MD-RN Relations -- There is Hope

Nurses Relations

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One of the things that I most like about working in the ED at an academic medical center is working with physicians-in-training (residents) and medical students. I find the vast majority of them to be smart, kind, friendly, and respectful. I try to remember at all times that I am helping to form the opinions of nurses that most of these nascent docs will carry forward into their "real" lives.

I was just approached by one of our soon-to-graduate residents who told me that the position that they're applying highly values a cohesive team and -- get this -- is asking for references FROM the nursing staff.

I hope that this becomes a growing trend which helps bridge the sometimes-wide gap which exists between the nursing and medical staffs.

Specializes in Psych, Substance Abuse.

I've had no problems with the psychiatrists I work with. When I call about a patient, they always want to know, "What do you think?" I've been told that most doctors don't give a crap about what you think. :yes:

I love working with students and new doctors because they are usually very easy-going and have always been willing to explain the rationale behind their actions.

I used to work with doctors who were totally dependent on their support staff and the best one, the big hot shot surgeon with the stellar reputation, was the one that listened to his staff the most. He had taught us well so whenever we questioned or made a suggestion, he always considered it. I miss having that type of relationship with my providers.

I work at a rural acute care 80-90 bed hospital. We're by no means a teaching hospital unless you count the nursing students who rotate through for clinicals. About half my patients are surgical (pre and post), the rest step-down, and med-surg overflow. About a third of my patients are pediatric. As such I constantly interact with hospitalists, surgeons, and pediatricians on a daily basis. Probably in total around two dozen docs or NP's, including around ten surgeons of various stripes. And these are mostly "older" practitioners, most of them in practice for at least 1-2 decades and probably more, with a few close to retirement.

With only one exception they are great to work with. Several of them make it a point to talk with the nurses about their patients before making rounds, others will seek you out afterwards to discuss new orders, patient progress, or care. On some occasions I've been asked my opinion about meds, whether a patient will be ready for discharge, or a diet change, or other aspects of pt progress, care and condition. Whenever I have questions or concerns they take what I have to say seriously.

This is my first hospital job, but there's nothing special about this place. I mean, we're rural, understaffed and underpaid. The "big" hospital (level 5 trauma, etc.) is about an hour and a half away. Friends that work there (for a few bucks more an hour) tell me that the docs there generally horrible and abusive to the nurses. So, at least in some places the horror stories are true.

Still, I tend to think the culture is changing, albeit slowly. Smart docs, NP's, PA's, and surgeons do best when they depend on, and work collaboratively with, smart nurses (and with other med professionals like RT and PT, etc.). The smart ones are learning that. Anyway, at least in my hospital, nurses are respected and treated as part of the team.

Now, if only we could get the (mis-)managing MBA's to respect what we do and what we bring to the table...

Good post. I hope we all hear more things like this.

Working at a teaching hospital I've seen both sides with the residents. The ones who know their stuff work well with the nursing staff. The ones that are overwhelmed are often rude and don't listen to the nurses because they don't want to appear to be someone who has to listen to nurses to make decisions.

I love the surgeons I work with...the other MDs...not so much. Which is weird, because I hear that at most places, surgeons are usually the most difficult to work with. I'm sure I'll be in for a shock if I ever work in a different open heart unit!

Asking for a reference from an RN probably deters a lot of jerks from even applying.

You are correct. I will have nothing to do with surgical nursing because of it.

Hello, OP I tried to send you a PM but your inbox is full. I've read several of your posts that I found very helpful about A&P and Pharmacology. You recommended two books and flashcards. whats your advice on what parts of physiology to focus on to prep for pharm? thanks :)

Autonomic nervous system, specifically as regards the neurotransmitter receptors, as well as cardiac electrophysiology. Also, renal physiology. Those are your biggest hitters and cover a huge portion of your therapeutic classes.

Autonomic nervous system specifically as regards the neurotransmitter receptors, as well as cardiac electrophysiology. Also, renal physiology. Those are your biggest hitters and cover a huge portion of your therapeutic classes.[/quote']

Awesome! Thank you for your help. I have been following your posts and have rented the Mosby's Visual Pharmacology to start. Were most of the tests in the lvn program mostly from lecture or textbook? i'm a visual 'bigger picture' learner so im trying to see what will help me stay on top and organized as possible :)

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