Older Doctor doesn't think nurses should be in charge

[angeloublue22]

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?

[guest1048932]

There's a saying, "Would you like to talk to the doctor or the nurse who actually knows what's going on?"

I find it's very easy for doctors to think that because they have the most training and education under their belts, they should be the one's in charge. That aside, there's a lot to be said for contact time with patients. It puts you in tune with their needs, their habits, and the patient as a person. Doctors have a bad habit of only seeing people when something is wrong and just do not have the contact time that nurses have. Nurses pick up trends and patterns, and notify doctors of them. Nurses are the eyes and ears when doctors aren't around. Why shouldn't they be in charge?

[Daisy4RN]

I have worked with many different people (docs, nurses, clerks, therapist etc) who have had a very high opinion of themselves. I just always try to remember to stay humble myself because the higher you place yourself on the pedestal the harder you hit when you fall. I just ignore them (most of the time!)

[Lololololoollkkgddfuih]

Your a young nurse, he’s an old doctor.

What if he was a young doctor and you were an old nurse? You’d be thinking “this kid who just got out of residency isn’t about to give me orders”

Humble yourself and learn not to be offended.

[Rose_Queen, BSN, MSN, RN]

3 hours ago, Ron Wallace said:

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No. There is so much wrong with this statement. The only person who ever works under a license is the person named on it. Period, end of story. Nurses work under their own nursing license. Students don't work under the license of their instructor/preceptor either. They work under an exception to the license requirement.

[Lololololoollkkgddfuih]

15 minutes ago, Rose_Queen said:

No. There is so much wrong with this statement. The only person who ever works under a license is the person named on it. Period, end of story. Nurses work under their own nursing license. Students don't work under the license of their instructor/preceptor either. They work under an exception to the license requirement.

So your saying a nurse can just open up a office and start nursing people without a doctor....?

[Sour Lemon]

13 hours ago, Jb92 said:

There's a saying, "Would you like to talk to the doctor or the nurse who actually knows what's going on?"

I find it's very easy for doctors to think that because they have the most training and education under their belts, they should be the one's in charge. That aside, there's a lot to be said for contact time with patients. It puts you in tune with their needs, their habits, and the patient as a person. Doctors have a bad habit of only seeing people when something is wrong and just do not have the contact time that nurses have. Nurses pick up trends and patterns, and notify doctors of them. Nurses are the eyes and ears when doctors aren't around. Why shouldn't they be in charge?

"Would you like to talk to the nurse, or the nursing assistant who knows what's going on?" They're in even closer contact with the patient, assuming you actually have CNAs on your unit.

I worked on a unit where the nurses wore blue and the CNAs wore maroon. I had a patient tell me, "You ones in blue are still learning. The ones in red are the ones who really know how to do the job." I wasn't changing her diaper the right way, I guess.

Anyway ...the person who was closest to her (CNA) and knew the most about her preferences was the most knowledgeable in her mind, but were they really?

13 hours ago, Jb92 said:

[Rose_Queen, BSN, MSN, RN]

8 minutes ago, Ron Wallace said:

So your saying a nurse can just open up a office and start nursing people without a doctor....?

Are you even a nurse, let alone a CRNA? You clearly do not understand basic principles of nursing licensure and the role of the health care team. Yes, a nurse can independently provide NURSING care- there are independent contractors who do so. Is there involvement of a physician as part of the HEALTHCARE TEAM? You bet! But a nurse does not work under a physician.

[pixierose, BSN, RN]

1 hour ago, Ron Wallace said:

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Um, no.

I work under my nurse manager. She hired me; she evaluates my performance. We are hired, fired, and managed by other nurses.

I operate under a nursing scope of practice, different than a physicians.

Nursing is clearly an autonomous and distinct scientific discipline. Nursing practice is not defined by physicians.

I am in agreement with Rose Queens assessment as I am unclear as to how a CRNA is so unaware of something so basic. Yes, I follow physician orders. That in no way means I work under a physician. They are not related. You mistake a lower level of practical power to subordination.

