questions about dealing with docs...

[jnette]

I'm a new nurse... although have spent my past 30 yrs. around the nursing profession and in the medical field.. have seen a lot, done a lot...now I need some clarification. Perhaps this comes as a result of having served in the military where the docs carried the rank, and therefore we all submitted to their say... but somehow, I still carry around this "outdated" concept of feeling that I must "obey" the docs.

It was a real eyeopener in school to learn about nursing autonomy and the nursing profession's view on this. But somehow, this past concept still lingers and I need some help in shaking it. I still find myself being intimidated by the docs (or at least FEELING like I SHOULD be) and like who am I to question them in ANY regard, or on ANY subject when it comes to patient care. I still allow them to make me feel like it's THEIR patient more than MY patient, and I struggle with knowing where I stand, where the line is, when do I question them, when do I make judgement calls on my own, do I have the right, and WHEN to do so, etc., etc.

Guess it's the old-school thing where the doc makes the decisions and the nurses implement his "orders" without question.

WHEN is it appropriate do do otherwise, how do I know, how do I stand up to it when it DOES occur.. are they "my boss" or not, can "they" have you fired.. etc. etc......... really need some help on this, some real clarification. I want to be a competent and responsible nurse, but I need further guidelines in working out

this issue to enable me to perform to my best abilities and know what I MAY and/or may NOT do concerning the docs. Thanx everyone, in advance. :)

[live4today, RN]

Lynn......welcome to Allnurses.com where we'll treat you right every time. I'll even leave the light on for ya when you're working the night away here, and Vegas will rescue you from being beat up on by those nurses with major attitudes....she'll even bring along her Allnurses Posse to help her out!

I've always treated doctors the same way I treat any other health staff employees/professionals.....regardless of their gender.

I am totally professional when I am at work, and I expect other health professionals to follow suit, especially when they are dealing with me. I take no prisoners, and won't be taken one either.

Just continue presenting yourself as the type of person that you are, and you will become known that way. Show respect no matter what towards the nursing staff, and question when nurses get an attitude with you when you did nothing wrong. You have a right to know.......NOT because you are a doctor, but because you are a part of the entire healthcare team that comes together in unity for the betterment of each patient we care for.

Glad to have your perspective on the Allnurses threads, Lynn. Who knows......your presence here may help answer questions for all concerned.....both docs and nursing staff.

[Brownms46]

Hello Lynn..:),

Glad to see your post on allnurses.com:cool:. I agree with what Renee or Cheerfuldoer stated. Everyone in the healthcare team deserves, and should receive respect at all times. I believe that it starts with each and every person on each healthcare team. No one should be hostile or disrespectful to those who have chosen to enter this field with their primary goal of giving the best care possible to all.

But that said, I have recently ran into one female MD who was not only disrespectful to the nursing staff, but made no effort at all to listen to what a nurse had to say. In fact she was down right rude. Now it is possible that some nurses, just don't know how to take you until they get to know you better. Or maybe they're just burned out, and they're just a little grumpy at the present. But when you stated that their attitudes change once they get to know you, it kind of makes me wonder how do you come across initially.

I must commend you though for coming on a nurse's BB and stating your case. I have a feeling you're a great person and well as a great doc, and only time will tell what kind of MD you become in the future. Don't let the attitudes of a few change you, as that would be a sad thing for all, as communication really suffers will doctors and nurses don't play well together.

Best wishes for a long and successful career, and may you smooth many more feathers than you ruffle...

[globalRN]

Two of the best doctors I have worked with are female...I don't hold female doctors to a higher standard....I expect all my colleagues to provide quality, patient centered care and be a real team player. Collaborative practice models work so well when everyone is seen as a valuable member and their contributions are respected and heard by all...no gameplaying or power issues.

Everyone wins and it benefits the patients/families most of all...the reason we are there.

[bagladyrn, RN]

Originally posted by Dr. Lynn

Bagladyrn,

Thanks for your response. I could be wrong, but I honestly don't think it's my behavior. As I said, I've discussed the problem with other physicians. The women said they'd dealt with it too and the men said they'd noticed it. It doesn't happen with every female nurse, just some. After getting to know me, the attitude ALWAYS disappears and we get along great. It just gets old having to prove myself. Sometimes I just want to be the b!tch they apparently expect me to be. Regarding male nurses, I think that they are treated differently, but I think the reason for this is in THEIR attitude. They tend to be very confident and are quick to both give and demand respect. If everyone behaved that way, we'd all get along great. Oh well...thanks for letting me v

ent.

