the chick couldn’t figure out basic acidosis vs alkalosis. Tbh, Id be scared shitless if that’s the person handling my care. But this person has no problem stating their income and how they know more than physicians.
I never really understood the “holier than thou” mentality amongst healthcare professionals It’s just a fucking job ffs lmao
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Oh I think I know her. Womp womp
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Nope, middle aged Slav and the park is several blocks away. Great, the attitude is everywhere
It’s so bizarre. I get along great with the CRNAs here, I’ve never gotten that sort of attitude from them. But I know those people are out there. If only people really knew just how much residency separates physicians from everyone else
In fairness to her I feel like my ass gotta review acidosis/alkalosis every month
Ph down, acid. Ph up, basic. See you next month
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Only not-doctors use the term “provider.” It’s so interesting. I mean, I know why, but it’s still super interesting
I could say healthcare worker instead. I was really only using the term as a catch all for people responsible for pt care. If I’m only referring to mid-levels, I’d say that
No it isn’t. Also please get outta here with that “provider” bullshit.
“Providers” is what they call hookers/escorts on escort review sites.
Avg 24% acceptance rate a makes it on par with most graduate programs. Learning is also fairly rigorous, as compared to other mid levels, or graduate programs in other fields. It’s not med school (5.5% acceptance rate). And it’s certainly not on par with the training anesthesiologists receive. But there’s no reason to shit on CRNAs individually. They took a path that was offered, and work hard to become competent and do a good job. The idea of making fun of someone for struggling with acid/base disorders, something like half my class struggled with, is shitty. Whether CRNAs should be able to independently practice, whether anesthesia needs more safe guards, and discussions of scope is a different issue. We can advocate for systemic change without being shitty to colleagues.
If you’re struggling with acid base disorders, you should shut up about being “well trained”
Must be nice, never struggling during pre-clinicals Wish I could relate
See, unlike you, I don’t call myself “well trained” or “anesthesia resident” or pretend to be something I’m not. If you’re going to start saying that shit, you better not be struggling with something medical students master well before residency. Maybe the whole trope that ICU nursing prepares you for CRNA school is a whole load of bullshit if you don’t even master something as anole as acid-base disorders. Maybe there’s a reason why a proper pathway to practicing anesthesia exists (medical school → residency → attending) and nurses undercut that with some bullshit, which clealry underprepares them.
?? Did I say any of the above? I’m an M4 student. Who knows their acid/base well enough for step 2 and working to integrate into clinical practice. CRNAs also have what correlates to pre-clinical. They aren’t just thrown into an OR. I’ve seen personal abuse hurled at CRNAs. There is rarely an excuse to scream at other ppl in the hospital regardless of your feelings of their pathway. I don’t disagree that CRNAs in their current form are practicing with too large a scope. But there is a way to lobby for change without shitting on individuals
We all struggled with it... Usually as a MS2.. but then there were 2 more years.... Then, in my case, 6 more years of res and fell, and then finally independent practice....
Just wanted to say I appreciate you trying to be reasonable and level headed despite not being given the same courtesy here.
Dude... If half of the class struggled with acid-base disorders..... I am really, really scared of what is going to happen when they grant them unsupervised practice.... they are in charge of acid-base during operations... Jesus take the ventilator...
I assume what happens with all other med students? You get good before graduation or probably intern year?
telling residents that CRNA is hard to get into is like telling the president being elected police chief is hard
Literally nothing is harder to get into than med school. Doubly so for residency. I’ll still congratulate people for getting into whatever they are applying to, and commiserate with their challenges
exactly! like the dude said in another thread, getting into CRNA has a 25% admit rate so getting in is still impressive, but MD med schools are anywhere from lows of <1% to 5% on average. add on the fact residency is another crapshoot process with ridiculous standards (like research when 90% of MDs will never touch research again)
Can’t forget about the quality of applicants as well
Lol CRNA berating a resident? Not sure I would take it with a smile. I don't think I could hide my annoyance.
Something I learned when I was a tech was to pick my battles. It was hard, especially when people were horribly condescending. But they want you to argue and feel bad about yourself, so the best thing to do is smile, nod, and say "thank you for letting me know". Unless of course they're wrong, or it's a serious problem.
Agree! Pick your battles. We don't have to respond to every negative thing.
Please keep on checking on these residents who keep up a smile in the face of adversity, because they more than likely are holding in a lot of pain and depression.
The gall of CRNAs to try to lecture residents. They probably think this is nursing school where they can bully student RNs and treat them like shit. If it were me, I’d say, “sorry but I’m not allowed to receive instruction from non-physicians - it’s against ACGME rules” as a polite fuck you.
The key is to know it’s not about you it’s about them. Do what you can to learn from every experience and keep the mindset that people don’t handle stress well. If you let them get to you you’ve lost. Just be confident that you’ll be better than them someday
It took me a while to see that the ones who treated me most poorly were the ones who were more stressed and less trusted by their superiors. The shit often runs downcreek
I love this. I share the same perspective thank you
You should pull him aside and let him know. It may make all the difference.