[guest1048932]

13 hours ago, Daisy4RN said:

I have worked with many different people (docs, nurses, clerks, therapist etc) who have had a very high opinion of themselves. I just always try to remember to stay humble myself because the higher you place yourself on the pedestal the harder you hit when you fall. I just ignore them (most of the time!)

What I was getting at with my comment, but I see it wasn't clear, was that nurses should not have to give up "being in charge" just because a doctor thinks that they deserve that title because doctors are more educated and qualified. I would argue that doctor's are overqualified to be in charge, and their talents would be wasted doing a charge nurses' work. CNAs and personal support workers are needed at the bedside because you don't need a nurse to change a brief, feed someone, or assist with ADLs; it's smart to use someone like a CNA or PSW to help with those tasks. PSWs and CNAs are able to do the job safely and adequately.

Nurses are the balance between education and patient contact time, plus, we have our licence on the line when it comes to patient care. I don't mean to put nurses on a pedestal (or myself for that matter) or put CNAs and PSWs down at all. Nurses, doctors, CNAs/PSWs/HCAs and so on are very important components of the team. CNAs are not qualified to do many of the things nurses do, just like nurses are not qualified to do many of the things doctors do, but that's why we work as a team. Everyone has an advantage somehow when you're part of the team, and those advantages are multiplied when you communicate and work together. A doctor is the most qualified, but have you ever seen a doctor put a patient in a brief?

As for CNAs and other professionals with contact time with the patient: Just because they have a lot of contact time doesn't mean they should be in charge. Their contact time is valuable and an asset to the team, but their knowledge base is not as extensive as a nurse, nor do they have the qualifications to do certain things. I truly, truly do not mean that in a demeaning way. CNAs. health care aids, personal support workers, social workers, etc etc are very important but their knowledge base is just not broad or deep enough to be in charge in a healthcare setting. I don't work with CNAs, just personal support workers, so I'm not exactly sure of what CNAs do, but I imagine it is largely similar to PSWs (assistance with ADLs, potentially doing vitals, but never giving medications or doing assessments).

While the PSWs I work with "know" the clients in our facility, as per our facility policy and procedures, PSWs can't do a blood draw, give medications, process doctor's orders, assess and redress someone's wound, or give sublingual Nitro if someone is experiencing chest pain from angina. What I was getting at with my comment is that nurses bridge that gap between contact time and qualifications.

That's what teamwork is about: working together. What a lousy team if people keep arguing about who's in charge!

[guest1048932]

8 hours ago, Ron Wallace said:

So your saying a nurse can just open up a office and start nursing people without a doctor....?

Actually, a nurse CAN do this. In Canada, nurses of the extended class, such as nurse practitioners (NPs), can open their own clinics. There are many nurse practitioner led clinics in Canada.

[Julius Seizure]

On 2/6/2019 at 5:28 PM, Sour Lemon said:

Anyway ...the person who was closest to her (CNA) and knew the most about her preferences was the most knowledgeable in her mind, but were they really?

In some ways, yes. In other ways, the nurse is most knowledgeable, and in other ways it will be the social worker, physical therapy, pharmacist, or physician. THAT is the value of a team approach. ?

[kbrn2002, ADN, RN]

On 2/6/2019 at 2:08 AM, vanessaem said:

I hope she knows that there are people who don't think women should be doctors.

She needs to just stay in her lane, shut up and just be a doctor or retire.

Not that it excuses this old school doc's attitude, but think about that statement. There are sadly still people that don't believe women should be doctors. That attitude was much more pronounced years ago and women entering medicine as doctors were few and far between. Depending on how long she's been a doctor her road to getting that degree may not have been easy. Imagine the attitude and probable bullying she got as a med student, probably one of a very few females in her program. She had to grow some very thick skin to survive and thrive in that environment. No wonder she came out of it a little on the prickly side.