A worn out topic

[artistnurse]

Ok, I know the question has been posted over and over. I've not seen any real definitive information.

I recently witnessed a doctor who decided to saunter into the hospital to see a patient, and as he walked towards the patient's room he passed the nurses station and barked the question of who the patient's nurse was. Someone pointed and he used a jerky hand gesture to beckon the nurse to follow him...as one might a dog....

I've also seen a doctor walk to a nurses station and bark out the charts he needed...the charts were directly on the shelf in front of him.

I was told in nursing school to never give up your chair just because a doctor was present. I've seen nurses scramble out of the way to give a doctor their seat just because he was standing close by (and there were plenty of empty seats elsewhere)

My question is....is this not the year 2010? I sometimes feel like we're living in the 18th century.

No, really, my question is.... are doctors really our colleagues as some nurses have emphatically stated? Or are we their subordinates/pee ons ready to jump at their beck and call (and I can tell some doctors LOVE that and use it often)? I've noticed some doctors can't wait to rip into a nurse for every insignificant thing...and the nurse just stands there and takes it. So where is the line (please don't say there isn't one...there has to be an accountability line even if it's on the border of professionalism)?

I'm not a docile person, especially if there's a male barking orders at me...I tend to have a problem with that (and mind you, I understand reasonable and professionally communicated disagreements, but throwing charts..scoffing, rude language, calling names, making inappropriate references to a nurses' intelligence...I just feel like if they open the door, I have a right to slam their fingers in it ;-p )

Honest and objective opinions?

[Ruby Vee, BSN]

i will tell you something i have never told anyone until now.

i was in a back office one day and was not deliberately hiding - i think i was using a computer in there cos mine had packed up, and i was waiting for it to be looked at. i had closed the door most of the way to get some peace and quiet. well two doctors on rotation in the unit i was working in were talking, and didn't know i was there. from what i heard, (they were fairly young), they thought that all nurses were fat b*****s, who were sl*ts and who were unbelievably dense, and were laughing about the stupid nurses they had had to deal with.

i didn't care cos i wasn't a nurse then. but my impression was that they really do think they are a cut above everyone else. dr's don't seem to see us as being on the same level as them, and my personal opinion is that they certainly don't see or treat us as professionals. we are just there to do the grunge work and ensure we run after them when they want info (in any form), or to do rounds so they don't have to be bothered with patient concerns too much.

now i'm not bothered by any of it now. i am older and know my own worth. and i have worked with some fat, lazy, obnoxious nurses who do give nursing a bad name.

i am getting out of it all soon and i am sooo glad. it is a losing battle trying to be seen as a health professional. i have never felt like a nurse - even when i was supervising other staff - and have worked my butt off to make people and patients in our ailing health care system happy; now i realise i have to make myself happy! i have now realised that dr's especially won't give us the recognition we crave (unless you are a nurse with a phd perhaps), not that that bothers me too much. but i have never thought nurses were seen as professionals - especially not by dr's.

young people -- young men especially -- can be peckerheads, and some of those peckerheads become physicians. physicians may be actually a bit delayed in maturation just because they spend so much of their life in school instead of out in the world interacting with other professionals. it's normal for young people to look down on their elders -- which sounds like what those two were doing. i'm sure they thought the cute young nurses (whom they might want to date) were intelligent, attractive and possibly more virtuous than the rest of us. i don't know about the two in question, but the majority of young docs grow out of this as soon as they've had a few close calls and realize that the "fat (bad word meaning female dog" he was ridiculing can save their sorry behinds. as i've worked in a number of top teaching hospitals, i've contributed to that education for many a young physician, and we've turned out some mighty pleasant, respectful and collaborative physicians.

[Ruby Vee, BSN]

i believe this may be at least part of the problem. and yes, we all know there are some female doctors and they can be mean, but they are relatively few. i also believe that new physicians get "broken in"--meaning they see more seasoned physicians treat nurses this way and nothing gets done, so the new guys think it's ok. i mean, i'm sure they share stories while playing golf of how they humiliated a nurse. thing is...they have to get the message from someone that they must treat a nurse with the utmost respect and, lo and gasp, they are in fact not gods. but who's going to teach them this if the behavior is overlooked, excused because people demand their time (as if nurses don't get pulled in all directions all day instead of a few minutes), or ignored....smh

no matter what's going on, or what they have to go through (nurses have to go through it too for much longer periods of time), we're not allowed to throw tantrums, but they are and we frown at the bad behavior behind their backs? one of the earlier responses said that "they're way up there and we're way down here"...sooo...i guess we are subordinates?

this is why i'm confused, i've been told that we're colleagues, but nurses' behavior and response to unacceptable behavior says different.

roughly half, if not slightly more, of the new residents we see coming through our icu with their bright, fresh medical degrees are women. they all do at least the first year of their residency in a teaching hospital like mine. it is the philosophy of our institution that we're here to teach -- our goals give equal weight to teaching, patient care and research. granted, we get student nurses and fresh, shiney new rns, pharmacy students and brand new pharmacists, rt classes and new grad rts and students and newbies of every other discipline. but we crank out quite a few doctors.

it is my job and the job of every nurse in my institution (and the previous teaching hospitals where i've worked) to teach those brand new doctors how to function as physicians and how to work with staff. we're aware that the interactions they have with the icu nurse in their first year of residency set the tones for their interactions with icu nurses for the rest of the careers. we can teach them to be good, respectful, collaborative team members or we can let them become petty tyrants. we must get great doctors wanting to work here, because the majority of them learn quickly and learn thoroughly how to be a member of a health care team. the few that are slow learners get re-educated by their colleagues, their superiors and by the nursing staff.

i've participated in the re-education of several slow learners. we didn't succeed every single time, although we usually do. and the resident that i had the most problems with in my entire career came through our medical school a few years ago as a visiting professor. when he saw me from across the unit, he ran up to me to apologize for the rough treatment he'd given me 20 years ago and to tell me -- in front of his merry band of medical students -- that nurses can teach you a lot if you're smart enough to listen. "don't ever let me hear of any of you being disrespectful to a nurse -- any nurse. we're all on the same team and they have a body of knowledge that you won't have unless they share it with you."

