Why do nurses hate medical students?

Leukocyte said:

Why do most nurses look down on medical students? I am a shy, humble/meek kind of guy, who has a high level of respect for nurses, yet I always seem to get "heat" and distasteful comments from nurses.

Do not take me wrong, some nurses were very kind to me, helped me out during tough times, and some even gave me Valentine gifts/flowers. However, MOST seem to be very mean to medical students.

Any nurses here would like to shed some light as to why?

Thanks.

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SNS? (Short Nurse Syndrom)? Because you're a doctor (or will be) and they're nurses? Because those who came before you were pompous asses?

While I am not a nurse, I have been where you are today. I think your observation is correct and can be felt by residents quite often. The people who can best answer your question are RN's who are now med students or doctors as they have seen both sides of the coin. I think the core of the issue is respect (RN's want it, MS want it...often times neither wish to share it with the other). It can be said WITHOUT A DOUBT there are things that will AUTOMATICALLY place you at a disadvantage and will certainly make things difficult on you
1. you look young. Regardless of your age, if you look mid 20's a RN will think of you as Doogie Howser or simply a snot nose. Those with gray hair or losing hair simply get more respect as a converse of the above statement.
2. You are short or overall "wimpy" looking (absolutely true).
3. You are female. Female docs/students are notorious for recieving greater grief than men
4. I personally have seen discrimination against those with non white back grounds, particularly Indian. This is likely a regional variation, but it is disturbing nontheless.

Sure this is basically an obvervation (all of which I have seen directly or felt directly), therefore the ideal medical student to start on the "right" foot would be : A 200 # white male at least 6ft with graying hair who is neither talkative nor shy.
The exact opposite is a 90# Indian female that looks 21 and is of short stature who is either very shy or overly talkative.

While this is a broad generalization and is not true of every setting...in all 3 states where I have been a student or resident, I find these generalizations to hold water.

Because unlike you, most medical students are pricks. This is coming from a medical student.

Leukocyte said:

Why do most nurses look down on medical students? I am a shy, humble/meek kind of guy, who has a high level of respect for nurses, yet I always seem to get "heat" and distasteful comments from nurses.

Do not take me wrong, some nurses were very kind to me, helped me out during tough times, and some even gave me Valentine gifts/flowers. However, MOST seem to be very mean to medical students.

Any nurses here would like to shed some light as to why?

Thanks.

Click to expand...

DocWagner said:

While I am not a nurse, I have been where you are today. I think your observation is correct and can be felt by residents quite often. The people who can best answer your question are RN's who are now med students or doctors as they have seen both sides of the coin. I think the core of the issue is respect (RN's want it, MS want it...often times neither wish to share it with the other). It can be said WITHOUT A DOUBT there are things that will AUTOMATICALLY place you at a disadvantage and will certainly make things difficult on you
1. you look young. Regardless of your age, if you look mid 20's a RN will think of you as Doogie Howser or simply a snot nose. Those with gray hair or losing hair simply get more respect as a converse of the above statement.
2. You are short or overall "wimpy" looking (absolutely true).
3. You are female. Female docs/students are notorious for recieving greater grief than men
4. I personally have seen discrimination against those with non white back grounds, particularly Indian. This is likely a regional variation, but it is disturbing nontheless.

Sure this is basically an obvervation (all of which I have seen directly or felt directly), therefore the ideal medical student to start on the "right" foot would be : A 200 # white male at least 6ft with graying hair who is neither talkative nor shy.
The exact opposite is a 90# Indian female that looks 21 and is of short stature who is either very shy or overly talkative.

While this is a broad generalization and is not true of every setting...in all 3 states where I have been a student or resident, I find these generalizations to hold water.

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Well then, I'll be OK. 6'3, graying hair (lots of it), 215 lbs and none of it wimpy, not shy but not going to put up with any BS from anyone either.

BTW, the worst people in terms of grief from nurses are (female) nurses that go to medical school, in my experience. Totally ostracized as soon as they announce their intentions. Pretty tough, actually.

Im a nurse just starting med school. Much of what has been said is true. I would add that there is a saying in nursing "nurses eat their young". They treat new nurses in the same way the presumably treat med students. Most ER nurses have a click. If you try to transfer in you better hope they like you or you will be out on your ass. So it goes beyond the fact that you're a doc and their a nurse.
My belief is that it stems from societal sterotypes about nurses. Nurses are belittled and not given much respect by much of the general public (name calling, sterotypes). Most people really dont know the extent of some nurses training and ability. When I started nursing school I didn't even realize the potential of this career.

As a male nurse I am constatly asked, "so are you training to be a doctor"?, or "have you thought about going on to medical school". Or introduced as "this is my male nurse". Hell, my grandma thinks all I do is change bedpans.. I don't have the energy to try to explain I havent changed a bedpan in years.. or that I have ran codes..

Anyway, I believe in humility.. In general if one is humble (or at least not cocky) they wont be antagonized by nurses.

If you are as nice as you say you are, then that is a shame you're not being judged on your own merits. That's wrong.

Unfortunately, there are a lot of med students who treat nurses like crap. I've had students treat me in a very arrogant, disrespectful manner. When that happens over and over, it tends to make you feel a little less inclined to go out of your way for the next student who comes along. Just as frustrating is to have a med student take the credit for something you as a nurse assessed/suggested.

I've never really noticed the things DocWagner listed. I try to base my feelings on the individual student, not on students as a whole.

A lot of medical students also treat other medical students like crap.

fab4fan said:

If you are as nice as you say you are, then that is a shame you're not being judged on your own merits. That's wrong.

Unfortunately, there are a lot of med students who treat nurses like crap. I've had students treat me in a very arrogant, disrespectful manner. When that happens over and over, it tends to make you feel a little less inclined to go out of your way for the next student who comes along. Just as frustrating is to have a med student take the credit for something you as a nurse assessed/suggested.

I've never really noticed the things DocWagner listed. I try to base my feelings on the individual student, not on students as a whole.

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cbc: That's wrong, too. Instead of working against each other, we ought to be working with each other.

I didn't say I treat other medical students like crap. I am saying many medical students treat each other like crap. Most of their priority is getting high honors and the residency of their choice, even if they have to sacrifice being nice. I don't blame them, and I don't do it (at least I hope I don't), but that's what I see. You're right, but what ought to happen doesn't always happen (and we ought to be fighting terrorism right now, not that senseless Iraq War).

fab4fan said:

cbc: That's wrong, too. Instead of working against each other, we ought to be working with each other.

