Our jobs as nurses is to protect/help/serve the doctors. - page 3

by thesundowner 3,753 Views | 26 Comments

As a nurse, it is my job to ensure that the admitting doctor and all of the consults accurately assess the patients, order the correct labs, order the correct meds, read the consults notes, and do not miss anything with the... Read More


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    this whole "we protect patient's from those stupid, mean doctors" mantra has probably been one of the most annoying things i've encountered in medical training so far.

    *** i can see how it would be very annoying to those physicians who are actually caring and competent. some of the finest, most humane and wonderful people i have had the privlage to work with where physicians. however not all are like that, just like not all nurses are caring or competent. i don't very often encounter incompetent physicians. i do often encounter uncaring and apathetic physicians. thankfully they are the minority. same for nurses i encounter.

    you'd be surprised how often we residents and attendings protect the patients from nursing errors.

    *** i wouldn't. i am a full time rapid response nurse. i get the same calls from nurses the residents do. nothing would suprise me anymore. i spent most of my career working in very demanding and high speed units where only the best were tolerated. now i work with all the nurses and physicans in the hospital and have learned that not everyone in health care is up to the standard i had previously experienced.

    i don't think i've gone a single day in the hospital this past year w/o fixing/preventing a mistake made by a nurse and this was fairly common during my two years of rotations during med school also (i'm a pgy-2 now). the number of nursing mistakes at every single hospital i've rotated through so far has far exceeded those made by physicians. the difference is that we doctor's only discuss this stuff in the physician's lounge

    *** apperently you have never visited studentdoc.net. "physicians lounge"??? wow, where do you work? i thought they did away with those years ago. i haven't seen one in 10 years. i am sure that over a beer i can match you story for story rn vs md mistakes.

    i feel like physicians are the only ones who get any training regarding working in a health-care team these days.


    *** if you are now recieving such training i would say it's about time. i would also guess it's not universaly taught in medical schools. i still seem to see a lot of "i am captian of the ship and what i say goes". i see this particularly in foreign med school grads and my hospital is full of them.


    yea, no. my job isn't to just diagnose or just do surgery and then leave the rest of the care to someone else.

    *** ya, you are right. there are lots and lots of great physicians out there. it's the nature of the beast that those that are not great are talked about more than those who are. i work nights and resident come and go. they do a two week rotation where we work together then they are gone. it's the rns who provide continuity here. in a situation where a physician actually really gets to know the patient and feels ownership for their care it would be different. in my job they are my patients, the resident is a transient, here today, gone tomarrow.
    SoldierNurse22 likes this.
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    I do agree, for the most part, but studentdrtobe makes some good points too. I think we all need to remember that we are all human and can make mistakes, especially when we work in very high-stress, fast-paced environments.

    However, if you make a mistake, please fess up and admit it. I'm tired of people blaming others for their mistakes. For example, a doctor once got mad and blamed the nurse because the nurse missed an abnormal lab value and didn't tell the doc about it. Yes, the nurse should have seen the abnormal lab work and done something, but when the doctor rounded on the patient, why didn't he review the lab work and address it, too? But, no, he seemed to think reviewing lab work was solely the nurse's job, not his own.

    Quote from studentdrtobe
    That's a fair critique. Unfortunately, it's all too common to encounter drug seekers in the ED. I feel like it's to the point where patients are assumed to be drug seekers unless proven otherwise.
    This is a prevalent problem in our ED, too, it seems. We once admitted a patient who had gone to the ED several times because of pain. They thought she was a drug seeker and so kept sending her back home. Then one day, someone thought to send her for some tests and found she was full of cancer, including mets to the bones. It was very sad. She didn't survive the year and she was only in her 40's or 50's (my memory is a big foggy on her age but she wasn't old).
    anotherone likes this.
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    Quote from studentdrtobe
    That's a fair critique. Unfortunately, it's all too common to encounter drug seekers in the ED. I feel like it's to the point where patients are assumed to be drug seekers unless proven otherwise.
    Some drs/nurses where I work seem to operate this way. Everyone is a drug seeker to them. No one is really sick. If you come in with "abdominal pain" might as well come in asking for dilaudid. lol
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    Quote from studentdrtobe
    That's a fair critique. Unfortunately, it's all too common to encounter drug seekers in the ED. I feel like it's to the point where patients are assumed to be drug seekers unless proven otherwise.
    Aren't people in the medical field supposed to treat patients without prejudice?

    Oh, and it is also common practice for a nurse to lecture patients about not having insurance?

    I no longer have pain-thankfully my surgery fixed that problem. I never became addicted to pain meds because they didn't help. But I feel sorry for the people who live in pain 24/7 and who have to depend on narcotic pain meds to get by. They are treated by pariahs just because the majority of the medical profession has lumped everyone who presents in pain as a "drug seeker".

    I think it's hypocritical to say you are a "healer" and the patients advocate when you walk around with such a mindset. After last year I discovered that the only person who can advocate for me is me. I lost all faith in the medical system and it wasn't until my first appointment with my neurosurgeon that it was restored. So no, it wasn't a nurse who healed me physically or mentally. It was the kindness of a Neurosurgeon and his PA who felt sorry for me because I had suffered for so long and no one would help me. They treated me like a PERSON who really WAS in severe pain and deserved to be treated as such.
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    Quote from Poochiewoochie
    Aren't people in the medical field supposed to treat patients without prejudice?

