what do nurses hate about doctors?

[futureMD]

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 ****** off a nurse? Dr's yelling about missing charts? Yelling for 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.

[CO2emission]

I have always appreciated MD's who counsel with the nurses as peers rather than subordinates. Nurses get them out of alot of difficulties. I also appreciated MD's who truly have a good bedside manner with their patients and listen to what they are saying, what the nurses are seeing, and what the diagnostics are saying. Remember it is the art of medicine. God has a lot to do with the outcome, no matter how good a doctor or nurse you are. I respect doctors and I know how much education and sacrifice it takes to become an independent practioner, but doctors have a medical way of thinking and nurses have a more holistic approach. If those two disciplines can be balanced patient care can be enhanced. Many times an experienced nurse will pick up on fine nuances that only being at the bedside can produce.

The thing I dislike the most is demeaning behavior, and I always will remember a doctor who treated me or my peers in a rude disrepectful way. I won't let that go unnoticed and will confront a doctor or anyone who feels that they are justified in treating me in that way--especially in front of others. At that point, I will make sure they are exposed and demand an apology.

Nurses do need to learn the art of SBAR, which you speak concisely and leave the emotion out of the equation. Doctors like factual information that is delivered in an organized and understandible sequencing. That leads to respect and acknowledgement that the nurse has the ability to put together cause and effect outcomes, and knowledge based on scientific research. Intuition plays a part when nothing else will. The tenacity in which a nurse presents their case makes the doctor more aware that something is not right, and there may be hidden issues with the patient that have been undetected. A prudent doctor will take note and start assessing and diagnosing possible issues with the patient.

Thanking those that help you along your path is always a good thing. You did not get to where you are completely on your own. But I think that sometimes forget where they came from.

Nurses need to check bad behavior, and need to make sure that respect is expected whether right or wrong. "I appreciate your concern, but..." or "I appreciate this information, start...call me back when this is completed for a status report." or "I am on my way in...have this prepared for me, thank you"

I have always asked why I didn't become a doctor. For me, nursing is the ultimate, I would not want to become a doctor--care for the whole person, not just a disease process is what I am about.

Ya gotta luv it that nurses are expected to communicate information in a way that accommodates doctor's limited adaptability to interpret the English language. So as we are being trained to do Doctor Speak are doctors being trained in the art of Nurse Speak. If they don't understand 'I need you to review a patient, I am very worried' then perhaps they shouldn't be practicing medicine.

[Indy, LPN, LVN]

Now this is always something that has mystified me, the patient is the one that hires the doctor, ergo the doctor shouldn't intimidate the patient. I also don't think patients feel empowered to dismiss a doctor if the relationship between patient and doctor is not working for them.

I have seen that it's very rare for a patient to tell off a doctor, even one that they very much disagree with. Personally it took me longer to disagree openly with my private physicians than it did to learn to speak up at work. I have no idea why, and it annoys me.

Also remember that minority patients frequently feel talked down to even if they are not, and have trust issues that one physician probably can't resolve and may even aggravate. Add that to a nurse who tries to get one message across to the doctor, who hears something else and may be frustrated or tired anyway, and you get things that don't make sense, like a new DNR order on a patient who tried to tell the nurse that she's allergic to amiodarone, and of course the patient had no desire to be a DNR.

The presence of the physician can intimidate almost anyone from time to time, so it takes extra effort to not abuse it. The same goes for nurses, except that we have much more time to make the patient feel safe and earn their trust. For the physician, the extra effort involves listening, asking questions, explaining a negative answer, (don't be afraid to say no, but I won't keep asking if you say why) and reigning in some of the bad moods. Oh yeah, and for the love of god answer the pager. Nursing culture at night has a longstanding tradition of not waking the doc without first making sure it's not trivial, it's not covered by standing orders, we did read the current orders right, it's not something that is transient or entirely fixable by regular nursing practice or stuff already ordered. Then we look around and figure out what else you need to answer before calling the doc, usually. So answer it, don't make me call the police to come wake you up, because I will, and when I do, don't call me crazy.

Oh, and when you do admission orders, try to think ahead and make sure you cover basic things like fever, pain, constipation and nausea with PRN meds. It doesn't have to be "demerol 25mg iv/im q 1 hr" like one infamous person I know, but you know, reasonable stuff.

As a doctor, you do have permission to look like hell, be groggy on the phone, make occasional mistakes, have less than perfect handwriting (mine isn't too great either), and sometimes vent -not in the patient's presence- about ordinary stuff or why you're in a bad mood, etc. If you act nice you can even be human. Those who don't abuse their privileges get the same niceties from me that I'd give anyone else and that includes "do you need to sit down" and sometimes coffee.

