Where I work, doctors never speak to the nurses unless A. the nurse calls/physically hunts them down or B. the MD has a verbal order and doesn't feel like logging onto a computer.
I was just thinking yesterday, as I kept missing the doctors as they came to see the patients (at least I assumed they saw the patients because hours later I would see progress notes pop up), that there are probably not many other jobs where different people working on the same "project/goal" (getting the patient better/discharged) never actually speak to each other about "project".
There are a few doctors who come to me and ask about the patient and verbalize their plan and ask me what I think and I share my nursing opinion and we have a nice discussion (maybe 5 MINUTES LONG) and the patient care is better for it.
I just don't get it. A 5 minute conversation would also minimize later phone calls/issues/missed things. . .
Are nurses that awful to speak to??
ALSO, my biggest pet peeve is when the MD writes "discussed with RN" in his progress notes when he/she NEVER SAID A WORD TO ME. That happened 3 times yesterday with 3 different physicians.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
My experience has been like the others as far as doctor-nurse communication. A collegial environment enriches every aspect of the job and (my unscientific opinion :-)) probably improves the quality of patient care. The only place where this was not the case was a snall surgeon owned hospital which I now call an Unnecessary Hysterectomy Mill - the surgeon was an egotistical jerk whose attitude permeated the whole place. If the top brass at your hospital has a dysfunctional attitude it may be "rolling downhill" - not much you can do about that, but it means that some aren't aware and may be amenable to approach. . .if you can catch them that is!
Specializes in Medical Oncology, Alzheimer/dementia.
For the most part there is really good communication between our doctor and the nurses, especially with our hospitalists. But there's one MD in particular that comes in, sits down at the computer with the chart, goes to see his patient, comes back to write orders, and leaves. He gave up so many opportunities to talk with us about their care.
Then there's another one who comes in, won't even greet or acknowledge us...then wants to be all cool with you when he needs something.
It's like "oh, I'm good enough for you to talk to now?"
Your post is about docs but u will give my perspective as covering provider.
I always try and talk to the nurses for the patients I round on. There are times when it doesn't happen, unfortunately. I do try and touch base via the phone in these cases but it isn't always possible. I very much value the nurse's opinion and I hope they call m with anything they might assess that I missed.
The two biggest causes for me missing the nurse is med pass and report. I try to avoid disturbing nurses while passing morning meds, which is normally the same time I am rounding. If nurses are in report, same thing. I will try and catch them both before and after I visit a patient but if they aren't available at either of those times and it is busy, I have to keep moving.
Just as new students should spend some time shadowing nurses so should nurses spend time shadowing providers. Neither is sunshine and rainbows.
All residents I've worked around have been polite and try to talk to the nurse in charge of their patients. As a night shift nurse, we do miss out on being a familiar face and voice to them but very rarely have I come across a rude doctor.
I really don't care if they speak to me in the hallway randomly but to ignore me in the room like I'm a plant is unacceptable.
Where I work I see a mix. Some doctors are wonderful, they may not hunt down the nurse, but always take our concerns or suggestions seriously. Almost all the specialists I work with are wonderful - some of them, a couple surgeons in particular, go out of their way to say 'thank you' and see how my shift went, especially if I've had to call them overnight. For the really sick patients, they will call for updates and ask if we need anything. They write their cell phone numbers down and will come in during the middle of the night if we call with serious problems.
Then there are the others. There are doctors who do NOT talk to nurses or couldn't care less about what we say. I think there was one who found out recently that I am happy to write up an occurrence report for grossly inappropriate orders. There are several doctors who do not answer pages, are AWFUL to call (to the point that some of our 'mean' nurses will volunteer to call them for new hires), and at least one who goes out of his way to do the exact opposite of what the nurse suggests/asks for.
I love love, love, some of my doctors. And I mean bake cookies for them at Christmas love. Then, there are doctors I tolerate. And one doctor that if he collapsed in the hallway I'd keep walking. I wouldn't let him treat the dog that bit me. The patient care is SO much better when we work together - I wish they all understood (or cared) about that.
To the poster who suggested going to med schools and the like, there are some that do that.
I had a MD that I kept having to call him later in the day to clarify things. I'd always start the conversation with, "Sorry I have to call you to clarify, but I missed you rounding earlier today so I don't know what you wanted." Eventually he started finding me. Still avoids all the other nurses, but he'd find me when I was on the floor and had his patients. Passive aggression used for good instead of evil. :)
In our facility (teaching hospital), the supervising docs started emphasizing to all the residents that they need to ask for the nurse during rounds. If the nurse is available, he or she is to be included in rounds. This has really improved communication. It also raises the standard a little for nursing. Nothing is more frustrating than getting report from an overnight nurse who can't tell me why a patient is NPO, whether the patient has actually gotten out of bed, at least a guesstimate of I&O, etc. I know I'm going to be asked these questions 10 minutes after report when the docs start rounding. If we can't answer those questions, it really downgrades the credibility of nurses to the docs, they rely on us less, and they have less motivation to include us in discussions. I've had good shifts and bad shifts. But I find that when I'm on top of my game, the docs take far more interest in including me. It feels good when I can point out an assessment finding that the doc's hadn't noticed yet - like a patient's off-handed comment that their peripheral vision is blurry, or that I noticed new pedal edema.
While not really related to the shared "project", one thing that really irritates me is the docs who walk down the hallway, and completely ignore me when I say a friendly hello (no hello, no smile, no nod, no eye contact, nothing). I don't know of any other type of workplace where this rudeness would be the norm or OK. Luckily the docs doing this are not typically docs for patients on our floor.
Failure to communicate is one of the largest reasons for medical error! I am currently working on my capstone project and my survey will be posted on this site shortly. Safety Huddles are now being adopted all over to bring awareness, to prevent errors before they happen, and basically so everyone is one the same page with a patients plan of care. These huddles have been proven to be very successful if everyone speaks their mind. But what happens if nurses and DR's are afraid to voice their concerns? All disciplines have been trained differenlty how to communicate. We need to all be effective communicators in order to ensure safe deliverance of care.
nursel56
7,122 Posts
My experience has been like the others as far as doctor-nurse communication. A collegial environment enriches every aspect of the job and (my unscientific opinion :-)) probably improves the quality of patient care. The only place where this was not the case was a snall surgeon owned hospital which I now call an Unnecessary Hysterectomy Mill - the surgeon was an egotistical jerk whose attitude permeated the whole place. If the top brass at your hospital has a dysfunctional attitude it may be "rolling downhill" - not much you can do about that, but it means that some aren't aware and may be amenable to approach. . .if you can catch them that is!