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Stop trying to reason this issue

Plain and simple,-- cause they're bitches

this is a hard issue. as a male nursing student who is seriously thinking of a career in medicine, i have seen that everyone often treats everyone like ****. it is not always a nurse vs. medicine thing. i have been amazed how the culture of medicine supports a kind of short, rude interaction between workers. as a student, i have made a point to just stick my hand out and force people to look at me, introduce themselves, and treat everyone with some humility and kindness. for the most part, this has worked. of course, some med students, residence and nurses are just grumpy. i find that they probably are taking themselves really serious and this work is a huge part of thier identity.
i hope that we can get past this argument and realize that in every profession there are rude people, so for all of us that are frustrated with it, make an effort and smile at other providers, nurses, nurses aids, rt, pt's, etc. most people are fundementally good, with good inentions, they are just tired, stressed and over worked.

briansle said:

Stop trying to reason this issue

Plain and simple,-- cause they're bitches

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Wow!
What stellar wisdom! Keep it up ZERO.

cbc: I didn't say you personally treated your fellow students badly. I'm sorry if you somehow got the impression that I was saying that.

Leukocyte said:

Why do most nurses look down on medical students? I am a shy, humble/meek kind of guy, who has a high level of respect for nurses, yet I always seem to get "heat" and distasteful comments from nurses.

Do not take me wrong, some nurses were very kind to me, helped me out during tough times, and some even gave me Valentine gifts/flowers. However, MOST seem to be very mean to medical students.

Any nurses here would like to shed some light as to why?

Thanks.

Click to expand...

Because nurses know that medical students are the offspring of doctors and that they grow up to be abusive just like their fathers

I work in CVICU, in a large teaching hospital.
We have never ending rotations of docs coming through and yup we can be bitchy.
The first reason..you arrive on the unit as a brand new face, you have demonstrated nothing yet but strangely your defensiveness makes you aggressive.
Your fear of failure makes you hostile.
I understand because I have guided and in some cases dragged a few residents through the CVICU experience, it is scary and the pressure can be enormous but alot of you fail to realize nurses are there to help you. Many residents and medstudents almost casually dismiss the bedside nurses assessment and her recommendations.

You do this just once and you will be labelled as not very bright and a potential danger to the patient...thats pretty hard to overcome.

When you walk onto a unit or a ward you are the "new" guy, being a doctor gives you NO free pass. You are required to show you are competent and more importantly you can actively demonstrate understanding that you are a member of the health care team.
You are only one voice and you need to accept that many other members of the team have more experience then you and you need to be able to listen and collaborate with the team.
Sometimes your goal as a student gets lost in the complexity of a patients needs and you need to recognize that and move back and accept that other team members are going to manage the situation more effectively than you.


For me personally any resident that comes into the unit trying to BS their way through the rotation will get a pretty hard time from me.
These are the students that blow off established practice and protocals and say new research says blah blah blah and thats what I am going to do.
This demonstrates disrespect to me and to the established practice of my unit. Someone who has never cared for a critically ill heart patient should NOT be choosing that moment to test out new research.
Arrogance will make me call the staff doc in a heart beat and get you overrided. Any time a resident in their first week in the unit starts acting like they have all the answers and begins suggesting new practice is going to get referred right back to the staff doc.

It's all about attitude.
Sometimes I don't think a lot of residents are aware of how their stress and anxiety are affecting their interactions with other team members.
Defensiveness at suggestions is an early sign that your anxiety is getting in the way of your practice.
You need to acknowledge that what you are doing is really hard and really scary.
You must remember every nurse at the bedside has lived through this same anxiety and fear. We all had to be the new guy and had to learn all our tricks of the trade.
Approach nurses in your new rotation as collegues, we are there to help you find your way. Come with a sense of humour for goodnesss sake...remember there are moments that are funny.
Tell the nurse at the bedside if this is your first time inserting a central line/art line/swan all by yourself...we will do everything to make it a good experience...remember we have assisted in hundreds of these procedures...we know all the tricks...ask for help when you need it.

Don't ever ever ask a nurse to do something you can do yourself..
here are the worst examples..can you get me a coffee? oh yes this has happened more than once
can you get me gloves, mask etc when all the supplies are on a cart a foot away...this is a regular arrogant little BS move by residents.. some residents order a nurse to do or retrieve things a foot away so they can demonstrate the "hierarchy".. the you are my slave mentality.
Dont go there or you will be universally hated as an a**.
Worse a lot of nurses will just walk away and leave you all by yourself to do the procedure...not a scenario you want for your first solo procedure.

Most nurses don't hate residents...I really love alot of mine, I take great pride in their success and in fact I have included more than one in my own surgical procedures.

The residents I have loved are the ones who knew their limitations,asked for help with humour, listened carefully when it was important and showed they were proud to be a member of our unit and our team.

Realoze when you arrive on that first day we know you are scared, we know you are worried you may fail or make a terrible mistake...remember we are there to protect you from your worst mistakes and we want to like you if you will let us.
Approach everyone with a willingness to learn and for goodness sake if you make an error don't stand there looking at the nurse and announcing to the staff guy a bald faced lie that leaves the nurse hung out to dry...this happens more often then alot of people realize...residents will try to BS there way out of trouble...don't do this...it is professional suicide...the staff doc has been working with the nurses alot longer than you...you will lose the respect of the nurse..which means ALL the nurses and the staff man will be watching you a lot closer.

Good luck and hang on to your sense of humour..it may be the only connection to sanity you will have at 3am in the middle of yor first open chest arrest.

The last poster is the PRIMARY reason that ICU nurses can get a bad name...the use of possesive phrases "my ICU", "You are required to show you are competent and more importantly you can actively demonstrate understanding that you are a member of the health care team." And competency is based upon your judgement and your judgment only? How arrogant of YOU. It is this exact creation of barriers on day ONE that make is so difficult to penetrate into nursing cliques...and that is exactly what they are.
Taking a medical student who has a zillion things on his mind and arrogantly stating that he/she must prove himself is a terrible thing. Instead of fostering the students/residents your attitude creates an adversariel relationship. I can tell...you are the one who thinks they know everything...you are the one who wants to be noticed and wants to be respected.
My sister in law is an ICU nurse...she is nothing like you, nor are 90% of the nurses I have dealt with. But you fall into the 10% who hate to be disagreed with...and absolutely hate it when the "new guy" just might be right.

