When you're a resident, you discover the myriad ways that one person can screw another. And you might imagine that having a bad intern would be the worst possible fate, or maybe as an intern having a bad senior resident would be tops. Now, having a bad intern can generate a lot of extra work, but there is no screwjob worse than what one senior resident can do to another.
This extends to both same service or consults or transfers of care, or best yet the ER. In all circumstances, the worst that can happen is always the same: one senior resident screws another one over.
I've been called to the ER to admit patients who don't even have charts yet, or labs, or even an x-ray. I've been called to admit a patient for observation for chest pain without an EKG having been done. I've had fellow medicine residents hang onto pending admissions until I took over the admission pager, leaving me with the new admission.
And worst of all, I've had residents lie to me about a patient's condition. That's by far the most common and most horrifying reality of the incompetence of some senior residents. For your benefit, some examples.
"Oh, her blood pressure was low, but it responded well to fluids. She's stable now." The patient was in florid neutropenic sepsis, and expired about 6 hours after this statement.
"His last cardiac cath, they didn't need to do any stenting, so he looks pretty okay." They didn't stent because he had triple vessel AND left main disease. He was a cardiac cripple.
"His last admission BP was low as well, so it looks like this is normal for him." So normal in fact that the last admission they addressed that blood pressure with dopamine and levophed.
But by far, the thing that gets me angry the most isn't this gross malpractice that I've described, but it's laziness. That's what bugs me. I've had people dump tons of work on me, couched in the noblest of excuses: "My son has to go to the doctor's today" "I have a meeting I have to go to"
Boo fucking hoo. More than once, I've had someone dump work on me so that they could leave the hospital for something, and as a result, I had to spend extra time in the hospital cleaning up their mess. And some people would flatly refuse. But I say bring it on, because if I meet someone who is so lazy that they are willing to dump their work on me, then I'd rather do it then let them ever take care of one of my patients ever again. I have literally carted people out of the ER and straight up to the ICU without a thorough evaluation because the care they had received was so atrocious that even blind, I could do a better job.
My feeling is that one person's laziness doesn't excuse me from providing poor care, so I will always pick up the slack. And it's a small price to pay to find out what doctors aren't worthy of my trust or my time.
