questions about dealing with docs...

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I'm a new nurse... although have spent my past 30 yrs. around the nursing profession and in the medical field.. have seen a lot, done a lot...now I need some clarification. Perhaps this comes as a result of having served in the military where the docs carried the rank, and therefore we all submitted to their say... but somehow, I still carry around this "outdated" concept of feeling that I must "obey" the docs.

It was a real eyeopener in school to learn about nursing autonomy and the nursing profession's view on this. But somehow, this past concept still lingers and I need some help in shaking it. I still find myself being intimidated by the docs (or at least FEELING like I SHOULD be) and like who am I to question them in ANY regard, or on ANY subject when it comes to patient care. I still allow them to make me feel like it's THEIR patient more than MY patient, and I struggle with knowing where I stand, where the line is, when do I question them, when do I make judgement calls on my own, do I have the right, and WHEN to do so, etc., etc.

Guess it's the old-school thing where the doc makes the decisions and the nurses implement his "orders" without question.

WHEN is it appropriate do do otherwise, how do I know, how do I stand up to it when it DOES occur.. are they "my boss" or not, can "they" have you fired.. etc. etc......... really need some help on this, some real clarification. I want to be a competent and responsible nurse, but I need further guidelines in working out

this issue to enable me to perform to my best abilities and know what I MAY and/or may NOT do concerning the docs. Thanx everyone, in advance. :)

I have a question. I've noticed a certain amount of "attitude" among SOME female nurses (I've never had a problem with a male nurse). I've always gone out of my way to be courteous and know it doesn't have anything to do with my behavior, because I've discussed the issue with other physicians (male and female) who've all noticed or dealt with the same thing. I'm honestly curious about this problem. Why are female physicians sometimes held to a different standard.

originally posted by nurse ratched

jnette - a phrase i love that you can use with docs when something seems weird in an order is, "do you have a minute to educate me on this?" it protects their fragile egos, keeps the working relationship friction-free and opens them up to give us valuable information (or backtrack and admit a mistake - i've seen it happen!)

...l like,..."what the he!! are thinking!"....lr:roll

.........................just kiddin......sort of......

Specializes in OB.

Dr. Lynn - glad to see another aspect of healthcare provider here! I can see a couple of possibilities for the attitude you are noticing. First, we as nurses may unconciously have different expectations for female providers (i.e.:we expect a certain amount of macho from the males and ignore it), we may be exhibiting exactly what we object to in others - I'm sure you have seen differences in treatment of male and female nurses and as another possibility - do an honest assessment of your own behaviour -many female physicians I have worked with, especially in their early years, have had to develop such an assertive/aggressive attitude to make it through their training, that it carries over into their practice. And honestly, can you say that you truly treat male and female nurses in exactly the same manner?

I'd enjoy continuing this as a dialogue/perhaps a thread on the subject of gender roles and expectations in the parallel fields of medicine and nursing - any interest?

Originally posted by Dr. Lynn

I have a question. I've noticed a certain amount of "attitude" among SOME female nurses (I've never had a problem with a male nurse). I've always gone out of my way to be courteous and know it doesn't have anything to do with my behavior, because I've discussed the issue with other physicians (male and female) who've all noticed or dealt with the same thing. I'm honestly curious about this problem. Why are female physicians sometimes held to a different standard.

Lynn,.....no one can possibly answer this question without knowing all the particulars....however l might suggest some possibilities...since there are far more female in nursing than males, you are maybe exp. the cattiness from females r/t the fact there are just more of them.....and coincidene on mere ratio/proportion...l have run into some males w/ attitudes believe me....not as many cause like l said...there aren't as many......How do you know it has nothing to do with your behavior?...you discussed the issue with other PHYSICIANS?...yeah...have you discussed it with the nurses in question?.....l can only speak from personal experience, and in the ER where l work....l can honestly say that our nurses treat male/female docs equally.....we do however express our concerns openly when we feel there is a possible problem with an order ect....and the docs who are felt to be less competent may feel the ire of the nurses....Does the staff see you as competent...and do you care?...or doesn't it matter cause.."l am the doctor"....l can honestly say that the past few attendings in our ER that the nurses influenced a change (one got fired)...were male.....Now the residents...that's another story...can't paint them all with a broad brush....some are great...those are the one's that frequently use the phrase, "what do you think about..."when COLABORTATING with nurses about a patient's care......the ones who aren't great...are the ones who hide behind the..l am the doctor..attitude........

