Thu 27 Jan, 2005 05:06 pm
Dealing with Doctors
If a nurse is out in the woods, 150,000 miles from the nearest doctor, is she still wrong?
Well, I got it wrong on my vote, I have never had a doc admit he or she was wrong. I did get a doc to listen AGAIN to lung sounds and cancel a Lasix order. But that's only once in about 24 years.
I've had them renig orders, but not actually admit fault. My theory, even at 3am, is CALL THEM AGAIN. As often as necessary. A surgeon that I don't work with anymore (sadly, because he was a good doc) would usually give you a lame order, then call back 10 minutes later and ask again what's going on. We sent a patient with bilateral chest tubes to the ICU in respiratory distress one night when he did that...his first order was just "get a CXR in the am." Yeah, not good enough...we were about to call him back but he beat us to it.
See, you guys are working with docs who have been doctors for too long. When I used to do hospital nursing, I worked with interns and residents, and, yes, they will admit they are wrong, because they know at that stage of their careers, you know more than they do. I've also been thanked by more than one doctor for using my head, and anticipating the plan of care, and being prepared for what they were going to do or need next.
I also worked for a float pool for one of the larger managed care companies where I live. And while I never heard a doctor say "I was wrong", I heard many of them personally thank me for working with them.
There's an old book out there called "Just a Nurse". One of the stories is from a nurse who used to work in teaching hospitals; it's not uncommon in this setting to have young doctors who are worried about the nurse's opinion of them. Before they get old and jaded, docs sometimes do care about your opinion. But on the flip side of things, they also get to work with a lot of nurses whose knowledge and skills are limited, so sometimes we are the ones to blame for their low opinion of us.
And, of course, you all are forgetting about that rare breed of doctor who used to be an RN. If you don't come at them with an attitude (which a lot of nurses do), they can be your biggest ally.
I work in a large teaching hospital in Balto where most of our docs (MDs and DOs) are interns and residents.
Granted, you get a few who are full of themselves but by and large I find the youngsters quite willing to listen, assist and discuss their decsions and plan of care with the nursing staff.
I also look at working with these people as a great opportunity to make a good impression on them of nursing and what we are all about. This opinion will stick with them long after alot of us are gone and will affect their attitude towards nursing for the remainder of their practice life.
Think about it