so what is the deal with you male surgeons?!

Discussion in 'Surgery and Surgical Subspecialties' started by soutery, Feb 11, 2015.

  1. soutery

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    I am not trying to cause an altercation but as a newly hired surgical nurse, you people are making me hate what I worked so hard to achieve! No matter what hospital or clinic I have worked at, about 90% of the surgeons of whatever speciality are all completely disrespectful, arrogant, narcissistic egomaniacs. I work so hard yet get treated like I am a subordinate and some sort of eye candy...for those of you who do not realise it but we do not work for you, you do not pay us, and it is very frustrating for those of you who do not appreciate us. This is to the point that when I do meet a respectful, generous surgeon, I am incredibly happy and surprised. I know this will stir flames and I know it is a topic which has been discussed several times but at work, it is like the elephant in the room because why do you still think that you are at the top of the hospital staff? Is it because of your training? The compliments you receive from patients or the over-rated pay? During training, we were always taught that this is no longer the 1970s and it has to be inter-professional team working because we cannot do our jobs without each other. There is no way a doctor could successfully do the job of a nurse because I don't think they could handle the stresses nurses are put through, particularly by patients. I don't think you guys realise how you interact with staff, particularly with nurses and I am not trying to start a fire if that's how it seems but it can be difficult to convey tone through messaging especially to strangers...
     
  2. ACSurgeon

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    What are you trying to accomplish here? I promise you that your approach is not effective. Coming to our forum to yell at us won't get you any sympathy. Talk about mutual respect...
     
  3. soutery

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    What the attitude is all about? The personality? The character? That is what I am trying to understand. And trust me, I am NOT looking for sympathy haha! As I said, it is difficult to convey tone through text so I am not speaking out of hatred, just frustration and confusion.
     
  4. vhawk

    vhawk 2K Member
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    I dont know what you mean by interpersonal team, I dont know what you mean by subordinate, but if you have spent any time in an actual operating room, and in particular if you have participated in challenging cases where things go wrong or things are tense, you will quickly realize that this is a completely asinine way to run an operating room and cannot possibly work, despite whatever sort of warm cuddly feelings those sorts of meaningless buzzwords bring up for you.

    Everyone in the room is, in a way, subordinate to the surgeon, and that is literally the only way it can work. Outside the OR, before cases, setting up cases, making decisions about how the OR works, all of that, sure, fine, its a team approach. When the portal vein is bleeding, its an autocratic dictatorship, full stop.

    Also sometimes people are jerks in a workplace environment, in a hospital or at McDonalds, the world still spins on.
     
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  5. soutery

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    But this attitude is one of the reasons why operations go unsuccessful. Sure, the surgeon for a particular operation is leading the team and yes if it is a difficult operation then things can get intense but that is not a valid reason for screaming at us. Yes being a subordinate is a term that gives me warm cuddly feelings where I imagine myself dancing with unicorns in a land filled with nothing but cotton candy and lollipops! This isn't even about in the OR, even outside the the theatre it is a case of, "I don't care what you have to say even if you are right, I am still on top and that is that". The number of times the nurses have actually had to correct a mistake by the surgeon especially when writing notes is unbelievable. When things go wrong, yes the surgeon with most knowledge of the case takes charge, someone has to...but ehmm that is not something which happens often.
     
  6. soutery

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    Because that is going to answer my question...
     
  7. Sirach38

    Sirach38 ASA Member
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    The surgeon is the captain of the ship in the OR. Period. It's his patient and his malpractice insurance on the line. Period. If you don't like it, find another job. You're a nurse and you are there to follow orders. Period. If you don't like it, go to medical school and get an MD degree, complete a residency, and pay malpractice insurance. You are not equivalent in any way to the surgeon (professionally speaking, not worth as a human). This "team" mentality where everyone is equal is largely propaganda used by nurses and fed to you in your education. Yes, you are part of the team but, your job is to take orders and say "yes sir".
     
