Talking to Physicians

mn_nurse · Mar 28, 2010

I also work in an ICU in a teaching hospital. Most of the docs that come through are in a rotation for 30 days during their 1st or 3rd years as residents. Most of them realize that the nurse is more familar with the patient and unit and will seek out the nurse when they are needing info. If the physicians seem unapproachable and you need to convey info, use the SBAR. (http://www.aspan.org/ClinicalPractice/SafetyinPractice/SBARReporting/tabid/3955/Default.aspx)It will help formulate your thoughts in a way that most docs can relate. One thing I try to do when I do my assessment is ask myself 'what do I need from the docs?' This way when they round I have my questions/concerns/needs all ready to go and then they are not surprised if I call them later.

tigarlily25 · Mar 28, 2010

Your just nervous, it will get easier as you gain more experience, and confidence, for now just know what u want to say, what you want to gain, and pertinent information you may need such as, last set of vitals, intake output, etc...dr.'s dont have alot of timr, so dont babble, just say what u need precisely and to the point.

barlowjb · Mar 28, 2010

When you need to call them on the phone concerning a patient condition, start by writing down what you want to say, then without procrastinating call them and get it over and done with.

Then when you see them in person, introduce yourself to them. For example if the Dr. comes by to make his/her round and you are close to where they are go up to the person and say "Hi Dr. So and So, my name is xxxx, I've spoken to you on a number of occasions" or something like that, or if the Dr. is visiting one of your pts you could say "Hi Dr. So and So, I'm xxxx the nurse for the patient Y, how are you, are you planning to write any new orders for pt Y" or something like that.

You don't have to go overboard with it, just do it naturally... you know what I mean? like say you see one of the other nurses when you are at work and you say "Hey Marie, how is it going" Kinda like that is what I mean.

You are new and you may feel a little intimidated for a while, but over time especially after getting through the stress of orientation you will get better and feel more relaxed with other nurses and physicians that you work with.

I hope I made sense

By the way Congrats on your ICU Job!!!

DLS_PMHNP, MSN, RN, NP · Mar 28, 2010

Everyone puts on their pants the same way, one leg at a time.

tookdaddy · Mar 28, 2010

I do this really cool "jumping into my pants" thing where both legs go in at once. But anyway..... Rarely do I start out by asking the doctor for something. I usually tell them what assessments are concerning me, and then I tell them what I think is going on. Doctors usaully end up giving me what I want when I do this. When I start by asking for a specific order, I am less likely to get what I want (especially with surgeons).

Kooky Korky, BSN, RN · Mar 28, 2010

be prepared.

have the patient's name, diagnoses (especially the one related to the concern you have at the moment that particularly relates to the doc you are calling or talking to live - like had an appy but is now having seizures and a neurologist has been called to consult. neuro ordered dilantin but pt is still seizing. neuro will want to know what the seizures look like, any prodrome, post-ictal description).

know the most recent vs and it can't hurt to have the i & o. what other meds is he on? any prn's given? when?

have the most recent labs. like, in this case, when and what was the last dilantin level? what was the one before it? and what dosage of dilantin has he been on for how many doses?

always have the chart with you. if you're not on paper charts, have access to the whole record quickly, quickly, quickly at your fingertips. put yourself in the doc's place - you are called by a nurse who has no numbers available, tells you to hold on while she hunts for the labs, the vs, all the info you need. you can understand why this doesn't go over well.

never let a doctor's impatience or rudeness stop you from getting what your patient needs. even if some tired or just rude doc snarls at you or says something vicious, you will have done your duty.

chart the response only in non-emotional terms "per dr. smith, no new orders at this time", even if he called you a jerk and slammed the phone down hard enough to break your eardrum. that part you write in a grievance.

don't hesitate to call back or get the supervisor involved if you need to. she or he has had more experience in standing up to these guys than you.

in person if a doc is rude to you and there are other staff around, sometimes silence is the best reply. they will feel your shame and hurt (don't let the anger show just then) and take up for you. maybe not right then if the rude butt was an attending, but later they will often let you know they were embarrassesd by his behavior and will help you.

most doctors are pretty decent. i'm not trying to scare you, just prepare you.

good luck.

gtoko · Mar 28, 2010

I agree ,using the SBAR format will help you organize and present in a clear, concise manner. Have a confident tone in your voice.

