"We're Just Nurses" ..... Grrrrrrr!!!

Specialties Emergency

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"We're Just Nurses, We're only looking at how cute his X-Ray is"

So yesterday I'm doing one of my last clinical shifts in emerg before I graduate (only a few more shifts to go!) and we have this septic baby come in. Lots of stuff was done for the baby, including chest x-rays. So we get the x-rays back, and I take them over to the light-box thing and look at them. In my head I'm trying to figure out what I should be seeing (if anything) fluid? consolidation? pneumonia? My nurse-partner comes over and starts to go through the x-ray with me, and explain what I'm seeing. Another nurse walks over and starts to go ga-ga over how cute his little chest is, and how cute his little teeny-tiny bones are. Mom and Dad hear her talking like this and come over to look at the x-ray too. Fair enough, I'd want to see it too. They ask if we see anything on it, and before me or the nurse I'm with has a chance to say anything, this other nurse replies: "We don't know, We're Just Nurses, We're only looking at how cute his X-Ray is"

I couldn't believe it.

I always try to read the x-rays with the docs, and have them explain to me what they see (or don't see), and have the nurses & docs explain to me what they're looking for......this lady left me speechless. I could feel the fire inside my head start to flame, and the nurse I was with was just as flabbergasted. Its attitudes like this about nursing that really made me second guess my decision when I first started school.

Sorry, I just had to get that off my chest.....How would you react to something like that?

Specializes in Emergency Room.

put it this way... most nurses may know what a bad xray looks like, for instance a huge infiltrate or a severe cardiomegaly, but for the most part it is not something we are taught to master. i can understand how you feel, but try not to be too upset. i doubt the parents took her too seriously.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Sorry, I just had to get that off my chest.....How would you react to something like that?
In the U.S., it is beyond the RN's scope of practice to interpret x-rays.

However, the other nurse's comment was very inappropriate and uncalled for.

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Specializes in CRNA, Finally retired.
"We're Just Nurses, We're only looking at how cute his X-Ray is"

So yesterday I'm doing one of my last clinical shifts in emerg before I graduate (only a few more shifts to go!) and we have this septic baby come in. Lots of stuff was done for the baby, including chest x-rays. So we get the x-rays back, and I take them over to the light-box thing and look at them. In my head I'm trying to figure out what I should be seeing (if anything) fluid? consolidation? pneumonia? My nurse-partner comes over and starts to go through the x-ray with me, and explain what I'm seeing. Another nurse walks over and starts to go ga-ga over how cute his little chest is, and how cute his little teeny-tiny bones are. Mom and Dad hear her talking like this and come over to look at the x-ray too. Fair enough, I'd want to see it too. They ask if we see anything on it, and before me or the nurse I'm with has a chance to say anything, this other nurse replies: "We don't know, We're Just Nurses, We're only looking at how cute his X-Ray is"

I couldn't believe it.

I always try to read the x-rays with the docs, and have them explain to me what they see (or don't see), and have the nurses & docs explain to me what they're looking for......this lady left me speechless. I could feel the fire inside my head start to flame, and the nurse I was with was just as flabbergasted. Its attitudes like this about nursing that really made me second guess my decision when I first started school.

Sorry, I just had to get that off my chest.....How would you react to something like that?

Since I am tactless, I would say nothing for the moment. When I'm in a calmer mood, I'd speak directly to the nurse involved. You will always have to work with jerks: you can't change that. But you CAN change how you're going to handle them. You allowed her to make you angry (she's embarrassing you? A direct affront to your profession?). Don't let other people's stupidity rile you too much because you're gonna have to deal with a lot more of it. You'll be much happier if you can learn to assert yourself gracefully now. I finally learned how after many years, but I don't do it gracefully. Most of the time I'm grumpy but I've been at this for too long!

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Specializes in Emergency.

Thanks for your comments everyone. I totally agree with you, I know it is out of the nursing scope of practice to interpret x-rays, and I should in no way be offering interpretations or diagnoses to the patient or family. But when she said that, and the way she said it (ditzy!) .... urgh..

Thanks for letting me vent!

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Specializes in Emergency, Trauma.

When pts ask me about their Xrays or EKGs, if it looks normal, I usually say "nothing's jumping out at me as out of the ordinary, but the physician has to read it to give you a definite answer"...if there's something wrong with the result, even if I've positive I know what it is, I go with "looks like there may be some abnormalities, which may or may not be normal for you, the doctor will really have to give you the results"...I hear nurses remark all the time with EKGs (which to me seems like a fairly basic skill for an ER RN to at least be able to recognize rhythym/obvious abnormalities), "oh I just do the test, the doctor reads the results" or even worse, when a pt asks why he's receiving a particular med, the nurse answers "because the doctor ordered it"..okay, I know I'm veering off topic, but these things just make me cringe.

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Specializes in Rural Health.

EKG's are our biggest for for those "what do you see" statements and I just smile and say....the doc will look at this and compare to previous readings and then be in to talk to you about the results. If they don't like that answer, I sometimes throw in...we have to compare your EKG to xrays and lab results to get a full and complete "picture" of the situation so as soon as the doctor has all the necessary information, he or she will be in to speak to you.

CT and complex xrays are sent to virtual land to be read by a radiologist where I work, so it's very easy to say...the doctor has looked at your (fill in the blank) and now the radiologist is reading it, which is done on all (fill in the blank) procedures. The final report will be faxed to us within the next 30-45 mins. and your doctor will be in to speak to you then.

