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The doctor nurse relationships and perceptions

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9 years 11 months ago #73635 by dreamerRN
I am reviving this post from the dead because I just wanted to add my two cents. As an RN working straight weekends, I try to limit my calls to the MD as much as possible-it's the weekend, for crying out loud! I have told particularly rude patients/families that I am not going to call on 6pm on a Saturday night because your mom sneezed once. (no joke!) However, there are times when patients or families tie your hands, so to speak. I usually preface those calls with, "I'm sorry for calling, but I know you'd probably rather deal with me than an irate Mrs. Smith who has your beeper number".
Then there are the times when I just don't know whether or not I should call or wait. I always err on the side of caution and call-sometimes I am wrong. But here's the thing-I really think that if when MDs get stupid calls, instead of getting mad at all nurses and letting it fester, take the opportunity to TEACH the nurse why it wasn't neccessary to call, what else you'd like him or her to do, etc. The next time a similar situation comes up, that nurse will know that it's OK to let it wait until morning, and will know why. Granted, you'll still get stupid calls from less intelligent nurses or new nurses who are scared shitless, but I really think it would benefit both parties to use it as a teaching tool. When MDs explain things to me that I may not fully understand, it helps me take better care of my patients.

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9 years 11 months ago #73674 by Docmomof4
I have to agree with HAM in terms of women being treated differently by nurses-totally true. They suck up to the men way more and respect them more, in my opinion. That being said, you can earn a lot of respect by giving it. I was a certified nursing assistant in college and med school and being on that end of things really helped me understand nurses. I have been in practice 9 years and to this day when I help lift or turn a patient I get a surprised look. Like I'm going to leave someone sitting in a mess! It's my job too!!

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9 years 11 months ago #73683 by asunshine
Dreamer, that was a very good post (I am an RN, too). Teaching one nurse how you like things means that s/he can teach all the new/dumb nurses, too, before they call.

One thing I have noticed in L&D and ICU is that the nurses drive the docs crazy when the patient has a non-reassuring finding that just needs to be monitored with no intervention for now. That drives the nurses bonkers because they have to watch every minute of the tachycardia/late decels/whathaveyou....

I guess what I'm trying to say is while a doc is comfortable with watch and wait from a patient management point-of-view, it can just be mentally hard for the front line nurses who have to stand by watching it, and that's why they keep calling and pestering for "something" to be done.

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9 years 10 months ago #73691 by dreamerRN
asunshine, your observation is very accurate. Why do you think it is that nurses have such trouble watching and waiting when physicians do not? Perhaps because nursing is geared more towards DOING things to/for the patient, and if you're not doing something, you feel like you aren't being the best nurse you can be for your patient.

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9 years 10 months ago #73694 by asunshine
For me, it was because I knew I had seen the Ominous Finding before and knew what badness could happen. To be brutally honest, the reason in my mind is because the nurse then has to take over all the worry--checking on the patient obsessively, evaluating the strip, getting the code drugs and backup staff geared up just to "watch", whereas the doc who is comfortable with watching is asleep in bed, assuming they'll be called if there's a problem. Meanwhile the nurse is going bonkers. Bonkers!

I know, that sounded insensitive, but it's at least the perception.

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9 years 10 months ago #73696 by jonesie
It's not that I don't have trouble watching and waiting, it's that sometimes that's really the best thing to do. Often, taking action when not warranted causes more harm (as I'm sure everyone has seen to some degree). And I'm not sleeping (Ha! I wish!), I'm watching the monitor/BP/UOP too, and worrying, and obsessing about whether I should do something and hoping things will go well in the next few hours and trusting that I'll get a call if they don't and coming up with a plan for when that call comes. Good to know we're all developing ulcers together....
Honestly, it's about trust, respect, and communication just like any other relationship.

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