A good nurse can make your day- a bad nurse can ruin it...and I am very thankful that I am so...appreciative of good nursing help ( after reading earlier posts)...and I happy that I far enough into medicine to NOT just see them as "order-doers"....
and RN's are liable for carrying out orders that were wrong ( not to the extent the doctor is but they sometimes have malpractice ins also and can certainly be called to court.)

myimd,
I was just rereading the posts, and I misunderstood you, I had thought the hypothetical situation that you gave was tylenol ordered for fever only. Sorry. In that case, there is really NO excuse for that nurse. It doesnt make sense to me either. :scratchchin:
HA definately classified as a pain. But MOST nurses wouldnt call you for that. At least none of the ones I work with.

Just so you guys don't think I'm an arrogant bitch, let me say that I'm kinda playing devil's advocate for the sake of discussion...and also because, as an intern, this is how I felt towards most of our nurses at our hospital. As I progress, I'm halfway thru the 2nd residency year now, and the nurses call my intern before calling me, I feel a bit differently. That filters the BS, and I'm so judgemental anymore. When *I* get a call from the nurse (now) it's the real deal - that means my intern didn't know what to do.

When I first started my internship, I couldn't for the life of me understand *exactly* what nurses did...outside of the obvious IVs, cleaning beds, and answering phones, etc. I didn't really know how to write an order, and didn't know what was *appropriate* for me to order. Do I order "turn the patient q2hrs...check vitals at least once per shift?" Do nurses "set up" the central line tray for me? Can I *order* that they do it? Some things (I learned) were actually *ofensive* if you write an order for it?

At our hospital (where nurses are completely outta control with their power seeking), and even the patients constantly complain about the quality of their nursing care, it *is* difficult to see past it. :yes: It's to the point at times where you haveta say, "look, if you want to make the decisions, go to medical school, but until then, it's *my* way." I find, as a young woman, the nurses treated me with less respect, questioned all of my orders, rolled their eyes, and seemed (basically) jealous of my position. They didn't even call me "doctor" at times, using my first name, or calling me "Miss." They don't threat the fellas that way...ever!! I see this, and it offends me.

I'll admit, the lack of understanding (therefore appreciation) I had for their duties set me up for a hostile relationship with the nurses. And the fact that I'm a woman probably does provide too much estrogen on the healthcare team. But, that's why I hinted to Dana that this would be a good discussion...because I can't be the only new, female doctor who feels, or felt, this way. And if the more experienced docs, and nurses, could shed some light on this topic, young docs like me would greatly benefit. :yes: (I think med students would appreciate this discussion more once they are housestaff. I've realized that as a premed/medical student I had kind of a twisted view of things - not much pratical experience on which base an opinion on...but here we go, another topic ).

Haaaa, I think we all add a little extra estrogen to the halthcare team!
I heard that nurses can be mean to med students/interns. I thought that it may contribute to some of the less than pleasant relationships between some docs and nurses.
Sorry that you had to experience such disrespect. There's no need for it. I think people who behave like that are insecure in themselves and sometimes do such things because they think some how it compensates for their own feelings of inadequacies. And I also see nurses who think they know it all. It irritates me as a fellow nurse, because they may not have the foggiest clue, and just because you know a little about the med field and a whole lot more than a lay person, doesnt make you comparable to the doc. So I can identify with you on that one. Im not from a very large hospital, but we maintain mostly prof. relationships with the docs, meaning no rolling of the eyes. Women can be very vicious toward one another. I like my docs who are woman.
==Dana

What an interesting discussion. PremedRN you are such a great debater this could have easily turned in to a flame war but didn't, what a pleasure to read

I think Myimd has made an interesting point, with the remarks that she percieves the nurses as being disrespectful and "almost jealous" that the doctor-nurse relationship between women is still being developed becuase until recently women doctors were few and far between. I have seen this dynamic in other women hierarchical relationships as well. Some of this I wonder is the changing of the professions, nursing is being recognized as a more dynamic profession that emphasizes more knowledge and critical thinking than it used to. So nurses are fighting for more respect from docs, male and female. Meanwhile, women docs are striving to earn respect in the workplace, not be mistaken for a nurse, etc, and also coping with the fact that medicine is moving towards a more team-oriented approach. I wonder if the combination of those two might cause some friction...