    Oh, and it is also common practice for a nurse to lecture patients about not having insurance?

    I no longer have pain-thankfully my surgery fixed that problem. I never became addicted to pain meds because they didn't help. But I feel sorry for the people who live in pain 24/7 and who have to depend on narcotic pain meds to get by. They are treated by pariahs just because the majority of the medical profession has lumped everyone who presents in pain as a "drug seeker".

    I think it's hypocritical to say you are a "healer" and the patients advocate when you walk around with such a mindset. After last year I discovered that the only person who can advocate for me is me. I lost all faith in the medical system and it wasn't until my first appointment with my neurosurgeon that it was restored. So no, it wasn't a nurse who healed me physically or mentally. It was the kindness of a Neurosurgeon and his PA who felt sorry for me because I had suffered for so long and no one would help me. They treated me like a PERSON who really WAS in severe pain and deserved to be treated as such.
    Did I ever say that this was my mindset or that I'm even an EM resident? No. So, don't put words in my mouth.

    It can't be denied, however, that in certain areas, a significant portion of patients who show up to the ED complaining of pain are drug seekers and not truly in pain. It isn't the medical profession driving everyone to be lumped into the category of "drug seeker" like you say. It's the administrators and government that force physicians and other independent practitioners to think this way. Prescribe narcotics to "too many" patients and you will raise suspicion of administrators who are worried you'll get the hospital in trouble or that you're being careless. I've seen this happen to colleagues and, while they came out of the investigation just fine (and found that they were justified in their prescribing activity), the whole hassle of being investigated and the potential harm to your reputation is pretty stressful. No one wants to go through that. Combine that with how good many drug seekers have become at pretending to be in pain in order to get narcotics, you can understand why many practitioners treat these patients with suspicion.
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    Quote from pmfb-rn
    *** apperently you have never visited studentdoc.net. "physicians lounge"??? wow, where do you work? i thought they did away with those years ago. i haven't seen one in 10 years. i am sure that over a beer i can match you story for story rn vs md mistakes.
    you just made my point. there's a huuuuuge difference between venting with colleagues in private or on an online message board, like sdn or an, and walking around in public wearing t-shirts saying that you "save patients from doctors." if this type of sentiment was restricted only to allnurses or only to the nurses lounge, yea i'd have no problem with it and it'd be completely reasonable to have somewhere to vent. however, when 3 out of 4 nurses go out of their way to tell me (condescendingly) that they protect patients from the mean, uncaring, incompetent doctors (while heavily hinting all of us are idiots) and when you have nurses walking around wearing t-shirts that say the same thing, that's when myself and other physicians start having an issue with it. we don't go out of our ways to point out the incompetencies of other healthcare workers or tell patients not to trust other healthcare workers (which is essentially the message you're conveying to the lay public). nurses, on the other hand, seem to delight in elevating themselves by putting other professions down, whether it's physicians or other ancillary workers. i've seen this way too often to count. that is thoroughly unprofessional and downright child-like behavior.

    btw, when i said physician's lounge, i was referring to the resident's lounge. i was under the impression that pretty much all teaching hospitals have these. it's got lockers to put your stuff in, little tables to grab a snack with colleagues, and a sofa. if you're in a community hospital, i guess it doesn't make much sense to have such a room. for what it's worth, we also have a nurse's lounge. i'm surprised you haven't seen one in 10 years! they're pretty nice to have.


    Quote from pmfb-rn
    *** if you are now recieving such training i would say it's about time. i would also guess it's not universaly taught in medical schools. i still seem to see a lot of "i am captian of the ship and what i say goes". i see this particularly in foreign med school grads and my hospital is full of them.
    this type of training has been in almost all us med schools easily for more than a decade, if not longer. like you said though, you work with a lot of foreign graduates. that may have something to do with it.

    Quote from pmfb-rn
    *** ya, you are right. there are lots and lots of great physicians out there. it's the nature of the beast that those that are not great are talked about more than those who are. i work nights and resident come and go. they do a two week rotation where we work together then they are gone. it's the rns who provide continuity here. in a situation where a physician actually really gets to know the patient and feels ownership for their care it would be different. in my job they are my patients, the resident is a transient, here today, gone tomarrow.
    if your patients are generally hospitalized for longer than the 2-week rotations that your residents are doing, sure i can see where you're coming from. most of the patients in my specialty are hospitalized for a week or less before being discharged. in this case, it's us residents that provide continuity. the current interns work 16 hr shifts daily, while pgy-2s and above do 28 hr shifts on on-call days. from what i've seen so far, both are longer than the nursing shifts; not only that, we're in the hospital for more hours per week than nurses are since we generally only have 1 day off per week. whatever. i don't want to argue about patient ownership anymore. i'm glad you take responsibility and ownership for your patients as i do for mine. my previous statement regarding this was more out of frustration and annoyance at the poster i was quoting. so, i apologize for even bringing this particular topic up.
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    you just made my point. there's a huuuuuge difference between venting with colleagues in private or on an online message board, like sdn or an, and walking around in public wearing t-shirts saying that you "save patients from doctors." if this type of sentiment was restricted only to allnurses or only to the nurses lounge, yea i'd have no problem with it and it'd be completely reasonable to have somewhere to vent.


