Wednesday, January 12, 2011
It has come to my attention that there are readers out there who are unwilling or unable to read the post below as an occasion of BLOWING OFF STEAM on a particular day about a particular set of individuals at a particular practice. Really? No one at work EVER did anything to annoy you? You never mouthed off just to VENT about a particular frustrating occurrence - even those of you who might be on, for example, a forum "designed to act as an outlet for blowing off steam?"
Please consider that in the comments section under this post I do take to heart the admonitions of readers who point out that my views might be biased or unfair or objectionable, and I do reflect and admit that I have some growing to do; that I do realize my mouthing off about two or three people was probably not fair to the dozens who don't come under the same category; that I try to describe to a reader the advanced training and clinical abilities of CRNAs; and finally, that this was actually discussed among physicians and CRNAs in our practice, and the views of both sides - the objections of CRNAs to being lumped together and criticized unfairly, and the objections of physicians to subpar work ethic from some CRNAs who, despite considering themselves MD equivalents did not demonstrate an MD-equivalent commitment to actually SHOWING UP - were laid out on the table. Each side asked the other to shape up on the particular problem being pointed out. Nevertheless, my chief and I persisted in the opinion that we did not feel we were "allowed" to call in sick, ever (though we sometimes do actually get sick enough to require it), and that we were held to a (perhaps unreasonably) higher standard than most professions have to meet.
While I can see why it would be tempting to demonize me for expressing how I felt on this particular day, I would ask that people consider that I was venting, that I was not alone in feeling this way, that some CRNAs in my practice actually agreed with me, and that some of the points raised (especially in the comments) might be worth discussing or even be of some value despite how grating they may sound.
Boston had another blizzard today. I was really worried about this one. It was supposed to snow hard, about three inches an hour from 3 a.m. to 12 p.m. with poor visibility, impassable roads, etc. I've driven home in snow like that, and I find it terrifying. Your car won't do what you want it to, and worse, OTHER PEOPLE can't be counted on to be either careful or able to control THEIR vehicles or even able to SEE you.
I texted my chief to see if there was any chance the O.R. would close and cases would be cancelled for non-call personnel, but it was business as usual.
So I went back to the hospital to spend the night last night before the snow started. My husband and I had been planning a quiet evening together, but all he could do was wave sadly at me from the window as my car pulled away.
My chief, worried that the bridges connecting his area to the hospitals would be closed, drove to the hospital at 2 a.m. and set up an air mattress in the anesthesia office.
My other colleagues left their homes at least an hour earlier than usual to brave the blizzard and arrive at work on time.
100% of the doctors in our practice made sure they reported for duty at the appointed time, literally come hell or high water.
How many of the nurses and nurse anesthetists did the same?
To be fair, one of the nurses had the honor and dedication to trudge through the snow from her house in order to make it. I don't mean to imply that there aren't dedicated, hard-working nurses. But several of the nurses called in "sick" and only ONE of the nurse anesthetists who were scheduled to work this morning actually bothered to come. What was their excuse? Too much snow.
It has become common for nurses to seek to be recognized as equal to physicians in much of the work that they do (even publishing articles to that effect in newspapers and journals). But on days like this, it's IMPOSSIBLE for the docs to gather around the water cooler without noticing and commenting on the vast difference in work ethic between M.D.'s and non-M.D.'s. It's just not possible to get through med school and residency making excuses for not showing up and meeting your duties to patients, just because conditions are inconvenient. Nor do we get to feel entitled to extra pay or time off for the extra time and effort spent getting to work hours and hours early due to a snow storm.
Moreover, with our verbal Socratic oath I believe most of us take an attitudinal, internal oath to be there for our patients whether or not we feel like it, have had enough breaks during the day, etc. Why else be a physician, if you don't have this kind of commitment to taking care of your patients?
So it grates. I hate to admit it, but it grates when what you think of as the practice of medicine, not only a duty but also a calling to be there to heal others, gets generically lumped in with the practice of other "health care providers." There is a difference, generally speaking, not only in training but also in the overall attitude to the work. Doctors don't take snow days.