I think that also managing people and learning to utilize them is a skill, one that unfortunately is not taught in medical school. However I think that that is something that you really start learning on the job. Some people are naturals, others take a little more work. So I am sure there is a learning curve there... some people of course never quite learn it!!

Elma, yeah, I maybe would be a better lawyer than a doc (Just kidding of course!) I try to keep things civil, there is nothing wrong with effective communication.
What you mentioned is probably part of it too. I just think, generally, women are more competitive with each other than men, or at least they show it better when they are. Im sure others dont feel the same way on that as me. Males in nursing is become more and more common too, and one thing I notice is that the male nurses dont take as much heat from the docs (both men and women) as female nurses do. What is up with that? I guess that is another topic.

As far as the intern and nurse relationship, I am starting to wonder if they are intimidated by the nurse's knowlege, when they have been through med school and feel they should know or be confident in knowing more. Surely they arent expected to know everything, they are just "babies".
It is a shame that med schools cant learn the student the role of each healthcare member when providing inpatient care, and just the norms of things. I think I will be ahead of the game in that arena when I get to that point in my life.

And now....thoughts from a new nurse!

Just like interns, new nurses make a lot of mistakes, too! I do admit, I did call a doc 4 times one night (the first night off orientation .

I think you are right in that many nurses have an "I must prove myself" aura about them. They can be incredibly catty, backstabbing and cruel . I think a lot of this stems from being a female-dominated profession. Also, there is not much opporunity for advancement in nursing unless you get an advanced degree. I have the same job and almost the same pay as nurses who've been there 30 years. No wonder they feel threatened by upwardly mobile young women such as ourselves.

Nurses are also *WAY* overworked. Who can possibly take care of 10 patients at once and do a good job--especially if more than one is crashing :yikes: ?

Oh this is long. I'm going to stop now. Flame me if you will!
amy

Hey amysunshine, its about time a fellow nurse arrived to add some input! :wave:

Did you ever think some interns/residents only thought you were just an order doer?

Im just curious. It is hard for me to understand how this comes about after spending many hours in the hospital even with the silly calls from some nurses and not totally being informed during med school of the totality of inpatient care. Surely there has been nurses who made some good catches/calls. If all we had to do was the physical things, I wouldnt think one would need a degree, but only an apprenticeship so to speak.

What are your thoughts?

And this is why I am going to probably end up in a mostly male dominated field...there is way too much backbiting and bitching going around when you get lots of females together. I get along much better with men and even though they can also be catty sometimes they are not as likely to be jealous of you. Some women are just awful always on the defensive and often times putting you down because of what you have or have not accomplished for that matter. Being prior military proved this to me...

efex, I totally agree with you! I get along with men much better than with women, and the estrogen is killing me!

Dana, I don't see too much of the "order doer" mentality. Most of us nurses are friends with the residents (you have to be--they're on call q3d!). Usually if I call for something, they say, "so what do you want"? And i'll say, "can we try 20mg of lasix IV x1 and if that doesn't work in an hour or two I'll call you again?" and they'll say "sure" or give me a different order.

However, the worst trouble I get is from FELLOWS! By far! Ugh! One fellow wanted me to look up a radiology report for her and tell me what it said. Sure, that's fine. However, since it was not up, she wanted me to call radiology, listen to the dictation that wasn't transcribed yet, and then report back to her what the findings were so she could give me an order. WTF?!?! I gave her radiology's # and (very politely) told her I was too busy to spend 20 minutes listening to dictation and gave her radiology's number. I had another cardiology fellow get upset with *me* for calling him because my pt was having an MI! No pain, but she was female, throwing up, ST changes, positive enzymes....but because she did not have crushing chest pain, this (male) fellow thought she didn't need any more intervention. grrr...I ended up calling his superior and she was started right away on nitro and heparin and scheduled for cath lab. Indeed, anterior wall MI. hm... I felt bad for going over his head, but I felt justified that time.

These are usually rare occasions, though. I think I get along well with the medical staff . There are definitely many times when *I'm* wrong, and they let me know, too. Hooray for teaching hospitals.

amy