One last question for you...you addressed yourself to us as DR Lynn...is Lynn your first name?....did you want to establish an open equal style of communication with us?...why didn't you use your first name......l can't judge from here...but is it possible your attitude isn't as curteous and respectful as you think????ask the nurses you work with if you REALLY care to know...then get back with us...we will be waiting to hear...........good luck to you...LR

Dr Lynn, I think that is really interesting. I had a conversation with a female doc about this recently (she is of the older generation and has been a doc for over 25 years). I personally don't think women are normally more catty or have more attitude than men do, but I do think it is often taken that way. When a male nurse becomes assertive it is completely accepted, but this is often not the case when female nurses act in the same way. I wonder if this is why some of them start acting with "an attitude".

The doctor I talked with said she also realized that early in her career she had contributed to this problem because she was always worried that she wouldn't be as respected as the male docs. In order to make up for this she was always tight laced and authoritarian, (a stark contrast to her behaviour nowadays!) which caused nurses to react to her in a certain way.

Personally my experience with the women docs has been positive overall. You want to talk about a group with attitude problems and I nominate anesthesiologists;)!!! Them, I have had some problems with!

Bagladyrn,

Thanks for your response. I could be wrong, but I honestly don't think it's my behavior. As I said, I've discussed the problem with other physicians. The women said they'd dealt with it too and the men said they'd noticed it. It doesn't happen with every female nurse, just some. After getting to know me, the attitude ALWAYS disappears and we get along great. It just gets old having to prove myself. Sometimes I just want to be the b!tch they apparently expect me to be. Regarding male nurses, I think that they are treated differently, but I think the reason for this is in THEIR attitude. They tend to be very confident and are quick to both give and demand respect. If everyone behaved that way, we'd all get along great. Oh well...thanks for letting me vent.

Specializes in ICU, nutrition.

Dr. Lynn, I, for one, do not deal with female doctors in a way that's any different from how I deal with male doctors. I feel that none of us benefit if anyone is using an "attitude" towards others, whether they think they hold a position that's more important or not. The only time I've displayed an "attitude" toward a doctor was when I'd called with a pertinent change in the patient's status and not gotten any orders or even feedback, other than, "Why are you calling me?" repeated over and over until I hung up. I don't display "attitude" toward the RTs, techs, secretaries, or anyone else I work with, for that matter, except when I feel they've overstepped their boundaries (like barging into my patient's room to do a test before they come ask me if it's OK to do it right now).

Having said all that, I don't really deal with female doctors too often. I think we have one neurosurgeon, one internist, and one hematologist who are female whose patients I see fairly regularly in ICU. Other than that I deal with mostly male doctors and an equal mix of male and female NPs. I treat everyone with respect, but I can count on one hand the number of docs I will go out of my way to assist (my favorite is when the doctor comes barking up to the desk, "Where's so&so's chart?" BEFORE looking in the spindle). And I've actually seen doctors pout because Dr. So&So has the chart so he can't see it right now and actually expect me to go take it away from Dr. So&So because Dr. Pouts-in-the-corner's time is so much more valuable than Dr. So& So's.

Then of course there are those famous doctors who show up at shift change and expect us to stop report, give them the chart, and sit at breathless attention while he thinks of some orders. I don't mind answering questions, but if you want vital signs, look on the chart, because that's where I'm going to look to tell them to you. I don't have them memorized. And I don't have all the patients' meds memorized either, so you can look on the MAR (which is on the clipboard beside my nurse's notes) to see what the patient is taking. I am there to take care of the PATIENTS, not the DOCTORS, and if I need to check on a patient while the doctor is perusing the chart, I will get up and leave him. I always give a brief update as to how the patient has been doing and point out pertinent information (pt went into a-fib last night, BP is crapping out so I gave her a fluid bolus, urine output is at a minimum, K was 2.9 this AM, etc) but if my patients need me, you're on your own.

One more thing: write your orders legibly because when I'm doing my chart check at 2AM, I need to know what it says, and I really don't want to have to call you to verify it at that time of night.

Finally, it's refreshing to see that a doctor would spend some time asking what nurses thought and seeing what sorts of things they discuss on a bulletin board. I deal with doctors in ICU that listen to nurses and respect what they have to say, but I know many nurses in other areas who feel disrespected by some in your profession.

