The Nursing Staff and Physicians
Although I have a while until I’ll be in a position to write orders and have clinical discussions with the nursing stuff, my 2 years of employment in an emergency department definitely taught me the importance of creating a positive relationship with the nursing staff. Just because someone doesn’t attend medical school doesn’t make them any less intelligent than you, and this applies to nursing staff as well. I know many nurses who are fully capable of overcoming the rigors of medical school, and several who actually considered doing so before ultimately choosing a career in nursing. Many of these individuals know medicine far beyond what is required of them, and have often taught residents a thing or two as well. The sad thing about this? Many residents not only fail to use the nursing staff as a support system, they completely isolate themselves with their arrogance. Everyone understands that the path to becoming a physician is a difficult one, and nurses are no exception to recognizing this. However, thinking that you’re a “doctor” and they are “only a nurse” is the epitome of arrogance in medicine. Assuming you automatically know what is best for a patient based on your title alone will not only lead to more patient complications, it will make nurses hate you. I have seen this first-hand. Time after time, there are a) the residents the nursing staff loves and b) the residents the nursing staff prefers to avoid. Sure, there are going to be times when a certain nurse thinks they know everything, and when this happens, I am by no means advocating being a complete pushover. After all, you need to do what you consider to be in the best interest of the patient. However, a physician and the nursing staff should be a team, and the creation of this team begins with the physician.
Increased Patient Care
First and foremost, if a nurse offers her opinion regarding a patient’s status and/or treatment, take the advice into consideration! I’ve witnessed multiple time when a resident has completely disregarded the advice of a nurse and lo and behold, the patient complications that arise could have been prevented if the resident had followed the nurse’s advice to begin with! Am I saying nurses are right all the time? No, absolutely not. But, neither are physicians. Humans are not infallible creatures, regardless of your profession. By culminating a collaborative atmosphere among healthcare employees, the likelihood of human error is drastically decreased. If you isolate yourself from your nursing staff and refuse to consider their opinions, the collaborative/teamwork aspect is non-existent. Furthermore, the nurses will be much less inclined to offer their opinions in the future, and you won’t have them as a safety net for your future decisions. Would you continue to offer advice to someone who incessantly shot you down? I highly doubt it.
Making Your Life Easier
Do not consider yourself superior to the nursing staff simply because you’re a “doctor”. Instead, learn what you can from them and develop a positive relationship. Not only will you establish a continuing education from their insights, you will make them drastically more likely to help you out. Obviously, more willingness to complete orders or offer help from the nursing staff leads to a much easier experience for you. Again, I saw examples of this time after time after time. Physicians who developed a rapport with the nursing staff received help more readily and typically appeared much happier. Physicians who failed to do so were… the opposite. Furthermore, nurses talk with each other, just like any other coworkers. If you make a bad impression on a couple, pretty soon the others will know it as well. Essentially, follow the Golden Rule and treat the nursing staff how you would like to be treated. It will make patient care much easier for you in the long run and will undoubtedly make you a much happier person. You should ultimately want to be able to call the nurses you work with your friends.
How to Create a Positive Relationship
This section contains information from an article I found through a quick Google search and I thought it was important to include as well.
In the article written for the Huffington Post by Brian Secemsky, M.D. states “…forming strong working relationships with nurses that are involved in my patients’ care has become one of the most important objectives since becoming a physician.” The article also discusses the two most common areas of creating frustration as communication and understanding the role of a nurse.
To address communication, involve your nurses as much as possible. As discussed in the article, allow them to observe your bedside rounds or provide them with a summary of your observations regarding the patient. A major contributor to frustration I regularly encountered was physicians who wrote additional orders and/or modified previous orders without telling the nursing staff. Be sure to verbally tell the nurse about the order immediately. Furthermore, make sure you sit down, collect your thoughts, and write all of your orders at once. Coming back and writing a new order every 5 – 10 minutes is extremely frustrating for the nursing staff. It’s understandable that additional requests are necessary at times, but incessantly writing additional orders because you didn’t take the time to sit down and think everything through is annoying.
The issue of understanding a nurse’s role is a simple fix as well. Rule number one, know that they are busy and their time is important too. Don’t waste it by asking them to do something so basic a 2 year old could do it (i.e. pressing a button to get a blood pressure). Needing helping in a time crunch is one thing, but don’t push it. If you’re being lazy, get over yourself and have some caffeine. If you really don’t know how, ask a nurse and they’ll gladly show you for next time.
Secondly, recognize that nurses have multiple patients and can’t always complete your orders right away. If it’s absolutely necessary for it to be done immediately, communicate this to the nurse in a calm and non-demanding way. Yelling or making commands won’t earn you any favors.
If you aren’t sure about how to create a positive relationship with the nursing staff, there is an extremely simple solution. Ask them! They will gladly tell you the things physicians do that bother them the most. This is exactly how the physician who wrote the previous article approached the situation. Keeping peace and avoiding conflict between physicians and nurses 100% of the time is impossible, as is true for any human interacts (even marriage!). However, you should be sure to remember that a positive relationship with the nursing staff is one of the most important things for your success in medicine.