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  8. soutery

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    Right okay actually yeah I'm coming across rude but I do actually want to know from a surgeon's perspective why you can sometimes appear to have a big ego and be quite rude. Or at least for those ones who are. A lot of my perspective comes from talking to fellow nurses which can be quite biased and the reasons I have gotten are things like, "they have bad social skills; they have large egos from the start; they have a lot of pressure on them" so I want to know the reason from practising surgeons. I can understand the whole pressure in theatre if things go wrong and the surgeon is the first one to be put under fire, so is that one of the reasons then? I am quite new to the job and I have been listening to what has been taught during training and if conflict has arisen then my senior nurse has always stepped in so it is a little different to see how different reality is. But probably it would change my perception
     
  9. Mad Jack

    Mad Jack Critically Caring
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    Here's the deal- you may not work for the doctor, but you are his subordinate. He writes your orders, he dictates the treatment plan, etc. You are lower on the food chain, period. Get used to it. That doesn't mean you aren't valuable or that your work should not be appreciated, but that you are not equals. The hospital views the surgeon as the generator of income, and you as an expense. He is an asset. You are expendable.

    Now that that is out of the way- I find it quite ridiculous that you find the stresses of nursing to be worse than that of being a physician. As a person who was a clinician prior to medical school, I can tell you that the stress physicians face, particularly surgeons, and the stress nurses face are entirely different. But at the end of the day, any surgeon could do a nurse's job if they were trained for it, but very, very few nurses would survive the training to be surgeons and the stress that comes with the job.

    Now, surgeons shouldn't be disrespectful to you, certainly. They should respect you as a human being, and respect the unique skill set that you possess. Being a jerk serves no one well. But be mindful of the fact that if you don't show up to work, they can just throw another nurse in in your place, especially with the glut of grads nowadays. If he doesn't show up to work, people could literally die. Be proud of the work you do, but don't get an overly inflated sense of self-importance or hubris.

    If you would like a slightly more respectful environment, you might want to consider medical intensive care. It's a bit more egalitarian at most teaching hospitals than the surgical units.
     
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  10. soutery

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    I guess it is.
     
  11. soutery

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    See that is the attitude I don't understand. Yes sir even when you are doing the wrong thing.
     
  12. soutery

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    Thank you for your response. But I disagree that any surgeon could do a nurses job...on the academic/medical side of course but in terms of patient interaction, no way! I don't think they would have the patience and compassion to be able to deal with patients particularly the difficult ones.
     
  13. SouthernSurgeon

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    Ve vere just following orders much?

    I often hate the airline industry analogies, but their lessons regarding communication strategies are good ones. While the surgeon is the "captain of the ship", that doesn't mean others don't have a voice. I have seen anesthesiologists, scrubs, and circulators all point out critical issues in the operating room. If they took the "yes, sir" approach, there'd be some dead people lying around.
     
  14. Mad Jack

    Mad Jack Critically Caring
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    You're a newly hired surgical nurse. You don't know a damn thing. Give it five years and stay in the same place, do good work, and build a reputation for quality practice. Then they might trust you when you say they're doing the wrong thing. Respect on the unit is earned, not given. You can't just trust every nurse to know their ass from their elbow due to the low standards of entry to the profession, the great number of people that entered the field in search of a paycheck, and the huge amount of variability in quality between nursing programs. Show that you're one of the good ones, and eventually when you say "this is a bad idea," they'll actually stop and listen. For now, you're just some noob that's viewed as someone to keep an eye on at best and dangerous at worst, until proven otherwise.
     
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  15. Mad Jack

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    I worked with a lot of foreign physicians-turned-nurse and they seemed to do just fine. I've also worked with many a nurse that has a bedside manner that was about as pleasant as nails on a chalkboard, but no one cared because you could count on them when shtf- not every nurse has to be a social butterfly that comforts and calms. There's room for nursing for all types, just as there's room in medicine for them.
     
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  16. soutery

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    But it is what I have observed from my senior nurses when they voice concern. Yeah nobody listens to the junior regardless of whether they are a doctor, nurse, PT, OT, whatever but it's actually looking forward. I do not want to be viewed as some second class citizen even when I do gain credible experience.
     
  17. LucidSplash

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    I'd like to hear some specific examples of things you have witnessed a surgeon doing that are "wrong" and yet you were required to "yes sir." Should we be allowed to assess or just expected to take your (very inexperienced) word that they were "wrong" and not merely a matter of style or preference.
     