(BTW, I used "he" in all my anecdotes about doctors because the doctors who actually did/do those thing are all male. Most of the female doctors I've dealt with don't do those kinds of things...well, there is this one...)

I.rae,

Yes, Lynn is my first name. I am on a first name basis with many of the nurses I work with (although THEIR supervisor reprimanded them for using my first name). Also, my competence has never been questioned and several nurses have told me I'm the best resident they've ever worked with. If fact, on more than one occasion, I have been the one they vented to about OTHER docs. I treat everyone with respect and only ask for the same in return. Like I said, this is not a problem with all nurses and certainly not the ones who know me.

Why is it that nurses have to tip toe around a doctor's ego when they go out their way to insult, belittle and god knows what else some get a way with? I say the best way is mutual respect for one another! My philosophy I don't go out my way to kiss anyone's ass but I do give respect and will expect it in return.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Dr. Lynn:

Welcome to the board! I guess, I have no useful contribution to your part of this thread---just wanted to say a few things. I can tell you this: we nurses have to "prove ourselves" all the time on the job w/each new dr. (and fellow nurse) we meet. I think this is sometimes inherent in nursing and medicine, like it or not.

As an experienced nurse, wherever I have started a new job, the doctors seemed to "put me thru the paces" as if to test my abilities out....also the new colleagues did this, to a degree. It is hard to take at times, but I don't let it get to me. I just do my job, honestly and thoroughly and let them see who I am and how capable I can be. If after that they don't like me, oh well, I am not there to make friends anyhow. USUALLY, With time, I see satisfying results.

So, Dr. Lynn, I think many of us can relate to what you are saying. I honestly do NOT treat female physicians any differently than I do males, and treat ALL people with the respect and dignity they deserve as human beings. I practice this same degree of courtesy with everyone from the housekeeping staff to the CHIEF of staff. I wish you Good luck to your in your career as a physician and again, welcome to the board. Always glad to have input from many different people.

Specializes in LTC, assisted living, med-surg, psych.

I've found that I usually get what I ask for (even from the jerks) because I make sure to do my homework BEFORE I call or fax with a request. Doctors, like nurses, don't have the time to deal with incomplete or erroneous information, and they appreciate it when we know what we're talking about. Most of them also appreciate it when we offer suggestions, even though they may disagree with us and veto any or all of our proposed solutions. It helps to not be easily intimidated; after all, doctors put their pants on one leg at a time just like everyone else, and no matter what some may believe, none of 'em walk on water! But as long as we approach them respectfully and behave in a professional manner, the majority will almost always be willing to consider our viewpoint. At least, that's been my experience so far, and I work with some MDs who are notorious in our area for being snotty to nurses; in fact, I've developed pretty good working relationships with most of these docs. (There are a couple around here who won't take ANYBODY without an MD behind their names seriously, but there's always gotta be one or two rotten apples in every barrel.......!);)

Originally posted by Dr. Lynn

I.rae,

Yes, Lynn is my first name. I am on a first name basis with many of the nurses I work with (although THEIR supervisor reprimanded them for using my first name). Also, my competence has never been questioned and several nurses have told me I'm the best resident they've ever worked with. If fact, on more than one occasion, I have been the one they vented to about OTHER docs. I treat everyone with respect and only ask for the same in return. Like I said, this is not a problem with all nurses and certainly not the ones who know me.

Lynn, welcome to the wonderful world of medicine...sounds like you are a fairly young doc....oh my,but this medical profession can be so cut throat!...l am glad you are on 1st name basis w/ nursing staff....we are w/ most docs too...but in front of pt l try to always use title...for the pt's sake as well as the doc......if the nurses feel you are competent...that is a great compliment to you...cause nurses have a true knack for knowing who giving appropriate care to patients...for one reason, it is the nurses who monitor the progress and response to the treatment that is ordered.....

Unfortunately, some people are just mean....there are thousands of reasons, don't let it discourage you...it is the same for us nurses too......keep following the Golden Rule and you will come out on top.....The absolute worse/meanest/nastyest nurse l ever worked with was male....he had short man syndrome...yuk..he was horrible....they are out there in all genders, sizes and colors and titles........good luck to you......LR

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