I'm not the doctor!

[sweetdreame]

Recently my husband's grandmother was a patient in the ICU. I am frequently used as the medical translator in the family, this time wasn't any different. I had the opportunity to make a couple of observations I would like to share with you.

Before I continue, let me tell you a little about myself. I have worked in many areas of the hospital. L&D (as and OB tech), Ortho/Neuron MedSurg, ER, Trauma ICU, CVICU (all as an RN). I recently started graduate school in hopes of gaining more autonomy and advancing my education. I LOVE being a nurse. I love the way it blends science and compassion. I am PROUD to be a nurse. Except for one thing.....

I have always had a problem with the societal perception of nurses. I love the show Grey's Anatomy (despite its medical inaccuracies), but can't help noticing that there are no nurses in major roles. I see nurses as a whole represented as coffee-fetching secretaries. My family even says to me "I know you're not the doctor, but what do you think about this....?".

This perception, of course, does not jive with the fact that many nurses have a Bachelor's or Master's Degree in Science, multiple additional certifications, years of experience, and have saved multiple patients from incompetent physicians.

This week, while observing the nurse caring for my family member, I realized a MAJOR part of the problem with the way nurses are perceived. My confused family member mistakenly called the nurse DOCTOR. The nurse replied...

"Oh, I'm not the doctor I couldn't handle that much responsibility".

EXCUSE ME?! Throughout our visit, she repeatedly dodged conversations, referred the family to the doctor with any questions, and generally made me feel ashamed about our profession. I realized that I have encountered that same attitude so many times in my fellow nurses. But WHY?? I once heard a nurse tell a physician who offered to help her clean a patient...

"Oh I'm sure you have more important things to do! This isn't your job."

This is just as much the physician's patient as yours, and if the job needs to be done for the good of the patient, why would you assume this meek, butt wiping maid position to the ALMIGHTY DOCTOR??

Let me start out by saying that I know all nurses are not created equally, but I think this is a mindset bred into many nurses from the beginning of our education. Instead of thinking "I am an educated, experienced caregiver who is more than capable of answering your questions. I shoulder a TON of responsibility every day I come to work." We are taught this...

"The doctor is GOD. The doctor is KING. You are JUST THE NURSE."

This thought is reaffirmed every time we allow a colleague's ideas to be dismissed by a rude attending, or when we don't speak up in family conferences, or when we say things like "Oh I'm not the doctor, that's too much responsibility". This inaccurate perception of the "pecking order" is not only offensive, but unsafe. This mindset is what makes you second guess yourself before calling that mean physician to report a critical value, or bring up an important concern. NO MORE!!!

I'm calling all nurses to WAKE UP!

Empower yourselves through education and experiences. Realize that you are not the secretary, the butt wiper, or the maid. You are smart, you are important, you are educated! Quit it with the subservient attitude and be the powerful PROFESSIONALS you should be. We are separate professionals, MDs are not your boss, they are your colleagues. Quit demeaning our own profession with your engrained lowly mindsets.

OK, rant over... feel free to comment, tell me what you think!!!

[GinRN777]

My standard reply when addressed as "doctor" is: "i'm not the doctor, i'm your nurse, i work for a living".

and doctors don't work for a living? Really?!

[Etone LPN]

"Just a nurse" ... This is my truth and payback with dealing with this.

Entered a pt's room in our ER that had a non-emergent problem. As I walked in, she said "Hi doctor." I then told her that I was a nurse not realizing that "Dr Smith" was 1 step behind me and hearing her say that proclaimed, "No, I am the doctor ... He is "Just a nurse." Knowing that he was just "pushing my buttons" for a reaction. I chose not to stoop to that level or even respond to that comment. Later during her discharge when I gave her instructions, she said ... That doctor was rude saying that. Nurses do all the work. I explained to her that Dr. "Smith" and I work as a team, and the reason I did not respond to the comment was that it would only tick him off and that we had 10 more hours in our shift ... Told her that, by the way ... before Dr "Smith" went to med school he was actually ... "Just a nurse", also ... Pt laughed as I wished her the best. Bottom line ... You don't have to play that game, just have to know what the rules are.

[TigerKim]

It is possible that she doesn't want that much responsibility. It's not a crime to pick the area of your comfort zone to make a living. We can't all be doctors.

[TigerKim]

I agree; I think the tone and meaning of what was posted, was changed.

[cinnybug]

I look at it this way. The MD is like the quarterback of a football team, calling the plays, executing the passes and hand offs and I, the nurse, am like a wide receiver. I execute the orders, catch the passes and run in the ball for the touchdowns. Do I want to be the quarterback? No. Am I proud to be the wide receiver? Yes. Can he win the game by himself? No Can I? No...it takes a team with each player being a trained professional in their position. We communicate and then execute. Each position deserving of respect.

[GeneralistRN]

OP should lighten up. That statement wasn't a big deal.