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  18. Mad Jack

    Mad Jack Critically Caring
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    You are a second class citizen until you're the one actually performing the surgery and your ass is on the line when that patient dies and the inevitable lawsuit comes down the pipe.
     
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  19. soutery

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    To be fair, I have been told than in ten years time I will probably end up being a horrid, apathetic person who hates their job just like the majority of society and I'm still in the happy love my job phase...I don't know, most likely
     
  20. Mad Jack

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    If you put 20 years into the ICU, you'll be pretty burned out, guaranteed. Very, very few nurses stay more than a decade, and if they do, they usually downgrade to sleepy community units. Academic intensive care will crush your soul- it's just a question of if you're willing to have it crushed to do a job you care about. That's what made the ones that stayed kind of special- they were in it for the love of the job, and they were willing to give whatever it took to do that job well, even if it was losing a little bit of that friendly spark and a touch of their soul along the way. You can't give that much without putting some damn good work in to make it worthwhile, and they were the best.
     
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  21. TraumaLlamaMD

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    True fact: female surgeons can be "rude" too.


    Especially when confronted by long-winded ranting about how horrible they are.
     
  22. ThoracicGuy

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    3/10. Needs more work.
     
  23. soutery

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    I don't challenge these surgeons, if I have an issue then I voice it to my senior nurse (my boss). You want to hear one? In the OR, patient's saturation levels declining and I tell this to the surgeon who ignores me and tells me to just concentrate on what he is doing then the anaesthesiologist interrupts to tell him the exact same thing.
    Doing ward rounds with a surgeon who despite physically assessing every patient's wound, not once was he washing his hands between each assessment.
     
  24. soutery

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    Yup I really should have done better in English
     
  25. soutery

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    I wish you could tell that to my senior
     
  26. Mad Jack

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    You should report a lack of hand washing like that, if he's making physical contact with the patients and their wounds. That's a serious IC issue and should be followed up on.
     
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  27. TraumaLlamaMD

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    It's the anesthesiologist's job to monitor the patient's vitals and make a judgement call about when to be concerned. You should be concentrating on learning to do your job until you've got enough experience that you can focus on other things too.
     
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  28. soutery

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    I do! And nothing is ever done of it
    I did! And nothing was ever done of it. But luckily my senior had a chat with him about it.
     
  29. soutery

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    Yes sir/mam
     
  30. TraumaLlamaMD

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    I'm of the mean, female variety. :)

    In all seriousness, as you say, you're new to the job. If someone brand new, who I didn't trust yet, interrupted me to tell me something that the anesthesiologist wasn't concerned about yet, I'd find it strange. I'd wonder why you were looking at the vitals instead of paying attention to see what instrument I might need next, or trying to learn your job before taking over someone else's.

    The good scrub nurses and circulators at my hospital are treated very well by our surgeons - but it's a two-way street. The most loved and competent OR nurses could probably get away with straight up telling a surgeon he's wrong, but more often they have the surgeon's back, paying attention to what's going on so that when things go wrong, they've already anticipated what he'll need and have it ready. If he misspeaks and asks for the wrong thing, they'll know, and give him what he actually wants. But very rarely will there be a direct confrontation, because that's usually not the way to get what you want.

    Does surgery tend to attract people who have a need to be in control? Of course. But if you find you're treated badly by every surgeon you encounter, you might consider changing your own approach. As they say, you catch more flies with honey than vinegar - something many surgeons could stand to remember too, but if you're looking for advice on how to make your own life easier, it's worth remembering. And to answer your original question, or what I think your original question was: yes, you can be treated well and your opinions valued. But you have to demonstrate first that your opinions are informed and experienced.
     
  31. soutery

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    Surprisingly the female ones I have encountered have actually been very kind to me! Don't get me wrong, I know my opinion is a stereotype because I have met lovely ones but the majority ehem. But actually my observations were correct and the anaesthesiologist did apologise for his lack of attention but that's what I'm saying. I can completely understand that yes I am a junior nurse so my opinions are worthless but I would not want this to be continued throughout my career and be viewed as a servant. I would want to be respected and if I did voice concern then for it to be dealt with in an appropriate manner...sure I know that that will only happen when I have years upon years of experience showing my competency but right now it is frustrating...I'm good at waiting though.
     
