what do nurses hate about doctors?

Keepstanding, ASN, RN · Jul 12, 2008

how about talking down to nurse's. treating nurse's as if they have no education or training. as if they have nothing valuable to contribute to a medical situation. :nurse:

running_nurse · Jul 12, 2008

Nurses don't sleep at night. Required to stay awake on the night shift. Docs get call rooms and sleep when they can. Just a helpful piece of info.

hypocaffeinemia, BSN, RN · Jul 12, 2008

Not trying to start a flamewar here or anything like that but as an incoming MS I this fall, what are some of the things that doctors do that usually p*sses off a nurse? Missing charts? Waking them up in the middle of the night? Give me a list so that when I become an MD, I'll be aware of these things and try to avoid them.

I'm not a nurse yet (halfway through school!), however as I work in an ICU I observe many of the issues that frustrate nurses.

Pretty much the top issues are a lack of listening and an air of condescension.

Here's an example that demonstrates such:

There was a patient who I was monitoring (I am a monitor tech) going all bradycardic in the 30-40 range, with a nice sloped depressed ST segment seen on most leads. They were initially admitted two days prior with atrial fib with rapid ventricular rate in the 160's. A cardizem drip broke this, followed by digitalizing. So after I alert the nurse to this rate and the ST sloping/depression (consistent with dig toxicity) I check the AM labs to see what the patient's dig level was, and there's no dig level. This being an ICU, the nurse puts in a dig level and it comes back 5.1.

Now, as you're not yet in school, you might not yet know this, but digoxin has a very narrow therapeutic index-- even more so in patients with renal insufficiency (this patient had mild insufficiency).

The patient was also symptomatic, so the nurse pages the cardiologist. The nurse describes the whole picture of everything going on, and then asks the cardiologist if he wants to do digibind (digoxin antidote) for the patient. The doctor apparently loses it and screams "I'm the doctor here!", tells the nurse to do nothing, and promptly hangs up.

Lucky for the patient, there was an electrophysiologist on the case as well that happened to make rounds a few minutes after this incident. He promptly ordered digibind for the patient, who was obviously in a state of digoxin toxicity.

----

What to get out of this is that it is important to set aside ego in order for patient care. When you're not physically here the nurses are your eyes and ears, and a competent physician recognizes and respects this.

You aren't obligated by any means to accept their suggestions-- after all that's why you're spending nearly a decade of your life and money to get to have the final say-- but a good physician explains rationale for decisions when they disagree instead of ruling by fiat.

Hope this helps, and best of luck to you.

Music in My Heart · Jul 12, 2008

not trying to start a flamewar here or anything like that but as an incoming ms i this fall, what are some of the things that doctors do that usually p*sses off a nurse? missing charts? waking them up in the middle of the night? give me a list so that when i become an md, i'll be aware of these things and try to avoid them.

i don't think many physicians are waking nurses in the middle of the night. for that matter, i doubt that most physicians are even awake in the middle of the night.

"hate" is such a strong word. things that i dislike in anybody, physician or otherwise, include:

an attitude of superiority
rude or dismissive speech
directed profanity
preferential behavior / ignoring input from those not considered "equals"
poor communication
unclear expectations
arrogance

if you are successful in your quest i would encourage you to be humble and to be as respectful of your non-physician colleagues as you are of your fellows. be willing to learn from the nurses. while they don't have the level of expertise that the physicians do, they do have valuable experience with patients and hospital systems from which a humble and attentive physician can learn and benefit.

futureMD · Jul 12, 2008

I don't think many physicians are waking nurses in the middle of the night.

Sorry, I didn't even bother previewing my post so I messed up the wording. What I meant was nurses waking up doctors (can a mod please fix/edit my original post? thanks). I once saw a doctor get REALLY upset at a nurse for waking him up in the middle of the night even though there was a real emergency!

I was a volunteer at the time and was shocked at the doctor's outburst. It's not like the nurse woke him up because she felt like it or anything.

Another time, one doc started cursing at the nurses because of a missing chart even though a PT took it!

Music in My Heart · Jul 12, 2008

Having spent more time as a health care consumer than anybody else I know personally I'll also share with you a patient's view.

Humility and kindness are so important. Don't think that the patients don't notice how the physicians treat the nurses. Also don't think that the patients don't pick up on the regard with which the nurses hold the physicians.