Also I've found that even when I explain things to family in a way thats articulate and cogent, they still don't take many of my answers to their questions seriously because it isn't from a doctor. Nowadays I hardly bother explaining anything to family because I know they'll just ask if the doctor can speak to them anyway, even after I answer their questions, even if the doctor will just be telling them everything I told them.

So I just say I'll have the doctor come talk to you if family asks me about a patients plan of care.

[sarose611]

As a degreed nurse way back in the day, I wsd taught that I was an intelligent, well educated and prepared nurse. I was disabusd of that idea with my first job. it was made clear that Doctors were more important, that what they said was law, and I had better get in line. I was to refer all qurstions to the Doctor, never share test results, vital signs or make any.comments beyond discussing the weather. over the years it has improved, but in the hospital, thr doctor still takes pecedence over the nurse.

[n6medjim]

Dr shows, Grey's Anatomy to House, I have always been very amused at the lack of visibility nurses have. We stopped watching Grey's Anatomy because I just can't stand the absence of reality not mention the lack of medical accuracy. I must mention it drove my wife nuts when I'd talk to the tv and criticize the program when I saw something stupid.

House, though I enjoyed the medical detective work to ascertain the cause of some mysterious malady, it drove me to total distraction to seen these scientific sleuth MDs run into the CT or MRI room with a pt and RUN the equipment! Hah! What a joke!

During my short career (began floor nursing at 63 with an abundance of gray hair on top), I'd enter my pt's room a the beginning of a shift and frequently have a pt address me as "Doctor." I would hasten to correct them and advise "No, I'm not a doctor, but I play one on TV!"

Re putting MDs on pedestals: unlike my parents who took everything that an MD said as gospel ("I have to cut your arm off" where the previous generation would promptly extend their arm with out question), I listen carefully and then, frequently research it later. I was taught with a lot of emphasis in RN school that nurses should never take any crap from an MD, that we were partners in pt care. Maybe it was my gray hair that gave MDs pause and leveled the playing field with this nurse. BUT, the really important takeaway is the importance of a nurse: we ARE >PROFESSIONALS

[GHGoonette, BSN, RN]

How many medical soapies and series cast the nurse as being the doctor's "romantic interest" or the "other woman" in a married doctor's life? Not that I watch stuff like that, unless I'm really bored and the weather's so terrible there's absolutely nothing else to do. Luckily the library's right opposite my hospital so I never have to worry that I have nothing to read, so you'll very rarely find me glassy-eyed in front of a rubbish-filled flickering box.

[Robert (EM MD)]

"This perception, of course, does not jive with the fact that many nurses have a Bachelor's or Master's Degree in Science, multiple additional certifications, years of experience, and have saved multiple patients from incompetent physicians."

Let's unpack this sentence a little, because it encapsulates everything that is self-contradictory and wrong about this mindset. While declaring confidence, it implies a sense of inferiority. I've saved patients? No, I've saved patients from incompetent physicians.

The implication being that a good doctor doesn't need the knowledge of a nurse to save the day. A doctor whose patient is saved by a smart nurse is a failure. If you feel secure in your knowledge that isn't so. On a good day, I save a life or two, and when I do, I save them from a disease process, not the incompetence of nurses.

Nurses have saved many of my patients. When they do, I say thank you, and try and glean some teaching points for my own future use. This adversarial attitude -- that for nurses to be built up, physicians must be torn down -- is doomed to failure.

The education piece, that nurses have master's degrees, etc., is also interesting. Physicians in general are not impressed with more letters after your name. They know that most of their clinically useful knowledge came from their years at the bedside. That's why we respect nurses that have put in many years at the bedside and have the skills and instincts that go with that. When you brag on your education and challenge physicians to a degree-off, you are actually getting farther away, not closer, to the respect you want and deserve.

Nurses have immense responsibilities. Physicians also have significant, and somewhat different responsibilities. We are responsible for a greater number of patients at one time, usually, responsible for certain high-risk procedures, responsible for the overall strategy of care. It's a different job. There's nothing wrong with saying that you are smart enough and hard-working enough to be the doctor, but you don't want THOSE responsibilities. There's nothing shameful in that. Nurses don't need to advocate via a rousing course of "Anything you can do I can do better!" Your profession is worthy of the utmost respect in its own right.

[BostonFNP, APRN]

Great post, thank you.

[registered.nobody]

One of my first realizations when I was a brand new nursing student was how much responsibility nurses have. This profession has transformed since the days when nurses wore dresses and were subservients and anyone who does not own up to that responsibility is putting their license and patients' lives in danger. Every day at work I have to utilize critical thinking, solve pharmacological problems, and decide what the patient needs before I ask the doctor for an order. I am a nurse instead of a doctor not because I don't like studying or am not smart enough, but because of the difference in the philosophies of each profession. It was a choice and I will not apologize for it.