Sad to see medicine collapsing like this. It’s one thing for titans in fields like debakey ripping residents a new one, but crnas? Come on what a joke
Completely agree 😂 It’s as hilarious as it is sad that this is happening.
Did he really do that? Disappointing.
Daughter dealing with this now. OB/GYN is so toxic it is CRAZY. Not just mid-levels but the residents forgot they are supposed to teach you and not make you constantly feel like a complete idiot. How is that helpful in the long run? Ego's are sky high for those people.
This is overall just a general problem in the medical community regardless of Crna or md.
This is the main takeaway with all this. The rot extends deeper and farther unfortunately. What worked for me back then is to remember these people are generally unhappy, and focus on my own happiness. Easier said than done, but I guarantee it pays dividends even after you complete residency, only then you have more power. Note: not advocating always turning the other cheek. By all means, defend yourself, but pick your battles.
This. This is a human decency issue- I don’t think it has anything to do with the roles. We need to all treat each other better. Yelling at other adults is unprofessional and does not serve patients.
I know it might be too late for this instance, but if you see something like this again- offering some words of support to the resident after something like this can go a long way. Something like “good on you for taking that and staying positive, we are all learning here” or something more you lol
No matter what the system does I will do everything in my power not to let it break my spirit
This is the type of person you find out the next week that decided to commit suicide. OP you should check in with this person.
Why are CRNAs critiquing a surgery resident? That's like me coaching ortho on how to smash a prosthetic into place.
Please tell that resident your good thoughts... it's so high pressure and the support system can be sketchy due to rough schedules. That's so kind of you
Just remember, if you don’t value their opinion, it doesn’t hurt your feelings. So when some twice divorced toxic attending tries to lecture you on hours and work life balance, if you don’t value their experience in work life balance then their opinion isn’t worth anything. If some know it all crna wants to lecture you on surgical techniques, again probably not worth your time.
I am like this resident. For whatever reason, I do a good job at not taking things personally. Never really bothered me getting "yelled" at. No different than all the sports I played. Under all that anger, there is usually a teaching point, so I try to focus on that. No need to feel bad for me. Worry about the people that can't handle it.
This is the way.
A CRNA lecturing a surgery resident about surgery? Bro I wouldn’t even let a real anesthesiologist lecture me about surgery, let alone a midlevel
What really gets me are the boomer physicians who think they’re god. Like you got into this profession back when you could just waltz into a classroom. Humble yourselves.
Why the fuck would the CRNAs lecture him? Those CRNAs cesspools are no where qualified to say a word in a resident's presence.
You get used to crap and blow up in private.
I don’t understand the thought process of being rude to other people. We’re all over worked, we’re all (residents) underpaid, and undervalued (again, residents). Everyone is having a miserable time so why go out of your way to berate residents for trying their best? It’s quite literally not that hard to be a kind person
Wannabe doctors, yikes bro.
I can’t speak for the other Crna’s but I don’t want to be a doc. Y’all are so in debt it’s crazy! I came out of school with like 22k debt, paid off after one year, and make very good money now.
Is it a ACGME program requirement that you have to be directly supervised by a physician not a CRNA?
Where do you work that staff is like this? I’ve never encountered anything like this in any place I’ve worked (NYC area). By an attending sure but never CRNAs. They generally know their role and stick to it.
Stop this CRNA nonsense. Enough of this. They need to be shown their place
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Nursing is so different from medicine so it makes no sense that nurses can just switch to being clinicians like doctors. Like highly absurd
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I disagree with both PA and NP being able to diagnose and treat independently. It’s not training or qualifications driven decisions but simply lobbying driven decisions. They are highly unqualified. And kudos to you for taking the MCAT and I hope you get into med school. We need more doctors and not more mid levels.
Honestly, I just think of CRNAs as “the help,” and the gall of the help trying to talk down to a surgery resident is farcical when they (at best) have a very superficial knowledge of anatomy, surgical technique, post-op care, etc.
Dead at the CRNA lecturing him, they don’t even understand anesthesia but are cool with lecturing someone in a different field Pathetic
So did you say anything or do anything to lift up the resident or just sharing on the internet?
Gave him some words of encouragement. He made a joke. Honestly still thinking about him. Maybe he is capable of brushing it off and already forgot about it but it’s wrong that he has to.
Fascinating to have surgical performance lecturing from a CRNA. I believe an appropriate response, including said smile, is "what's your name again?". Especially if working with them for years. Especially after using names of all your nursing staff all day to show it isn't a name memory issue.
The behavior of bullies is just projection. They’re miserable and inept so they must reflect that outwardly somehow. CRNA’s are incompetent at baseline, so don’t even engage with them since they don’t know shit anyway. They are not our equals, they’re lesser.
OP, you should also check on that guy because these are the types of guys who endure this abuse silently without showing any weakness, and when they reach a breaking point, they are more prone to committing suicide. So please check on him. (CRNAs are prick all my homies hate them 😤)
i thought this bs stuff ends in pre-med, but no it keeps going :(
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damn i thought i was gonna escape it soon ...