  32. ACSurgeon

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    So, here are some explanations (note: not justifications. It doesn't make it right but it explains why):

    - Our training and practice expects near perfect performance at every step of the way. This isn't just for critical tasks but for mindless things too. On the other hand, we are surrounded by people who routinely perform at barely acceptable performance. This isn't limited to nurses but includes many non-surgical physicians as well. This includes lack of work ethic, lack of interest to learn and grow, and at times pure laziness. This gets to be tiring. It makes our effeciency and end result suffer.

    - examples of the above include nurses paging about orders without checking the computer to see if they are in, nurses telling patients they don't need their DVT Px and us finding out incidentally later, nurses paging to the HUC number rather than the number outside the patient room where they are sitting, nurses not knowing their patients name even though they have 2-4 patients and the physician team has 25 patients (giving me a room number won't help), nurses paging about a problem with literally no attempt at trouble shooting or even having a recent set of vitals. The list goes on.

    - some surgeons think they are special. Some think they have to display a certain demeanor. I disagree with that.

    - some believe in the "I give orders and you say yes sir"

    - Ultimately we are trained to make decisions, especially when things don't fit a classic presentation. Nurses are trained to follow simple algorithms and aren't trained how to troubleshoot the unexpected.

    - you talk about how hard you worked to get where you are. Attending surgeons have 9-15 years of additional grueling training than a bsn. If your 3 12's per week is rough, try 12 consecutive 12's followed by one or two days off (in which you're expected to work on research or study) then you'll get a sense of what we go through.

    -Nonetheless, all inhumane behavior is unacceptable. Most rude behavior is unwarranted. But you should cut us some slack once in a while.
     
    #32 ACSurgeon, Feb 11, 2015
    Last edited: Feb 11, 2015
  33. ACSurgeon

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    Disclaimer: despite the impression you get from my posts above, I'm actually very friendly with all hospital personal especially surgical floor/ICU nurses.
     
  34. soutery

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    Okay this puts things into perspective for me so thank you. But btw my qualifications are from the UK so I hold much more than a basic b.s.n.
     
  35. soutery

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    Well you can ask those associates degree nurses yourself...i am not one of them. Holding a first class degree Bsc(hons) degree in physiology, a first class degree in nursing studies and a masters degree in public health all from highly ranked UK universities plus sitting qualifying as an R.N in the US means I am not straight out of some community college... We are actually a lot more intelligent than some of you think
     
  36. soutery

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    Don't get me wrong, yup doctors go through much more vigorous training but not all nurses are mass produced in a factory as you seem to think
     
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  37. soutery

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    No one profession has the knowledge to treat a patient purely on their own...it is a team effort whether you agree or not. Can orthopaedic surgeons successfully treat patients without nurses, PTs, OTs, podiatrists? Could they do every single professions role by themselves or would it be too much? You wouldn't sit and tell an O.T what to do because they are experts in their field just as nurses are experts in their field
     
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  38. steelpoop

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    Woah OP you come across as very arrogant yourself! No one here cares about your educational history and qualifications. All that is being said is that doctors train much more intensely than nurses but that does not mean to say that nurses are second class citizens. I appreciate those nurses who can handle the patients who are a nuisance and that is something that is part of your training and it helps us a lot. There is nothing worse than working your ass off for a patient who doesn't seem to appreciate your effort and for me, that's where the nurse steps in to deal with that patient. I agree than doctors cannot do it all though which is why the nursing and allied health professionals exist and those that do a good job should be applauded and not be treated and looked at as second class but there are some situations where doctors are the experts and we expect you to do as we say. In the OR, prescribing drugs, implementing treatment plans. But there are also situations where we actually rely on other professions for advice. For example, at times i may have set a guideline for how i want patient X to be treated by physical therapy but sometimes the PTs do their assessment and deem it as inappropriate so we have a discussion and i respect what they have to say because when it comes to physical rehabilitation of patients, they know a lot more than doctors...it is what they are trained to do.
    I think with more experience, you will learn how to handle arrogant surgeons but maybe you have quite the ego yourself so you take what your colleagues say to you in the wrong way. Just for my curiosity, why physiology to nursing? Why not medicine?
     
