The relationship between doctors and nurses...

Published

Specializes in LTC/Behavioral/ Hospice.

Ok, don't shoot me but I think for a long time I was under the mistaken impression that doctors are automatically nurses "bosses". I know, from reading allnurses for a few months now, that that isn't always the case. What I am wondering is, what exactly IS the relationship between nurses and doctors? Where does doctor authority end when it comes to nurses? I'm sure I will learn this as I go further into my studies. Please be patient with me.:chuckle

Dog eat Dog? LOL

As a nurse my boss is another nurse as is most in the hospital where I work (nurse managers). As for doctors- we have a relationship of working together as we do with PT, OT, Social Work etc (and like all departments- you work better with some than others). In our hospital, we can write up Docs, the same way we can write up aides- and yes we have done it including myself when a Pt's safety/health was on the line. They can do the same for us. Doubt they do or have the time.

Hope that helps- that is just one perspective.

Specializes in Nephrology, Cardiology, ER, ICU.

In a good environment - doctors and nurses work closely together. They support each other and teach each other. I work in an ER where we have a very good relationship with the doctors (I'm a case manager). It is not necessarily a boss/employee relationship - its more than that. I'm sure you will encounter this as you pursue your career. Good question.

Where I work, the docs are available for consults, when we need a 2nd opinion or when there is a question regarding the patient's care. Otherwise, my "boss" is my nurse manager.

The only civilian situation that I can think of where a doctor is a nurse's 'boss' would be a private practice in which the nurse is the direct employee of the doctor. (Don't know about military as I haven't been that route.)

Otherwise, the nurse and doctor are part of the same healthcare team that provides care for the patient.

In CCU we see the doctors frequently and are their basic eyes and ears so to speak I often give a brief verbal run down of a Pt's condition to the doc as he rounds. They usually begin with the chart and then ask: how does s/he look today? lungs sound any better? eating any better? having bowel movements? etc. whatever the case may be as to illness. Our docs are for the most part very informal and easy going there are of course exceptions to the rule but it is usually an environment of working together toward a common goal. Being CCU we mostly see the same docs all the time Intensivists, Pulmonolgists, Nephrologists, Thoracic Surgeons and Cardiologists.

I worked med-surg for many years and the docs were a lot less inviting of comment or opinions and we saw them for much shorter periods and much less frequently.

In a hospital setting, the doctor is responsible for the diagnosis and treatment plan for a patient. She looks at the patient, lab results, clinical findings, and (the good docs) input from other health care team members. Nurses, respiratory therapists, physical and occupational therapists. The doctor then decides what to do for this patient and writes these as orders on the chart. Part of my job as a nurse (notice I said "part of") is to carry out these orders. I am also responsible for noting patient's response and reporting this to the doctor. The doctor cannot possibly be at the bedside of all her patients; I act as her eyes, ears, nose, and hands; she is the quarterback of the team, calling the plays; but I have a duty to provide my input too.

She (the doctor) is the one who truly carries 24/7 responsibility for this patient. She is not my boss; she cannot hire or fire me; she does not pay my salary. She is in "charge" of everything that goes on with this patient, and hopefully, I can be a great help to her by doing my part of the job, making accurate and complete continuing assessments, conveying my observations and concerns in an appropriate manner, and carrying out her orders in a timely fashion. Respiratory, PT, and OT also follow doctors' orders; the doctor also is not their boss.

As a full-fledged member of the health care team, it is also my responsibility to question orders I don't understand, or orders I don't feel comfortable with. My "quarterback", the good doctor, will appreciate this and explain what she has in mind, especially if I question in a professional way, seeking knowledge and understanding.

Of course, I have my own "nursing diagnoses" and "plan of care". Not all my work involves doctors' orders, and the doctor cannot "boss" me, except in the area of her patient's care. The relationship should be a team, with the doctor the head of the team; not boss-employee.

This is an ideal situation. Not all doctors are like this, although I have worked with many who are. And I'm glad it's their call, not mine.

Specializes in Med-Surg.

We're collaborators in patient care. :)

Specializes in Home care, assisted living.

I came across an interesting term in one of Dr. Ben Carson's books. He refers to nurses as his medical "sisters". (of course male nurses would be "brothers"). So I guess the relationship between doctors and nurses would be brother-sister, complete with sibling rivalry. :roll

Specializes in NICU.
I came across an interesting term in one of Dr. Ben Carson's books. He refers to nurses as his medical "sisters". (of course male nurses would be "brothers"). So I guess the relationship between doctors and nurses would be brother-sister, complete with sibling rivalry. :roll

That's actually pretty accurate, at least at the teaching hospital where I work. We all work together and call each other by first names, at least when the families aren't around. But it's like the doc is the older brother or sister, and the nurse is the baby of the family. Being the oldest child comes with some degree of power over the little ones. Basically we're working as a team, but really in the end what the doc says, goes.

Try thinking about this another way. Doctor is the name of an acedemic degree not the name of a profession.

The profession is physician.

There are many people with Doctorate degrees in nursing.

These are two seperate professions.

Thier focus is different just as the focus of a chiropractor or acupuncturist are different and yet you can hold an acedemic doctorate degree in either of these professions.

One profession does not direct or "boss" another. They can not because they have different knowledge bases and different philosophies. How could a Acupuncturist direct a chiropractor?

+ Join the Discussion