Freeeedom! said:

The last poster is the PRIMARY reason that ICU nurses can get a bad name...the use of possesive phrases "my ICU", "You are required to show you are competent and more importantly you can actively demonstrate understanding that you are a member of the health care team." And competency is based upon your judgement and your judgment only? How arrogant of YOU. It is this exact creation of barriers on day ONE that make is so difficult to penetrate into nursing cliques...and that is exactly what they are.
Taking a medical student who has a zillion things on his mind and arrogantly stating that he/she must prove himself is a terrible thing. Instead of fostering the students/residents your attitude creates an adversariel relationship. I can tell...you are the one who thinks they know everything...you are the one who wants to be noticed and wants to be respected.
My sister in law is an ICU nurse...she is nothing like you, nor are 90% of the nurses I have dealt with. But you fall into the 10% who hate to be disagreed with...and absolutely hate it when the "new guy" just might be right.

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Sounds like a bad case of SNS (short nurse syndrom), alright.

nathansackett@e said:

i find that they probably are taking themselves really serious and this work is a huge part of thier identity.

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that is a good point, and the more I think about it the more it makes sense.

The frustration mioa is demonstrating, while a little over the top, is understandable. My opinion is that if one want to work in a tight unit like that they shouldn't work at a teaching hospital. Teaching institutions stiffle nursing autonomy by nature. I MUCH prefer a private hospital(2 of the 5 have been teaching) for nursing practice. At a private hospital you develop relationships with the intensivists, hospitalists, et al. This fosters a close knit unit, trust, and less ego trippin'.

Nurses are terrible to new nurses, too. THey see it as their territory, and you are a stupid, rude newbie with lots of knowledge and very little ability. They are responsible for the patients, and they have their own professional license on the line if you screw up. First off, the nurse will ALWAYS be with the pt, while you will not. The nurse has loads more experience with the pts. than you do, and they want you to listen to and value their opinions.

Many newbies fail to realize that nurses are a HUGE asset to their learning. PIss a single nurse off, you are setting yourself up for failure. Kiss the nurses asses, and you will be treated much better.

briansle said:

Stop trying to reason this issue

Plain and simple,-- cause they're bitches

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Thats not fair to say either. As an RN, I treat ALL students with respect (nursing students as well as med students) Here in Akron, OH, I haven't really run into difficult med students, just lucky I guess. At my hospital, everyone seems to work together well (auxillary staff, nurses, attendings, and residents.) That is really unfair of you to say.

cbc said:

Because unlike you, most medical students are pricks. This is coming from a medical student.

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there are sometime when I see med students do things I don't care for
I.e.... not maintaining pt dignity... talking down to pts...I could see how this could cause nurses to get upset... BUT I try to keep in mind that they're only learning... just my two cents

and PS... some people are just cranky and hate everone...

wow..short nurse syndrome... and over the top



Your level of nazel gazing would be amusing if it wasn't for the fact you are actually responsible for other peoples lives and you actually believe the bull you wrote.

Try pulling your head out of your a** for a moment and reread the post. Put your ego back where it belongs...for goodness sake do you actually believe you know what you are doing the moment you walk onto a busy hospital floor you have never been to? I can hear you say "ofcourse"
But the nurse who says she does know what she is doing is on a ego/power trip only looking for attention from doctors..right?
Because that is what you are all about and it is impossible for you to believe that anyone else could have any other motives.


Why not try out for one day what I said?
Drop the attitude and actually act like what you are...a brand new employee in an unfamiliar area...most logical and intelligent people learn on their first day of a new job to be respectful to their more experienced colleagues so they can be successful. It's not because the other employees need it( they have already EARNED any respect) , it's because you need the help.


Ofcourse you will have to learn the hard way...and you can then take comfort in calling nurses names and wondering why you are so intensely disliked...and forever be wondering why some of your colleagues are having a great experience while you struggle.


If all the nurses you are interacting with are bitches you may want to consider the common denominator in all those relationships is YOU....


You think that is arrogance right? The short nurse syndrome... because I have the audacity to say that a nurse evaluated a doctor...thats just sooo wrong isn't it? The only explanation for you is the nurse is on a power trip looking for attention. It certainly couldn't have anything to do with you.

It never ever crosses your ego soaked brain that nurses actually aren't desperate for your approval ..it would be impossible. To believe that a nurse does anything for any other purpose that has no relation to you would mean that you aren't as vital and important as you think you are...and well that just can't be possible..so they are just meanspirited bitches on power trips out to make themselves look better than you...

I don't want my ass kissed..and what a backhanded slap in the face that kind of comment is...I don't want your respect because I don't need it...I want the respect of the people most important to me..the patients.
I want you to pay attention to the assessment I provide because the information I have is new to you. I want you to value it because the guy lying in the bed is relying on me to tell you what I know....the patient is actually the most important person by the way...I know..you are shocked..but it's true.

You attribute everything to an ego stroke because thats what gets you off.....you think of everything in relation to ego because you are immature...you see your own performance only as it relates to how it will make you look and how you feel about yourself and you attribute that same attitude to everyone around you....look at your comments...it's all about ego..the short nurse looking for the doctors attention and approval....that is not me...that is you projecting your focus onto everyone around you because your head is up your own a**.

I work for the patient...I don't need to be reassured constantly and patted on the head anymore....the fact that my patient is still alive when I leave is good enough for me and when you get to be a grown up doctor it will be enough for you too.


Maybe it's too late for you..you have such a terrible case of it's all about me you may never wake up but hopefully someone else will figure it out and learn there is absolutely no reason to make other people miserable so you can feel better about yourself. .


What is actually the funniest part about all of this is I would bet my next pay you spend the better part of your day being nice to nurses and you would never have the guts to say out loud in person to a nurse you are working with anything you have said here.