Don't underestimate the value that nurse attitudes about physicians have on a patient's sense of well-being, the patient's evaluation of the physician, their willingness to continue a long-term relationship, or the quality of their referrals to their friends.

I'm still just a nursing student. However, I have several physicians whom I hold in very high regard - partly because of the outcomes, partly because of my personal interactions with them, and partly because of the way that they interact with the nurses and the evident attitude of respect and collegiality that the nurses have had toward these physicians.

Music in My Heart · Jul 12, 2008

Sorry, I didn't even bother previewing my post so I messed up the wording. What I meant was nurses waking up doctors (can a mod please fix/edit my original post? thanks). I once saw a doctor get REALLY upset at a nurse for waking him up in the middle of the night even though there was a real emergency!
I was a volunteer at the time and was shocked at the doctor's outburst. It's not like the nurse woke him up because she felt like it or anything.
Another time, one doc started cursing at the nurses because of a missing chart even though a PT took it!

Dude, you probably know decent behavior. Treat the nurses decently. For that matter, treat everybody in your life decently.

Follow the Golden Rule and you won't go wrong.

Rabid Response · Jul 12, 2008

Maybe my hospital is the exception, but I really enjoy working with the doctors who staff my unit. Of course there are occasional moments of friction when I get kind of PO'd, but I'd rather let you know about the things that make me LIKE working with most of our MDs.

1. From the attendings on down, most of them have made an effort to learn my name and to use it.

2. They listen carefully (or at least appear to do so!) to my input regarding patients.

3. They ask for my opinion.

4. They thank me for calling their attention to changes in a patient's condition, even when it means waking them up in the middle of the night.

5. The best ones readily admit to me when they don't know something.

6. My favorite docs maintain a sense of humor.

7. One or two of them even have legible handwriting.

So, reading over my (hardly complete) list, I think most of it boils down to issues of communication and respect.

mom4josh · Jul 12, 2008

Writing orders that are unreasonable the load we have on med/surg.

Examples: ordering q1h accuchecks on a med/surg floor when the nurse has 6 patients (send them to ICU if they are that unstable); not placing a cath in a pt who is severely contracted and has IVF running at 200 cc/hr and urinates every 5 minutes AND already has a decub starting which they got in the NH but WE have to dress and re-dress every time they are changed; not answering your pager until hours later; getting upset when we report critical values (because we are REQUIRED to); getting upset when a patient has a change in rhythm and we report (because we are REQUIRED to)...

I think you get the point?

I, myself, like the "golden rule" method as previously mentioned.

BBFRN, BSN, PhD · Jul 12, 2008

futureMD said:

Sorry, I didn't even bother previewing my post so I messed up the wording. What I meant was nurses waking up doctors (can a mod please fix/edit my original post? thanks). I once saw a doctor get REALLY upset at a nurse for waking him up in the middle of the night even though there was a real emergency!
I was a volunteer at the time and was shocked at the doctor's outburst. It's not like the nurse woke him up because she felt like it or anything.

Another time, one doc started cursing at the nurses because of a missing chart even though a PT took it!

https://allnurses.com/ethical-issue-paper-t1118/

UCLA Nursing_08 · Jul 12, 2008

i’m not a nurse but i frequently interact with several doctors in my unit. i remember a situation where an ms iii came in and inquired about a patient’s medical test. the patient’s medical record was loosely organized and the doctor seemed to have this cast of apathy on his face. we asked him questions about the patient and the doctor didn’t seem to communicate too well with us. five minutes later the doctor was called to see his second patient in another unit. some of us found one patient’s medical file on the table and paged the doctor immediately to come pick up the file. well, the doctor didn’t come pick up the file until 5 hours later!

i definitely suggest that when you start medical school this fall, do the following:

1. keep an open mind.

2. don’t think yourself as a know-it-all. be humble!

3. treat your nurses and allied health care members with friendliness and respect. remember, nurses are the backbone of health care. without them, doctors will be doing more work.

4. communicate your needs to the nurses.

5. write legibly. i know mds are busy but make the time to write your orders and comments clearly. what you document down on a patient’s medical file can be used as a legal document if something goes wrong with the patient.

6. when given a patient’s medical record, maintain confidentiality. don’t leave it on the lobby or in another nursing unit. it annoying to see doctors, nurses, etc. leave medical records flatly exposed on the counter.