bottom of the food chain

this is not a new concept, as i mentioned it in one of my first posts. medical students are the bottom of the food chain that exists in the hospitals. the best way to survive is to always be conscious of this, and to keep in mind that one is never above grovelling. it’s when grovelling doesn’t work that the food chain becomes a problem.

 being a young, female (and dare i say a mildly pretty one, too) that is training to be a doctor still has it’s obstacles. granted these obstacles are completely different from when the original pioneers broke the barriers of a male dominated field. ironically, instead of it being the male physicians who hold back the female medical students, it’s other women in the healthcare profession. (actually, i think this occurs in every profession). women can be catty, horrible people who hate to see other women succeed.

i have been fortunate. i made it through 20 weeks of clinical rotations without being completely degraded. here’s how it plays out:

being my first realday on psych, i had no idea what i was doing. not only did i have to reacquaint myself to the rotation, i have to become more accustomed to the system at a new hospital, and no two hospitals are even remotely similar. i was officially done working with my attending at 11 (glorious!), but he asked me to see a patient that would be coming in sometime in the afternoon. of course, i acquiesced.

there are two sections to the psych floor – one for the volatile (6400), one for the calmer, more medicated patients (6100). i generally will be working in the section with my volatile patients just because of the type of patients my attending works with – but this new patient was going to 6100. i allow the patient plenty of time to arrive, plus time for the nurse to get all her business in order, and i wander up to the floor.

i know what you’re thinking – the nurse probably treated me like dirt…but no. i wasn’t kidding when i said we are the bottom. today, i treated like the scum and hospital filth on the bottom of a secretary’s shoes.

i arrive and look around for my patient’s chart. it’s sitting by her on the counter, and before i even touch it, i politely ask if the nurse was still working on the chart. “you can’t take it, she’s still doing stuff.” okay, no worries. the nurse comes around and states she’s done. “well, i still need to take care of the orders.” the nurse tells her she has done the orders, or at least, that’s how i interpret it. nevertheless, i say “no big deal”, as in, by all means, do what you gotta do – i have the whole afternoon off and the patient sure as hell isn’t going anywhere (you need a key to get in and out of these sections).  what does she say?  “oh really? it’s not a big deal?” in an extremely sarcastic, rude tone. despite her lack of manners, i hold my tongue, despite everything my mother has ever taught me both by example and by the lessons she’s told me. i promptly explain what i meant, clarifying that i am in no rush and will wait until she’s done.

when i interpret her as being done, i ask for where the paper is that i need to fill out, but this i ask the nurse. clearly, the secretary needs to take the stick with a 4 inch diameter OUT OF HER ASS.

so i take the chart and review the ten page, life history of my patient all the while filling out the form i am responsible for. this will be the first patient i am going to see on my own, so i want to ensure that i do a thorough job. i then go into the patient’s room to speak with her. all in all, i was probably actually gone from the secretary’s sight for about 30-45 minutes, but it’s not like she didn’t know where i was when i was gone.

when i return, she confronts me telling me “when you take the chart, i can’t get orders done, and then nothing will get done for this patient. and i have to leave at 3.” first, let me say i apologized. twice.  and one of the times, i’m pretty sure she rolled her eyes at me. but, i’d like to note that 1. it was only 1:50 and 2. the nurse already took care of the orders and 3. her job is not so vital that this patient will just slip through the cracks if she’s not there.

it took every ounce of my patience to not scold this old hag for her behavior. i know children with better manners than this woman. thank god i will spend little time in that section, because i have a feeling this woman and i will be going to battle. she has exhausted my patience despite every effort i made to be kind and show that i knew she was boss – but not for long wench.


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