IMO, if you give the nursing staff the respect that they deserve, the majority will bend over backwards to help you out, esp. if you are only there for 4 weeks. With that said, you will run into the occasional nurse who will defend their territory and criticize every order that you write if it isn't what other physicians have done. This is good if you are screwing up an order, but bad, if she is just giving you a bunch of crap over something that he/she knows little about. You will see the same personality traits among physicians. Some are nice, some sphincters. Try being nice to the entire nursing staff for one rotation and I bet it will be a breeze, and, you may make some new friends outside of your med school circle.

I don't know why I am injecting myself into this flame war but here it goes. I think it has a lot to do with both med students/physicians and nurses not understanding the role of the other. Nurses have an extemely challenging and technical job that does not receive the respect or pay that it deserves (trust me I know, my fiance is a trauma critical care nurse at a Level 1 trauma center). Nurses are the caregiver with the most interaction with the patient and the ones that carry out most of the orders a physician writes. This could lead to obvious disagreements due to the fact that the nurse has a more intimate relationship with the patient and is unable to make some important decision with the patients care. For instance my fiance recently had a patient that was having unusual bowell movements and my fiance was sure the patient had a Clostridium difficile infection. She spoke to the critical care doc about it but he didn't agree even though he had only seen the patient for 5 minutes that day. My fiance eventually sent a stool specimen down to the lab and sure enough the patient was infected with Clostridium difficile and the treatment plan had to be altered by cutting some of the antimicrobials and adding probiotics to the diet to increase normal flora to out compete the infection. In this case the nurse's greater interaction with the patient led to her having an insight that the physician did not but the physician failed to recognize this which leads to animosity. In addition, nurses (in particular charge nurses) are responsible for the smooth operation of most units. This obviously could lead to confrontation and disagreements with transient medical students and physicians that spend far less time in the unit than the RN's. To compound the matter, nursing education emphasizes different priorities then physician education (at least from what I have seen with my fiance and her friends who just graduated with their BSN's). Medical education in the United States emphasizes "Evidenced Based Medicine" and the scientific method whereas Nursing education emphasizes system design and implementation and psychosocial skills. Although these different paradigms about how to best care for the patient do not necessarily conflict there are times when they can. For instance, moia's comment that:

These are the students that blow off established practice and protocals and say new research says blah blah blah and thats what I am going to do. This demonstrates disrespect to me and to the established practice of my unit. Someone who has never cared for a critically ill heart patient should NOT be choosing that moment to test out new research.

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is a prime example of a situation when these 2 paradigms conflict. The nurse is concerned with the "established practice of the unit" which is a system implementation way of going about the situation while the medical student is concerned with the most effective treatment based on scientific research. The problem is both the nurse and the medical student are trying to effectively advocate for the patient but each feels differently about how to do this. The nurse feels that a critically ill patient is a patient that the established system should be used to treat because it has worked in the past and most of the caregivers are familiar with this method. In contrast, the medical student feels that the critical patient is a patient that should be treated with the most effective treatment based on scientific studies since there is scientific evidence that it is more effective. I feel this disagreement is due to the differences in the values of their respective educational systems. In this case I feel (and I am biased due to my future career as a physician) that the new research is most likely the way to go (I am always bringing home papers to my fiance about the newest research). However, there are times when it is more important to ensure a smooth running system then ensuring the most scientific treatment is used (for instance during a mass casualty situation where it is more important to triage by whatever mechanism has been practiced then by saying something about how new research says that a different triage system is more effective because there is a learning curve to the different system and after the incident has occurred it is too late to learn a new one).

Thus, ultimately the reason why there is sometimes animosity is just a failure to understand the differences in the two professions and to recognize when the other profession might have a better way to do things. Whether that be listening to the RN and taking them seriously because they have more exposure to the patient or being willing to try out new research on patients that fit the criteria for the research to be used. Ultimately, we are all in this game together (along with all the rest of the Allied Professions) and we all want what is best for the patient.

P.S. One more thing that I have found drives RN's crazy is not answering pages. They are paging for a reason (even if it is your fiance and you do not work at her hospital).

medic8m said:

My opinion is that if one want to work in a tight unit like that they shouldn't work at a teaching hospital. Teaching institutions stiffle nursing autonomy by nature. I MUCH prefer a private hospital(2 of the 5 have been teaching) for nursing practice. At a private hospital you develop relationships with the intensivists, hospitalists, et al. This fosters a close knit unit, trust, and less ego trippin'.

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I can vouch for that. I spent a day shadowing a hospitalist in a community hospital, and ICU rounds consisted of sipping coffee in a conference room while the RNs gave report. Then we all talked about how to best manage things for the patients.

That guy was Chief of Staff for that particular facility, by the way, and he had complete trust in the skills and experience of the nurses there. I saw a really good discussion about treatment plans, and few to no displays of ego.

I work at a teaching hospital now, and the nurses in the ED are the sort that like teaching. They have nursing students around, and they work with med and PA students to instill some good habits -- so they don't grow up to be "toxic docs."

But the nurses up on the floor... man, some of them are hating life. When a new IM intern comes in, a few of those RNs have their world shaken up. I guess they either learn to work with it, like my ED colleagues, or they grit their teeth and endure.

moia said:

wow..short nurse syndrome... and over the top



Your level of nazel gazing would be amusing if it wasn't for the fact you are actually responsible for other peoples lives and you actually believe the bull you wrote.

Try pulling your head out of your a** for a moment and reread the post. Put your ego back where it belongs...for goodness sake do you actually believe you know what you are doing the moment you walk onto a busy hospital floor you have never been to? I can hear you say "ofcourse"
But the nurse who says she does know what she is doing is on a ego/power trip only looking for attention from doctors..right?
Because that is what you are all about and it is impossible for you to believe that anyone else could have any other motives.


Why not try out for one day what I said?
Drop the attitude and actually act like what you are...a brand new employee in an unfamiliar area...most logical and intelligent people learn on their first day of a new job to be respectful to their more experienced colleagues so they can be successful. It's not because the other employees need it( they have already EARNED any respect) , it's because you need the help.


Ofcourse you will have to learn the hard way...and you can then take comfort in calling nurses names and wondering why you are so intensely disliked...and forever be wondering why some of your colleagues are having a great experience while you struggle.


If all the nurses you are interacting with are bitches you may want to consider the common denominator in all those relationships is YOU....


You think that is arrogance right? The short nurse syndrome... because I have the audacity to say that a nurse evaluated a doctor...thats just sooo wrong isn't it? The only explanation for you is the nurse is on a power trip looking for attention. It certainly couldn't have anything to do with you.

