Long time lurker. Really appreciate all the hard work ya'll do! I'm a medical student starting a MICU rotation. I know the MICU is a very intense environment with a lot of strong personalities. Wondering what are some of the things I can do or avoid doing as a medical student to perform good patient care while still staying on an ICU nurses' good side (whether as a student or even as a future provider?)
Also, as a student, what is a good way to ask for overnight events for a patient? I noticed when I started today that whenever I asked any of the nurses if there were any overnight events, they would get angry and annoyed like I was wasting their time? Is there a better way to ask these types of questions? Should I be more specific with my questions?
Well, I don't know that someone bringing food to try to be nice is patronizing. Obviously, you can't form any real relationships with people just by bringing them gifts/treats/etc, but patronizing seems an over the top way to describe it. Generally, I think it shows that you have at least thought about your colleagues and would like to open a better relationship.
This person came here to get advice on how to start to form relationships with nursing staff, and I mentioned it is not a bad way to break the ice. Certainly this person has to make intelligent decisions and absorb as much as they can while in the ICU, and also has to share a bit about themselves if they are to really get to know anyone. Trying to offer simple advice.
Simple as that! Sorry if it rubbed you the wrong way!
The one thing that makes me annoyed at residents is when they order labs at "the end of my shift" that could have been ordered earlier. There is an unwritten rule that you should get all of the work "written on your shift done on your shift" and if you write orders at 0650, I'm probably going to stay late to do those labs. Thus, if feasible it would be preferable (unless truly stat) that you write the order for say 0730. Otherwise, you shouldn't have to work to get on someone's "good side" it should be their default. If you have too hard it's probably them that has the issue.
Step one...seems so simple and yet I’m constantly amazed by the number of students/residents/etc that don’t bother...introduce yourself, learn my name, tell me why you are there...just questions, observe a procedure, tertiary assessment, assist with something...don’t just show up or bulldoze your way in.
Step two, as previously mentioned...do NOT touch any pumps, machines, etc. If you want to know how to read one, ask and I’ll help you. But DO NOT TOUCH
Step three, again seems intuitive but I’m always shocked (and pissed off) by the numbers who interrupt while I’m providing patient care. Don’t come and shove your way in between me and the patient I am obviously working with. Your assessment is Not more important than direct patient care. Step back and wait, use this time to ask me questions. Or simply say, I’ll check back in a few minutes.
Step four, if you don’t know what some piece of equipment is or does or how it functions, admit it, ask me. I am more than happy to teach you. I would much rather you ask and learn something than be afraid of asking a “stupid” question. We ALL started out at zero.
If I like you, I can give you just enough information and guidance to sound wonderful. Never underestimate the nursing staff as a great resource, even after you are the attending. After all, we are with the patient for 12 hours straight often for days on end.
The ones who realize that we are all partners in the game of healing patients do well. You can’t do your (future) job without nursing staff, and we can’t do ours without doctors. Respect our time and our judgement and listen to our concerns and you will likely find that you get the same in return.
As already pointed out, you are here asking so you are ahead of the game.
I agree with much of the above, but prefer that residents not introduce themselves. Then again, I've been at my job for over ten years and don't know the names of many of my coworkers with whom I don't work with regularly (and some that I do). Then again, as someone described by my family as borderline Asperger's syndrome (not longer in DSM-5, but still there in ICD 10 and 11) I may not be the best metric. Still, many of us in the ICU (especially at HCA facilities) are in "triage survival mode" (I literally haven't taken more than 10 lunch breaks in as many years) and niceties like chit chat and introductions is a luxury we cannot afford. You shouldn't have to work hard for people to treat you with professional respect, it should be the default. I sometimes believe that the same "miasma" that mediates difficulties faced by residents from nursing staff shares at least a good deal in common with the attitude responsible for what is termed "nurses eating their own" except in the former case the meal is wearing a white coat instead of scrubs.
Instead of “how did the patient do last night?” Ask a specific question, maybe a question about something that you are concerned about or that you need to understand better. That will show the nurse that you did do your research on the patient before showing up. ICU nurses have a lot of knowledge, use them as a resource. Also, try asking the nurse: what in particular are you concerned about? And: what do you think this patient needs next?
Also, know that when you show up in the morning, very likely another medical student or an intern or a resident have already stopped by and asked the nurse the same questions. The night shift nurse might be busy trying to finish tasks or charting, or the day shift nurse might be busy getting report and doing an initial assessment. Be respectful if they look busy. Oh, and introduce yourself. Who are you, what’s your position, what team you are working with. That way I can answer your questions more appropriately.
ptier_MNMurse, BSN, RN
70 Posts
Well, I don't know that someone bringing food to try to be nice is patronizing. Obviously, you can't form any real relationships with people just by bringing them gifts/treats/etc, but patronizing seems an over the top way to describe it. Generally, I think it shows that you have at least thought about your colleagues and would like to open a better relationship.
This person came here to get advice on how to start to form relationships with nursing staff, and I mentioned it is not a bad way to break the ice. Certainly this person has to make intelligent decisions and absorb as much as they can while in the ICU, and also has to share a bit about themselves if they are to really get to know anyone. Trying to offer simple advice.
Simple as that! Sorry if it rubbed you the wrong way!