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  39. vhawk

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    Source? Not in my experience. If I was making a list of top 1000 reasons operations are unsuccessful, "undemocratic critical decision-making process" wouldnt crack the list. But I am nothing if not humble and introspective, so I'd be happy to be proven wrong.

    Have a little empathy and a little introspection. Imagine being in his or her shoes. **** has officially hit the fan. There is audible hemorrhage. They ask for a tie, or a stitch, and your response is "Sorry doctor, its my break, I need to leave but Courtney will take care of you." You can perhaps imagine how in this stressful situation the surgeons concern for the tone of his voice or the connotative way you are going to interpret their requests might not be a priority?
    I'm skeptical, or if not that then I'm jealous of wherever you practice. In every environment I've been in, its exactly the opposite. Whenever they are able, surgeons go out of their way to kiss the ass of everyone else in the OR and in the hospital in general, because they've learned from experience that nothing good comes from standing up for yourself, making your preferences known, or just generally using common sense. It is only during those critical stressful times that we allow our guard to slip and speak as if we were talking to rational humans interested in improving patient care.
    I'd love to hear some examples, and I daresay I speak for the rest of the thread.
     
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  40. vhawk

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    This will be a test of your self-awareness. Of the last 50 times you were certain that the surgeon was doing the wrong thing, now, with the benefit of hindsight, how many of those times would you say:

    1) You realize now it was the right thing
    2) You realize now that you have insufficient training to determine whether it was the right or the wrong thing
    3) You realize now you are right, surgeon was wrong, and the patient was harmed
     
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  41. vhawk

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    Long story short,it would be EXCEEDINGLY difficult for me to consider anyone else in the operating room to be a "co-captain" or whatever you have in mind who has a shift-work mentality. If I have ever, at any point, seen you leave a room during a critical or even just important portion of a procedure because it was "time for your break" or "your shift was over," you have forever lost your privilege to claim that you are a champion of patient safety, that you are an equal member of the team, or that we all must work together. At that point, you have declared unequivocally your priorities.

    Sadly, in my experience, this rules out anyone except the surgeon and the surgery residents. This is my bias, but I feel its a justified and well-earned bias and I'm happy to debate it with anyone.
     
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  42. ACSurgeon

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    As a highly educated nurse, you should know that this does not apply to the VAST majority of your co-workers. Even those with BSN or NP degrees, many attended less than rigorous programs, and some just couldn't care less beyond don't the absolute minimum while on the job...
     
  43. Winged Scapula

    Winged Scapula Cougariffic!
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    Unfortunately it appears you did not read the Sticky above which states clearly that such postings are in violation of the TOS (or as noted above, is akin to coming into someone else's house, dropping your pants and ****ting on the floor). Respectful comments are welcome but derogatory ones are not.
     
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  44. SLUser11

    SLUser11 CRS
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  45. soutery

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    Oh yes! I managed to beat that thread with a 10/10. This must be what winning a Pulitzer's award feels like. Interesting that patients seem to have a lot more gratitude towards nurses as we spend most time with them and the most intimate contact... but I hope that statement does not violate the rules
     
  46. soutery

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    But in all seriousness I can understand I came off on the attack so apologies for that but I did genuinely want to know the answer...my wording was inappropriate and thanks to those who gave me an insight and those who clarified the "I'm the doctor, you're a nurse" yup
     
  47. balaguru

    10+ Year Member

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    I've always felt we should be more lenient on trolls, especially clever ones. After all, the revered William Osler trolled under the pen name Egerton Yorrick Davis.
     
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  48. dr zaius

    Physician 10+ Year Member

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    Maybe if you actually recorded I/Os on patients when an order for strict I/Os is written instead of repeatedly paging about whether or not we can d/c the qAC finger sticks physicians wouldn't be so hostile towards you.

    Not you in particular, just...nursing at my facility...unless you do this. In that case, I'm talking to you.
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
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  49. soutery

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    Oh honey I completely agree with you on that one! We should very much be more lenient on those darn trolls
     
  50. soutery

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    You are not talking to me because that does not apply to my situation but thanks for that little story. A little pointless but still very interesting for me to read :)
     

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