Thank you for being interested enough to come here and broach this topic. As i said, attitude is seldom one-sided. You may be the victim of a certain amount of cattiness or resentment. I really would suggest that you ask the nurses directly, if possible in a nonconfrontational way, why they seem to be showing an attitude. Perhaps approach this through one of the nurses with whom you are comfortable already, expressing that this is not in any way punitive, but in the interest of improving funtioning. I do know that when there is tension between co-workers it can be uncomfortable and affect the work atmosphere.

I really do have to disagree as to the treatment of male nurses - I think that if you read some of the other threads, you will see many of our male colleagues commenting on the difference between the way they are approached and the way their female coworkers are treated. I'm old enough, both as a nurse and a person to be confident in my knowlege base and have at times had this viewed as confrontational. Actually only get truly b*tchy when that is the only way left to make what I consider to be a vital point regarding patient care/safety. As a travel nurse, I have no issue with continually having to "prove" myself as I am always the new person and an unknown quantity, but I do appreciate being treated with respect and given the benefit of the doubt.

[Sleepyeyes]

OK, I confess, that might've been me, Dr. Lynn. There was a person in street clothes who I didn't recognize at the patient's chart and I'd already caught 2 family members peeking that week, so I walked over to get nosy and intervene for my patient's confidentiality, if necessary.

Well, I got "the look" at about the same time I saw the pen poised over the dr.'s progress notes.... :chuckle ... so at least I knew she wasn't an interfering sister-in-law. I then apologised and addressed her as "Dr." four times in the next 2 sentences.

Moral of the story: Please tell all the docs to wear a lab coat with ID on it while they're on the unit.

When the male docs come in wearing jeans and dragging their preschoolers, pts think it's cute, but if we nurses don't know you, we're thinking someone's pirating pt. info. from the chart, and we tend to get territorial about it.

On the whole, I have no problem with male/female docs. Actually I was a little surprised to find that some are more brusque with the nurses than the male docs are. The last female doc I had to call at home in the morning though-- she was WONDERFUL!! == in the middle of getting the kids off to school, making breakfast, etc, and there I am with a pt whose IV kept clogging while getting a very important infusion.... to ask for a PICC line.

She very neatly rose to the occasion, and amid the chaos of noisy children and flipping pancakes, discussed possible reasons why the IV's kept clogging, and eventually concluding that the best option was a PICC line. I signed off, realizing for the umpteenth time, that she ROCKS! and I simply could NOT EVER be a doc.

(cause sometimes, we nurses wonder if we shoulda tried.... )

[caroladybelle, BSN, RN]

Welcome Dr. Lynn,

Actually alot of the younger MDs have patients call them by their first names - in particular, if the last name is difficult to pronounce.

I personally prefer female MDs (sorry guys - a personal bias). I've warned the new ones about the sluttier male old line MDs - girls got to stick together. I can't imagine ever giving attitude to anyone - male/female, MD/DO/RRT/LPN/CNA/NP - unless I had taken a serious amount of abuse first. But that, admittedly, is not true of everyone. But in my case, it would not be acceptable behavior of a Southern lady.

If it becomes a problem, ask the individual "What makes you feel like treating me like that" and put them on the spot. Require an explanation of the perpetrator. You will either get one or/and stop the behavior.

[RNConnieF]

Dr. Lynn,

Welcome to the board. My sister is an MD also so what I am about to say comes from personal observation; are you sure you aren't sending out non verbal cues that set off the nurses? I am only asking because having watched my sister fight her way though med school I know that the mechanism that she employed to garner the respect she deserved from her fellow doctors (male) was to adopt a very aloof, condescending, "I know more than you ever will" attitude. This condescension became so much a part of her personality that she continues to adopt it even in her private life. If I had a nickel for every time she told me "What a waste, you're way to smart to be a nurse, you should have gone to medical school", I would be able to afford to send my daughter to med school. My daughter already has the "attitude" and she hasn't started yet. Maybe it's the attitude that makes the doc and not the doc that makes the attitude.

