Nurse-Resident Communications

[TWStudentNurse]

I am doing a presentation on nurse-resident relationships/communication as part of a broader topic of interprofessional teams and healthy work environments. Wondering if all the nurses out there have comments on the following:

1. As a nurse, what kind of challenges do you face in terms of communications/collaborations with residents, med students, staff MD's?

2. What do you think could be changed to enhance the MD-nurse relationship?

3. Any anecdotes or extra details you want to share?

Thanks!

[Double-Helix, BSN, RN]

On my unit, the nurses have an awesome relationship with our attendings.

On of the things that we do is "nurse presentation" during rounds. So the nurses round with the residents, attending, med students and (during the week) our peds pharmacist. The nurse is in charge of explaining the patient's history, current system's review, and presents any concerns/questions that the nursing staff have about the patient. It's a great way to get everyone on the same page and talking.

[TWStudentNurse]

Thanks so much for your quick reply. Can I ask what city you work in and how long you have been in practice, just for the purposes of classifying different strengths and weaknesses that nurses report? Have a great day!

[MomRN0913]

My 3rd year psychiatry resident cousin has a nice long rant on FB about the nurse who calls her ever 15 minutes to screw with her. Reporting a temp of 97.9, asking for an order of vasoline to lips, an order for kleenex.....

this nurse has been known for years to do this to the residents.

Maybe some of the hazing should stop? ( even though I find it kind of funny)

[CharmedJ7]

I find in general new nurses have a far easier time talking to residents than attendings on my floor, partly because they're who we have the most contact with. And for the most part, the residents are receptive and easy to work with. I think a lot of nurses enjoy the power dynamic of the new docs who still need a large degree of guidance (think: what's the dose for zofran? what would you give? what's standard here?). The biggest hurdle is the residents who walk in with a poor attitude and superiority complex. That said, the superiority complex can go both ways and I've definitely heard complaints from the residents about nurses being unnecessarily rude and overly smug about little things that come down to familiarity and how the hospital works (think: standard dosing, phrasing of orders, etc).

Can't we all just get along?? :). I love the idea of nurse presentations mentioned above. The most loved attendings and docs in general are the ones that will turn to the nurse and ask about their concerns, "anything from a nursing perspective? What are you watching?" I also love when the MDs come to tell me the plan and why they're ordering certain tests or drugs, although I do know nurses who hate this because they find it overbearing.

It's basic, but I think both ways it comes down to the degree to which the other person feels listened to. And maybe that's easier with residents because on bulk, they are more willing to accept help and thus are more receptive.

If it makes a difference, I work in a very large teaching hospital in a bigger city on a surgical floor. It definitely seems that here, surgical floor nurses have far better relationships with the docs then medical floor nurses, and of course ICU nurses seem to have the best relationship of all because they are a required part of rounds.

[Creamsoda, ASN, RN]

I think for the most part its a good relationship. One thing we have had some issues with are timeliness. I often see it more on the rapid response side of things, when ill talk with a nurse about a patient, offer a suggestion and they or I will ask the resident for orders, they will often agree but have to "clear it with the attending", which I understand, but often it doesn't happen until "rounds" and that can be a few hrs away when the patient would benefit sooner from an intervention. So at our hospital this issue was brought up with residents and attendings and hopefully they have discussed it with them so things can be expedited.