    *** i haven't actually seen such t shirts. the only references i have ever seen to them was here on an. i wouldn't wear one. however as you very likely know sometimes people exagerate or over emphasize in order to make their point. i think talking about such shirts is an example of that

    however, when 3 out of 4 nurses go out of their way to tell me (condescendingly) that they protect patients from the mean, uncaring, incompetent doctors


    *** there actually are mean, uncaring and incompetent physicians out there. i have protected my patients from them. to be honest i hardly encounter truly incompetent physicians. however lazy and uncaring is more common, though still unusual in my experience. in my roll as rapid response rn i can't tell you how many times i have had to make calls to staff physicians in the middle of the night because the resident simply refuses to provide the care a patient needs. certain services are much worse than others. in my hospital ortho, ent, and neuro surgery residents seem to have more residents i would call lazy or uncaring. medicine and general surgery are great! every single time i have had to call staff in order to get the patients needs met it has worked out well for me and the patient and bad for the resident.

    (while heavily hinting all of us are idiots) and when you have nurses walking around wearing t-shirts that say the same thing, that's when myself and other physicians start having an issue with it.


    *** well as i said i have never seen these t-shirts but your feelings about them are perfectly understandable.

    we don't go out of our ways to point out the incompetencies of other health care workers or tell patients not to trust other health care workers (which is essentially the message you're conveying to the lay public). nurses, on the other hand, seem to delight in elevating themselves by putting other professions down, whether it's physicians or other ancillary workers. i've seen this way too often to count. that is thoroughly unprofessional and downright child-like behavior.

    *** i agree. in my opinion nursing suffers from a severe self esteem problem. i can cite a number of examples that demonstrate this to me.

    btw, when i said physician's lounge, i was referring to the resident's lounge. i was under the impression that pretty much all teaching hospitals have these. it's got lockers to put your stuff in, little tables to grab a snack with colleagues, and a sofa. if you're in a community hospital, i guess it doesn't make much sense to have such a room. for what it's worth, we also have a nurse's lounge. i'm surprised you haven't seen one in 10 years! they're pretty nice to have.

    *** i actually work in two hospitals. one part time and one full time. both are large teaching hospitals. one is a famous magent (whoop-t-do) hospital (part time) with a number of residencies and fellowship programs, and the other is university affiliated and staffed by residents 24/7. neither has a physicians, nurses or residents lounge. i have worked as a rn in 4 states and haven't seen a physicians lounge in years. in my experience they have all been replaced by staff lounges. i am guessing you are located in either the northeast or the south?


    if your patients are generally hospitalized for longer than the 2-week rotations that your residents are doing, sure i can see where you're coming from.


    *** it's not that. it's that with our patient population we have many, many frequent fliers. over the years we (rns) get to know these patients very well. each time they are admitted the on duty resident is meeting them for the first time. we have a guy with serious mental illness who fakes injuries. for a couple years it was blindness, then for a long time it was chest pain. then for a year or so it was seizures. his current thing is to have unwitnessed "falls" with claims of bumps to head. this guy knows exactly the right words to say to get the reaction from staff he wants, and what he wants is to stay in the hospital as long as possible. recently he was head ct'ed 3 times in 24 hours by different residents until i came on duty and put a stop to it. i know that every situation is not like mine.

    most of the patients in my specialty are hospitalized for a week or less before being discharged. in this case, it's us residents that provide continuity. the current interns work 16 hr shifts daily, while pgy-2s and above do 28 hr shifts on on-call days. from what i've seen so far, both are longer than the nursing shifts; not only that, we're in the hospital for more hours per week than nurses are since we generally only have 1 day off per week. whatever. i don't want to argue about patient ownership anymore. i'm glad you take responsibility and ownership for your patients as i do for mine. my previous statement regarding this was more out of frustration and annoyance at the poster i was quoting. so, i apologize for even bringing this particular topic up.

    *** i get you. the vast majority of residents i work with are great. nice people who try their hardest to provide good care. there are some exceptions and of course the exceptions are the most interesting and thus talked about the most. i recently worked with a pgy-2 med resident. super nice guy, wicked smart, and very attentive to his patients too. in my roll i work very closely with them. in fact i get all serious calls before they do. i work them up and make the call to to the resident. by the time i call them we have data (assessment finding, labs, x-rays, etc) and i have already implemented emergency interventions (bi-pap, intubation, fluid boluses, narcan, d50, atropine etc) our last night working together he pulled me aside, shook my hand and said "pmfb i have learned a lot over the last two week, thanks for keeping me out of trouble while i was learning".
    a resident like that gets respect, consideration (grouping calls anyone?) and we let him eat from the never ending supply of nurses food in the staff lounge


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