Older Doctor doesn't think nurses should be in charge

[angeloublue22, BSN, RN]

I worked with a very old school doctor. She has held on to old school ways of looking at healthcare. For instance, doctors are in charge of nurses. I love speaking with her because she gives a lot of insight into how healthcare has changed. The only thing is she not willing to change with it.

The other day she got angry after speaking about focusing on team care and not so much hierarchy, which is encouraged and used by everyone else in the facility. I'm the lead nurse in small satellite facility and at the main office there is a supervisor case manager RN that she must work with. After we both got promoted and she was approached by the case manager RN to see a client about a med issue, she started to complain to me. She stated...

Quote

"I don't know why you nurses have to try to be in charge all the time. I shouldn't have justify my decisions to someone who is lower than me. Why don't you just stay at the bedside like you're meant to?"

I again brought up the team approach and informed her that we see the clients more and can recognize their needs faster and more accurately, so of course we should have a major influence in decision making. She of course argued back and I let it go because I wasn't going to change her mind. I was flabbergasted that she said any of this. After she kept complaining to every nurse and not listening to our recommendations, which was effecting patient care, she was asked by the other providers (team players) to not return to our facility and they would work extra to cover her shifts.

This was a rant but also a heck yeah for our awesome providers.

Has anyone else had this issue with providers?

[Emergent, RN]

I worked with an awful doctor who also was so disrespectful and condescending of nursing. She was in her 50s but had only been a doc 5 years tops.

She had a veneer of being an extremely hip, progressive person, very liberal, liberated, an outdoor fanatic; the last person you'd expect to be a hierarchical throwback to 1960 in the workplace.

Eventually she was driven out by the sheer force of the nurses who could not tolerate this insufferable woman.

[Davey Do]

Good subject, angeloublue22.

With the old Docs, I wonder if it's the God complex thing. I got into nursing about the time the older Docs still expected nurses to be their handmaidens and the young Docs were introducing themselves by their first name.

Too bad this older Doc couldn't see the value of the team approach, something I was introduced to in the late 80's. The medical director of our chemical dependency treatment unit would sit down with the nurses and therapists, discuss patients and give perspectives. I loved being a part of the team and learning from my colleagues.

Oh well. Old mindsets die hard.

[Davey Do]

31 minutes ago, Emergent said:

She had a veneer of being an extremely hip, progressive person, very liberal, liberated, an outdoor fanatic; the last person you'd expect to be a hierarchical throwback to 1960 in the workplace.

Eventually she was driven out by the sheer force of the nurses who could not tolerate this insufferable woman.

I hear what you're saying, Emergent. I had a supervisor when I worked at Mixed Nuts Health Systems whose exterior was a Hang Loose, I'm Okay, You're Okay Type and had a side business as a Therapist on Metaphysical New Age Get In Touch With Your Feelings Endeavor but really uptight when it came to problems in the workplace.

I was the one who was forced out, but got a good severance package and unemployment benefits when she was found by the Office of Employment Security to have terminated me unjustly.

[Jory, MSN, APRN, CNM]

I'll tell you what I have told other physicians:

I don't work FOR you, I work WITH you. I work FOR the hospital. There is no "above" and "beneath" here.

[Sour Lemon]

11 hours ago, angeloublue22 said:

I worked with a very old school doctor. She has held on to old school ways of looking at healthcare. For instance, doctors are in charge of nurses. I love speaking with her because she gives a lot of insight into how healthcare has changed. The only thing is she not willing to change with it.

The other day she got angry after we speaking about focusing on team care and not so much hierarchy, which is encouraged and used by everyone else in the facility. I'm the lead nurse in small satellite facility and at the main office there is a supervisor case manager RN that she must work with. After we both got promoted and she was approached by the case manager RN to see a client about a med issue, she started to complain to me. She stated, "I don't know why you nurses have to try to be in charge all the time. I shouldn't have justify my decisions to someone who is lower than me. Why don't you just stay at the bedside like you're meant to?" I again brought up the team approach and told informed her that we see the clients more and can recognize their needs faster and more accurately, so of course we should have a major influence in decision making. She of course argued back and I let it go because I wasn't going to change her mind. I was flabbergasted that she said any of this. After she kept complaining to every nurse and not listening to our recommendations, which was effecting patient care, she was asked by the other providers (team players) to not return to our facility and they would work extra to cover her shifts.

This was a rant but also a heck yeah for our awesome providers. Has anyone else had this issue with providers?