/off soapbox.

[nursval]

Just treat them as you would like to be treated. If you need to call a doc in the middle of the night, do yourself a favor and make sure you have ALL information in front of you when you make the call, :heartbeatespecially a recent set of vitals. Some are just grumpy no matter what, but you are only human jst like they are, so just try to be as quick and efficient as possible. They aren't that scary once you get to know them. God Bless!

[CO2emission]

Just treat them as you would like to be treated. If you need to call a doc in the middle of the night, do yourself a favor and make sure you have ALL information in front of you when you make the call, :heartbeatespecially a recent set of vitals. Some are just grumpy no matter what, but you are only human jst like they are, so just try to be as quick and efficient as possible. They aren't that scary once you get to know them. God Bless!

I'm not too sure that most of us see them as scary. The general theme seems to be that many of us see them as downright rude and I'm sorry but I don't accept gratuitous rudeness. I think we are well versed in being efficient when contacting a doc. Nurses are not their whipping boys. Bullying is an offence and it needs to be reported.

[cdsga]

Well, bless their hearts. When you take the self centeredness out of the equation and put the patients needs over the character of the doctor, just remember. Do no harm. If that means changing the way we report to doctors to include a sequenced organized way of communicating rather than presenting random thoughts for someone else to put together, then so be it. It's best for the patient and ultimately it may get you the order that you need. Basic nursing duty requires caring for the patient and speaking for them in ways that they are unable at times to do. I don't condone subjugating oneself to the point of being powerless any more than manipulating the situation and information to get what you want. Just do what is best for the patient. I have seen nurses really set themselves up for massive retaliation because of their delivery of information and sometimes their reluctance to deliver that information. Fear can sometimes prevent the most pertinent facts from being communicated. I always think when I have to talk to someone about something that could end in an argument or disagreement or in feeling demeaned--I don't have to live with this person, I just have to get through this situation. I must do my homework, have the facts and present them with the purest intent and make sure I report the information and my feelings to my supervisor or peers to gain support. Unfortunately, society has placed nurses subordinate to physicians, and until that superiority is equalized, there will always be this issue where animosity arises between doctors and nurses. Sadly, we tend to remember the situations that hurt our feelings, not the many successful interactions we have--because in reality, all interactions between doctors and nurses should be productive, not counterproductive--it's an expectation between humans, but when interactions are counterproductive, they stick out and scar us. We tend to remember them for years. We never forget. Maybe we should just think of them as "ignorant" and forgive them and move on with the situation allowing a fresh start everytime. We don't always know what has transpired to cause them to be the way they are. Just let them know you didn't cause it and you won't be affected by it.

[nerdtonurse?, BSN, RN]

What I hate to get from a doctor, especially when I call them in the middle of the night -- pt desating, rhythm change, change in LOC, I mean, serious stuff -- is "well, what do you want me to do about it?" Hullo, does it say MD on my tag anywhere?! You want off the hook, write me some standing orders and PRN meds.

The other thing is if Doc A is covering Doc B's patients. Call up with d-dimer of 7.25, SOB, chest pain, symptoms that admittedly could be a PE or a arthritic with asthma, and you get, "well, what do you think they should get?" I think they should get the @*@!@ off my floor and into the ICU, I don't want to code this lady!

*sigh*

[alfa-sierra, BSN, RN]

Kudos to you for seeking feedback. I 've been a (male) nurse for 15 years. Some doctors are genuinely confident, humanistic and have a sense of humor. Others, both male and females, have all the quirks pointed out in the postings replying to you. Personally, I believe male and female doctors treat nurses the way nurses allow themselves to be treated. I'm always chagrined when a nurse begins a phone communication with a MD with " I'm sorry to bother you...". Sorry? Bother? This is not a form of coloquialism. This is an example of a very common form of self-devaluation. Another form of enabling negatively charged differential treatment is an ill-disguised subservience on the part of so many nurses. Nurses double standards in their interactions with MDs accordind to the MD's gender are not uncommon. There has been studies on this subject showing female nurses being much more accommodating with male doctors versus female doctors who are now, by the way, in the majority. If a doctor ruffles my feathers in a matter of jeopardy to a patient's welfare, I'll let them know it courteously yet firmly. I have found that nothing is more effective in highlighting rudeness than courteous assertiveness especially when it comes with a reminder of potential liabilities involved. A good sense of humor is also effective in leveling the field, in either side. On the other hand, when I finish communicating a clinical scenario to a MD I'm not familiar with, I prefer to ask "what would you like to do?" (even though I may well know from my experience in a particular specialty what the correct intervention is) rather than spell out the intervention to the MD, unless a suggestion is solicited. Otherwise, the nurse will run the unnecessary risk of making a less secure MD feel like a rubber-stamper. I like a MD to offer me attentive listening when I offer clear, concise, relevant information. Hanging up the phone without conclusion of pt's business will automatically generate as many phone calls as needed to see it through. It is not worth the outburst.

