How Should Medstudent Act Around Nurses

hoolahan, ASN, RN · May 24, 2001

Your GPA must be 4.o if you are smart enough to realize nurses can be your best friends.

Just remember not everyone who wears scrubs is a nurse for one thing. But even so, you should talk nicely to everyone. You never know when you will need someone's help, so don't burn any bridge's.

#1 If you don't know....look it up first if it's not a crisis, then ask. We are not your personal PDR's. There are so many drug's out there, that believe it or not, not all nurses know the correct dose of every single drug, when you don't know it, don't ask us to look it up, at least not routinely. If you don't abuse us, we will volunteer to look it up when we can see you are very busy.

#2, Please tell a nurse privately if it is the first time you are doing a procedure. Do NOT read the package insert for inserting a balloon pump at the bedside over the pt, don't laugh, I've seen it done!! This way, you can develop a signal, and we can tactfully say, doctor, let me get you your sterile gloves, for example. Do not EVER attempt to defibrillate a pt without having received instructions. Beleive me, the nurses will respect you more if you ask before using equipmwent you are unfamiliar with.

#3 Always clean up behind yourself. I had a doctor who did this for me the first time after 15 years of nursing. He shared with me that he was responsible for a nurse sticking herself with a HIV-infected needle, and he has lived with enormous guilt ever since. Please dispose of all sharps in the proper receptacles, don't throw your show covers in the stairwells. If you take out chest tubes, please put the pleuravac in the appropriate biohard bag, instead of leaving the bloody tubing flapping in the breez or hanging off the side of the bed where my uniform will brush up against it.

#4 Don't eat the nurses lunches out of the staff refridgerator, and if we order pizza, chip in a buck, we know med school is expensive, but a buck is some effort. It would be nice if you work in a place where they don't supply the coffee, you also chip in to the coffee fund, and if you take the last cup of coffee, please make another, or at the very least turn off the pot to keep it from burning!

#5 Treat every pt like they were your mother or father. Or a special loved one. Do not perform procedures without local anesthesia if it is needed. So many doc's are in a rush, and people are hurt for no reason.

#6 WASH YOUR HANDS!!!!!!!!!! Dont' come out of a room where you just did a rectal, snap off your gloves, and use my pen!!! Wash after every pt, and procedure, it really doesn't take that long to do.

#7 Don't expect everyone to be nice. Some people are just nasty, have achip on their shoulder, and no amount of niceness will ever gain their cooperation. You will learn this quickly, and don't waste energy on them, or take it personally. Please don't judge every nurse by the actions of one.

#8 Don't talk about other nurses who you do not like/respect on other units, believe me, it will get back to the person. For that matter do not talk about pt's in the cafeteria, elevators, etc...same reason. Don't get involved with hospital gossip. If you hear it, make an excuse to remove yourself from the area. There are some docs who are worse gossips that many little old ladies I know (No offense to the LOL's).

#9 Put things, like charts, dopplers, etc...back where you found them.

These may sound more like common sense, but if I didn't see these things done all the time, it wouldn't need saying.

#10 May I suggest you make rounds on the units, depending on the size of the hospital of course, just after shifts change like 9pm (after 7 pm comes in, or 12 mid, after 11-7 comes in) so you can ask if there are any problems/concerns, so maybe you can address them before you try to take a little nap. It doesn't always work as planned, but it may save you a few phone calls.

Good luck to you!!

MollyJ · May 24, 2001

This is truly a wide open question. My husband is an FP and a faculty in a FP residency. I say with complete modesty and truthfulness that he has an exemplary body of knowledge and he is known as a doc who treats people with a lot of kindness and respect. He started as an orderly and knows how it feels to be at the bottom of the hill where upon from all p**p rolls downhill.

This is what I see him do. First of all, he works really hard to be a knowledgeable doc. And he works really hard. He's not a slacker and he gets out of bed to see people when it is part of the job. He rarely, rarely yells at people. In the worst of times, he gets testy and those that work with him know testy is testy and he's not happy. They shake a leg to get him what he wants.

He's not afraid to learn from anyone. His residents, nurses, hispanic patients who don't speak English, Immigrant docs who are not yet licensed to practice in America, paramedics/EMICT's, me. He listens and learns. But he practices so well that people know they can learn from him. He is freely able to GIVE and GET respect.

He sets a standard of excellence for himself and he's painstakingly patient at teaching others what he wants for excellent care. He will tell you _several times_ that he wants visual acuities on his eye patients, that he wants frequent vitals on his chest pains in the ED, that you CAN feel free to send a UA on a young female that has dysuria BUT if he's spent enough time with you teaching you what he wants AND YOU STILL DON'T GET IT, you will start to lose credibility with him. And that doesn't mean he starts to treat you badly, you can just tell he doesn't trust that person. On the other hand, if you start to anticipate what he wants, he will acknowledge your knowledge, your foresight and your increasing abilities. He makes people feel appreciated for accomodating his preferences and people want to work hard with him and for him. He creates and upholds a standard of excellence in his office and in the ED (where we met--aw, isn't that sweet?!)and other places he works.

He does something that I have seen some docs do well, others not at all. In true Emergencies, he brings diverse groups of folks together, provides leadership and helps them to perform at the trauma/code/delivery skillfully and feel good about what happened. I think that this happens because he does all he can to have the best skill and knowledge base possible for emergency care, ATLS, NALS, PALS, ACLS. He is blessed with great technical competency that FP's don't always have--he likes putting in subclavians, interosseous infusions etc and that is borne of practice. He sticks to the "cookbook" in these cases, communicates effectively with consultants (surgeons/OB's), isn't afraid to call out the marines (air transport) and takes the time OVER TIME to teach his ER or L & D team what he likes and rewards them for doing it his way though his genuine manner. He doesn't blame and he doesn't gossip about surgeons who had to be called multiple times from the golf course. Over time, specialists learn that when he says, "You need to come," they need to come. (Which is what nurses want docs to learn about us.) _The precursor of alot of what he does is that he took time to notice excellent medical care when it was performed by his mentors_. So he knows what it looks like. As you already know, not everything you see constitutes excellence.

