New Intern

klone, MSN, RN · Jun 23, 2014

Don't be a **** to the nurses. Yeah, that's about it.

Good luck!

applesxoranges, BSN, RN · Jun 23, 2014

If your company allows you to put in orders, I would put the orders in when possible. Most hospital systems are trying to move to a system where doctors are responsible for putting in their own orders to help reduce errors. If you are doing a verbal order, you probably will need to write it down despite what the name says.

My old job used a system called EPIC which was designed for minimal nurse entry but the doctors rebelled in our area so they had to teach nurses how to put orders in. The company that made EPIC was shocked at how resistant the doctors were. They also allow doctors to create order sets for easier data entry.

If the nurse is in a room with another patient, don't start asking questions about the patient across the hall. I've had a lot of residents do that. My preceptor yelled at one that it was inappropriate to do that.

Esme12, ASN, BSN, RN · Jun 23, 2014

klone you kill me!!!! :roflmao:

Respect their knowledge. Ask their advice. look it up if you don't know. Find the respected experienced nurse...talk with other interns/residents/MD's. Don't be a doormat though. Be friendly....confident...smile, make eye contact. LISTEN. When they question an order ask the nurses rationale she might have a different insight...and hear what she says...then offer your rationale. You two just might agree. If ha/she still insists you are wrong...look it up!

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You will run into that sarcastic person and they might not be the best person to ask questions of....chalk it up to experience and move on.

....buy coffee and bagels.

BrnEyedGirl, BSN, MSN, RN, APRN · Jun 23, 2014

The fact that you are even concerned about this makes my heart smile :) Be kind, listen and pay attention,..we are all PEOPLE working together to help other people,....simple as that,...be part of the team and respect each unique role and you will be fabulous!! Best of luck to you and congrats on all the hard work!!!

nurseprnRN, BSN, RN · Jun 23, 2014

Here's a story I've told here often. It was originally aimed at nurses, but you can get the idea. :) Never be afraid to ask for advice, don't ever think that because you can sign your name "MD" that you know more than nurses about the actual process and outcomes of taking care of sick people (especially when the ink is barely dry on the diploma, but really, anytime). Good docs love to work with good nurses, and good nurses love to work with good docs. Just make sure you let them know they're good. :)

Years ago, I worked at Stanford University Hospital in the cardiac surg ICU. The Chief of the service was Norman Shumway of blessed memory, he who did the first work enabling human heart transplantation (though California law at the time made it impossible for him to be the first to have a donor heart to use), and we had a great unit with one of the very best nursing managers I ever worked for. The first of July he would come into the unit for rounds with the new house staff, and took them around. While pouring his coffee from one cup to the other to cool it, he would say, "You see these nurses? These are the best nurses in the world. If one of them ever tells you to do something, you do it. And if I ever hear of any of you abusing one of them, you are out of here." He repeated the same thing in the OR, minus the coffee.

And that is why I never knew that cardiac surgeons were supposed to be egotistical jerks until I left there. Nary a tantrum or a thrown instrument or an unkind word to a patient, either. It can be done, but it starts at the top. The chief residents out of that program went all over the country to run programs of their own and they carried that culture with them-- if the programs at Johns Hopkins, or Minnesota, or San Diego are peaceful, thank Norman. The only one of his residents that I ever knew that was a jerk is in private practice-- I had occasion to contact him to ask him a clinical question a few years ago and he's still a jerk.

TheCommuter, BSN, RN · Jun 25, 2014

Use the Golden Rule when dealing with nursing staff: treat us exactly as you would want to be treated. Mutual respect goes a long way in fostering relationships that contribute to to betterment of our patients.

In addition, if you are stumped by something going on with a particular patient, don't feel shy about asking for the nurse's suggestions. An experience nurse has been there, done that, and has probably seen the same scenario play out so many times that (s)he intuitively knows what to do.

Good luck to you. Thanks for reaching out to the nursing community!

BrnEyedGirl, BSN, MSN, RN, APRN · Jun 30, 2014

Another thought,......It is okay, and in my personal case preferred, to explain why a suggestion isn't the best one. I generally have great relationships with the docs I work with, if they're jerks to me, they are usually jerks to the waitress, the bank clerk etc and I just move on. One nice thing about working in ED is that we always have a doc with us, we can ask questions and most of the docs are happy to share their expertise and teach. This makes for a much happier environment for all of us and a smoother process for our patients. Over the years I have learned each docs little quirks and preferences and I frequently learn something new. This helps our sense of team and is one of the best reasons to work in the ED!!

Nonyvole, BSN, RN · Jul 1, 2014

If somebody says that they can't do that, it's just fine to ask why. It's not fine to throw a tantrum, say that they do not know how to do their job, or imply that they should break the law. True story. Doubly so if you're, say, on a recorded telephone line.

And if you do make a mistake, or have an off day, own up to it. Apologize where necessary. Bring in fruit baskets and other treats, if you're able to afford to, at times other than major holidays.

Cuddleswithpuddles · Jul 1, 2014

This, in of itself, is a heartwarming post and thread. Thank you for the taking the time to seek advice!

In addition to all that has been said above, please take heed when a nurse says something vague but ominous like "I do not know what is wrong, but this patient changed and he does not look right" especially when said nurse is experienced and has spent time with the patient. I know this can be a frustratingly subjective and vague but, at the very least, bookmark that thought. Nurses may not have your knowledge and training but we do spend hours watching, touching and talking to patients you will probably see only for a short period of time during the day. A slight pallor to the skin, a sleepier disposition, anxiety in a usually easy-going patient or a patient who was previously belligerent and demanding suddenly becoming oddly silent... Those are the things that I could not put a finger on but have preceded catastrophic events.

Cuddleswithpuddles · Jul 1, 2014

Also, please listen when a nurse who deals with a lot of end-of-life issues tells you that a patient may benefit from stopping medical treatment and going into hospice. Everyone makes incorrect calls but, in my experience, it is mostly the doctors who want to forge forward with aggressive care in the face of a poor prognosis. It is not that nurses want the patient to die. However, I think since nurses are the ones who have to coax patients to take pills that cause distressing side effects, shove NG tubes down, put in Foleys, clean incisions from surgeries that are supposed to "save" their life, do CPR and shock them, we see the struggle a little closer and often question is it worth it? When a nurse asks if all of this is worth it, take heed. More often than not, the family and the patient him/herself asks that question too.