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?
I don't have a problem with a physician describing the nurse's role to other physicians. When I was in nursing school (just graduated last May) we were taught about the roles of all the other health care professionals, not just the nurses. So I was taught about the physician's role by a nurse, as well as being taught the role of CNAs, LVNs vs RNs, RTs, PTs, OTs, etc. This seems to me to be a necessary and very important part of any health care professional's training.
When any nurse, but especially the old nurse tells you "This patient is going bad" or "This looks a lot like patients I've seen who had..."(see, we're not diagnosing here, and trying to save your ego too) - PAY ATTENTION! Otherwise you are going to be running in and scrambling to deal with the patient who indeed does have....
Oh and on a workplace etiquette level - ask before you scarf down that food in the nurses' breakroom. Unlike the doctor's lounge, that food is not provided by the hospital. Most of us will gladly share if asked and the "moms" among us will often urge food on those who look about the age of our own kids.
I work in a teaching hospital, and I would LOVE to leave a list of tips for these wippersnappers!
+ I am with "your" patient 12hours a shift (often more than one shift in a row) and if I think it would be helpful for the patient to have an order for MiraLAX, simethicone, a suppository, etc., please consider it. I am not the doctor, but I do know my patients. There PD will not work if they aren't pooping....you will learn this too!
+ Our units has a lot of chronic/repeat/complex patients, and I do know a lot about these kids and their families. If I tell you "Johnny is very anxious" I am not trying to get you to prescribe him something to help him sleep (we don't do that to 12yr old kids) it's because it is probably important to know, at least on a you know it basis.
+ If I call you because the kids BP is High or Low, don't ask if I am sure! Yes I am sure! And NO I don't need to change the cuff -- it's the same correct cuff I have been using all shift, and probably all week. I need you to get up and come see the pt like I asked you to.
+ If I need to call the Attending or Fellow, it's not a slap in your face - I need to do what's best for my patient. We're all here to learn and you need to leave your big ego at home.
+ No, I cannot take EVERY order as a verbal order - it is not safe. There is a Resident and a Senior for a reason.
+ You cannot have the chart for 2 hours.
+ In the morning when you & your dr friends are taking up all the computers & all the chairs, at least let me see the chart you've had for over an hour. I need to review the orders with the next nurse.....but please don't get up or anything because your feet might hurt.
+ If you MUST have a drink at the nurse's station (despite all the signs saying NO drinks, and do you see any of use with drinks?) PLEASE do not spill it! If you do spill it, don't look at me to clean it up!!! If you spill it on our information binders, well you need to figure out how you're going to work that out - not just leave them there, all soaked in your coffee or tea. (yep, happenend last week) We use all the information in there to take care of these complex little kids and I think your mom should have raised you better.
+ Don't call me at midnight and ask me where the pt's I/O's from the day shift are - really not my problem. I already asked Suzie Sunshine...she didn't think it was important to get them in the computer I guess, or maybe the kid is shutting down (just kidding on the last one; we have internet access at our hospital and it's a huge problem for productivity). If there aren't any I/O's in there, NO I cannot "estimate" them; the best I can do is have you come up and talk to the patient or call that cute nurse your were swooning at change of shift at home (you seemed like you might want her phone number). I realize it will affect your "plan" but I can't help you with it, I've already asked my CN 15 times about I/O on RENAL kids, but whatever! I'm a little older, not so cute anymore, and obviously getting a little bitter.
+Don't call me at 10 or 11 pm when I am passing out my meds to ask where my first set of vitals and the I/O's are: look, we don't have a tech and I am taking care of a fresh transplant and 2 other patients. When I can humanly get them in the computer, I will. And don't tell me you need them so you can "go to dinner" or "pick up your take out"....hmm, I might not get them in there for quite some time. If you really need to know how the kid with the new kidney is doing, come see them!!!
+ If you MUST talk to me when I am on my precious lunch break of 20 minutes trying to cram in whatever food I can, you better not be calling about something stupid that "I can help you with"
I rather wish all Doctor would introduce themselves by name and speciality. We have so many different ones , new ones it is impossible to know who they all are or what they do .
I love when the Docs have the time to ask me and listen to how I see their patients are doing or what concerns I might have. I love it more when they actually then address my concerns. :)
Goodies in any shape or form goes along way on our unit
I forgot- don't hit any buttons, it looks easy, but I'll beat you with a wet noodle because of past experiences with unintended boluses. Not even "silence," just hit the nurse call button if you need help. If you hit "OFF" your attending will do the beating, so don't do it. Even the attendings leave our various alarms and buttons alone, they are dangerous.
WRITE YOUR ORDERS LEGIBLY (sp). I'm sorry that English is not your first language but you are a smart guy/girl. I'm sure you will figure it out.
There's hospitals where orders are written on paper still?
But then again, I could say, "Make your computer-entered-orders logical." Don't check off the "continuous" order and then type in "prn" next to the drug name. Continuous = drip.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
oh and on a workplace etiquette level - ask before you scarf down that food in the nurses' breakroom. unlike the doctor's lounge, that food is not provided by the hospital. most of us will gladly share if asked and the "moms" among us will often urge food on those who look about the age of our own kids.
there's a great one! i had jumped up, leaving a barely touched lunch in the break room when my patient arrested. i came back to find the intern calmly finishing it for me. when i protested he said, "oh, it was just lying here. i thought it was up for grabs!" i made him order me a new one delivered because the cafeteria was closed and i had only brought one lunch!
Dont be lazy or hurried and just write the orders neatly....for the sake of patients safety.As a student I havent run into a rude intern yet,usually they are nice and explain you things,however I run into an "older" rude doctors....
noahsmama
827 Posts
I don't have a problem with a physician describing the nurse's role to other physicians. When I was in nursing school (just graduated last May) we were taught about the roles of all the other health care professionals, not just the nurses. So I was taught about the physician's role by a nurse, as well as being taught the role of CNAs, LVNs vs RNs, RTs, PTs, OTs, etc. This seems to me to be a necessary and very important part of any health care professional's training.