[ceecel.dee, MSN, RN]

I'll take a female (always smart and professional, much better listeners, admit to human characteristics) over male (little boys who stamp their feet, whine about missing supper, can't find a thing independantly and need mom...I mean nurse...to hand him the appropriate form) Dr. any day of the week.

PS Pardon my gross generalizations.

[hoolahan, ASN, RN]

Hi Dr. Lynn, welcome.

I am going to go out on a limb and say maybe I do treat female docs differently. For me, it as a response to observing how female docs are treated by their male peers. Esp. Female surgical residents. I think it is deplorable how female docs have been publically bashed. So, in response to that, I try to be nicer to the female docs!

Unfortunately, I guess the effects of being dumped on, then roll downhill, b/c I have rarely been treated well by a female doc. Just the other day I was in an ortho office, I am a case manager so, not in a uniform, and a female surgical fellow was in the office area very loudly c/o a pt who keeps calling her to question one thing or another. She said, "Well, you know she's a nurse, they are always the worst patient's. Give them a little bit of knowledge and they think they know everything.!" Even her male counterparts were giving her eye signals to SHUT UP in front of the other nursing staff right in the same space. Unfortunately, this is the attitude I most often observe from female docs.

My basic rule is, I am courteous and respectful to everyone, as long as that is reciprocated. When my observations are trivialized, or any doc attempts to disrepect me, esp in a public area or Heaven help them, if in front of a pt, then, and only then, will I let them have it with both barrels. I will no longer give them the courtesy of giving that feedback in a private area, if they insult me in front of a pt, they will hear my reply in front of the pt. I am nobody's whipping girl!

[SmilingBluEyes]

Dr. Lynn: Just a quick anecdote to encourage you; I feel my life was saved by a *lady resident *4 weeks ago. I am not being dramatic, either.

Short story: an undiagnosed ectopic pregnancy ( 5 cm big!) growing in L tube. No one would listen when I requested something beyond serial beta hsg's to check progress and ensure it was not tubal ( I was at risk due to scarring issues). Well nearly 8 weeks into the pregnancy, I started to spot every so lightly, NO pain or any other s/s of ectopic pregnancy.

Anyhow, this lady resident jumped in and very efficiently diagnosed and treated me; the darn thing ruptured during surgery! She has been my advocate ever since, taking care of my physical and even emotional needs and is there for me when I need. I respect her beyond words. THAT is a HUMANIARIAN! See, anyone can be a "doctor" (or nurse); well-earned title though it is---- but a humanitarian? Now, that is a doctor I can respect. As a NURSE and a PATIENT. So keep on keeping on...if you do your job this way, you will win the respect of all you wish to, but more importantly, will feel really GOOD about YOURSELF. This will make you impervious to any "attitude" from many you meet. Good luck!

[Youda]

Originally posted by Dr. Lynn

I.rae,

Yes, Lynn is my first name. I am on a first name basis with many of the nurses I work with (although THEIR supervisor reprimanded them for using my first name). Also, my competence has never been questioned and several nurses have told me I'm the best resident they've ever worked with. If fact, on more than one occasion, I have been the one they vented to about OTHER docs. I treat everyone with respect and only ask for the same in return. Like I said, this is not a problem with all nurses and certainly not the ones who know me.

Maybe you're just being too sensitive. Maybe it has nothing to do with you. Maybe you're dealing with a nurse who just had to work her days off with mandatory OT, got yelled at last week by the NM because she forgot to put a bedpan away because she ran to help out with a code, etc., etc. Maybe instead of reacting personally to the behavior you're seeing, you could give a little support, like, "You seem like you're having a bad day . . ." whatever.

[st4304]

I watched and listened for years as my mother's male physician blew off her complaints as "female hormones" and even started her on Prozac for awhile. Finally, I got her in with a female Dr. who actually listened to her and put a Holter on her. She was in and out of A-fib. She also had hypertension and hypercholesteremia. My pediatrician is female, my GYN is female and my FMD is female. I am a cardiac nurse, and a cannot tell you how many stories I have heard from my female patients about how their FMDs misdiagnosed their heart disease (women have atypical angina!) as 'female problems' or 'anxiety'.

Lynn, you sound like you are a very sensitive and caring person. I am sure you are a great doctor! Good luck to you and I wish you the best.

Sherri