It never ever crosses your ego soaked brain that nurses actually aren't desperate for your approval ..it would be impossible. To believe that a nurse does anything for any other purpose that has no relation to you would mean that you aren't as vital and important as you think you are...and well that just can't be possible..so they are just meanspirited bitches on power trips out to make themselves look better than you...

I don't want my ass kissed..and what a backhanded slap in the face that kind of comment is...I don't want your respect because I don't need it...I want the respect of the people most important to me..the patients.
I want you to pay attention to the assessment I provide because the information I have is new to you. I want you to value it because the guy lying in the bed is relying on me to tell you what I know....the patient is actually the most important person by the way...I know..you are shocked..but it's true.

You attribute everything to an ego stroke because thats what gets you off.....you think of everything in relation to ego because you are immature...you see your own performance only as it relates to how it will make you look and how you feel about yourself and you attribute that same attitude to everyone around you....look at your comments...it's all about ego..the short nurse looking for the doctors attention and approval....that is not me...that is you projecting your focus onto everyone around you because your head is up your own a**.

I work for the patient...I don't need to be reassured constantly and patted on the head anymore....the fact that my patient is still alive when I leave is good enough for me and when you get to be a grown up doctor it will be enough for you too.


Maybe it's too late for you..you have such a terrible case of it's all about me you may never wake up but hopefully someone else will figure it out and learn there is absolutely no reason to make other people miserable so you can feel better about yourself. .


What is actually the funniest part about all of this is I would bet my next pay you spend the better part of your day being nice to nurses and you would never have the guts to say out loud in person to a nurse you are working with anything you have said here.

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Feel better now?

I've spent enough time in ED's as a paramedic to make the judgements that I have. Most nurses are capable and competent, advocating for the patient and working with the rest of the health care team. Then there are the bitter, vindictive people who think that the reason the patients show up is because of them.

And, I have told nurses to f-off, to get out of my way, and to grow up. But only when they deserved it. As do you.

hakksar said:

I think it has a lot to do with both med students/physicians and nurses not understanding the role of the other. ... nursing education emphasizes different priorities then physician education (at least from what I have seen with my fiance and her friends who just graduated with their BSN's). Medical education in the United States emphasizes "Evidenced Based Medicine" and the scientific method whereas Nursing education emphasizes system design and implementation and psychosocial skills. Although these different paradigms about how to best care for the patient do not necessarily conflict there are times when they can. ... Ultimately, we are all in this game together (along with all the rest of the Allied Professions) and we all want what is best for the patient.

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Hear, hear!

I think the key to the whole issue is to have a little understanding for the fact that there is a difference in the way various members of the care team approach patient care; to see this as a positive thing (if I was the doc and your RN fiance saved my bacon by correctly catching the c. diff., I would buy him or her a bottle of wine); and to not get all huffy when the inevitable conflicts come up.

I work with some brilliant people, in all the various roles. But I've seen a sleep-deprived PGY-3 insist that "if X, then Y" always applies, physical exam to the contrary. And then there's the one RN who seems to believe I did something horrible to her, though I have no idea what, and she's no help because apparently she's not talking to me. (Which is weird, because I finished 7th grade a long time ago, and for her it was even earlier.) None of us are perfect. But the ones who really do well, in any capacity, are the ones that listen and consider, and then do it their way, explaining if necessary.

...And I'm "just" a tech, so to me, new med students are fine unless they talk down to me, or leave their skanky biohazard lac trays laying around the department. Take that noise to the equipment room, dammit.

There are a wide spectrum of nurses, but about 75% of them are jerkos (in my estimation). Why?

a) You get the ones who are hypocrites: they claim their bitterness stems from the crap that gets dealt them by everyone else, yet they are the worst offenders themselves. These are usually the older nurses who have the most experience. Since they have done their job for so long - no matter how simple or isolated that job is - it is their God-given right to act like they know more. It's not enough for them to just explain something. They have to laugh at you and loudly and condescendingly act out. And not just to physicians, but also to fellow (younger) nurses. Once I heard some old battleaxe lecturing a new nurse about some mistake and it was so condescending and arrogent that - even though I had nothing to do with it - I wanted to clothesline her. The new nurse was really upset and it was over NOTHING ...but the old nurse wanted to get in her power trip of the day.

b) You get the ones who don't give a crap, usually who are also self-centered. These are the lovely ladies who sit around reading magazines during 'work'. Don't disturb them! One nurse was playing an Internet Shockwave game when our team was rounding. An attending needed lab values and I asked her if I could use her computer. She gave me an irritated look and said, "there's another one on the other end of the station". OH, I'm sorry I almost violated your high score! I forgot that's why you're here ...for 'Gem Drop'.

c) They take the credit and shun the blame. Oh, yeah, a nurse will puff out her chest all day long when they pick up on something you missed (and they do - I can admit that). But when you dare to point out a mistake of theirs, you're just a little piece of "S" doctor and they all swear to make your life a living hell. I made a mistake writing an order once, where the dosing was incorrect and too high by a factor of 10 (P.S., the nurse didn't check it, she just gave it) - there was no adverse reaction to it, but the nurse loudly said in front of the attending, "that kind of mistake REQUIRES a write-up". Same nurse made a mistake a few months later and I say, "well, guess we need to fill out a mistake form". NOPE! Every nurse on the floor yelled at me about how "you're just trying to undermine us ...there was no adverse outcome, so forget about it." And the other doctors said, "just forget about it ...all these bitches stick together."

d) They act like they are the ones making decisions ...until something wrong happens. Then it's, "oh, talk to Dr. So and So". Nurses will happily bask in the praise of patients - "I see you waaaay more than the doctors." "My dad is getting better thanks to you!" - and will never mention a doctor. But when a complication arises or a family is just jacked at some random thing, it's page time! And they leave you there, or even worse, decide it's time to play patient advocate (note: they didn't say a word about this when the patient's family wasn't around) and start saying, "oh, I TOLD you that you should do that."

I could go on, but I'm getting too worked up. But if I have to, I will.

P.S. Where do nurses get off saying, "be extra nice to us ...or we'll be your worst enemy!" Nice. You want to turn the medical profession into a battlefield, then don't get pissy when you get your ass crushed.

