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Sunday, October 17, 2010

The Most Dangerous Person in Healthcare

I have always said that the most dangerous person in healthcare is the one who will not admit that they do not know everything. Plain and simple. We all have our dumbass moments. This goes for doctors, nurses, therapists, techs. None of us are immune. At some point in someone's career, they will encounter a new patient who is a bit more challenging or has a condition with which we have not had much experience, or will be exposed to a new type of procedure or a newly-developed better way of doing things. It is the nature of the work we do.

With that being said...

We all also have our moments of, well, cockiness. We know when we are right. The good doctor/ nurse/ therapist, when faced with these moments, will admit that they could possibly be incorrect, but they feel confident that they are correct, and they will assert themselves with the other members of the healthcare team. The beauty of this job is that there are almost always tests that can be done to confirm our hunches. One has to find that delicate balance of speaking up and advocating for the patient when they think they are correct, yet still be humble enough to know that the human body is design at its greatest and we will never understand every single miniscule thing.

And then there are new grads.

The newly degree-holding, newly licensed, newly credentialed beasts that they are. We all were new grads once. Yes, me too. But I don't ever recall a time where I had this sort of issue. I can reflect back on my time when my role switched from being a college student completing patient care under the licensure of my preceptors and instructors, to being a big girl with my own license and credentials. Yeah, I felt like a million bucks the first time I signed my name. Andrea, RRT, RCP. Those capital letters behind my last name to let people know I was qualified just seem to do something to people. For me? I was scared to death. And I made a career move that would later serve me well in my transition of roles: I took a position at a small hospital where there was only one therapist staffed at night---me. I didn't have the luxury of hanging back timidly while the more experienced took over. I was in the thick of it: full arrests coming into the ER, asthmatic kids, emphysematous grandparents, and neonates needing resuscitations. And so I got over my fear. And became confident in my skills and my education and my abilities while realizing that there is no way, in that tiny hospital, I encountered every curve ball the human body can throw our way. Stellar career move. The best thing I coud have done for myself starting from scratch, even though it wasn't intentional. Truthfully, I started out with a salary and benefits package that was pretty obscene for someone with such a lack of experience, and that is what drew me in. It was only later, when I discovered I belong in a big hospital and I am charged with more critical care that I made the realization that the first role I had made me a better therapist.

So back to other new grads...
Where in the blue Hell did they come from? And in case someone from my work comes across my blog, let me clarify that I am not speaking of one in particular, or even one discipline. It is a New Breed. Gone are the days when they bow to the more experienced like we did. And no field is exempt. Gone are the days where they emerged from college, looking scared and timid. When they valued the input of those who have been practicing for as long as they have been alive. Yes, we all sign our name with the same credentials, but in my department, we are blessed to have some pretty experienced therapists in our midst. And I will be the first to say that if any one of those ever have something to teach me, I am all ears. They have seen more than I have seen, done more than I have done. But the new grads of today? They don't have that humility, that attitude. And this goes for all: doctors, nurses, therapists, techs. I can remember when it was that time of year and the first-year residents showed up at the hospital. You could always spot them with their scared-to-death stare with eyes as wide as dinner plates. And they knew that, even with MD behind thir names, they still did not know as much as an ICU nurse or RT who had been in their field for years. They would humbly ask me to tutor them on ABG interpretation or help them intubate the tricky airway. Not anymore. A few weeks ago I had a code where the first-year tried and tried to intubate, causing trauma to the patient's airway and allowing the patient to get too hypoxic between attempts to where I finally had to yell at her to stop and let me deliver some breaths. And she looked at me, aghast, stating that she was a doctor. Yes, she was, but that was MY patient.

The sad thing is that I am exactly where you find these arrogant beasts these days--night shift. Day shift positions in hospitals are pretty coveted and snatched up by those with more seniority. The vacant positions are almost always on nights. And so I am stuck. Night shift is very, very young. And maybe it is that I have been doing this for enough years that I am starting to develop the salty crust of experience. Maybe it really is that new grad these days are arrogant SOB's. Whatever he cause, it is leaving me feeling old and weary and seasoned in a way I didn't feel before.


  1. it's not just in healthcare. i see it ALL.THE.TIME. in teaching, in HR, in management... it's really very sad, the arrogance. good luck w/ your night shift!!

  2. Sad, sad, sad. But I'm kind of glad I'm not the only one noticing this trend!