Tips for New Interns: How To Get Along With The Nurse

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

I taught an ACLS class this afternoon, and all the participants were 4th year medical students. They're scared and excited about being real DOCTORS in a few months! One of the topics that came up was how to be on good terms with the nurses. I came up with a few ideas right off the top of my head, but what do you guys think? What would you tell them?

The first few things I thought of were:

Don't ever tell a nurse your first name is "doctor." Your mother gave you a first name, and although I have known a few MDs with the LAST name of "Docter", I haven't ever met anyone with a FIRST name of "Docter." And nothing irritates an experienced nurse MORE than being asked to call some kid 30 years younger than herself "Doctor Smith." I'm likely to say "then you can call me "Mrs. Vee." You don't want that.

When you come to see my patient, tell me who you are. And don't ever tell me "I'm his doctor." We have a lot of those in most hospitals. Are you the psych consult, the cardiologist who admitted him, or the nephrology resident coming by to evaluate him for dialysis? It would be nice of you to say "Hi, I'm Althea. I'm the pulmonology resident here for a consult."

Bring us chocolate. We like chocolate!

So what would you guys like to tell the new residents who come to work with us?

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Specializes in ICU, PACU, Cath Lab.

Never...and I mean never say the words.."you are just a nurse" You will find out quickly what the consequenses for this statement are...and usually include very lil sleep due to the "just a nurse" having to call you every 10 minutes to update you and get an order for tylenol....and then one for zofran....and then one for.....ok I think you get the pic....and then when we save your patients life and your bottom in one swift move you will feel like a donkey behind.

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Well, as a student, I am already territorial with my patients. Please, all Docs, if I am available (doesn't mean you have to waste time hunting me down or anything)... please brief me in person about what your are thinking about my patient along with those written orders... Don't just do a drive by.

... also this helps me know if you understand my patient or not, if you don't I will need to worry.

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Specializes in ER and Home Health.

If you are going to bring us chocolate, remember that just not any chocolate will do. I am totally addicted to See's Chocolates. Any of the See's chocolates will do. See's is just so totally awesome.

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Specializes in pediatrics, public health.
Never...and I mean never say the words.."you are just a nurse" You will find out quickly what the consequenses for this statement are...and usually include very lil sleep due to the "just a nurse" having to call you every 10 minutes to update you and get an order for tylenol....and then one for zofran....and then one for.....ok I think you get the pic....and then when we save your patients life and your bottom in one swift move you will feel like a donkey behind.

Wow, have doctors actually said that to you? I'd have a hard time resisting the urge to smack them.

Here's a few from my (so far very limited) experience:

-- If you give me verbal instructions and I ask you to write an order, please just write the order (in our hospital, we're not allowed to take verbal orders except in emergencies). If I ask for written clarification of an order, please just write it, don't waste your breath complaining. Even if your verbal clarification is clear to me, it might not be clear to the next nurse who gets the same patient. I am saving you from being paged at 1am by the night nurse.

-- If you write parameters that you're to be notified if a pt's heart rate is greater than X, don't get upset with me for calling you when their heart rate is greater than X. If you're not happy about it, rewrite the parameter.

-- If you put one of your pts on contact or droplet precautions, please know why, and please have a good reason. Don't put them on precautions "just in case" -- if you're not sure if they should be on precautions, consult the infection control specialist -- that's why they're there!

-- Please speak to me in a polite tone of voice, and I promise to return the favor.

-- If you're calling about a stat lab draw (or other stat order), please ask "has the lab draw been done yet?" not "why hasn't the lab draw been done yet?". Nearly every time I get this question, I've already drawn it and the lab just hasn't processed it yet -- and if I haven't drawn it yet, it's because I have 3 other stat orders and the other nurses are too busy to help me with them, or the pt is a "hard stick" and I'm rounding up a more experienced nurse to help me.

I'm sure there's more, but those are a few off the top of my head. I should add that most of the residents and other MDs at our hospital are very nice and a pleasure to work with -- but there's always a few exceptions to that rule (this goes for the nurses where I work too!)

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Specializes in ER.

Bring your own stethoscope, but if you forget, don't walk away with mine. If you do walk away with it, just bring it back, and bring chocolate with you.

Don't be offended if you catch us peering at your name badge, or if we ask who you are when you pull down a chart. If you MUST take the chart to some quiet place leave a note in the slot about where to find it (and you).

Don't be scared, most of us don't bite. And all of us know how to give tetorifice, so you'll probably be OK.

If you do get bitten we're sorry, but no one got any lunch today (remember we said bring chocolate?).

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Specializes in Neuro ICU and Med Surg.

Treat the nurses and ancillary staff with respect.

Don't walk around trying to make us mad (yes we have one right now who is doing that.)

Write so we can read it or we will call you for clarification.

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Specializes in ICU/Critical Care.

Nrsang, I think I know which intern you are talking about.

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Specializes in Pain mgmt, PCU.

If you have a pt who will be in bed for more than overnight PLEASE fill out the DVT order sheet!

Don't forget they need to eat.

Don't tell me to turn my back when they go out for a smoke.

Listen to us when we say "I'm not sure what is going on but here is what I see right now".

Allow us to titrate the PCA. Even if they have a hx or drug abuse, a total knee hurts and needs to be medicated!

Don't give a stupid order like LOC. Laxative of choice. Who's choice, mine or the pts? We actually have this order written on a regular basis in the hosp. When I brought it to the charge nurses attention, she replied, "Oh, we used to have a list of standing orders we could chose from. We don't have that any more but that's what they mean"! I think that's one of the WTH moments too.

That's it for right now.

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I am a student nurse and it drives me absolutely crazy when a doctor comes into my patient's room while I am in there and they totally ignore me. I'm not saying I need a speech, but just an acknowledgement that I am in the room is fine. Bonus points if you want to teach me something useful and you're nice about it. Also, don't be rude to my patient - I am very protective of them and if you are rude I WILL report it to my nursing instructor or primary nurse...there's no reason to be rude to a patient.

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Specializes in ED.

"Please" and "Thank You" go a long way! One of our hospitalist actually writes, "Please" on his order sheets...it's a pleasure to work with him! I had a pt today who came in with cellulitis s/p dental extraction and the admitting doctor said to me, "Go see who pulled her tooth." Ummm...sure, but "Would you please go see who pulled her tooth?" would surely be a lot more polite! Please remember this, and thank you in advance!!!!:)

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OK, well besides "Bring us chocolate," a very excellent idea mind you, I add these few:

1. No trippin. Be proud that you've made in through medical school, etc, but there's still a lot of learning to do.

2. Be collegial. Experience has taught a great many things to a great many nurses.

3. Here's one I just went through at a particular hospital. The physician teaching on a particular subject, presented something in his Ppt presentation and classroom presentation as "what is the nurse's role." Now I know some could argue this, but it bothered me a bit. Why? It seemed somewhat presumptuous of him to teach the nurse's role when in fact he is not a nurse. There is a difference is approach--it's a different discipline, even though certain medical issues and functions will overlap. I wondered how he would feel if a nurse presented on something and taught about the physician's role to other physicians. Again, on some point it seems arguable. I just think he should have been more careful in his wording. (Overall his presentation was very good otherwise. . .)

4. Understand that indeed nurses should be patient and respectful of you; however, don't be so quick to blow their insights and perspectives off--you may live to regret it.

5. Bagels are good too.

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