× Debates, Issues & Talk

The doctor nurse relationships and perceptions

15 years 5 months ago #65824 by PremedRN
I started this thread off of another topic, so hey docs, nurses, and all others, what do you perceive what a nurse does.....what a doc does....similarities, differences, and why, sometimes, is there animosity between those 2 positions?

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15 years 5 months ago #65825 by **DONOTDELETE**
I am an intern in internal medicine. I perceive doctors as the "order-givers" and nurses as the "order-doers." I don't understand what requires such "critical thinking" with regard to nursing duties. Doesn't the nurse just do what they're told?

Please educate me.

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15 years 5 months ago #65826 by PremedRN
Im glad you responded, and wasnt afraid to say what you really think.
Yes, it is true that the docs/residents order medical interventions and the nurse carries them out but oh yeah, nurses have to critically think, let see, what would be good examples.....
1st off, education wise, nurses have to take anatomy, physiology, pathophysiology,pharmacology,microbiology, know what and generally why medical interventions are being ordered, it goes more in depth as far as pt diagnoses and what's involved in the patients care, we have to know signs an symptoms of medical things, educate patients to watch out for such signs, and what preventions they can do to sustain good health. Did you know that if you ordered the wrong doseage of meds, and the nurse gives it, he or she is responsible for it by law? I have to know I am giving a correct dose, and if you order anything I think will harm the patient I dont have to go along with your order?
If I have a patient in with abdominal pain with RLQ abdominal pain and the pain suddenly stops and the abdomen is rigid----I better alert the doc---this means trouble-possibly ruptured appendix. I have to be able to read telemetry monitors and know I am right about what rhythm this patient is in when I call the doc and he gives me an order for a cardiac med to treat the dysrhythmia, if I am wrong, if that patient is given certain meds and I have the wrong rhythym, I can stop the patients heart from treating the wrong rhthym, with the med. When I have 2 patients going down the tubes I have to be able to 1. Know the early signs of the potential complications to be able to prevent the patient from becoming unstable by calling you, when I notice such 2. Know what to do while waiting for you to answer back 3. Prioritize, know which patient needs the more immediate attention, and at the same time handle both. 4. I can code the patient without a doc being present (I am ACLS)
So there is a lot more to it than a lot of people think. Sure we have to pass a buttload of meds, and wipe a butt or two, but it is not the only thing that is expected of us. I hope this helps. I really had no idea that residents, some docs, thought differently about nursing.

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15 years 5 months ago #65827 by myimd_dup1
Okay. Let me be honest, as twisted as my views may be. :guilty:

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15 years 5 months ago #65828 by PremedRN
No, that's cool, I like honesty. We are all adults here, and we can handle it.
Yes, I agree too about the giving the drug thing, I dont think the nurse should be accountable for the drug, but it is the law, because the nurse gave it to the patient. So any dose I know nothing about, I have to look up, or trust that the doc and pharmacist knows what their doing, since they know more about that stuff than I do.
It does matter that we have to know the symptoms of things, if I was so dumbfounded not to call the doc for certain things I need to be watching out for and miss the big clues, I am basically causing the patient harm, even death in some cases.
Yeah, all those nurses doing bull crap like that, calling for something stupid that can wait makes the rest of us look bad. But please dont think all nurses are mindless because of them. I think that is why, in part, docs dont take nurses seriously when something is going really wrong, (from my own experience), and think all we do is pass meds, start IV's, and wipe butts.

What critcal thinking do you guys do? What is your definition of critical thinking if you dont think some of my examples are? Sure generally, nurses dont have as much of an intellectual challenge, but doesn't mean they dont have to critically think. Would you like it if I let one of your patients go down the tubes, when I should have known to call you based on his symptoms? That is not thinking- it is being incompetent.
Or would it be okay, since we just pass meds, and wipe butts and aren't required to think?
And yes, if you order something that I think will harm the patient, NO, I dont have to give it, I dont mean an ethical conflict, or potential complication, but just as there are nurses out there who you wonder how they got their licenses, there are docs like that too.

If a patient codes on me, and a doc's not readily available, I can begin ACLS, shock, give meds, without a doctor's order. Of course, not any nurse can do this, one must be certified.
Good debate girls!

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15 years 5 months ago #65829 by myimd_dup1
hmmm...I think I'm beginning to more fully understand.

One additional thing that has kinda bothered me. It seems at if nursing school teaches it's graduates that *they* are the patient advocate, and that docs are uncaring, and lack compassion. It is therefore the nurses duty to provide compassionate care, and be the "patients advocate."

Against who? The doctors? I hear nurses telling docs all the time how *they* are only fighting for the patient....as if doctors don't. As if doctors are uncaring assholes who lack compassion, and need an intermediary to protect the patient from themselves. That ?nursing philosophy is offensive. I care, *I'm* a patient advocate, I am compassionate!!! To imply otherwise is completely misguided.

Why do nurses dislike MDs. I hear them, Dana, I hear them on the medicine floor, I hear them in the CCU, I hear them dissing the docs. They don't like us.

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