Doctors at Clinicals?

FORTHELOVEOF!!!! · Apr 24, 2012

I ignore them for the most part, they are busy, they don't have anything to tell me that they don't tell the nurse or write in the chart so I just stay out of their way. Ask your nurse if you're interested in what they told her and check the chart. Every clinical site will be different though, just go with the flow.

Esme12, ASN, BSN, RN · Apr 24, 2012

I am starting nursing school in the fall and was just curious about whether nursing students have any interaction with the patients' doctors at clinicals. Do you work as a team or is it really just the staff nurse that partakes in meeting with the doctor?
[ I'm aware there is a rule against taking an order from a doctor]
Thanks in advance.

Your focus at first will be to focus on the patient care and learning the basics. Interaction with the MD's will come much later. As a student you may not take any orders from the MD.

NCRNMDM, ASN, RN · Apr 24, 2012

It's true that you can't take orders for an MD as a student. However, some of our instructors want us to call the doctor and alert him/her of changes in patient condition just for the practice. We will call (with our instructor and the unit's charge nurse by our side) and give a quick run down of SBAR. We will then hand the phone to the charge nurse and let her receive any new orders. We also sometimes happen to be in the room when the docs come to check on their patients. Here's an example.

One day at clinical, I was in the room doing a head to toe when the doc walked in. I asked if he wanted me to leave, and he said no. While in the room, he began asking me how the breath sounds were, how the bowel sounds were, what the vitals were, how the heart sounds were, etc etc. He then let me look at the surgical site with him, and he described a lot of things to me. It was a great educational opportunity, and it was a good way to get over some of my fears about speaking to a physician.

You will have some opportunities with the docs, but you won't really get into that until you are an RN on a unit. Don't seek out exchanges with the physicians, but if the opportunity presents itself, don't run from it.

symphie · Apr 25, 2012

Just like with nursing staff, or staff in general, you will find some who are very helpful and some who really don't want you around. Usually doctors are willing to let you stay in the room when they're rounding on patients, which is VERY helpful. If you see a doctor going into your patient's room to assess or talk to the patient, go in with them. You are considered part of the healthcare team and have every right to go in and listen to the patient's plan of care.

Some doctors will go above and beyond for you, too. I had one doctor in particular on my OB clinical floor who would pull students into the room every time he saw us and teach us something new. He even remembered what he'd taught to who already! We all sent him a thank you card at the end of the semester.

First semester you'll be focused more on patient care than assessment, so you won't be as involved with the doctors. But don't be afraid of them. They can help you learn so much, just like the nursing staff.

KelRN215, BSN, RN · Apr 25, 2012

Not much. I would suggest that you take it upon yourself to go into your patient's room during rounds so that you can hear what the doctors talk to the patients about (they hardly communicate that with the nurses, so they certainly don't with the nursing students) and you'll get a better idea of what's going on with your patient. If there is a change in the patient's condition or something that warrants notifying the MD, the patient's nurse should be aware and should probably be the one to call the MD since he/she is the one ultimately responsible for the patient. In certain rotations (L&D, Psych) when I was in school, there seemed to be more contact with the MDs just out of necessity.

If there is a "meeting" to be had or anything, it's sometimes best for the student to not participate. If it's a team meeting and just involves the professional people, absolutely try to get in and see what they discuss about this patient and the plan moving forward. If it's a family meeting, and the medical team, social work, case management and nursing are already there, in my experience it overwhelms the family even more to add students to the mix.

When you do your final clinical- preceptorship- is when you should really start to interact with the doctors more. That's one thing I wish I could have got my student to do more when I had her last semester. It just so happened that she'd be there on the stable shifts and the next shift I'd come in and the same patient would be coding with the rapid response team there or would have acutely developed cerebral salt wasting in the 12 hrs since we left.

anonymousstudent · Apr 25, 2012

It has been dependent on the facility in my experience. I very rarely speak to attendings, but the residents are always around, and depending on the area of expertise, are more than glad to have lengthy conversations with me about my patients and why they are doing what they are doing. I've actually learned a lot through this process. They obviously don't focus on the things we focus on as far as how the view the patient, but you can get tons of really helpful information from them. I also agree with standing in during rounds. MANY times my patients have been so doped up they don't even remember the doctors coming to see them. I have been able to verify for them that they were seen, which diffuses a lot of anger, and I've been able to pass along information and reinforce teaching.

dee78 · Apr 25, 2012

I did most of my clinicals at a teaching hospital so they are used to students/residents and the learning environment. I made a point to stay in the room if the residents were rounding, I learned while they learned. I interacted with doctors as much as they were willing. Since it was a teaching hospital, most were willing to teach when they realized I was eager to learn.

Remember with most things in life, you get back what you put into it.

turnforthenurse, MSN, NP · Apr 26, 2012

We didn't really interact with doctors. I would round with them and with the RN I was with but that was about it. As a student you are not allowed to take orders from them. I remember I was in my geriatric rotation and an MD came by and started giving me orders. I told him I couldn't take orders from him because I was just a student and he smiled and said to me, "don't ever say you are "just" a student" and walked off :)

Katie71275 · Apr 29, 2012

We are encouraged to be in the room when the doc is rounding so that we can hear what his plans are and his assessment. Most of the doctors our our facilities(not all though!) are aware we are students and are very helpful in explaining to us what they just said.