Event 1: "Ah, Carmen, you're killing me!" exclaimed the seasoned ED nurse in front of our colleagues upon discovering a blood work order for one of our patients. "I've already set the IV, and he was a tough stick. I won't be poking him again or drawing blood from it. You'd better find someone to get an ultrasound IV if you want blood! This is poor patient care coordination!"

Event 2: "Doctor, the patient is hypotensive; come with me to critical." The seasoned doctor responded, "No, resuscitate the patient by yourself." [After 5 minutes] The seasoned doctor questioned, "Carmen, what are you doing? Why Normal Saline, and why are you not telling the nurses what to do? It seems like you don't want to be involved in patient care or communicate. Maybe you should just shadow me instead!"

P.S. It felt like nothing I did would have been good enough.

Picture me, eight months into an Emergency Medicine PA fellowship role, with three years of non-clinical experience to back me up, juggling the demands of a high-pressure environment while navigating the complexities of interprofesional communication. In such a demanding field, this can easily become a challenge that can either make you or break you.

Take, for instance, the day with the seasoned nurse. I had ordered a Soft-tissue CT scan with IV contrast for a patient with a neck mass, a medical puzzle that needed careful consideration. Aware that the test would mean a 5-hour wait, I thought consulting with the attending about the specific blood tests first would be a smart move. Little did I know, it would lead to a public dressing down. Now, fast forward to another day with yet another seasoned provider, a doctor this time who asked me to resuscitate a patient by myself; a task I hadn't encountered yet in my journey through emergency medicine.

The escalating intensity of the nurse’s and doctor's remarks had turned from what seemed like a tough-love-kinda teaching to something more similar to bullying. In what felt like emotionally-driven conversations, the interactions took a concerning turn as attitudes turned unprofessional and intimidating.

In these moments, communication challenges rooted in differing professional perspectives clashed with unprofessional conduct, lead to the pressing question: What is going on?! Should we as individuals learn how to take the punches? Should we just always walk with a shield instead?

Teaching, interprofesional communication, and learning styles play a pivotal role in the shaping of who we will become as providers. While most times, we collaborate with educators or colleagues whose methods align with various learning styles and values, there will be instances when we encounter providers whose approach can hinder our professional growth. It is up to us to pivot.

I felt demoralized, so small, so incapable. But In that specific moment where I had to make a decision—do I put up with this or do I end this—I realized I had nothing to lose and only everything to gain by speaking up for myself.

Take Away

Fostering respect is non-negotiable, and when you stand up for yourself, you take up space, and you rise. Willpower, resilience, setting boundaries, and speaking up for yourself early are pivotal skills in your journey towards professional growth. And as mastermind athlete Robin Arzón suggested: “Instead of planting a seed of self-pity, plant a seed of fire. Sometimes criticism comes from a place of injustice, and it is toxic. Use those injustices as fuel, and carry on”