What if all docs had to nurses first?????

That's really a shame because that can color your perception of the profession for years to come. I had a similar problem in my first job. The nurses acted like they knew everything and that I was only getting in the way. It got to the point that I had to remind them that even though it seemed we were on the same level, it only seemed that way. I am very open to suggestions and discussion about patient care, but do not presume for even an instant to take a condescending tone with me and tell me how to do my job. I have never even had a supervising physician get anywhere close to being cross with me, even though they could tell me to go jump in the lake if they wanted to, but those nurses sure did like to lecture me on things they knew very little about. Some of the things they would say were a little presumptive for only having an RN behind their names.

Its all about how you approach someone. I have had nurses save my *** a couple times just like I have saved some of theirs', but they did so by approaching me with an attitude of mutual respect rather than condescention. But, if you do want to come jump down my throat or treat me like you wouldn't spit on me if I were burning, I will not hesitate to write it up and remind you that an associate's degree does not qualify you to question my MEDICAL judgment.

ok i appreciate the underlying message of your post and agree with much of what you said but just needed to point out that not all of the nurses have and associates degree, some have bachelors and some have masters (yes working the floor i know a few) anyway this still does not change the fact that your job entitles you to write the orders. but please realize that many many nurses have advanced education and some may have higher degrees in their chosen field than you or other pa-c's do in yours. (some PA's only have abachelors and RN they are talking to might have a masters, so becareful with the educational snobbery) Calling someone on what you think their educational level is is not cool.(especially when you may not even be right. ) everybody should show the appropriate respect to all of their coworkers regardless of their educational background.

ok i appreciate the underlying message of your post and agree with much of what you said but just needed to point out that not all of the nurses have and associates degree, some have bachelors and some have masters (yes working the floor i know a few) anyway this still does not change the fact that your job entitles you to write the orders. but please realize that many many nurses have advanced education and some may have higher degrees in their chosen field than you or other pa-c's do in yours. (some PA's only have abachelors and RN they are talking to might have a masters, so becareful with the educational snobbery) Calling someone on what you think their educational level is is not cool.(especially when you may not even be right. ) everybody should show the appropriate respect to all of their coworkers regardless of their educational background.

AMEN. I think that is what this thread is all about. There has to be a way for us to promote professional understanding between nurses, PA's, RT's,pharmacist, ect., ect. so that we can optimize how we do what we do. Your post PA-C in Texas illustrates the basic problem. Please don't misunderstand, I am not saying you are the problem I am just stating that your feelings are, unfortunately, very common. I think that you will agree that ther is a certain degree of mistrust that each health profession has for the others, and the only way that I can think to resolve the issue is through joint efforts to understand each others work. I think that nurses shadowing doctors is an excellent idea, personally, I think that the more everyone (doctors, nurses,ect) know about each other's job, the easier it will be to foster mutual respect.

AMEN. I think that is what this thread is all about. There has to be a way for us to promote professional understanding between nurses, PA's, RT's,pharmacist, ect., ect. so that we can optimize how we do what we do. Your post PA-C in Texas illustrates the basic problem. Please don't misunderstand, I am not saying you are the problem I am just stating that your feelings are, unfortunately, very common. I think that you will agree that ther is a certain degree of mistrust that each health profession has for the others, and the only way that I can think to resolve the issue is through joint efforts to understand each others work. I think that nurses shadowing doctors is an excellent idea, personally, I think that the more everyone (doctors, nurses,ect) know about each other's job, the easier it will be to foster mutual respect.

Well said! We are all in this ( at least in premis) for the patient's best interest. To truly accomplish the best care for our patients, we've gotta play nicely together!! I amde sure that I followed a tech, and ER nurse, a surgery process, an outpatient lab tech, the patient flow coordinator, and the cath lab etc.... to have a functional knowledge of how the pieces fit and worked together at this facility -- was truly an eye opener and exposed how some of the distrust or disgruntled behaviors are rooted in a lack of knowledge about what the other team members do!!

I have worked with two different doctors that were nurses first.

So have I, and they were two entirely different experiences.

One was very patient and always understood the nurses problems and point of view.

The other was very patronising, with an atitude of "I've been in your shoes so don't tell me how how hard it is or that this isn't possible"

I think at the end of the day, it's a queastion of individual personalities regardless of prior experiences.

I worked a few weeks covering for a nurse that pre-rounded for the Hospitalists docs. Their case load was unbelievable. I went home aching all over every day, and I wore scrubs and waking shoes. The regular nurse usually wore street clothes and heels when she worked. I don't know how she did it. I had a greater respect for the patient load most doctors face after working with them..the pager going off every five minutes, the tremendous numbers of orders and progress notes to write, having to make instant decisions on a patient they may have only seen for a few minutes...