I love to look at Xrays and EKG's, however our docs not only look at the current but also previous and compare to baselines, which is WAY outside my scope of practice so while patients may fret about their results and get upset...I can't tell them anything either way because I truly have no clue. However, I would use more tact in my statements than "I dunno....I'm just a nurse".

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Specializes in CCU/CVU/ICU.

As far as explaining xray and ekg results with patients/families...i suppose the various ways of deflecting these answers 'to the doctor' are all well and good.

However, with ecg's, i have no qualms in telling the patient/family what i'm seeing...though many times it's a good 'habit' to be a little non-commital (rather than 'certain' ...) of results. ALOT of this is how you approach people and explain things, your comfort level, and your skill/ability. Thus far, i've not been dragged out of the hospital in chains and sent to nurse-jail.

As far as x-rays, i explain chest-films to family members alot. I'm not diagnosing things...but once the family has been informed of results, i'm more than happty to show them. This, i've found, helps the family to get a better 'idea' of the issue...and helps to foster a better 'impression' of nurses as far as i'm concerned. Or...i could just say 'i dont know...i'm just a nurse...ask the doctor...but they sure are cute..'

Also...i am a firm beleiver that nurses who rely on '...you'll have to ask the doctor...' or '...i cant give you information because it's against the rules...' or '...it's out of my scope...' can make themselves seem like they're hiding behind walls and concealing their inability...which could potentially add tension to already tense situations.

The trick to this, of course, is how you present yourself/the information, and your skill at navigating the 'grey-areas' (or i suppose 'pushing the envelope') of your 'scope'....and refrain from being dumb when going about it. It's done ALL the TIME by LOTS of nurses all over the country.

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Specializes in Emergency.

I usually try to say something like "These x-rays of your child will be evaluated by a radiologist, which is someone who specializes in interpreting these images. Since my specialty is nursing, I can't interpret your child's x-rays or diagnose their condition, but I can explain what these x-rays will show us. Some of the things a radiologist will look for is fluid in the lungs, which might indicate pneumonia. X-rays can also show if there is fluid elsewhere in the chest. If you are interested in knowing more, the doctor would be happy to explain the results of the x-ray with you".

I try to avoid saying "I don't know", or "I can't tell you, you'll have to ask the doctor". The only time I say "I don't know" is when a patient asks me if a certain medication has a certain side effect (ie reglan and dry eyes, or something weird like that). I'll say "I don't know the answer to your question, but let me look it up". Then, I'll look up the answer on my PDA right in front of my patient and in less than 15 seconds, they'll have their answer. Sometimes, being able to answer a patient's question is therapeutic in itself.

I wish nurses would stop saying "we're just nurses"...it reinforces the public image that a nurses job is to follow the doctors orders or assist the doctor. Whenever I get a patient that says something like "nurses follow doctors orders", I say "actually, my job is to protect you from the doctors orders and to advocate for your needs". :lol2: Ha ha ha ha...how many times have you seen MD's prescribe a medication for a patient who has a documented allergy to that medication? Or write orders for the wrong dose? Or say "we can give the patient either a IM injection or a rectal suppository for their nausea". As a patient advocate, I'll say "How about sublingual zofran instead?".

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that nurse doesnt have the right attitude. to say that , "were JUST nurses" clearly degrades the profession. while it is true that there are other stuff that only doctors are really proficient at, that doesnt stop us from asking from doctors regarding stuff in xrays or the likes. i mean i dont stop myself from asking the doctors i go to duty with regarding stuff like that. learning is NEVER static, it is always dynamic.

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Specializes in ER, telemetry.

Well, in regards to EKGs, I have had a certain level of training in reading them, so I do feel confident in my ability to read them. However, if a pt asks what the ekg shows, I usually tell them that it does not show anything life threatening or serious, but the doctor is going to look at it to be sure. I always explain what meds are for, and if I don't know, I look it up or ask the doc. Nurses who respond by saying, "the doctor ordered it", IMO, are either lazy or stupid.

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Specializes in med/surg, rural, ER.

We may not be trained in reading x-rays, but with practice we can become fairly good at it. We had a neurologist in the ED the other night admitting someone and she asked the RNs what we thought of the chest xray, the patient and her plan. (fluffy lungs, obviously needed lasix) In collaborating with us she agreed to 40mg of IV lasix (vs the 20 she originally thought) and called for an Internal Med consult. It was nice to be asked about what to do.

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Specializes in Emergency.

I understand your frustrations at that nurse's reply. I do think that it makes a nurse better if she/he can look at tests (labs, ekgs, xrays, etc) and have some kind of idea what is wrong. I used to fly on a helicopter for an air ambulance company and we would walk into very small town ERs where the Drs, PAs,ARNPs would literally have us look over everything to make sure they didnt miss anything. They would wait for us to intubate, insert chest tubes, etc. The look of relief on their faces was amazing. We took classes on EKGs, spent time with trauma docs, etc to be able to be competent enough to give our educated opinions about care of the patient. Our medical control (a trauma doc) was always a phone call away if we had questions, or if we just needed to make sure we were going down the right path. Plus, we had to be able to look at chest xrays to determine if there was a hemo/pneumo because if so - a chest tube had to be placed before flying because of flight physiology with air expanding, etc.

Education will only make us better - even if it is just a doc explaining the why and what for of a situation, etc!! Keep askin questions!!

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