Just picture the person in their underwear...

Good luck :)

matchsticktgt, LPN · Mar 28, 2010

I also work in an ICU in a teaching hospital. Most of the docs that come through are in a rotation for 30 days during their 1st or 3rd years as residents. Most of them realize that the nurse is more familar with the patient and unit and will seek out the nurse when they are needing info. If the physicians seem unapproachable and you need to convey info, use the SBAR. (http://www.aspan.org/ClinicalPractice/SafetyinPractice/SBARReporting/tabid/3955/Default.aspx)It will help formulate your thoughts in a way that most docs can relate. One thing I try to do when I do my assessment is ask myself 'what do I need from the docs?' This way when they round I have my questions/concerns/needs all ready to go and then they are not surprised if I call them later.

:cry: the link doesn't work - any way of fixing it??? pretty please

Ivanna_Nurse, BSN, RN · Mar 28, 2010

Fake it till ya make it. We all started there once. After some practice and getting familiar with the docs, it will be like butter on hot toast. Ivanna

enchantmentdis, BSN, RN · Mar 29, 2010

Hi, I am just starting as a RN in an ICU. For some reason I feel very inferior to other nurses and physicians as a new grad and I have trouble talking to them. How do I boost my confidence to be more outgoing instead of quiet and how do I talk to them easier?

Hi: As a nurse in the trenches for 15 years i have some sage advice for you: there will be times when you might have to turn to a doctor and say "you know, it would help if you would listen to what i have to say". I have actually had to tell physicians not to berate me in front of other staff, and that if they have a problem with me take it to a private environment, be professional and don't yell at me to get your point across.

You will boost your confidence as you gain skills and sensitivity while caring for your vulnerable patients, for they are at your mercy.

In order to be more outgoing don't be afraid to approach someone and say " Hi, i am nurse happy gal', and extend your hand". Touch is so important. And maintain a professional demeanor and keep a sense of humor. Also if someone-- a nurse, unit clerk, cna, whatever, is relaying a story about their pet, remodeling of their home, or type of food they like, chime on in and start talking. They will instantly like you if you find common ground and if you find this common ground, you will have allies. This is how i became friends with nearly everyone i worked with---except management, LOL!

You've asked a great question. You will become a psychologist of sorts if you study people before, during, and after speaking; and try to anticipate the needs of others before others do---especially for the MD and the patient, whomever. When you satisfy a need such as providing the pain med before requested or hand the physician the lab work before he yells for it, you will see miraculous things happen, and your confidence and well-being will flood your heart with a nearly unbearable sense of purpose and duty to mandkind. Good luck to you --dear fledgling nurse. ZEE pepeeell expeeert.

Blackheartednurse · Mar 29, 2010

I can definitely relate to what you feeling..I'm a new nurses on my six week of orientation and I also feel very intimitated by my fellow more experienced co-workers and with doctors I'm not so much intimitated by THEM per say but I worry more about not understanding what they want me to do, incorrectly transferring a telephone order ,misunderstanding a verbal order..basically I havent had any doc screaming at me yet in my short career but I definitely see it coming once I start working my own...I'm anticipating doctors dissatisfaction with my work when I will make some mistake in the future (I mean everyone makes mistakes sometimes!) Usually I just tell em straigh up honestly "look I'm new here I'm on orientation have patience with me I will try to do my best and if I dont know I will ask my preceptor" that seems to work and ease my relations with doctors,they seem to understand that I'm in the middle of the training and everyone including them were once new and green.