P.P.S. Lest I forget, the 25% of nurses that are great - you guys rock. You truly act as part of the team ...including taking responsibility when things go wrong. You understand the stresses of us staying up all night and are considerate to that. You can be nice to us WITHOUT needing us to kiss your butt. When a nurse is great, I AM nice to her - not because she demands it, but because she deserves it.

Treat them with respect, as you should everybody (including pts) and your happiness factor will go up 10x. A bit of courtesy goes a long way, esp. when you are tired and post call.

d) Nurses will happily bask in the praise of patients - "I see you waaaay more than the doctors." "My dad is getting better thanks to you!" - and will never mention a doctor.

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THUNK!!

Sorry, that sound you just hear was me falling out of my chair and on to the floor because the above statement made me laugh so hard. I want to find the parallel universe where this hospital exists, because I've worked at three different hospitals and have never seen this happen.

Usually, when most nurses treat a med student badly, it has more to do with the med student than the nursing staff. Seriously, we know that some day we will have to deal with some of you as attendings...why set ourselves up for future grief?

From a personal perspective, I feel that the pt. care is the primary issue, so no matter how much a student/intern/doc may piss me off, I am not going to do anything that could compromise the pt. If that means that I have to be treated badly in order to get the pt cared for, I can handle that for the moment...there will be plenty of time later to address that administratively.

I would have to say that the majority of students/interns I've dealt with have been thankful for any kindness or help you give them. There's really only one who sticks out in my mind (that was nearly 20y ago and I still remember his name)...we had a "come to Jesus" meeting, and he straightened up.

This gets me to thinking, I wonder if nurses ever hate me and I don't realize it. If anything, I always thought Nurses are pretty cool and and helpful. I try to say hi to them, but it seems hard to strike conversations with them since I don't know what interests them or what they like to gossip about.

I'm sure nurses give a nasty attitude at times, but it never compares to the bullsh-t I see from residents or attendings.

It's a relief nurses are there, not just for patients, but I think the hospital would be miserable without them.

I've had a couple patients tell me that they are very thankful to nurses, but not so much to the doc... Nurses seem to have their agenda straight, but I worry about what kind of mixed up agendas some docs and residents have, and I think some patients can sense that.

I guess it depends on where you are, and who you are dealing with. My wife is a float nurse (she 'floats' to all floors), and she preferrs the residents to most doctors. As she works straight graveyards, she has to call the responsible physician/resident at all hours of the night. Per her report, residents are 'nicer' on the phone after being woken up at 2 am than a seasoned physician would be.

That said, reading through this fourum, and based on my past medical experience, it is safe to say you'll find A$$H@les work in every field of medicine. CNA, EMT, LPN,Techs, RTs, RN, RNP, PAC, and MD. All are capable of being A$$h@les. Some people are just born that way... it builds character for those of us that deal with them!

BB

Having been a nurse for the past four years, I am outraged that I never found this site sooner! I've been completely oblivious to this feud between Med Students/Dr's and Nurses - and I do love to get in on a bit of bitching and backstabbery! I've worked in 22 facilities, so I consider myself a bit of an expert when it comes to workplace culture in hospitals... Humour me...

Personally, I have gotten along quite well with almost every resident/student/etc that I have met in my time, and I can say the same for the vast vajority of my nursing colleagues. A typical encounter goes something like this: Dr smiles and says hello, I return greeting and ask how his/her day off was, we have polite chit chat about this and that, and sometimes a bit of gossip about hospital management. Somewhere along the line the Dr lets me know what his/her plan of medical treatment for the patient is, and I factor this in with my care plan - I haven't had a patient die on me yet due to poor communication so I guess this little sysem is a winner.

To many of you who have left weird little posts, I have only one thing to say: grow up and get a life! In the real world, no one really gives a toss who you are. We all just turn up to work and do our job.

I suppose if one has gone through "x" many years of med. school watching "ER" and "Trauma" thinking that "this is how it really is!", and then rocks up to work on ones first day barking orders etc like that poor doctor with the dicky knee, then naturally one must expect a comeuppance of sorts. And one thing I do know about my dear colleagues is that they do love giving precocious loud mouth twits the comeuppance they so richly deserve. However, I also believe that should my fellow nurses be having a bad day and lash out at a Dr, they may very well deserve the title "bitch".

I don't think nurses harbour an innate hatred towards medical students, and to suggest that they do, well... I suppose you'd be the sort of person who receives "special" hidden messages from the evening news that only you can understand... Take your haloperidol and be quiet, others have work to do. But seriously, if you just treat people with the respect they deserve, you'd be surprised at just how nice they can be (that includes the people that polish the urinals and mop the corridors)...

Lastly, if a nurse really does give you so much grief it upsets you, lodge a complaint through nursing administration and the nurse will be disciplined. We don't hesitate to complain to medical admin for the same reason - thats why these procedures exist: for when ego's spin out of control...

Steve, RN

shod0039 said:

I suppose if one has gone through "x" many years of med. school watching "ER" and "Trauma" thinking that "this is how it really is!", and then rocks up to work on ones first day barking orders etc like that poor doctor with the dicky knee, then naturally one must expect a comeuppance of sorts. And one thing I do know about my dear colleagues is that they do love giving precocious loud mouth twits the comeuppance they so richly deserve. However, I also believe that should my fellow nurses be having a bad day and lash out at a Dr, they may very well deserve the title "bitch".

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I like how medical students and residents are "precocious loud mouth twits" who deserve a comeuppance and who apparantly have learned to be physicians by watching TV shows. Whereas nurses who act poorly are just "having a bad day". I'm not going to generalize and say this shows the thought process of the entire nursing profession (even though I think it does), but it at least reveals a lot about good ol' Steve.

I have definitely seen a divide between nurse and med student/resident based on gender. Women residents (esp the surg residents) are given the evil eye from day one. I have personally witnessed groups of nurses sit around and dis the female residents one by one. (Of course they do it to the guys too.)
Nurses claim that women surgeons aren't as friendly and colloquial as the guys. And maybe that's true in some cases, but these women probably had to deal with nurses, attendings, etc. underestimating them their whole career just because of their gender, so they might have the right to be cautious.

And nurses can't flirt with the female docs either

kinetic: It also shows that despite reply after reply of solid advice on how to have a good working relationship with the nursing staff, you choose to focus on continuing the dissention. This does not bode well for your future...I can see some rough roads ahead for you. It's a team effort; it's not just all about you.