On the other hand, why shouldn't medical students have a rotation where they go with nursing, lab, pharmacy, respiratory, etc.? It wouldn't have to be a long one, maybe one or two shifts each. Then they could see what the departments have to deal with, and why sometimes their orders may not be done instantly.

On top of that your average doctor would be 40 before they "graduated" from their residency. Also, don't forget that many of the "atheist", pinheaded, scientifically orientated docs look down upon much of nursing. If they even touched nursing they would consider themselves unclean!

they'll have to go to a hospital someday..... hahahahahahaha:rotfl:

Exactly! We could start a whole new thread about miserable nurse peers. And we already know there is no fixing them, so why the docs?

I think I've had more nurses make me cry than doctors. In the OR, I teach the heirarchy:"Anesthesia gets the blame for everything unless there is a resident then he/she gets the blame and if there is a med student, it's all their fault." It's just in fun because as the circulator RN I am "responsible" for the room.

I just love it when the new residents start in the ER in July (yes, the ER. I work both). One of the 3rd year residents saw me shaking my head at the newbie, and the newbie saw it, too. The newbie asked why and the 3rd year said, "She can tell you're new". I also tease them about how fresh they look the first week, clean shaven, pressed clothes and coats, full of energy. I tell them I can't wait to see them in a month when the "new" has worn off. I don't tell them what to do or order but ask gentle questions like, "Do you want to order ________?" or "Can I get _____ for you?" They appreciate it and in return, give me respect for being helpful without being condescending.

I think I've had more nurses make me cry than doctors. In the OR, I teach the heirarchy:"Anesthesia gets the blame for everything unless there is a resident then he/she gets the blame and if there is a med student, it's all their fault." It's just in fun because as the circulator RN I am "responsible" for the room.

I just love it when the new residents start in the ER in July (yes, the ER. I work both). One of the 3rd year residents saw me shaking my head at the newbie, and the newbie saw it, too. The newbie asked why and the 3rd year said, "She can tell you're new". I also tease them about how fresh they look the first week, clean shaven, pressed clothes and coats, full of energy. I tell them I can't wait to see them in a month when the "new" has worn off. I don't tell them what to do or order but ask gentle questions like, "Do you want to order ________?" or "Can I get _____ for you?" They appreciate it and in return, give me respect for being helpful without being condescending.

Yes, we call them "fresh meat". You are right about the order of blame in the OR, it's a hoot. :rotfl:

The current Chief of Staff at work used to be a nurse. She's one of the best, most compassionate, most enthusiastic doctors I've ever met, plus the nurses on the units she most closely associates with adore her. (Probably the docs hate her.)

I love your idea. It would weed out some bad apples. :)

I asked a surgeon once why did they insist on calling the med students "Dr.____". He said they have to get used to the idea that they are the doctor and they are the ones who have to know what to do, so from the moment they entered medical school they call them "doctors". Some of them just run with it.

One med school I know of has a "white coat ceremony" where they "induct" all the 1st year med students into the medical community by putting their first white coat on them. Many community doctors attend, not just the medical school instructors. It's a big deal.

PA's and doctors should get a "whiff" of what nurses do for a living. Not a nice sterile shadowing of an RN with an aid doing the dirty work but rather the whole experience.

Anyone that's going to be writing orders should know how the order gets carried out and the problems with IVs, pharmacy, incompatabilities...etc, by DOING it. Anyone that's going to be in charge of a patient's care should be able to at least visualize how it gets done.

The example of someone writing "IV fluids PRN" and not including information that the nurse needs to set it up, is an example of a doctor/student that doesn't have a visualization of what happends to that order after they write it. On the flip side, nurses should all get some time with PA's and doctors to understand why they take these issues for granted. Comparing course materials from all the schools to get an appreciation for what the others train for. I think both sides would be surprised at what the other does not train for.

As for Roland's comment about atheistic. I believe he was getting at the stereotypical scientific-minded just-the-facts type A. An example of a person accepting Darwin's theory of natural selection with modification V. creationism. I personaly can't see why the two can't coexist because dating a fossil is still theoretical.

I think it would really open their eyes as to what we actually do. Most physicians think nurses give medication, take orders from the docs, and assist pt with ADL's. They are clueless otherwise!

We had one fe doc who was a nurse and she was so bad I wondered how she got through school. She was intolerant, impatient, and flightly. Often she misplaced her pen only to find it behind her ear or under the chart she's looking through. This is out of the norm I from the earlier postings but its the only RN to Doc I know personally. One bad apple...

It might not be a bad idea ... as a co-req..... They would be better doctors...