You can escape somewhat as an attending, long road
RIP
Who yells at premeds? The most I got was why are you shadowing, medicine sucks go do something else.
i meant the ego, soooo many ppl in pre-med and medicine have ego
CRNAs are fucking pricks
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Overheard an attending once tell medical students that he was rounding with that “it doesn’t even matter what’s wrong with the patient anymore because at this point he has grown more weary than them by working with these students”. I was shook.
Overheard an attending once tell medical students that he was rounding with that “it doesn’t even matter what’s wrong with the patient anymore because at this point he has grown more weary than them by working with these students”. I was shook.
OR peeps are the chill peeps usually (or at least that was the case when i rotated) unless it messes up timing/schedule then whomever messed it up is screwed for the day. That CRNAs kid ain’t getting picked up on their own from day care ya know!
Long ago I think the Duke surgery residents were on call q2-every other day. Major disadvantage/downside? You miss half the cases! 🤣
Someone should stop the cycle
>This guy is always smiling, always so kind and positive Sounds like a fascade. Check on him. Ask if he's okay
Current M2- when I get to clinicals how do I not cry when this happens? Is it wrong to stand up for yourself (in a professional manner of course)
Haha, then you go home after that happens most days for a year, and you contemplate how you’re gonna kill yourself. Lol, so glad I always smile so people know I’m happy.
CRNAa scare me. They've messed up my mothers anesthesia twice now. I'm truly terrified at the autonomy nurses have to independently do what physicians do in the majority of US states. I'm not even a physician, just a patient, and it terrifies me.
CRNAa scare me. They've messed up my mothers anesthesia twice now. I'm truly terrified at the autonomy nurses have to independently do what physicians do in the majority of US states. I'm not even a physician, just a patient, and it terrifies me.
lol
Underneath that smile could be a very hurt soul, we all wear masks
One day just one day he’ll be on the other side. But as a nice Doctor that knows his stuff and does not need to be a condescending jerk off
Sad. Sad. Sadly the perpetrators are hiding their insecurities by berating someone else. Rise Above it.
Residency in India: saw one Cardiac Surgeon scold his resident: “to go work in kitchen n then come n scrub with him.” I was devastated just listening to that.
It's a lose lose situation. If he goes off on them then he's labeled an asshole.
I don’t know why I keep getting updates on this forum, mostly everytime Crnas are being brought up but who knows. As for your friend, it suck’s for sure. Sadly there’s dicks everywhere and within every profession, and it seems like medicine and healthcare have more than other careers. Furthermore, no anesthesia providers, md, do, or Crna, should be giving any tips to a surgery resident unless potentially asked. We know as much about the little intricacies of surgery as surgeons know of anesthesia. Weird thing is, most interactions I’ve seen have been nothing but positive. This might be a cultural thing at their hospital or within their residency or just with the douchey attending and the douchey Crna. Glad they have thick skin, it is needed in the hospital and as time progresses, and they become more experienced, they stand up for themselves.
Where yall work. The CRNAs are the chillest people in the OR
This is how you break the cycle of abuse in medicine.
I love all the comments about the CRNAs in this story but very little directed at the attending that was the real issue in the post. But, again, y’all will make such wonderful colleagues in the OR.
So he was reprimanded by both his attending and the CRNAs, and you .. praise the guy and bitch about the "wannabe doctors." It sounds like he just sucks and your mid level hate is silly.
Yes, I praise him because he was doing a good job. Just because the Asshole attending wants him to do it HIS way doesn’t mean he sucks or was doing something incorrect. While I can understand the stress on the attending, yelling badgering and belittling the guy isn’t going to help the resident who is actually doing the surgery. He handled himself and managed his emotions better than the attending who has been doing this for years. The dialogue should have remained between the two of them. Why the dumbass glorified nurses thought they can comment on anything is beyond me. Just play on your phone and STFU. You don’t have an ounce of the training or knowledge he has especially in his specialty no matter how many years you’ve been doing your pretend doctor role. Until you physically scrub in and physically preform surgery STFU. “SoUnDs LiKe He SuCkS.” Just like a nurse to comment on something they know nothing about. Stop pretending. You’re not a doctor. Seriously. STFU
I think you need to work on yourself a little. The frenzied vitriol in re: nurses with advanced degrees- you seem a little unhinged. Doctors do deserve credit for all the knowledge they were exposed to and the tests they passed. However the lowest IQ possible to become a doctor is 115 pts. We both know many R.N.'s and P.A.'s that easily exceed that intellectual capacity. None of these types of healthcare workers has the right to behave like an abusive ass. I will treat a person with a higher level of training with general common respect but I will not assume that they have a superior level of clinical knowledge until it has been fully demonstrated. Respect is earned by proof of competence- not by having passed a test of minimal requirements to protect
That is a dog. There are roughly 400 separate breeds of this species in the world. Lol