He is interested in the world and hobbies. He loves to talk about a myriad of different topics and has an uncanny ability to make people feel like their area of interest is interesting and important to him. He knows how to value people as individuals.

He is really hard on himself when he makes an error, but strives to learn from it. He struggles to make time to take care of himself. This is probably what he does the least.

As you can see, I'm a little stuck on him, but I think he is among the finest docs I've worked with. The very fact that you are willing to take the time to ask says alot about you, too. Good luck in your studies.

LoisJean · May 24, 2001

When you get all done with what you are doing, you come right on up to Northeast Michigan -you are refreshing. Reading your post has given me hope.

chrn · May 25, 2001

Michigan DOC-to-be:

Your on the right track, just asking about interacting with nurses. You will work with us every day of your career, probably more than with other doctors. Mutual respect always works for me. I have never wanted to be a doctor, I do not resent the money they make, I would not want that level of responsibility. But on the other hand, there are surely many things about my job you wouldn't want. If the patient is truly the focus of both of our jobs, we can easily agree that the patient needs both of us. Your attitude speaks a lot...I predict a very popular doctor-with nurses and patients.

StaceRacer1 · May 25, 2001

Let me just say that I can tell right now that I would choose you as my doctor some day!!!!!!!! You actually care about what we see each and everyday. That means that you would even LISTEN to your PATIENTS!!!

You will make it far in the mediacl field by acting in this fashion!!

I can also tell that SOMEONE has taught you a little phrase called "bedside manners" when you asked the ? "how you should act around us?" That is a characteristic that most residents do not have and ever develop!!! Keep that in mind. Keep thinking of others, besides yourself and you will go very far.

GOOD LUCK!!!!!

[ May 24, 2001: Message edited by: StaceRacer1 ]

rncountry · May 25, 2001

Ditto to everything the first responder posted. Just curious, are you an MSU student? Are you doing doing clinicals at Sparrow Hospital? Just wondering, used to work there. I wish you much luck, I believe you will be wonderful. If by chance you are at Sparrow, take the time to look up Dr. Tom Tarter. Last I knew he was in the ER. I worked with him as a resident, and he could tell you much on how to be a decent person with the nurses and with your patients. He had PBS follow him through med school and his residency.

Nice to have a med student ask how to have good relationships with the nurses, we are all members of the same team.

huladoula1 · May 25, 2001

The fact that you are ASKING this question is remarkable and demonstrates your willingness to practice collaboratively - Good for you! Just keep asking questions, think before you speak, and always request input with the nurse(s) before writing orders, talking to the patient, interacting with the family, etc. etc. They'll be your most valuable resources & teachers.

Best of Luck to you!

kewlnurse · May 25, 2001

Be friendly but realize that at work we are not your friends.

Loose ANY attitude you may have, we can and will bury you if you don't.

Practice your penmanship, we will wake you up at 3 am if we can't read your orders.

If we tell you to order a certain pain med a certain way order it, we know infinatly more about pain control than do, and will probably remain that way throughout yor practice unless you specialize in it (ie order percs q3, i don't care what the pdr the pharmacist or anybody else says about it being q4h, and valium can be given with narcs for post op spasms with no ill effects)

Don't be a know it all.

If we page you call back ASAP

If we tell you to come to the floor because somthing looks wrong with a pt, RUN, don't walk.

Show respect and you will recive it.

If your cute (females only please) gimme your phone number

natalie · May 25, 2001

You WILL see nursing substandard care delivered to your patients in the form of:

Delayed order entry

Delayed or omitted medications or treatments

Medication errors

Failure to rescue

Lack of notification of lab values

Lack of familiarity with your patient

Family complaints regarding lack of care

Obvious lack of hygiene

Lack of nutritional assistance

When this occurs, please look to the cause further than the nurse assigned to your patient. Familiarize yourself with the staffing levels on the unit, the number of hours worked by the nurse, the nurse's caseload on that particular day, the nurse's familiarity with that unit, the ancillary staff or lack of, etc.

I'd wager you'll find the answer to the substandard care somewhere in the above. Nurses appreciate Doctors who know this and go to the source of the problem, which is at the Administrator's/Board of Trustees door.

The nursing shortage is reaching critical mass. It's going to get ugly out there.

natalie · May 25, 2001

Forgot to mention,

A big thank-you to you for even asking the question.

midwesterner · May 25, 2001

thank you everybody for all the kind words of advice...to answer the question of rncountry: I go to med school in FL, however I fully intend on coming back to michigan to practice

I learned my appreciation for nurses, techs, aides, and the rest of the hospital staff early on when I used to tag along with my father on the rare occasions when he would make his rounds at the hospital...as I got older and when he understood that I wanted to become a physician...he drilled it into my head the concept of respect...over and over and over again...respect for the patient, respect for the nurses, respect for the techs, aides, volunteers, housekeeping staff, everybody, respect, respect, respect...at the time I was like, yeah right pop whatever you say, what does the nurses or the other hospital staff have to do with you...however, as I got older and wiser I learned about the actual "subculture" that exists in a hospital setting...I realized how right he really was...so I guess I have my father to thank for my humility and "bedside manner" he was always loved by his patients as well as the rest of the hospital staff...I realize that I can't be just like dad...however, he's the type of physician that I'd like to emulate in the future