I am an American.

Nurses Relations

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In the last staff meeting, NM states Dr. A has complained because the female nurses make eye contact with him. We were instructed to respect his (and other doctors) culture and NOT make eye contact or appear assertive. When asked to clarify assertive we were told assertive was "asking or suggesting something for the patients".

Excuse me! I am American and I am living in America! How come these doctors don't have to respect my culture? How come they don't have to respect me (I am a woman)?

Of course I will continue to make eye contact and I will continue to request things my patients need and I will continue to suggest things that the patient needs. I will continue to advocate for my patients. If the doc doesn't like it... tough crap. I live in America and have the rights afforded American women. I am not giving them up to stroke the ego of a bigot.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
there's one more alternative: acknowledging that it takes time, effort and insight to adjust to a different culture, and cutting the guy some slack while he's working on it.

we don't know that he expects everyone in the u.s. to do things his way; we know only that he's uncomfortable with what we regard as normal american behaviors. once he fully understands that nurses mean no disrespect when they look him in the eye and make suggestions, it's very possible that he'll get used to our way of doing things.

surely the man didn't come to the us without knowing at least a little something about our customs. if he did, it's his own damned fault he's offended. it does take time, effort and insight to adjust to a different culture, but i don't see this guy attempting to do so. instead, he's asked the nurse manager to ensure that the culture adjusts to him -- and the idiot of a nurse manager went along with that. i'm sorry he's uncomfortable with american behaviors; but if he's in america, he needs to suck it up and deal rather than complain that americans in america are behaving like --- well, like americans!

Specializes in Peds, PACU, ICU, ER, OB, MED-Surg,.

I think the biggest problem is the reaction of the NM. When this was brought to her by the physician she should have discussed the difference in customs of eye contact. Eye contact is not the biggest problem either, I would be willing to respect his culture and not make eye contact. The bigger problem is not wanting nurses to be "assertive." We are no longer the doctor's "helper" and fetch things and pour coffee. We have our own license to protect and serve. We too have spent years of our lives in educational pursuit. We are, our patient's advocate! This is what must be explained to the physician, perferably by the board of medicine for the hospital.

I think the biggest problem is the reaction of the NM. When this was brought to her by the physician she should have discussed the difference in customs of eye contact. Eye contact is not the biggest problem either, I would be willing to respect his culture and not make eye contact. The bigger problem is not wanting nurses to be "assertive." We are no longer the doctor's "helper" and fetch things and pour coffee. We have our own license to protect and serve. We too have spent years of our lives in educational pursuit. We are, our patient's advocate! This is what must be explained to the physician, perferably by the board of medicine for the hospital.

ABSOLUTELY!!! She should not have passed along his complaint and instructed the nurses to avoid eye contact and to stop being assertive. Nurses are there for the patients, and if a doctor misses something and a nurse catches it, that nurse needs to speak up. To expect a nurse to do otherwise is outrageous.

After his complaints, the NM should have taken the time to explain to him that this is the way it is in America -- the nurses working with him are part of the health care team, one of the important links in providing proper care, which sometimes requires them to speak up AND have eye contact to ensure understanding. (Also, a nurse just might save his butt someday by catching something he missed.) Once he adapts and learns this, it just might make him a better doctor (or at least perceived as having a better bedside manner.)

I don't care if he just stepped off of an airplane into our country -- a cultural awareness class would have been a good idea -- and it should have happened before he saw patients. Maybe it should be hospital policy for foreign-raised doctors relocating to the states to take such a class? Might make the transition easier for all involved.

Not unless you're being arrested, or fired, for making suggestions. Just complaining about the way American nurses do things isn't a violation of anyone's liberties.

This is true, however it could also be argued that the Dr. is creating a hostile working environment along with putting patients at risk because he is uncomfortable with female nurses doing their job by making suggestions.

Another part of this is that you can pull the military trick on not making eye contact for very long. You make momentary eye contact and then look at a fixed point above the shoulder. By doing this you are technically respecting his wish for less eye contact AND doing it in a manner that does not indicate submissiveness.

Specializes in Emergency.

My 2 cents:

Where I work, we have lots of staff (not just MD's) from other countries, cultures, religions, etc. America is the Melting Pot...right? We (all staff) are required to take a cultural diversity class, and any kind of intolerance from anyone is not tolerated. Lots of our doctors are from other countries, where nurses may or may not have the kind of responsibility we do. We nurses do treat our doctors with respect, but at the same time we expect to be treated with respect as well. We all try to understand and be tolerant of our cultural differences and respect them, but it is understood that the patient is the priority, and that sometimes culture is not as important, since we are all working towards the same goal.

Most staff understand this, and those who won't adapt are not there long.

Amy

Biggest part of nursing that a lot of people don't get is when to listen to management, and when to pretend you are listening.

:yeah:I almost spit my coffee! Thanks; that statement really needs to be a motivational poster hung in every nursing lounge in the country!

To be honest, I think the NM was aiming just for that type of response. It seems like s/he was paying lip service to the doctor's complaint, knowing full well that nobody would implement her suggestions. As a PP mentioned, I would smile sweetly, ask her to put it into writing as a policy change, and then I'd gladly obey. Many times, managers back down from, umm, not-so-wise edicts when they know their name (and license) will be attached to it.

Specializes in Med-Surge, ER, GI Lab/Scopes.

Cultural sensitivity does not outweigh patient advocacy and our legal obligations as nurses.

Specializes in ER, cardiac, addictions.
Cultural sensitivity does not outweigh patient advocacy and our legal obligations as nurses.

No, it doesn't, and it shouldn't. But, unless steps can be taken to encourage the doctor to understand and trust the nursing staff, advocating for the patient isn't likely to work very well with him.

No, it doesn't, and it shouldn't. But, unless steps can be taken to encourage the doctor to understand and trust the nursing staff, advocating for the patient isn't likely to work very well with him.

Well, then he can suffer the consequences of his failure to collaborate. We are not without means.

Specializes in ER, cardiac, addictions.
Well, then he can suffer the consequences of his failure to collaborate. We are not without means.

You're absolutely right about that. But which is more important to you: making the doctor suffer for failing to grasp the finer points of American hospital culture, or working on better nurse/doctor communication and trust? Which is more likely to benefit the patient in the end?

Nope not at all.

He has a license. So do I. That is all. He can choose to put his license in jeopardy, or not. That, is his decision. He is an adult, and a lot will be expected of him. This is a good thing.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

another part of this is that you can pull the military trick on not making eye contact for very long. you make momentary eye contact and then look at a fixed point above the shoulder. by doing this you are technically respecting his wish for less eye contact and doing it in a manner that does not indicate submissiveness.

the problem with this is that it requires us to adapt to him when it should be the other way around.

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