Mid-levels doing rounds who will NOT acknowledge or interact with nursing

[FireStarterRN, BSN, RN]

There is one nurse practitioner who does rounds for cardiology who will not talk to any nurses. She won't ask questions, won't even make eye contact. There's also a PAC who is almost as bad, and is haughty and condescending when she does deign to speak to one of the RNs. She will interact with the charge nurse however. She is also with the cardiology practice. It's such a detriment to quality care, in my opinion. It's ironic that every single one of the cardiologists is communicative, personable and easy to work with.

I find this behavior more common with the mid-levels. Are some of them insecure? The two women who do this also make a point to dress in lab coats and skirts, they dress more stereotypically like MDs than the women doctors.

My gut feeling, based on my knowledge of human nature, is that this type of mid-level practitioner is striving for recognition of what they perceive as their higher place of importance in the hierarchy of healthcare providers. Like a mid=level manager, they feel it is unwise to rub elbows with those beneath them. They exaggerate this behavior while becoming established in their practice in order to cope, then it becomes an ingrained part of how they operate.

[Keepstanding, ASN, RN]

jerks !

[FireStarterRN, BSN, RN]

Too bad I made a typo in the title, maybe a moderator would kindly fix that?

I'm not sure if they are jerks, but are insecure about their social status?

[Corey Narry, MSN, RN, NP]

Let me start by saying that there are good and bad individuals in every profession and in every level of nursing. Not knowing anything about the individuals you mentioned, it's hard for me to pass judgement. I tend to give people the benefit of the doubt, but if the behavior continues, I am suggesting that you confront the person and if that goes nowehere, bring the issue up with the physicians they work with.

[StNeotser, ASN, RN]

I've seen a couple of awful NPs who will not talk to the nursing staff at all and if you don't notice them writing orders then they will just walk off. When we phone them to say that we needed an order for X or Y they'll say "Why didn't you say when I was there?" Eh, because the only evidence you were even here was a chart put back in the chart rack with the new orders NOT flagged up. However, those are two bad NPs in 6 years or so I've been in this game so I'll have to say the majority do care about our input and do ask us questions about patients.

[nerdtonurse?, BSN, RN]

And if I may use a nerdish word...DORK.

And my greatgranny's favoritie...eejit!

I want to be a NP ... but with God's grace, may I never forget the first word in my title will be NURSE.......

[FireStarterRN, BSN, RN]

I'm wondering if the one woman, the NP, is just super shy. She rotates with the other cardiac mid-levels and perhaps she has trouble interacting in a less secure environment than her usual. Sometimes shy people can come across as aloof.

The PAC I describe is definitely haughty towards nursing however. I think she has some self esteem issues that she is over-compensating for by being arrogant.

[Smitty08]

As an APRN myself, I really do find that offensive. If anything, I try to esteem RN, LPN's - heck- anyone in this field who works as hard as we all do everyday. One aspect of the role of APRN is role model and mentor. Its very unfortunate that some might look down those who might actually be the NP's of the future. I agree they have some self-esteem issues to work out, in addition to growing some "people skills" and basic manners. I wish I could apologize on their behalf for their unkind behavior!

[David13, MSN, RN]

In my opinion, the OP nailed the issue: INSECURITY. Theses are people who are only interested in how they are perceived, and they want to be perceived as doctors, not as nurses, because they believe that to be more prestigious. The unfortunate part of the whole situation is that this type of behavior does nothing to improve outcomes for their patients and, in the end, actually detracts from their professionalism.

[canoehead, BSN, RN]

Speak to the docs. If they aren't interacting with nursing they aren't completing their job duties.

[traumaRUs, MSN, APRN]

I'm also an APN or mid-level or whatever the title is today. Personally, I was a nurse for 14 years prior to becoming an APN and it was my positive interactions with mid-levels that spurred me back to school.

Everyone has met one or two rotten apples. No need to dwell on them when most people are nice and polite and that includes mid-levels.

[labcat01, BSN, RN]

Maybe it is just the "culture" of the cardiology practice?? That really stinks for the nurses. All the mid-levels that I work with are phenomenal- especially the cardiology PAs. They are easy to approach and talk to and the NPs are really good teachers and also really knowledgable. I can't imagine what I'd do without them. I'm sorry you are not as lucky :)

(really, I'm not bragging- I've just been so appreciative of our mid-levels this week!)