Does This Place Exist? - page 2
Just curious. Does ANYONE work on a unit or in a facility in which there is true collaboration between the nurses and physicians? One in which the doctors REALLY care to listen to what you have to... Read More
Jun 13, '04Quote from mattsmom81Just like our place. I was horrified when floating to med/surg. I was helping a nurse with a patient who was near coding. The nurse handed me the phone as a cardiologist yelled calling her stupid because she didn't know the rhythm. The MD responding had his book out and refused to come to the phone. I told the MD, "this is a non monitored unit and the nurses do not take the dysrythmia class. He recognized my voice and suddenly became VERY NICE. He didn't know it was a unit nurse on the phone.I work with docs who collaborate with the nursing staff in my ICU's...but this has been more a personal decision/style of the doctor and has not been part of the 'culture' of the place.
Smaller units like rehab where a few docs manage care seem more amenable to a team approach it seems. maybe this is similar to the physician who can be a bear to hospital staff, but treat their office staff well. Perhaps this has to do with a closer working relationship in a smaller setting (and less outside influence from other doctors egos perhaps)
Sometimes I suspect the poor treatment many doctors give nurses is due to peer pressure and the need to 'control' us women and keep us in our places. The age old battle of the sexes. they look at us as a female profession yet.
As to control: well in ICU I have a bit more clout than I did on medsurg, but its still management bowing to the docs come crunch time.
On the unit we took a tip from a Laura Gasparis class calling a "code pink" to document any verbal abuse. All of us support each other from charge nurse, clinical specialist, RN, LVN, CNA, clerk, RT, housekeeping, just everyone available responds to 'record the code pink'. Then the MD is written up. That cardiologist was written up by the two of us on the extension.
It is a good place to work because for the most part we have unity. We have also attended California Nurses Association classes so know the laws and regulations.
Example: We don't say, "I am uncomfortable floating" we say, I am not competent to care for patients on that floor."
We learned hundreds of such things in classes. Our patients get excellent care. We can't 'settle' or we lose the gains we have made.
Jun 13, '04KUMC psychiatric research. You can't ask for better MDs, DOs, RNs and staff, or better interaction. A tremedous place to work.
I don't work there anymore (had to move out of state) but I truly loved it. Easily the best place I've ever worked.
Jun 13, '04The unit I work on has great collaboration between physicians, PAs, NPs and RNs. Almost all of us treat eachother with respect. I feel fortunate to work there
Jun 13, '04Yes I worked on a unit like that in the early 80's. Unit direcor was a pulmonologist who had RN's doing Grand Rounds with the Resident's, taught us to read CXR and great collaboration with our headnurse.
Twenty + years later, I attend meetings at this facility, and still see my colleagues who were newbies then. RN Staff still has great input into decision making.
Jun 13, '04Quote from VickyRNActually yes, the place does exist, and I work there!Just curious. Does ANYONE work on a unit or in a facility in which there is true collaboration between the nurses and physicians? One in which the doctors REALLY care to listen to what you have to say and value your opinion and actually discuss with you treatment options for the patient? Also, do you feel that you have a measure of control and autonomy in your work environment? (Or, is it 'management's/doctor's way or the highway'...)
In our unit, the doctors and physicians really discuss what's going on with the patients. If they're doing rounds, they come to us and ask us what we think and what we need.
We also do rounds with them (charge goes for all pts, we do individual pts). They teach us how to read the CXRs and CTs so that, when you come back from that stat head CT or whatever, you can give them a heads up. No, it doesn't mean we do their job for them, it just helps us to work smarter!
I also have to say that for a lot of our docs...if you don't get something, they are usually more than willing to sit and explain it to you. Heck, sometimes it goes the other way! Just recently, I had one of our residents call me over to the X-ray board so that I could show the monthly resident what was going on on a person's head CT. LOL
As for autonomy...I have plenty of autonomy! I am definately not one of those nurses that calls the doctor for every stupid little thing! Our doctors trust us to make some decisions without calling them. You know, they say something to the effect of "just write what you need, I'll sign it later"! LOL
What it boils down to is this. After you work side-by-side with these docs for so long, they trust you and you trust them.