[msjellybean]

Now on the other hand, as some of the posts on this forum have been examples of, nurses are always happy to bark at a phlebotomist, environmental tech, dietary aide, new nurse or any other health care worker and team member while loosely tossing around the word "STAT" just because they can or feel they can.

I stopped reading the thread after your comment, because I felt compelled to agree with you on this. While I was in school, I worked in the hospital's diet office. We have room service style kitchens and I was on the other end of the phone. I was frequently treated like dirt by the nursing staff and even managed to get yelled at by a few docs, when it was something that was totally out of my control. It was often presumed that since I was answering phones, that I must have had nothing more than a high school education.

Back to the original topic. On my floor, our younger docs are much better at treating us as colleagues; while the older ones are much more of the mindset that "I'm the MD, you're the RN. I tell you what to do, you do it." I've learned over the months which docs will be ok with me asking for a specific drug vs. which ones need to be hinted at when I need something. We will sometimes get medical patients on the floor and it's my discovery that the hospitalists are much more apt to treat the nursing staff as colleagues. Now... the CV surgeons are totally different, but thankfully that's not my area!

[BellaInBlueScrubsRN]

I don't have a problem giving up my seat for a doctor. When I am running my hiney off and have finally sat to chart, heck no I'm not going out of my way to move. If its a slower day or I'm caught up, I'll stand and say "You can sit here." If a fellow nurse needed my seat for my computer or somewhere to sit a chart, I'd move too. I don't think its a sign of worshipping the doc or moving backwards in some movement. Its respect and also just being nice.

[WalkieTalkie, RN]

I will not take the badmouthing, "come hither" motions, yelling, or demeaning tones. That will be either taken up with that doctor when it's appropriate (i.e., not interfering with patient care), or through the proper channels.

As for the chair thing, well, it depends on the situation. If it's a doctor who respects me and needs to use the computer to look up labs and care for my patient, and I'm not really needing the chair, then I will absolutely get up. If it's a doctor who disregards me, doesn't bother to know my name, and has a god complex, I'm not getting up. You treat me right, and I'll make your job a little easier... that's the way I look at it.

[nursel56]

. . .i've participated in the re-education of several slow learners.

lol-- if ever there was an appropriate time to use this :nuke: it would be now, and on behalf of nurses all over the world, i thank you.

we didn't succeed every single time, although we usually do. and the resident that i had the most problems with in my entire career came through our medical school a few years ago as a visiting professor. when he saw me from across the unit, he ran up to me to apologize for the rough treatment he'd given me 20 years ago and to tell me -- in front of his merry band of medical students -- that nurses can teach you a lot if you're smart enough to listen. "don't ever let me hear of any of you being disrespectful to a nurse -- any nurse. we're all on the same team and they have a body of knowledge that you won't have unless they share it with you."

did you cry? i would have. maybe in the coat closet, but i would have. i thanked the vice principal of my hs, sister l. (the disciplinarian) who had written in my yearbook "to the girl who made my job possible" for everything she taught me without knowing she did, she seemed surprised and touched - and we're friends to this day. you just never know, and it's solid gold to get unsolicited feedback as you did with slow-learner-doc who remembered you.

[mykrosphere]

i have been a nurse for ten years (as of yesterday in fact!) and i have only run in to two docs that really rubbed me the wrong way.

i have worked in a few different areas, and i think 2 a-wholes in ten years isnt so bad, considering i run into way more than that just going to the grocery store.

[caliotter3]

I used to love to come back to the nurses station and find several charts thrown all over the place from the visit of a doctor who was sneaking in just before shift change on their way to work. In today's climate, I can imagine a management-type berating the nursing staff for the breach of confidentiality.

[Asystole RN]

I give up my chairs for MDs and retrieve charts for them. I do this out of a sign of professional respect for their position, not the individual.

I also do this for unit managers, NPs, supervisors, social workers, physical therapists etc...

I do not do not believe being polite and respectful is a sign of subservience.

[anonymurse]

I try to show everyone little kindnesses, aides, docs, everyone. It's not something you can turn on and off like a light switch. I'd rather default to on than off.

[pagandeva2000, LPN]

There are several issues I see with this subject-one it is very hard for nurses to stand up for themselves when their own support system (meaning nursing supervisors, associate directors and DON)does not staunchly advocate for them. My DON, for example, would personally take gasoline and burn the entire hospital down before she stands up to even a 1st year green behind the ears short jacketed resident.

Then, it is also what the residents witness. If they note that the attendings can disrespect nurses, they may imitate the same behavior, which does not help us.

So, because there may not be any support, each nurse has resorted to their own tactics, but unfortunately, it is not consistent. I always advocate for myself, but the more timid one may not. Some are very tactful and charming, and know what to say and to whom... Sad, indeed. Nursing is still a subserviant position as far as many physicians believe.

[artistnurse]

The hospital I am at now has some awesome hospitalists. They're professional, thorough, they care about the patient. They're respectful. I go out of my way to make things easier for them. I haven't had too much of a run-in with an unprofessional physician, but when I did I let them know they can go eat dirt. I have no problems with them after that. There's nothing wrong with being respectful. But there is a line between respect and subservience. If subservience works for you, have at it. It doesnt work for me.