Things you wish doctors would do/say differently?

[Larissa5838274]

I feel a bit like I'm invading a sanctuary here, but I hope it's well received. I'm a new grad doctor, previously a physio, and my partner is a nurse. Before medicine, I already had the view that nurses are the cornerstone and bedrock of health care. Im aware that the only reason I did medicine instead of nursing is because I'm not nearly good enough of a person to do what you do, in the environment you do it in. My studies have only confirmed this. Doctors would be left floundering without nurses, many having no idea how to action the things they themselves ordered. 

I'm aware, and extremely grateful, that there is a change happening among the newer generation of doctors. There's less superiority complex, less toxicity, less bullying, and a better (right) regard for the whole healthcare team. That being said, we all know there are still absolute shitheads out there.

I would like to ask you nurses two things:

1) what are things you wish doctors would do/say differently? Worded another way, what do doctors do that make you feel disrespected, belittled, ignored, etc? Not just talking about the doctors who yell and curse. Disrespect of any level I think is unacceptable, even if it's not bothering to make eye contact with you on rounds. Anything a doctor has done that's made you feel even a little rubbish, I'd like to know about it, so I can both avoid it and communicate better in cases where it's an unfortunate misunderstanding.

2) How would you feel if another doctor stood up for you when a doctor was being rude to you? I've been politely but firmly challenging and confronting doctor attitudes as both a physio and med student, with more success than not (we won't talk about that one...), and I have every intention to continue doing so as a junior baby doctor all the way through my career. But, I don't want to presume to be some kind of rescuer. Truthfully, I'd confront anyone being rude to someone else, regardless of roles (e.g. nurse to doctor, doctor to nurse, doctor to doctor, nurse to cleaner). But I know it could come across differently. At the same time, I know nurses can be anxious to speak up for themselves from fear of repercussions. So, would you appreciate doctors calling each other out for rude behaviours?

Side question: what are one liners/ things you wish you could have said to doctors in the past but couldn't? Let's vent! And also fill up my pocket with things I could workshop and rephrase to stick it to bullies in a way HR can't get mad at me for

[Rionoir, ADN, RN]

I dunno, that's a tricky situation. Some people deserve the dressing down they get once in a while for being lazy and/or ignoring things they shouldn't. Maybe look to see if the other nurses are smirking first before inserting yourself. ?

 

[DavidFR, BSN, MSN, RN]

That you even think the way you think as a doctor is a huge encouragement. 

I can't speak for the US but in the two countries I have experience of (France and the UK) things have evolved over the years. Doctors are no longer Gods but colleagues. 

I do get angry with doctors stating the obvious. I once reported a fall and the young intern's response was, "You know, you have to pay atttention with eldery patients on blood pressure medication! Be more careful!" I did inform him that I do survey my patients, I just can't divide myself up in pieces and  be in every room at the same time, the whole shift. Sadly even with the greatest of surveillance, sometimes patients fall. 

I also won't  tolerate doctors trying to advise me on drug administration - that's a nurse's domain. You prescribe the drug, the dosage and the route. If it's IV I know whether to put it in glucose or saline, which volume and over how long thank you. I do it all the time, you don't. If I come accross a new drug I don't know I'll check it out with pharcmacy. 

This is a two way street. I've seen know-all nurses argue with doctors, not because they actually disagreed with the clinical decision being made but just to show off some knowledge (or lack of it) and "prove" they can "argue with doctors". I'll challenge a decision I patently think is wrong, but that happens very rarely, and I do respect the greater years of training of education many of my doctor colleagues have done, just as I expect a care assistant to respect my decisions unless I'm really out of line - and I will listen to care assistant's opinions/point of view.

[mmc51264, BSN, MSN, RN]

I wish the surgeons would quit telling the pts they can go home. At 0600!! Get report and I go in and they are dressed and ready to go. They don't have home health PT set up, or many of the things needed for discharge. Because then they don't answer pages when we need the actual d/c order. 

[londonflo]

And their 'ride' is already there! Looking at you with 'daggers' in their eyes!! complaining about the time...

[canoehead, BSN, RN]

True, if you are discharging the patient please let them know they need to allow time for the process after you put in the order.

When I'm calling in the middle of the night I really don't want to bother you, but it's the job. I'm worried, and sometimes unsure if I need you, but I won't be calling just to annoy. (I'm sure there are some vindictive jerks that do it on a power trip but if I call repeatedly I'm definitely trying to help the patient) And I HATE calling for Tylenol in the middle of the night, but if its hours of pain for the patient vrs 5 minutes of pain for the physician, I will. Standing orders are your friend.

When I think the patient is circling the drain you will hear "please respond to the bedside" Thats code for come here and look for yourself, it's bad. Possibly there is family standing in earshot, or I want to be clear about what I need. I imagine there will be a similar phrase where you work. 

If I have a demented patient and you order 0.5 of Haldol, I will curse your name with vigor! If you order one unit of insulin, the same, and I will go wave the vial over the patient and threaten them with an injection. These are the why-the-hell-do-we-bother orders. Aricept for the 90yo bedbound patient....please. I want a little extended release morphine for her arthritis, instead of Tylenol Q4h PRN, and let her feel comfortable while she's ill. (lazy nurses don't give prns around the clock remember)

Welcome to the family, you're going to be learning a lot about the human condition.

[beachynurse, ASN, BSN]

As a school nurse, if you are dealing with pediatric patients, please don't write notes for parents just because they ask you too. I get so many requests for leaving class 5 minutes early for kids without assistive devices, or any need for the accommodation. I've even had MD's write a letter requesting a student to have a service dog at school. The service dog turned out to be her 10 year old mastiff that had no training and she just wanted to bring her dog to school. When I called the MD to ask him about the letter, he was floored, and said he had just written the letter because the parent asked.. Please ensure any requests or accommodations are truly needed. 

If you aren't sure how to fill out medication orders for the school, please call the nurse at the school for advice. In my school division, I cannot accept orders that are incorrect, and I can't accept the medication either unless we have a valid, correct order. That only delays the student getting their medication at school.