I hope you're able to look at situations more broadly when you're in the clinical setting. Such narrowmindedness could be tragic for your patients.

Dear Kinetic:

You've reeled me in hook line and sinker... I don't know if you just want to start an argument for laughs, or whether you really are experiencing these delusions of persecution by the big bad nurses (getting those "messages" from the evening news too, I presume?).

I never once said that all residents/etc are loud mouth precocious twits. I did say that I've gotten along well with the vast majority whom I have had the pleasure of working with. I also said that should someone be inspired to practice medicine like Dr. Dicky-knee from "ER", then they deserve a comeuppance (and that nurses, who can be quite territorial - we like to mark out our turf at the start of each shift by pissing around the perimeter of the ICU - are most likely the ones to give it to them). I suppose that goes for the breed of bellicose and belligerent RN's you come accross from time to time as well.

Now, if we could just agree that our relationships with our colleagues are solely the result of how we interact with them (with the exception of the occasional prickly jerk who probably tortures kittens for pleasure anyway), I'll be able to spend more time on forums where real issues are being discussed.

Thankyou for your feedback,

Steve

PS: I'm certain that you are a very well educated individual, so you must know how ridiculous it appears for you to make character judgements of people whom you really don't know the first thing about, based solely on their contributions to an internet forum with a topic as inflammatory as this...

fab4fan said:

kinetic: It also shows that despite reply after reply of solid advice on how to have a good working relationship with the nursing staff, you choose to focus on continuing the dissention. This does not bode well for your future...I can see some rough roads ahead for you. It's a team effort; it's not just all about you.

I hope you're able to look at situations more broadly when you're in the clinical setting. Such narrowmindedness could be tragic for your patients.

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Here's a thought: in the midst of all this advice on how medical students can act in order to improve working relationships with nurses, I see nothing about the opposite. Why no posts about what nurses can do to improve working relationships? I guess I'm just being narrowminded again -- I shouldn't bring up such things.

Kinetic, I've been reading some of your other posts and the thought occurred to me that perhaps you enjoy playing the role of devils advocate and stirring things up. Now hang on a minute tiger, thats not a criticism, so please don't attempt to destroy me with your perspicacity and cunning wit just yet!

What I suppose I'm trying to say (and be patient, I'm only a nurse and haven't got real good developed langwidge skills and stuff) is that perhaps you've cottoned on to the idea that when you insult or antagonize a person (or a group of people, in the case of nurses) they naturally want to fight back. And perhaps you find the ensuing discourse amusing. Which leads me to ask: do you really and truly believe that nurses in general have it in for medical students? Or are you just having a bit of fun?

Personally, I love having students of any discipline on the ward - and most students enjoy their placements on my unit. If I saw an RN/MD/anyone giving a student a hard time I'd step in and stick up for the student. And I'm not the only one - I'd say the vast majority of nurses feel the same way.

Nope. I don't play Devil's Advocate. I just like to point out things.

P.S. I don't believe I ever intimated that I had incredible wit or perspicacity. Neither do I feign modesty.

flighterdoc: I should have known...you are still trying to make the er nurses happy right? All those years of being a paramedic and not getting the respect and praise you deserve has really upset you.
I imagine you have had lots of opportunities to tell ER nurses to f-off...well I say go on tell all the nurses who piss you off to f-off...really..don't hold anything back.....let them have it...no really...they deserve it right?
I say tell every nurse that isn't thrilled to do whatever you tell her to f-off and get out of your way...

As soon as you can write orders for a critically ill open heart patient with LVAD or IABP and CVVHD on the oscillator maxed out on epi/levo/milrinone and being paced then you can come to Cv and tell me too..I already know how to start an IV and I don't have to go antecubital every time and I can intubate (I can actually put the tube in the trachea not the esophagus) so there isn't anything you can teach until you can actually finish a rotation..successfully.


kinetic
The comments about hypocrites and the like...yes you will meet nurses who behave like asses...just like doctors and bank tellers.
I think that the bit about nurses laughing and pointing at you when you make an error is a little bit of projecting though ...I am sure you have the same feelings anyone has when an error is pointed out...you are embarrassed and a little frightened...so everything surrounding that moment is sensitive.
I just have never seen anyone react this way to an error...we take them a little more seriously.
A good error (yes some can be good.)..one that does no harm and teaches you...and is funny...well it happens to all of us..if someone is being an ass then you need to ask to speak to them privately...let them know that you don't understand why the person felt it was necessary to attempt to humiliate you...I don't know..I just wouldn't let someone do that if they were being vindictive. If it was funny and people laughed..well relax..it means you didn't hurt anyone.I would watch out for flighterdoc though..can't you already see that one laughing the loudest while making sure to supply the donuts and coffee?

The nurse playing on the computer...you are NOT the only person who is pissed about that...in fact you may not realize we are standing behind you cheering you on when you hip check the lazy ass off the computer. Never ever believe nurses are happy about laziness..we are not but because of the union we are helpless.Once you are on a unit for a decent amount of time you will hear that person being bitched about.
I too have had the experience of having an older RN bitch me out over something that didn't seem that catastrophic...we already know but the problem is management doesn't see it as a problem...they assign the older,grumpier more experienced RN's as preceptors...alot like having a really bad resident and for orientation we have to tough it out...it's a test to weed out those that can't or won't stand up for themselves...it's very Darwinian and nobody likes it but again there is nothing we can do except when we see it happening make sure to try to intervene. I worked charge alot and unfortunately you can't be everywhere so we have to rely on anyone who witnesses this to come to us or defend the nurse. Some docs really don't want to get involved but if you can tell a nurse you like and trust they will usually find some way to help the nurse out.
I had two and I just told myself what doesn't kill you makes you stronger and then made my poor husband listen to my complaining.


I work in ICU so shunning the blame is impossible..you screw up..well there is no hiding it. I accept my part. I think docs need to do the same but I feel like there is a time and place for it but unfortunately nurses are not welcome at M and M's. Time is always at a premium and sometimes we do discuss errors way too publicly...errors should be discussed in a private area for everyone. I have seen residents purposefully humiliate other residents in front of staff..luckily I can say with most of our staff they stop that very quickly..but some residents will do it in front of nurses and some will humiliate nurses in front of peers and residents and staff. I don't know why people think it is an appropriate thing that will help anyone learn anything but it creates a really nasty environment.