I agree with her, to an extent. It drives me crazy that everyone needs to be praised and told how equal they are to do their freaking jobs. I do see physicians as "above" me in a work sense. For the most part, I am there to carry out the orders they write.
Does that mean I can abandon common sense and just blindly follow orders? No, of course not. I expect and appreciate the same use of common sense when delegating tasks to nursing assistants. That doesn't mean nursing assistants have the same level of education or responsibility that I do, though.
I think administration is out of line using nursing staff to call up physicians and "make" them do things ...but if you tell nurses how important and equal they are, they're more than willing to "save lives".
I once had a physician ask me why anyone even bothered to call him. "Why don't nursing staff and administration just get together, write their own orders, and leave me out of it?" He had a point.

[guest974915]

2 minutes ago, Sour Lemon said:

I agree with her, to an extent. It drives me crazy that everyone needs to be praised and told how equal they are to do their freaking jobs. I do see physicians as "above" me in a work sense. For the most part, I am there to carry out the orders they write.
Does that mean I can abandon common sense and just blindly follow orders? No, of course not. I expect and appreciate the same use of common sense when delegating tasks to nursing assistants. That doesn't mean nursing assistants have the same level of education or responsibility that I do, though.
I think administration is out of line using nursing staff to call up physicians and "make" them do things ...but if you tell nurses how important and equal they are, they're more than willing to "save lives".
I once had a physician ask me why anyone even bothered to call him. "Why don't nursing staff and administration just get together, write their own orders, and leave me out of it?" He had a point.

Sour Lemon, while I mostly agree with you, I shudder with the notion that, "doctors are in charge of nurses". Both of my parents are retired nurses going back to the 1950's-this 'old school' way of thinking also went hand in hand with subservience, pandering, verbal/physical abuse, and unwanted sexual discrimination on the part of male physicians that was rarely reported and almost never taken seriously. I get it though, there is a power hierarchy in medicine and the "buck" ultimately stops with the prescribing provider. However, I would like to see Nursing as more of a collaborative effort which gives mutual respect to all parties.

[Sour Lemon]

Just now, morelostthanfound said:

Sour Lemon, while I mostly agree with you, I shudder with the notion that, "doctors are in charge of nurses". Both of my parents are retired nurses going back to the 1950's-this 'old school' way of thinking also went hand in hand with subservience, pandering, verbal/physical abuse, and unwanted sexual discrimination on the part of male physicians that was rarely reported and almost never taken seriously. I get it though, there is a power hierarchy in medicine and the "buck" ultimately stops with the prescribing provider. However, I would like to see Nursing as more of a collaborative effort which gives mutual respect to all parties.

I understand and believe in a hierarchy only when it comes to work. When it comes to our intrinsic worth as human beings, we are equal and no one should be expected to tolerate abuse.
People seem to frequently confuse the two. That's what is difficult for me to understand and agree with.

[thinbluelineRN, MSN, NP]

Thankfully I have only experienced this with one doctor- he is a psychiatrist and is in his mid-30's, you'd think he'd be more forward thinking. Good thing- he does not work there anymore and the nurses are very happy about that!

[TriciaJ, RN]

I'm not completely against a hierarchical structure; doctors do have more education and responsibility. (Ever had a CNA who wanted to run his own program? Exactly.)

However, no one has license to treat another as less-than, or be abusive or condescending. When the OP's doctor was venting it may have been helpful to explain how she benefits from the current system. Or she may just be unhappy about not being queen bee. Probably a good thing she isn't coming back.

[Corey Narry, MSN, RN, NP]

To me, "being in charge" needs further context. It sounds like this person described by the OP just feels that physicians should be de facto leaders in a totalitarian sense for anything by virtue of their degree which shouldn't be the case. Can a nurse be an executive? sure, there are nurses that have become CEO's but these are people who also have additional training in administration. They are no longer just wearing their nursing hat at that point. In the grand scheme of hospital hierarchy, the CEO, CNO, CFO, Chief of Medical Staff, Legal Counsel, etc are all important roles that are respected for their individual contributions to overall hospital operations.

It is different, however, when we talk about our individual micro-team structure. In mine for instance, I would hope that we defer to the physician or other types of licensed providers in terms of decisions on medical management of patients, the nurse for their judgement on how the patient is responding to the treatment or whether the treatment is even implementable given the unit work flow/skillset, the pharmacist for whether the treatment has a higher risk of adverse effects, the social worker for understanding community and financial resources limiting patient recovery...you get the point. I'd say we all "lead" in our own respective specialty roles.

[Ruby Vee, BSN]

On 2/3/2019 at 3:32 AM, Jory said:

I'll tell you what I have told other physicians:

I don't work FOR you, I work WITH you. I work FOR the hospital. There is no "above" and "beneath" here.

Yeah! This!

I have also had to tell a physician or two that very thing. Some of them take it very well; others don't.

I had one (foreign) physician tell me that he didn't have to listen to me because FEMALES were beneath him. I repeated the comment verbatim to the chairman of his department. Guess whose contract wasn't renewed for another year, and who found himself in communication workshops, anger management classes and a seminar on workplace relationships in America?