Does This Place Exist?

Just curious. Does ANYONE work on a unit or in a facility in which there is true collaboration between the nurses and physicians? One in which the doctors REALLY care to listen to what you have to say and value your opinion and actually discuss with you treatment options for the patient? Also, do you feel that you have a measure of control and autonomy in your work environment? (Or, is it 'management's/doctor's way or the highway'...)

I work on a inpatient rehab floor, and it is very much like you have described. We have one doctor that can be a butthead at times, but he always eventually listens to what we have to say. In our unit, management does listen to what we have to say.

I know, hard to believe, but true!!! Amazing, isn't it!!!

Yes, Vicki, there is such a place, and I work there.

Granted, we are not a hospital, but a dialysis facility, and we have one nephrologist (our medical director) who visits monthly, so he really relies on and values our observations, assessments, and input. We are quite autonomous in our dailey interactions and tx. of our patients, although we do follow the governing body policies and procedures as our guidelines.

He has recently added a Nurse Practitioner to make more frequent rounds as he is two hours away. She, too, is quite accessible and open to our input and it is more of a team effort between all of us.

Now, if we could just get the "company" to act accordingly... ... even the doc would like to see this happen !

Yes there is. The OB unit that I work on is great. The doctors are very respectful of the nurses, which is a first for me too. Most of the nurses work well together too, with the exception of maybe two...you always have to have a few bad apples.

Wow! So happy to hear that these places exist. Hopefully this will become more and more a trend for the future.

It is a realilty where I work as well. Granted it is not a hospital, it is a ped clinic. The doc i work with is wonderful. She is very personable and very thoughtful. She discussed patients and is always willing to listen to nursing concerns and eager to explain anything. She is wonderful to learn from. It makes all the difference to work in an enviroment where your valued and respected.

Just curious. Does ANYONE work on a unit or in a facility in which there is true collaboration between the nurses and physicians? One in which the doctors REALLY care to listen to what you have to say and value your opinion and actually discuss with you treatment options for the patient? Also, do you feel that you have a measure of control and autonomy in your work environment? (Or, is it 'management's/doctor's way or the highway'...)

That type of unit does exist, we have one, our PICU has a great medical staff and a great nursing staff, they all work together. It helps that there are only a few Peds intensivists, 4 to be exact and they all get along with each other. They respect the nursing staff and listen to them, the nursing staff have great respect for the doctors. There is a lot of trust there. Everyone is on the same page with the same focus, the patients. They do great work up there. :balloons:

Many of us in our critical care unit have worked together for more than a quarter century. Some of us came as new grads, others with much experience. We respect and like each other yet know each others faults too.

We have attended weddings, graduations, and funerals.

Nurses from all over this continent and from Europe, Asia, and south of the equator are part of our team.

A couple were not meant to be critical care nurses and have transferred.

When floating to telemetry or med/surg we get to work with friends too. Former registry and travelers have come on staff.

Our manager was recruited from overseas with experience. After a few years as staff she is now our boss. We treat her as boss at work and more like a friend at parties.

All our docs have known us that long, or we remember when they were interns. This is good because we don't take it personally when one yells at us when we call at night. Useless to change it. He is a great doctor and friendly man during his normal waking hours.

When we attend conferences we have an informal session in a conference room over breakfast after work to share what we learned.

I represent my unit on a committee that advocates for quality patient care and working conditions for nurses. The top management is mixed. Sometimes I suspect they play "good cop, bad cop".

But guess what? All out units are following the new ratio law. Most of the time we staff to acuity and have releif for meal and rest breaks too. Now we are trying to get a lift team!

The NICU benefits when one of us suffers a back injury. LOTs of training is needed and our committee so far has succeeded in getting the training for nurses who transfer.

Of course there are problems. We get frustrated with each other. One of us is downright rude to new nurses until she is confident in thier skills, so whoever is preceptor warns them on the first day. Later they often become good friends. I am told by some that I am an asset most of the time, BUT on the rare quiet night I talk too much.

SO, I try not to. Just wait for my break and read and post on ALLNURSES.COM

I sure don't, and it's a "Magnet" hospital. Wish that I knew where such a place exists.

I work with docs who collaborate with the nursing staff in my ICU's...but this has been more a personal decision/style of the doctor and has not been part of the 'culture' of the place.

Smaller units like rehab where a few docs manage care seem more amenable to a team approach ... maybe this is similar to the physician who can be a bear to hospital staff, but treat their office staff well. Perhaps this has to do with a closer working relationship in a smaller setting (and less outside influence from other doctors egos ?)

Sometimes I suspect the poor treatment many doctors give nurses is due to peer pressure and the need to 'control' us women and keep us in our places. The age old battle of the sexes..ugghh..and they look at us as a 'female' profession yet.

As to control: well in ICU I have a BIT more clout than I did on medsurg, but its still management bowing to the docs come crunch time. TPTB tend to listen when I say 'no more admits..we can't safely handle it' where on the floors the admits just show up no matter what the charge nurse says.

No I don't feel I have much control over my work environment.

There are MDs that collaborate and listen to the nurses, but we're the one's who have to seek them out and tell them what we find and what we need for the patient. They don't always actively seek us out. I think everytime an MD rounds they should speak with the primarily nurse to find out what's really going on.

Jnette, I hate to say but here the nephrologists are awful, arrogant and jackasses, almost all of them.

It doesn't exist in the OR where I work.

Christine

Thanks for sharing your perspectives. Doesn't seem to be much of a pattern, just someplaces are like that and others aren't. Does Magnet Status help at all? (One BIG teaching hospital in our area has just been 'magnetized'--morale still seems pretty lousy).