Finishing my intern year at a program about which I've had nothing but good things to say. However, there is one aspect of this year that is frustrating and seems to be irreconcilable.

I will admit right up front that I have a "strong personality." I'm direct and very forward with opinions at time. I am enthusiastic. I am not afraid to ask questions, of anyone. While these appear to be good qualities (and are generally commended in male physicians), my type A personality has been of great detriment.

The year started off with a complaint from a nurse that I asked them what I should do for management of an issue. I did this because I was advised to ask the nurses for suggestions so they don't hate me. Yet it was a mark against me. Subsequently I stopped asking the questions and tried to demonstrate confidence. I've maintained nothing but a professional rapport with them but this seems to have backfired and now I am perceived as the devil-resident. I am direct. I am methodical. And I am a take charge person. I am also tall, thin and wear makeup. The combination of these factors has put an X mark on my back.

This has translated to what seems to be a conspiracy against me. On most ward months, something trivial comes up with a nurse and my program director is informed. When I say "trivial" it is below trivial. For example, I knocked on a patients door and was told to come in. The patient (female) was seated on the edge of her bed with a towel around her body and a shower cap on. Fully covered. They had said to come in so I started asking questions. The patient asked me to leave because she was "bathing" and I apologized and left. Subsequently, the nurse told the nurse manager that this had happened and the nurse manager told her to tell me. I apologized to the patient and she was understanding and everything was forgotten. However, the nurse manager told the chief resident who told the attending physician who told the program director (yes, this DID happen) and I was called in for "unprofessional" conduct. In all reality, I simply knocked and entered a room for <30 seconds after I'd been told "come in." The escalation was outstanding.

I was told to be "sweet" because nurses don't like type A women physicians and expect female physicians to be maternal, sweet and subdued. These are not characteristics used to describe me so I've adopted phoniness in my interactions. Previous interactions were polite and professional but not "sweet."

Yet it continues. I work hard to not irritate them but I make a small mistake (that other residents make multiple times) and I am told on and lectured and advised to work on "people skills."

I am so exasperated. I'm nauseated by the "sweetness" that I have to embody but do it for the attendings because they are my bosses and I respect their advice. Clearly my first impression was not a good one on the nursing staff and in turn, this has led to the perception among the attending staff that I am difficult to work with. How can I change this? I'm under microscopic examination so each mistake is blown up. I am not infallible. What do I do? Has anyone had anything that slightly resembles this situation?

..........................- trust no one
- show absolutely no weakness to nurses
- pretend to need help & "just can't figure it out" around insecure/arrogant people around you
................................Incidentally, before I had the idea to send the survey on motherhood in medicine, I sent out surveys to the nursing staff at my hospital to see what they truly felt. My suspicions were confirmed - a lot of shallow, catty B.S. that could be brought forth because it was anonymous.