Doc as partner

hellonurse36 · Sep 1, 2006

I worked in a small ER as an extern and had that same experience with many of our docs. I think some of it has to do with the culture of the unit you are on, as well as the particular MDs and what kind of day they are having as well as your attitude and how you present yourself. I now work at a large teaching hospital (CICU) and for the most part I feel like I am "part of the team". I find that if I participate in rounds, show interest in the plan of care for the day, give suggestions etc the team appreciates it, and I feel like I am being proactive in caring for my pt....of course, there are a few docs who are a "little less approachable" than others - I just say hi, tell them I am Mr. X's nurse today, he's had a good day (short update on any issues they have been following) and if they need anything let me know. I love when a MD comes by to consult. Usually they just sit down with the chart and start to figure things out. I will introduce myself as the pt's nurse and ask them if they want a run down on the pt's story. Most of them seem very appreciative and I usually end up discussing their consult recommendations with them and thus am "in the loop" on my pt's complete care path. I am a great believer in a team approach and try to work with everyone who is involved in my pt's care. Makes me feel more appreciated too!

Terri in Greenville, NC where Ernesto has cancelled school for my three kids!!

banditrn · Sep 1, 2006

I loved some of the docs when I worked in post-anesthesia - I tried as much as possible to take the patients from a couple of them because the other nurses couldn't seem to get along with them, and I did.

I knew what they expected as far as patient care, and I respected their reasoning - in return, they treated me with respect, and were willing to listen to me when I had suggestions.

Most of the other girls seemed to just want to sit back and back-stab.:uhoh21:

TazziRN, RN · Sep 1, 2006

That's a relationship you usually find in any critical care unit. I don't know why, but docs that I have heard from floor nurses sound like real b*stards are no problem in ICU or ER.

banditrn · Sep 1, 2006

That's a relationship you usually find in any critical care unit. I don't know why, but docs that I have heard from floor nurses sound like real b*stards are no problem in ICU or ER.

That's true, Tazzi. I had the same experience when I worked in ICU with the specialists - I think it was because we worked more closely together, and I'd been there so long that I knew almost automatically what these guys were thinking.:wink2:

TazziRN, RN · Sep 1, 2006

Some docs will, if they trust you enough, let you do some benign things without an order and then cover you when they arrive. I've never seen that happen on a medsurg floor, only in critical care.

Elisheva · Sep 2, 2006

I wonder if hospitals in larger cities are better about that. Big fishes in big ponds. I live in a rural area, mostly blue and gray collared workers, so the docs here are big fish in a little pond. Some have the mindset that they are minor celebrities - legends in their own minds, and the hospitals tend to cater to their whims. But the good ones are really good and much appreciated.

Guest717236 · Sep 2, 2006

I worked on 2 different crisis intervention teams, the Docs were great.

We were treated with respect and they relied on our assessments

of the patients . It was a true team approach. Since we were an

outpatient clinic with a few inpatient beds, staff had to function

closely as a team for safety.

It was one of the best experience I have had.........

Our Docs had compassion, one called me from a local breakfast place.

One of our patients was decompensating. He wrote a pink paper,

called me to have me call the police and waited with the patient.

He traveled 30 min to the hospital to check on the patient after our

clinic hours. We treated Doc to lunch as he did not get breakfast that am.

steelydanfan · Sep 2, 2006

I think that it is not where you work, but what you bring to the table; that will give you the respect you think you deserve.

One does not simply appear in ER or ICU, one gets to work there through dint of hard work and study. The reason ICU or OR or ER nurses are rewarded respect is because they did the hard work and study that allowed them to function in THAT area.

It's not that you come to work there, and are somehow respected; you are respected because you had the smarts and guts to GET to work there.

It takes YEARS of experience, training and education to even feel COMFORTABLE, nevermind calling this MD at 3 am to report some change YOU know is significant and have to make him believe you know your stuff.

steelydanfan · Sep 2, 2006

I loved some of the docs when I worked in post-anesthesia - I tried as much as possible to take the patients from a couple of them because the other nurses couldn't seem to get along with them, and I did.
I knew what they expected as far as patient care, and I respected their reasoning - in return, they treated me with respect, and were willing to listen to me when I had suggestions.
Most of the other girls seemed to just want to sit back and back-stab.:uhoh21:

Excellent post!

Sometimes it is about knowing your docs!

Elisheva · Sep 2, 2006

I think that it is not where you work, but what you bring to the table; that will give you the respect you think you deserve.
One does not simply appear in ER or ICU, one gets to work there through dint of hard work and study. The reason ICU or OR or ER nurses are rewarded respect is because they did the hard work and study that allowed them to function in THAT area.
It's not that you come to work there, and are somehow respected; you are respected because you had the smarts and guts to GET to work there.
It takes YEARS of experience, training and education to even feel COMFORTABLE, nevermind calling this MD at 3 am to report some change YOU know is significant and have to make him believe you know your stuff.

I guess my problem was that I "simply appeared" on a med-surg floor as a 4.0 grad who worked very hard to learn her stuff. Apparently, med-surg is the red-headed step child of nursing and only those smart enough to work in the units are worthy of being afforded any respect for their efforts.

Thanks for the attitude adjustment.

GatorRN · Sep 2, 2006

I agree, most such relationships are found in critical care units. It's true as well that some things can be done without an order, and when the docs come in they'll write one to cover you, but only in critical care. Critical care nurses work more closely with the pts, due to better nurse/pt ratios, and have more autonomy.

I've even had some docs ask me what I thought we should do for the pt, which I found very shocking the first time it happened. I think they understand that in CC the nurses can work more one on one, hands on, with the pts and therefore trust our assessment and judgement a little more, for some reason.