Thoughts on nurses who became physicians

[NurseMcMuffin]

Hello Allnurses,

Long time follower. I was a pediatric nurse who went to medical school and am becoming an intern later this year. When applying to residency, my being a nurse was widely valued by the program directors and even landed me several Ivy league interviews which is awesome and I believe speaks to the strength that our perspective bring to medicine. I was very supported by the nurses I worked with while taking my pre-reqs. However, this has not necessarily been the case while as a medical student which has been stressful and unfortunate.

When I began my clerkships in the 3rd year, I was on my pediatric rotation. I was in the room of infant with RSV who was desatting to the mid-high 80's. Respiratory had given a neb due to the thick secretions and the patient hadn't been suctioned, so I took it upon myself to suction the baby, repositioned and when the baby continued to have increased WOB after a few minutes I turned up the oxygen by 0.5 and then 1L. I told this to the nurse when I left the room and went about my day. Later I found out she had gone above my resident and to the supervising attending to complain that I was left alone in the room with an "unstable" infant and allowed the baby to desat. She did not want me in her patient rooms without being supervised by a resident (which truly is not feasible as I am to pre-round before morning report). The reason I delayed was because I watched the sats and counted the respirations for a few moments to make sure that my suctioning intervention had worked before going up on flow. I even explained my reasoning to the nurse.

The nurse and I had talked about my having been a nurse prior to medical school. I'm in no ways green. I was a charge nurse, have trained new nurses and nursing students alike and have been certified in my field of nursing. I understand that I am an unknown variable and that nursing is protective of their patients (rightly so). I apologized to this nurse as perhaps I had overstepped. I spent the rest of the rotation going out of my way to find her and tell her when I was examining her patients and what I would be doing in the room. She refused to speak with or acknowledge me in any way. I'll admit this bothered me as I have always prided myself on being a team player and I believe in killing with kindness. Respect is not given but is earned..but, I also assume people to be reasonable.

I had thought that expressing my background with her would create a sense of cohesion and mutual understanding between us. I wanted nursing to know that I understand their plight and aim to be a provider that can bridge the gap between nursing and medicine to improve patient safety. After this incident, I didn't tell future nurses that I had been a nurse. I don't do so because I am afraid that it will lead to potential animosity towards me when I am a resident. Your thoughts on if this is something best kept to myself or am I overthinking this? 

[lifelearningrn, BSN, RN]

I think you're overthinking it. You will always have someone who will question or complain. Don't change who you are based on one experience. Congratulations on Med school! 

[DavidFR, BSN, MSN, RN]

Some people are just jealous to see other people trying different things and having a go at something they haven't done. I've known 2 nurses turned doctors and yes, their nursing perspective contributed to them being very good doctors, as I'm sure you will be. 

[toomuchbaloney]

Don't worry about things that are outside of your control.  Just be you and do the right thing, that's always easy to defend.  

Good luck. Nurses make excellent medical providers.  

[JKL33]

Just move on/let it go. That nurse sounds somewhat maladjusted/miserable. I bet if you would've walked out of the room without doing anything and requested that she attend the child/intervene, the criticism would've been that you acted high and mighty and wouldn't even help the baby because those interventions weren't your job as a big shot doctor.

Some people are just not happy and are always looking for an opportunity to tell themselves that they are better than someone else. Don't waste any of your time/life on it. Those problems are theirs, don't let them become yours.

Don't assume you're going to have extra problems with nurses because of your circumstances or that you'll need to bend over backward in order to get acceptance. I don't think that will work out well. Just go with professionalism, basic respect and general kindness.

Good luck with your internship!! ??

[londonflo]

Quote

so I took it upon myself to suction the baby, repositioned and when the baby continued to have increased WOB after a few minutes I turned up the oxygen by 0.5 and then 1L. I told this to the nurse when I left the room and went about my day

I have a different take on this. you should have activated the call system to nursing to do your great interventions before telling the RN and then acted on them. . The RN may have been in  report telling the next shift about the baby being stable, ..Now it takes a call back "I was not kept informed. ("where you you RN"???)  the baby has oxygenation problems".

[JKL33]

londonflo said:

I have a different take on this. you should have activated the call system to nursing to do your great interventions before telling the RN and then acted on them. . The RN may have been in  report telling the next shift about the baby being stable, ..Now it takes a call back "I was not kept informed. ("where you you RN"???)  the baby has oxygenation problems".

I think we can have our opinions about how it should've or could have been handled by the OP in the moment, however the subsequent backlash from the staff RN was straight up malicious; I can think of no better word at the moment.

In your scenario, "hey--thanks for helping--but can you please also push the call light next time you're in a room where there's trouble? ??"  That's a little different than trying to besmirch the OP to his/her attending and refusing to speak to OP thereafter. As I said, miserable person.

[ponderingDNP]

DavidFR said:

Some people are just jealous to see other people trying different things and having a go at something they haven't done. I've known 2 nurses turned doctors and yes, their nursing perspective contributed to them being very good doctors, as I'm sure you will be. 

Exactly! Jealousy written all over that...and/or a little bit of an inferiority complex. What busy RN has a problem with anybody of equal or higher qualifications stabilizing a patient of his or hers? Makes no sense to me.

If it was me and the OP was rounding on my patients, I'd take the opportunity to go relax the nurse bladder, confident that my patients are in good hands. But that's just me.

[cowboysandangels, BSN]

I think having a nursing background is the best case scenario for a med student.  You already have experience in medicine, you understand the relationships between doctor and nurse, and clearly you have a passion for it and are moving forward.  I am happy and excited for you.  You will never please everyone.  Take it like a duck coming out of water and let it roll down your back.  

[Barriss Offee]

I am sort of similar to you. RN to PA. I remember being on an emergency medicine clerkship in PA school and one nurse treated my very similar to your experience. Some nurses don't like med/PA students I think and take it upon themselves to try to bring you down. The inverse can be true as I have heard of PA/med students being rude to nurses. 

You are definitely overthinking. You counting the respirations is not delaying care. That's literally the only way to check respiratory rate. 

[C.Love, MSN, NP]

It may be jealousy, As an NP, on rare occasions I run across weird situations where the nurse  treats me kind of poorly but most nurses are super nice to work with.  I'm glad you're in Medical School. You will find more positives than negatives bringing your RN experience and intuition in. 

 

[brandy1017, ASN, RN]

My only question is I thought when we suction we are supposed to increase oxygen briefly before as the person will desat from the act of suction.  I never worked pediatrics or neonatal though so don't know the rules there.

Congrats on medical school and your internship!  Wish you the best!