Doctors and Nurses communicating? LET'S IMPROVE THIS!

MRed94 · Nov 19, 2002

OK, Doc, I am the one who spends the most time with the patients, ask ME how the patient is doing and what I THINK might be the best thing.................

I'm NOT invisible, you know.

My $.02

Teshiee · Nov 19, 2002

Valuing our opinion when it comes to our patient would be very nice. Half the problems doctors can resolve or catch is only because "we" tell them so they can do what they do best!!!! I guess old traditions die hard. I wasn't long ago when a nurse would give her seat when a doctor approach the station and you dare not question a thing he/she ordered! I know some doctors wish they could go back!!!!!

hoolahan, ASN, RN · Nov 19, 2002

Instead of always telling us what we did wrong, how about telling us when we did something right? Or even great, like saved your pt's life b/c we picked up on an internal bleed post-op, and dogged the docs unitl they responded!

Don't be condescending.

Explain your rationale when a nurse questions an order or a decision.

Say please and thank you.

Clean up your messes, put a biohazard bag under the pleuravac when you pull chest tubes, TELL the pt's nurse you are pulling the chest tubes!!! Please don't hang dirty chest tubes over the side rail, esp when the Y is still connected to a pleural tube as the mediastinal tubes are dangling in the breeze!!

researchrabbit · Nov 19, 2002

Some barriers to communication that I've noticed:

Superior to inferior communication:

When an MD uses my first name, I should be extended the same courtesy. (As it is, for me they all have the first name of "Doc" except for a valued few...I've found this makes a world of difference in how I treat them and I have yet to have a doc object...and when I assume I am equal to a doc I am much more likely to be treated as an equal and be heard and respected).

Body language:

Physicians need to make eye contact and use "open" body language (no crossed arms). It's pretty hard to talk to someone who is giving you signals that they are not going to listen.

Impoliteness:

A doc with a reputation for rudeness or anger is difficult to approach.

Time pressure:

Many docs rush in and out and can be hard to catch...and they are impatient because they are already late for something else.

Some barriers I've seen on the nurse's part:

Fear:

Of anger, looking stupid...

Desire for mind reading:

Say up front what you want when the doc is THERE and the situation is going on (of course, be polite). And you might have to say it every time until they get it right. Don't assume anything. Docs can be as ignorant as the next person about some things.

Defensiveness:

You are much more likely to make the doc react to you in a negative way if you begin by being defensive or self-deprecatory (that "kick me now" attitude).

Heck, if you want a compliment, blow your own horn -- that will remind the doc what you did and that it was exceptional. (remember, many docs are guys and many guys don't get the whole compliment thing -- and those who do may be wary of complimenting opposite sex coworkers for ANY reason).

RN always, BSN, RN · Nov 19, 2002

WOW, research rabbit said it all! I love it............

SmilingBluEyes · Nov 19, 2002

what research rabbit said. i can't possibly improve on that (you rock research rabbit!)..... mutual respect and professionalism should be a goal. it's also like sjoes' tag line says..

we will get exactly as much crap as we will take.

it's the truth.

ceecel.dee, MSN, RN · Nov 19, 2002

The patient Bill of Rights supports ALOT of nurse advocacy issues and can address the defensiveness/not-want-my -orders-questioned issues. I have a highlighted copy that supports many nursing behaviors that some doc's don't understand.