Nurse and MD relationships in the ED

[amzyRN]

One of the reasons I moved to the ED is because of the greater degree of collaboration and respect between MDs and RNs. I have not yet started in the department at my hospital but I am sure hoping that what I have heard is correct. I was so tired of walking on eggshells around surgeons and some of the cardiologists with fragile egos that felt the need to try to humiliate and assert dominance over other members of the health care team. In fact this is one of the main reasons I left the floor.

I was having to defend myself too much, not that it was a huge burden or anything, to remind someone that they show some respect. But I found it annoying that I would have to do so. As an adult of 30+ years, I have a policy of mutual respect. I can take criticism and will try to improve my way of thinking but don't tolerate bullying or anyone that tries to make me feel like I am not as worthy of the same respect that they expect.

What have been your experiences in the ED of RN/MD interactions? What do you suggest to prevent MDs from falling back on old habits of treating RNs badly? Was my presumption correct about working conditions between MDs and RNs in the ED?

[Anna Flaxis, BSN, RN]

My experience is that physicians, no matter what specialty, are just like everyone else and put their pants on one leg at a time just like everyone else. You will have physicians in the ED that you only speak to when you have to, some that you enjoy a collegial relationship with, and some that are just downright wonderful human beings that you feel proud to work elbow to elbow with, and everything else in-between. Just like on the inpatient unit.

[ReadyToListen, CNA, EMT-B]

Burnt-out, snobbish, energetic, and respectful show up in all departments that I've been in. I think the difference you've heard about in the ER is the fact that no matter how someone else of any level treats you, there's not a lot of time to think on it or let it bother you. If it was truly offensive, you'll pick it up with them later. Neither you nor the other person has time to bother about whether a tiny, insignificant misunderstanding was your fault or theirs so there's less to get into conflict about. I work resource pool so I've seen nearly every MD there is to see at my facility and working in the ER is far and away my favorite! Just about to head over there in fact... :)

[Lunah, MSN, RN]

I have always worked with a wide variety of docs, from those with whom I only engage for patient care info, to those who are my besties, and a range in between. :)

[Momma1RN, MSN, RN, APRN]

My experience with our ER docs has been wonderful. Most of them treat us like friends and not coworkers. That being said, there are some that take a while to warm up and "trust" new people in the department. The docs I work with are very approachable and love to teach so I never feel intimidated to ask them why they've ordered a certain test or med. Cardiologists, man. My experience with them on the floor was like yours. So rude.

[JBudd, MSN]

Our docs are great, and generally have a good deal of respect for us. We make some pretty good teams.

[gemmi999]

In my experience ER docs tend to be wonderful to work with. It does take them a bit of time to get to know the new nurses and for you to know their work flow (which ones are okay with giving pain meds, which pain meds they like to give, etc). Most of them have been pretty great about not only teaching when I have a question, but in asking questions and letting the nurse guide care. I *always* ask questions when I don't understand why a drug is being given because that is how you can prevent mistakes--wrong medicine ordered for patient, etc.

Just be aware that due to high volume of patient's ER doctors see on a daily basis, you will have to advocate for your patient, especially if the doctor thinks the patient should be discharged and you disagree. In my experience if you advocate for a patient, even if the doctor doesn't agree with you, they will respect you more because they know you're not scared to go to them with a concern.

[Hp4373]

I LOVE my ED docs (most of them)! There are a small number that get on my nerves and think that they are better than everyone but for the most part they are awesome. We go out and have drinks, run races together and are friends on social media.

[JV-RN]

The docs in the ED I work at have been great! I am still fairly new in the dept and whenever I work with a new doc the first thing they do is introduce themselves to me. They are very approachable and nothing like the docs I worked with at my previous workplace!

[NotYourMamasRN]

I honestly can't think of a single bad interaction that I have ever had with one of my ER docs. They treated us like the superstars we were as ER RN's. I can surely think of a few times that I wanted to choke out the intensivist in my ICU and some of the docs I dealt with in SNF. The ER always had the best RN to MD relations in my opinion.

[MassED, BSN, RN]

I think it honestly depends if you work in a teaching facility or not. I have worked in 3 ER's and the last being a level 1, teaching facility. Dealing with residents in their stages of development, so to speak, is not easy. Some are great, others, not so much. Just like nurses. In smaller, non teaching ER's, I used to call doctors "Dr. Such and such." In a teaching hospital, we are first names only. Interesting dynamic. Annoying a lot of the time, since it's an ER nurse who ends up teaching a new resident. The attendings seem to not want to bother with teaching their residents the ropes.

[Nalon1 RN/EMT-P, BSN, RN]

I think one of the difference between ED docs and others is the constant interaction between nurses and docs in the ED.

When I was in ICU, I saw the doc once a day for maybe 5 minutes and had one or two phone calls with them some days, same for the specialists.

In the ED, your there with them their entire shift, and they rely on you more for information. And as said above, some do take a bit to get confidence in your or the group of nurses. You will always have personality differences, but the ED attracts a specific type, both nurses and docs.

For me personally, my facility has a great group of cardiologists, they have always been patient and willing to share knowledge with me. Same for nephrology. Some of our GI docs are a bit short and can come across as rude, but really are nice.

Surgeons and Ortho, well...