× Debates, Issues & Talk

The doctor nurse relationships and perceptions

14 years 5 months ago #65908 by MTaylor
I agree Lindsey, but saying

I just don't see why there's any doctors vs nurses issues. As an intern in my 3rd month, I can't say enough positive things about the nurses that I work with.

is like saying "my parents are so cool, they support me, they have my best intersts at heart...I don't see why other people don't love their parents..."

Obviously, some people may not like their parents because their parents may not be like your parents.

All nurses are different. All institutions are different. At some places, most of the nurses like most of the doctors. The nurses chose to work at a particular place *because* it's a teaching hospital. At other places, most of the nurses hate any resident. It varies.

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14 years 5 months ago #65909 by Lindsey
I'm not saying I don't understand that these drs vs nurses problems exist. I understand very well that they do. BUT if folks could keep their egos in check, then there's no reason that there have to be these kind of silly issues. It's pretty clear what each of our jobs are.

Was just giving the nurses at MY institution some thanks because they help me out a LOT! That's all....


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14 years 5 months ago #65910 by merri
quick comment - today in my physiology class, I was talking with another classmate. She asked what I am doing. I said premed. I asked what she is doing. prenursing. She laughed and said we're supposed to hate each other. interesting. just thought it was funny how the negative feelings have trickled down to the pre-years...

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10 years 4 months ago #71664 by dr.reets67
Just returning to this site after a fairly long break. :grin: Also if I repeat something already posted - oops, it's a long thread.

I find this discussion interesting because I have certainly come across situations where I have had enormous respect and reliance on nursing staff :cool:and others where I have left the ward after issuing a terse directive "to just do it please" whilst fuming inwardly. :mad:

But what I have noted is that it all comes down to respect, professional courtesy and the feeling that you are in a team - for the patient's benefit.

Working in psychiatry I cannot do my job alone. On the whole the nurses have more face to face interaction with my patients, and I seek out their opinion as my management decisions esp. prescribing meds impacts on how they manage an agitated or at-risk patient. They then feed back how my patient is progressing due to my decisions. The nursing staff rely on me to keep abreast of the issues, co-ordinate the care of the patient's physical well-being/Mental state and medicate them sufficiently to treat them, relieve their suffering/torment and keep themselves, other patients and staff safe. With the common goal of returning the patient to functionality and living in the community as best as possible.

It is also comforting to have another staff member in the interview room with a patient that you do not know, or has a history of impulsivity - safety in numbers. :o Hats off to 'my' nurses who on finding out that a patient is unwell will be proactive and alert me early and direct staff to assist me by doing such things as taking vitals, handing me their drug chart, organising an ECG and getting stuff together to take bloods. :grin: :grin:It makes my decision making process and initiation of my response a lot quicker. Then there is the quick nudge esp. on a long, late shift over inconsistancies in prescribing - does not happen often (thank goodness only a couple of times - and really bloody embarrassingly obvious!). :blush: I think our system in Australia is slightly different - the doctor is ultimately responsible for the medication error. So it's nice to know they mostly have your back on that.

Now the flip side. I hate nurses that assume because I am not with the patient as much as they are I don't know what's going on - I'm nosy and observant. :whistle: Nurses that assume that they are the sole patient advocates - Pl-eeze that just smacks of narcissism and professional discourtesy - they need a refresher in the concept of a clinical team. :mad: Then there is when they do not agree with your diagnoses or management (rather wider latitude in psych than other areas of med - We haven't isolated the Schizococcus bug yet! :crazy:)and rather than discuss it with you in professional way they sprout off to all and sundry how stupid your management is and they could do it better - If that is the case I'd be happy to support them going back to study and become a doctor. :/ Then there is the 'lazy' nurse or one that cannot prioritise according to clinical need - that's when I put on the 'Me doctor - You nurse' hat and direct more forecefully.

Now to the subject of hours - Sure we have some horrid hours. 4 out of five weeks one night on call being on the ward/ED/Community facilities/phone contact until 10pm and then phone contact and being available to come in until 08.30 the following morning. Then we are still rostered for that following day, but can take the morning off if it has been a horrid night. Our catchment area covers hundreds of square kms. Then there is the 1 in 6 weekends as well - from 08.30 saturday to 08.30 monday, with 4.5 hours on the ward on Sat/Sun mornings. There is little flexability in this due to staff shortages. :crazy: :cry: Then I know that the nurses are regularly being asked to do double shifts and fill in for sick collegues (due to fatigue) especially when the ward is unsettled. They also sit out in the High Needs Area for an hour at a time with some very unwell and unpredictable patients (some of whom have past history of assault). :( So both doctors and nurses don't have it easy. It is sad that there is a focus on the things that divide us rather than the common stressors that unite us. :(

I am lucky I have had the opportunity to have worked/still work with some really brilliant and experienced nurses :cool:who have shaped my professional development (and we socialise too ;) ). I tell the med students/junior docs that I supervise to take on board what nurses say, as they often have a great wealth of experience to draw on. But also to temper this with your own experience and knowledge, because you are the one responsible for your clinical judgement - No one else :).
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10 years 4 months ago #71665 by dr.reets67
Re. the 1am constipation order or similar trivial seeming requests - I find its either an inexperienced nurse asking or an experienced nurse fed up with repeatedly asking the home team to write it up it - and it's forgotten. But you have to be careful you need to assess whether there is a reason it has not been prescribed. But hey what heck I am paid to be on-call...

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10 years 3 months ago #71768 by HAM
One caveat to all of this discussion, while valid, is what the director of the medicine residency told me the first day of my medicine clerkship in 3rd year: "Nurses usually don't like women doctors, especially interns or students, so watch your back and don't piss them off."

This seems kind of harsh, but I think it comes from years of experience. Unfortunately, I must say that he's been right all along the way. Women have a different social hierarchy. We collaborate with each other on the same level or when we have stuff in common but resent/envy/despise those outside of these cliques. And there are cliques in all arenas of life - scholastic, social, professional. It has been established long ago. . .us and them. The foundation of the physician-nurse relationship was that of boss-employee. The field is very chauvinistic still, despite the large number of women in the field.

Not to wax philosophical...I can say what I know to be true: all of the interns are frustrated by the frivolous 3AM pages. And most of them respond to them in the same fashion. Yet if a male and a female intern/resident/staff physician is abrupt with a nurse, nine times out of ten, she will tell on the female physician.

There is a reason women are called catty. That seems sexist but it is simply based on the way we naturally socialize.

This all sounds very sexist. It is naive to believe that there is no difference between men and women in social hierarchy/infrastructure/relationships/behavior.

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