Hazing Rituals for New Hospitalists

Jack Percelay writes…

September, kids are off to school, football resumes, and new grads start hospitalist careers.   Part of the orientation we provide new hires should be anticipation and emotional preparation for any hazing rituals they might face from patients, hospitalist and other physician colleagues, and, perhaps most challenging of all, nurses.

Maybe “hazing” isn’t the right term; maybe it’s “proving oneself “or “establishing credibility.”   Patients are easy; they are just interested in being cared for by a good doctor, and don’t know who is “new.” Hospitalist colleagues also seem less likely to engage in hazing.  We all remember our experiences as a brand new attending, and understand that to attract and retain high quality hospitalists, we need to support new grads as they solidify their skills.  Proving oneself to physicians outside of one’s own HMG is also relatively straightforward. Tell your docs how referrals and interactions work in your particular institution with attention to idiosyncrasies, squeaky wheels, and the occasional IED.

Here are some hints for new hires:

  • Don’t be a cowboy; ask for help.
  • Establish yourself as a team player with good work habits.
  • Get to work a bit early and stay a bit late.
  • Be flexible with scheduling.
  • Switch with someone else even if it inconveniences you.
  • Don’t owe favors; be owed favors.
  • Flush.

From my perspective, nursing staff is often the most difficult and skeptical audience. Residency doesn’t matter; clinical competency must be demonstrated on site, at the local institution.  But medical expertise and a high IQ are insufficient; from an EQ standpoint (emotional intelligence), trust needs to be established.   New hires need to prove that they are members of the team who support and respect other team members.  How does one do this? Introduce yourself.  Learn names.  Gather your own supplies for procedures and clean up after yourself.  Review any new orders in person with the patient’s nurse.   Think out loud so that your thought process is clear to the nursing staff and ask whether they have any other suggestions or questions.  End your interactions with, “Is there anything else I can do for you.”  AND whenever you answer a phone call from a nurse who is “just letting you know,” ask, “Would you like me to come by and see the patient, I can get there in x minutes.”  These simple steps can go a long way.

As a tall, 50 year old, male, I have an additional recipe for success:  brownies (340 degrees, 47 minutes, extra chocolate chips).  I cook 2-3X a month, and almost every weekend I am on.  It’s a terribly effective bribe; everyone is a friend with whoever brings in food.

This works for me when I start a new job, but will it work for younger hires?  And what about women?  Hazing rituals/challenges female physicians face, particularly in the hospital setting, seem to differ from those males face.

Let me know what you think about these gender differences, and I’ll discuss them in my next column.

L’shana tova.

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