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.
I sincerely appreciate that the MDs sometimes discuss pt care with the day nurses, because we generally funnel our concerns through them.
I don't work nights or on the floor anymore, but when I did have issues that were not critical enough to call the covering physician, I would make sure the issue was relayed to the day shift nurse, and would document and place a note on the front of the chart for the physicians to see. That is the nice thing about day shift, physicians, social workers, and other departments are all in building so it is so much quicker and easier to get stuff accomplished
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 can't "like" the above post enough.
This is an excellent point -- that meaningful communication needs to flow both ways.
It seems to be a trend in many of these posts that teaching hospitals seem to be a bit more collegial. I found the exact opposite. At my last hospital, we have private docs and an academic program. The attendings and residents were much more aloof, less likely to come find us, and less likely to ask our opinions. The privates usually treated us very well and respected our input.
The whole "doc vs. nurse" thing needs to go the way of the Dodo.
While the OP's post sounds like theirs is a general culture, sometimes, I think it's nurses getting their panties in bunch over feeling "disrespected" over minor issues with docs, that is 50% of the problem.
I think being pleasant, helpful, and knowledgeable goes a long way in collaborative relations with docs. That said, there are always those outliers that are just plain disagreeable overall, incompetent, and shouldn't be in medicine. I've come across a few RN's that have popped out of that same mold.
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.
Maybe they're just as busy/stressed as we are, and don't have the mental/physical energy to smile and nod at every person they pass in the hallway.
Not that this would ever actually happen, or any benefit would even come from it, but sometimes I fantasize about a group of nurses going to the medical students' classrooms each semester and being kind of like guest lecturers on doctors and nurses working as a team. Or even occasional meetings with physicians and nurses where issues with things such as communication can be addressed. A meeting where we can share our side and they can share theirs. Where we can say what works best for us and how they can help reduce our workload and vice versa. In the perfect world, doctors and nurses should work together and make each other's work days easier. Something as simple as "hey doc, how about you put that chart back where it belongs after you're done with it so im not wasting time running around looking for it later." Ok, lame example, but point is I'd like more of a dialog with the doctors and get on the same page.
I've actually known of nurses, dieticians, various therapists, and social workers who regularly addressed med students on particular areas of their expertise. Don't feel like you can't be an agent for positive change. But you might have to do the initiating. Don't fall into the trap of thinking something could never change. you just be the one to start the ball rolling. And please don't wait for others or start being a complainer but taking no responsibility to help others understand your thinking. Go slowly but get goin'. I want to read about you, Sleepy RN, in Nursing History someday and the great changes you helped bring about to our profession.
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.
Sigh.
Start with simply greeting the doctors. And if you can do it gently, find out if you are the nurse referred to in the docs' charting.
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.
Well, maybe they are hard of hearing? Focused elsewhere? Shy? It might not be a status, race, age, gender thing at all. Not sure? Forget about it, pray, ask if you can help them with anything. It's probably been a long time since a nurse volunteered to help them.
Specializes in orthopedic/trauma, Informatics, diabetes.
I think they get in their heads and may not realize what is going on.
Where I am, we had a boatload of residents, most are really nice. The attendings are also pretty good. I worl weekends and a lot of the attendings take the calls one the weekends.
A neuro resident told me that he had 65 pts that he was responsible for on Sat. They aren't all on one unit either, so he was pretty busy, but he did take the time to talk to me.
I love the ones that TOTALLY ignore the nurse and it comes back and bites them in the butt. They learn pretty quick that need to listen the nurse.
I MAKE them talk to me. Actually we have many docs who do embrace the value of the nurses' input and like to touch base with the nurses as much as is possible, and some who are a little more reluctant about it. It helps that the over all culture leans toward doctors and nurses communicating.
I seek them out. I always say hello to all of them by name even if I don't need to talk to them. I have worked at this place for over six years so I know 98% by name and face.
I've won over some well-known resistant doctors simply by persisting at wishing them a good morning, initiating discussion, and little by little becoming that familiar face who, once they start listening to/talking with, becomes a trusted source of information.
It's so much easier to work with them when they know you. You aren't an anonymous face or voice on the phone. I'm fighting that antiquated notion that doctors are superior beings. Of course they have more education, more responsibility , and a different role than I do. But we are all working for the same goal -- to provide the best care to our patients. So it makes much more sense to work together.
Not that this would ever actually happen or any benefit would even come from it, but sometimes I fantasize about a group of nurses going to the medical students' classrooms each semester and being kind of like guest lecturers on doctors and nurses working as a team. Or even occasional meetings with physicians and nurses where issues with things such as communication can be addressed. A meeting where we can share our side and they can share theirs. Where we can say what works best for us and how they can help reduce our workload and vice versa. In the perfect world, doctors and nurses should work together and make each other's work days easier. Something as simple as "hey doc, how about you put that chart back where it belongs after you're done with it so im not wasting time running around looking for it later." Ok, lame example, but point is I'd like more of a dialog with the doctors and get on the same page.[/quote']
I would so love to do something like this. I think it's truly a valid point to discuss team work in this setting. I also think it could work both ways -- with doctors discussing with nursing students ways of working as a team and what they appreciate most of the nurses they work with.
For instance, I hear a lot of nurses say, "Don't hand-hold them. They ordered that INR. They should look it up." However, I have that patient in front of me, while Dr. Awesome is in his clinic all day seeing other patients for a multitude of issues. Yes, I'm busy with all my patients but he is busy too, and I'm his eyes while he's away, so I think he'd appreciate me giving a heads up on an abnormal lab.
I actually had this very discussion with a student I was precepting, and one of the GPs joined in the conversation to agree with me that it is very helpful and appreciated.
ChristineN, BSN, RN
3,465 Posts
I don't work nights or on the floor anymore, but when I did have issues that were not critical enough to call the covering physician, I would make sure the issue was relayed to the day shift nurse, and would document and place a note on the front of the chart for the physicians to see. That is the nice thing about day shift, physicians, social workers, and other departments are all in building so it is so much quicker and easier to get stuff accomplished