How to build good relationships with MDs?

[RoyalNurse]

Hi everyone,

I work in a CVICU, have a little over a year of experience, and have noticed that I have a "friendly stranger" relationship with most of the MDs on our floor.

Meaning I tell them info if I know it when they ask, or look it up if I'm not sure, they write orders with little to no consultation from me, and I'll tell them any issues I have at that time. Then they leave, and I'll call them back if anything else comes up. If I ask a stupid question, or if I don't know something right away, I get hostile behavior most of the time. Which has made me wary of asking questions. I have learned to get information in a round-about way, reading their notes after they leave, asking other nurses, looking stuff up on Micromedix.

I see other nurses actually talking to these docs, joking around a little, putting in seemingly valuable nursing input, and looking very comfortable while doing it. They seem to have no problem asking any questions, even stupid ones, and don't seem to get the same treatment I do when they don't know something. I know the patient gets better care this way, I think less gets missed or overlooked when you have these type of relationships with medical staff.

Maybe I'm too sensitive? I'm sure it's something to do with me, almost every doctor I encounter has this attitude towards me. I greet them with a smile, and always act professional, and I don't play any games. Maybe I appear too standoffish.

Any suggestions?

Thanks for any advice! :)

[FLmomof5]

I cannot say what you can do because I am not a nurse yet..... but here would be my .

I was commisssioned a 2LT in the USAF in 1985. My father was a LTC in the USAF on the date of my commissioning. It was not unusual to have LTCs, COLs, and GENs at our home. I learned that they were men like any others. I didn't have the "awe of rank" that most 2LTs had. I treated them with the respect due them, but didn't respond in fear and was confident among the higher ranking officers. They responded in kind.

The other nurses have probably been there longer and have had opportunity to work with the MDs more and they also have more confidence in their work because of their experience. Treat the MDs with respect and always be kind. Give them a smile once in a while. Thank them when there is an occasion to do so. Be confident in what your ARE able to do and things will improve in time and they get used to working with you.

Good Luck!

[MinnieMomRN]

I'm a new grad, so I have all the novice nurse anxiety that goes along with it. It can be intimidating to be around so many more experienced nurses and docs. One thing that I have found to help is to take initiative. If I see a doc writing orders, I will go up to him or her and say "Hi Dr. XYZ. I'm the nurse caring for Mrs. PDQ today." Most docs jump right in and are willing to tell you what the plan for the day is, and answer questions. I have found that they like to be approached rather than try to find me. This has also cut down the calls/pages to them later, and when I do a relationship is already established so they are less grouchy (if at all). Good Luck!!

[RNperdiem, RN]

My relationships with the docs are "friendly stranger" too.

I am an introvert by nature, and cannot do the chatting and joking that some other nurses do.

I stick with being polite and professional. I make a point to listen to what is happening on rounds and bring up patient issues then. Bringing up patient issues is part of being a patient advocate, and it does not come easily for me. Doctors would rather you speak to them on rounds than be paged later.

[azhiker96, BSN, RN]

First build up your professional relationship. Once they respect you as a professional, you can add in some interpersonal items.

For the professional part, remember they are doing a job also and make sure you don't interrupt them without a pressing reason. When they are reviewing a chart they are taking in data and processing it with what they've learned and experienced. If I butt in, it interrupts their thought process and they lose valuable time. Now if I have a good reason such as the pt's BP is 220/106 or the pt is apneic, they usually don't mind. If it's to mention a ballgame score, I'm treading on warm ice.

It also takes time. The doctors need time to build up their trust in your assessments. One thing that helps is if you talk to the doctors with data rather than conclusions. If I tell a doc their pt's bp is high, they then have to ask me "How high is it?" Instead, say pt's bp is 182/94 and then the doc can either ask for more data or give you an order without wasting time.

Once you've established a good professional rapport then you can sometimes find an odd moment to talk about non-work items. I spent several minutes talking with a neurosurgeon about the sale items at a local organic food store. Found out he does a lot of the cooking at home. I just mentioned it to a fellow nurse and the surgeon looked up from his notes and joined in.

[classicdame, MSN, EdD]

Once they learn they can trust your judgement they will probably come around.