Now...here's my little disclaimer. I think part of it has to do with the fact that we're ICU nurses. It's not that I think I'm any better than any floor nurse, but the acuity level and the knowledge base is different and the doctors treat you different because of that. I'm not saying it's fair, it's just what they do....I know, because I've actually had this conversation with a few of them.Last edit by NeuroICURN on Jun 13, '04
Jun 14, '04The trend I seem to be seeing is if you are in a specialty area like OB, ICU, PACU, OR ER where you work with basically the same set of physicians you do see a real spirit of cooperation. I have always had great working relationships with the docs in the ER. I think a lot of it is based on trust and the more you work with someone the more you trust their decisions. I have seen docs on the floor go off on staff who really had no connection to the problem, they just happened to be in the wrong place at the wrong time. Thank you, I will stay in my ER with folks I can count on.
Jun 17, '04Quote from CNM2BSorry, Kim, that it's taken me so long to reply :imbarCan someone tell me what a Magnet hospital is???
Here is a good link that explains what Magnet status is:
Jun 29, '04Quote from lady_jezebelAmen! Magnet is such a joke!I sure don't, and it's a "Magnet" hospital. Wish that I knew where such a place exists.
Jul 5, '04Quote from DixieleeI think knowledge and experience with the abilities of each other contributes to a working enviornment conducive to quality care and respect.The trend I seem to be seeing is if you are in a specialty area like OB, ICU, PACU, OR ER where you work with basically the same set of physicians you do see a real spirit of cooperation. I have always had great working relationships with the docs in the ER. I think a lot of it is based on trust and the more you work with someone the more you trust their decisions. I have seen docs on the floor go off on staff who really had no connection to the problem, they just happened to be in the wrong place at the wrong time. Thank you, I will stay in my ER with folks I can count on.
I have had a doctor tell me they don't want a nurse caring for his patient only because it is an unfamiliar new nurse. We make sure the preceptor introduces new nurses to him. Unfortunately I don't assign newer registry nurses to his patients. Once he has seen a registry nurse on the unit for a while he thinks they are staff and is OK with it.
What do you think this physicians specialty is?
Jul 5, '04Quote from DixieleeI agree. In the NICU where I work, usually there is a good amount of collaboration between the doctors and nurses. Even the monthly residents take our advice quite often, because it doesn't take them long to realize that the nurses are at the bedside with these kids 24/7 and often know them inside-out. Some docs, of course, will always have God complexes and you have to play verbal games with them to get the stuff you want ordered..."Hmmm, this baby didn't look nearly this pale a few days ago, whatever could be wrong, Doctor???" Whereas most of them, you can just say, "Hey this kid looks horrible, can I get a crit?" and they're totally fine. They actually like it sometimes because we notice those tiny changes a lot more than they do. And even the most arrogant docs will listen to an RN that they know is the baby's primary nurse, because they can't deny that we'd know that baby better than they do. They even welcome nurses in daily rounds to give suggestions regarding the plan of care.The trend I seem to be seeing is if you are in a specialty area like OB, ICU, PACU, OR ER where you work with basically the same set of physicians you do see a real spirit of cooperation.
The funny thing is, it's the nurse practitioners that are rather stubborn and don't seem to listen to us sometimes. It's kind of a cross between the nursing "we know this baby better than the docs" and the doctor "but I'm in charge here" attitude. Usually their decisions are right on, but if we doubt them, there's not a whole lot we can do to convince them otherwise.
Jul 6, '04Utopia General Hospital doesn't exist, but there ARE facilities that value nurses and treat them well. I worked in such a place as a new grad (Rush in Chicago). Since it was my first "real job" I didn't know just how good I had it, and naively believed that all hospitals were pretty much the same. When we transferred with hubby's job and I went to work in a hospital that treated nurses dreadfully, I came to appreciate what I had left behind. I have worked in 5 hospitals in 5 different states, some pretty good, some really bad, but have never again seen the level of professionalism I experienced as a brand new nurse.