[pattyweb]

what do I hate about some docs? When I've made several pages and calls to their answering services in the middle of the night when my patient's condition is worsening, and I don't get a call back for a solid hour at least! When I get b.s. orders and have to call up the rapid response team anyway, then have to call the doc back shortly after because we saved this patient from coding!

What else do I hate- rude condescending physicians who don't care about the patient or their outcomes.

Realize that the nurse is there for the patient when you cannot or choose not to be. The nurse knows what is going on with the patient, even if she has 10 other patients and has other crises going on. The nurse has had at least some education and some experience to know how to care for her patients, and at least on our shift on our floor, we help each other out and can help troubleshoot before we call Dr X at 3 am.

[flygirl43]

How about abusive, disrespectful, arrogant etc, etc, etc...gag!!!!

[gilf7243]

Most of the doctors at our hospital are nice but there are a few that we fear to call at night. I work ICU step-down unit. I usually try to wait until morning since I work at night but if the patient has a significant change of condition for example low blood pressure, high blood pressure, new hear irregularities, or repiratory issues that are of new onset you really need to speak to a doctor immediately. Sometimes you have to page the doctor 3 times before they return the page. Sometimes they don't call back at all. Sometimes they disagree with the nurses judgement and say, "This could have waited til the morning!" and hang up on you. Sometimes they won't even let you finish your sentence and talk over you and miss out hearing important details before they hang up. I have had a situation one time that I had to call the hospitalist for the patient and call a rapid response b/c the doctor never called back. Then that same doctor gave us crap for using the hospitalist. What else could we do?? The patient couldn't wait for the doctor. It was a dire situation. That only happened one time though. I believe this doctor was disciplined for that incident. Hope this helps.

[bobweiss]

As a basic member who is an out-patient, but very much pro-actively involved and self-educated in fields involving my own health issues I find something interesting here. I receive the majority of my care within the VA system, but also have used doctors and hospitals outside that system. I have an observation somewhat similar to many of you nurse professionals and have observed physicians, whom I have respect for because of their knowledge not be curt or abrasive, but dismissive of opinion or even mere suggestion that doesn't concur with their professional opinion. Being outspoken and opinionated by nature I never turn the other cheek and immediately come back at them, but not with anger...with fact/s justifying my stated opinion. In the fields I'm familair with I am able to freely engage with them at their medical jargon level. Good doctors I've observed will politely engage me in discourse and respect my input when they see that I have familiarity and have obviously done my homework, and they realize my motivation for said discourse is sincere. Those of, to put it kindly, a less than competent ability become irritated and red-faced and if they respond in a dismissive manner I engage them as if it were mortal combat as I will not take condescending and/or sarcastic interchange. This comes to the fore much when any reference to a holistic protocol, whether efficacious and proven to so be or not, comes up. Such, usually appears to stoke their systolic and annoy them, but my sentiment is tough sh*t if they think I'm going to tolerate thier sardonic displays they're going to get a rude awaakening. In all things, all individuals deserve to be heard out with a civil manner and behavior, until they give good cause they do not deserve such concession. When they fail to do so I give them a well-calculated albeit polite dressing down and damn the consequences. That ("polite dressing down") may seem a contradiction in terms, but not really and is dependent upon one's technique (HA!!). I then go about making my case about why said protocol should be at minimal, not dismissed out of hand. Until medicine in general sheds the brainwashing effect of big pharma I fear we shall still have to endure the formal practice of medicine being rendered from a narrow-minded perspective.

My conclusion, quite expectedly is, I still have great respect for you folks I refer to as the "enlisted troops" who serve within a system rife with abuse in many quarters and where the tendency for closing ranks and covering up (to a degree) is an attitude that needs changing. I sense widespread frustration with it and can empathize with all who must deal with it daily and who take their personal medical mission seriously and with great professionalism.

[madwife2002, BSN, RN]

My list would be long and rude in answer to the question but my pets hates include

Lack of respect to patients and staff

Rudeness

No telephone manners

The lack of the doctors ability to understand they are not GOD

They are sexist (ie Males nurses fare better than female nurses)

Look at my signature for another reason

They blame others for their mistakes

They dont listen

They are poor team players

and on and on and on