I have seen a lot of floor nurses who are truly at the end of their rope....I care for one patient..sometimes they can have 8 patients just out of ICU..the acuity is terrifying..the patients are 16 hours post CABG and half of them could be pretty sick but we no longer have stepdown..they go to the floor and the nurses are usually brand new grads unsure of themselves and really totally overwhelmed.
You may be right..they are hating life and the future looks pretty bleak...it's not going to get better.
I don't know what the solutions are but I do know that there is no reason why we can't support each other.
There are some like flighterdoc who will never see that nursing has any value and we are only there for him to condescend to but hopefully there are a few of you that know most of us are trying to do a really difficult job without the time or resources to do it.

I think I posted some good ideas but I don't think anyone is really all that serious about the question.
I have seen some really awful relationships with nursing and medicine but I have also had some great experiences.
I had a med student,a resident and a fellow in the OR observing and assisting on my recent neurosurgery...they made me laugh and they made me feel confident in their abilities and I allowed them the opportunity to learn from and practice on me.
I think that is the highest praise you can give ... to allow them to see you naked and defenceless on an OR table...holding your life in their hands.

Try looking at it from that perspective...that is my standard of competence.

flighterdoc..you would never have made the cut.

I am a nurse, but I am not rude or hostile with anyone. Perhaps I am in the minority. Treat me with common courtesy and I'll treat you in the same manner. Act like a jackass and I will do my best not to be near you, but I will not tell you to f- yourself because the clinical environment is not the place. Displays of that sort of behavior at work are unprofessional for either group.

I have never heard of SNS. I suppose I've learned something new. Fortunately, I can guarantee you that I don't suffer from that condition. I do not want to be a doctor....never have and never will. I am sure that there are nurses out there that do display the sx.

I'd also like to point out that the entire "flirting with the doctors" mentality is a tired stereotype.

I agree with the person that pointed out that nurses do have the reputation for "eating their young". I believe that is true and I believe that it could apply to new doctors as well. Keep in mind that some people are just miserable human beings and the people they are actually friendly to are probably few and far between.

I am another nurse checking in. I've never wanted to be a doctor, nor marry one for that matter. I don't think I'm that rare, so get over those old misguided misconceptions. It doesn't serve you well. I'm a nurse because I wanted to help people, and I truly like the patients ( for the most part).

I've had very few problems with doctors or med students over the years and I've been a nurse since 1976. I did not let the problems I did have color my opinion of all other med students, interns or attendings.

We are all part of a team with a common goal. At least that's always been my viewpoint. It seems to have worked well over the years. It's been my pleasure to work with doctors and students that held the same belief for the large part.

I have had discussions with med students or interns in the past, when receiving orders that I cannot comply with. Things like drips on dopamine, dobutamine and the like because they exceeding floor limits (telemetry). Or heparin rate adjustments based on the labs. It helps to remember there are reasons why we tell you we cannot comply. It's not personal. And if I've ever had to point out errors (and I have) I try to treat the matter in the same fashion I would like to be treated. I take the person aside to discuss it. And I do not have to tell the rest of the staff about it unless I have reason to believe this person bears watching..(like after I leave when my shift is over, he will try to go to a less experienced nurse and continue to try to write a bad order, and yes, I have seen it happen). But this is rare overall.

I've done the same for nursing students. I take them aside to speak with them. I try to ask them questions about what was done and help lead them to the correct solutions without my having to just say "This is wrong. Here's what you should have done." Usually it can end up with the person seeing the error more clearly. I hope this method helps with their ability to think and reason through a problem and will thereby avoid another similiar error in the future.


hakksar, I thank you for your insightful post. For the rest of you, there is no reason we cannot have a working relationship that is respectful and benefical to all of us. Keep that in mind as you go through your training. It's very unfortunate to read what appears to be some very hardened attitudes so early in your careers. I urge you to reconsider and perhaps challenge yourselves to change these beliefs. We nurses are not the enemy. We should be and can be partners in healthcare.

I am an RN who does not hate medical students. Why would I? How silly.

Freeeedom! said:

The last poster is the PRIMARY reason that ICU nurses can get a bad name...the use of possesive phrases "my ICU", "You are required to show you are competent and more importantly you can actively demonstrate understanding that you are a member of the health care team." And competency is based upon your judgement and your judgment only? How arrogant of YOU. It is this exact creation of barriers on day ONE that make is so difficult to penetrate into nursing cliques...and that is exactly what they are.
Taking a medical student who has a zillion things on his mind and arrogantly stating that he/she must prove himself is a terrible thing. Instead of fostering the students/residents your attitude creates an adversariel relationship. I can tell...you are the one who thinks they know everything...you are the one who wants to be noticed and wants to be respected.

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I totally agree with the above comment....... As a nurse myself, I have found many other nurses to be very territorial and at times arrogant bitches...

Med students don't really do much till they're 4th and 5th years in uk. so really they just stand around and attend ward rounds, plus we need someone to wear white coats. they don't really speak to the nurses or the nursing studetns probably coz we're busy running the ward and doing our job. how much input do medical students really have anyway? i'm more likely to get asked what inteventions, drugs, treatments, blah blah the patient will need rather than them.

Ha ha ha.!
It's wierd, you guys sound afraid of the nurses, probably why all the backbiting is happenning here not to their faces. i'm asuming the majority of people posting are med students (or med students to be god willing). Remember guys that whilst your floating around the hospital, with no particular responsibility for anything, the nurses are actually at work!
I know that all you qualified lot know the real score.
Everyone should try to remember that doctors aren't better than nurses because i don't think any of you would be any good at nursing. i could say that being a lawyer is better than being a paralegal but then they're not really doing the same job are they??
The real story is that while nursing looks like it's on the up and up, maybe medicine needs to advance more too. come on guys! are you really telling us that you can't find some great new procedure or discovery that only you can deal with?? You guys need to move with the times!!! Everybody else is moving on and it's not like nurses are catching up anywhere else other than advanced practice. There's still the question of a cr**py union, mandatory overtime, cr**py holiday time etc.
And the prestige... why it's practically tantamount to announce ourself as a physician and onlookers to react as if you were superman. isn't that enough??