Why do medical students/residents/attendings hate nurses?

[Medikit]

Hellooooooooooooo??? Look Mr. Med Student and any other lurkers who know nothing about anesthesia..Pull your nose out of your med school books and read some history books..Nurses have been administering anesthesia long before any physician..it wasnt until you could make $$ at it that physicians became interested in it. Another stupid post by another spoiled lil med student..go cry to your mommy not to us nurses

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[Cowboy DO]

Hellooooooooooooo??? Look Mr. Med Student and any other lurkers who know nothing about anesthesia..Pull your nose out of your med school books and read some history books..Nurses have been administering anesthesia long before any physician..it wasnt until you could make $$ at it that physicians became interested in it. Another stupid post by another spoiled lil med student..go cry to your mommy not to us nurses

That doesnt mean its "nursing" and not "medicine" just becasue a nurse is capable of doing it. Also I'll agree that nurses have been giving anesthesia, and doing a good job at it, for a long time (~1890). However for the sake of argument, (and the amount of joy your responses bring me) I dont belive that they were doing it before any physicians. But again what do I know...prove me wrong.


P.S. that puke thing is gold Medikit...gold

 

[Hope4Ava]

I just wanted to add that when I was a staff nurse or even now that I'm a NNP, and I called a doc at 2am or whatever time it is, it's because there is a concern I need to address no matter how "stupid" it may seem to you at the time. Sometimes it's the littlest things that clue you in to a big problem. I only made the mistake of not calling a doc for something that "probably could have waited" until the moring ONE time only to have her come in yelling at me and questioning why I didn't call so I have no hesitation about calling if I think I need to. It's my butt that's on the line if I don't. I'm going to be held accountable. It's my license and OUR patient that I need to protect.

I agree with whoever said the problem is one side has no clue where to other is coming from.

And to the person who made the comment about a nurses education....ever heard about a doctor amputating the wrong leg of a patient.....sometimes it's as simple as knowing your right from your left (btw, I know a lot of these cases are not just the docs fault---I'm not doctor bashing. For the most part I have nothing but for the docs I work with and I can only speak on my own personal experiences.)

Or how about when my own baby was in the hospital and had an order written for a morphine drip at 0.5cc/hr (maybe the doc should have reached for that calculator; I'd rather someone use a calculator to work out a simple problem and get it right than not and get it wrong so yeah I'm guilty as you charged). Had that nurse with her "dummied down education" not known that that was too much who knows what would have happened to my child.

I'm not on my nursing high horse because I've seen plenty of times where both parties should have known better but didn't (example: doc makes baby NPO but orders no IVF's.......nurse carries out order and makes baby NPO but doesn't ask for IVF's..........baby goes 9 hours without IVF's and ends up with blood sugar of 22 by the time day shift comes in and gets report)

I could go on and on but my point is that patient care works best when everyone works as a team. Ever read the story of the little girl at John's Hopkins that died of dehydration. Perfect example of what I'm saying.

And yes I know I was off the original topic.

NEVER discount the value of an education.. My education as a nurse might be insignificant to you but it means a lot to me.

You are never too educated or too smart to make a stupid, avoidable, deadly medical mistake.

 

[Mr_Money]

BTW anesthesia is the practice of NURSING not Medicine. Seacrest Outtttttttttttttttttttttttttttttttttttttttttttttttttt !

Uhh...for your information, anesthesia is the practice of MEDICINE while supervising NURSES. I could explain this to you further (how ALL the major advances in anesthesiology were made by physicians, etc.) but why bother? With an idiotic closing statement like that, I already have all the insight into your personality that I need.

 

[deltamed]

I would like to comment on the whole eduction disparity bewteen nurses and MD's. As a RN (diploma grad) for 20 + years, a undergraduate degree in Chemistry, BSN, Masters in Anesthesia and a CRNA who was educated, yes EDUCATED in a DO medical school..yes took the same physiology and pharmacology courses, anatomy courses ect..who do you think were at the top of the bell curve when it came to grades in classes ? Its not about being a MD or a RN or whatever the hell you want to call yourself its about the initiative to educate yourself and keep current. Just because im a RN with a CRNA does not mean im stupid and dont have the education a physician has in the sciences. What happened to clinical experience and gaining insight and vision from working with the critically ill ?? Is it really so much better that a spoiled med student who has never worked a day in their life is so much superior then someone who doesnt go to med school?? No im not just a technician, I have a brain, I can make intelligent decisions on my own..why does everyone automatically assume I want to go to med school and be a doctor ?? Yes all you MD's and wannabees out there you are not at the top of the food chain you only think you are and you should really be grateful for everyone who helps you or saves your ass when your home sleeping or golfing. BTW anesthesia is the practice of NURSING not Medicine. Seacrest Outtttttttttttttttttttttttttttttttttttttttttttttttttt !

hahahaha. "EDUCATED in a DO medical school?" Wtf does that mean? You took 3 1/2 years of med school then dropped out?

What I don't understand is that nurses used to be treated truly like crap by the older generation of doctors. They were basically bossed around and ordered to do whatever the attending wanted, secretarial or otherwise.

Now that they are treated much better by younger doctors and med students, with more respect and more as part of a team. Yet there are some who can't accept that medicine, like every other industry is a heirarchy with doctors above them. You get people like this crazy fairy up here with an inferiority complex trying to show that nurses should be at the same level as doctors in that heirarcy. Companies have team leaders and so does healtcare - doctors.

 

[Whisker Barrel Cortex]

I just wanted to add that when I was a staff nurse or even now that I'm a NNP, and I called a doc at 2am or whatever time it is, it's because there is a concern I need to address no matter how "stupid" it may seem to you at the time. Sometimes it's the littlest things that clue you in to a big problem. I only made the mistake of not calling a doc for something that "probably could have waited" until the moring ONE time only to have her come in yelling at me and questioning why I didn't call so I have no hesitation about calling if I think I need to. It's my butt that's on the line if I don't. I'm going to be held accountable. It's my license and OUR patient that I need to protect.

I had no problem taking phone calls, no matter what the time, if they were true problems that needed to be dealt with. There were many times that I wasn't called with significant changes (increased oxygen demand, change in rhythm, etc) and many times I was called with non urgent situations. I guess my expectation of an RN, given his/her level of education, is that they should be able to discriminate between these two situations. The vast majority can, but some cannot.

 

[Hope4Ava]

Whisker Barrel Cortex,
I understand what you're saying about being able to tell the difference between urgent and non-urgent.

I guess for me it's things from personal experience that just make me pick up that phone. I just couldn't live with the guilt of a bad patient outcome if things could have been avoided by a simple phone call.

Besides nursing school, I haven't done any kind of adult nursing so maybe it's different. The NICU babies can change so dramatically in such a short peroid of time that it's hard to sit and wait even on the little things.

 

[sones]

As a former ICU RN I know it happens. Nurses can be very poor to judge when it comes to calling docs. You don't need a diet change at 2am etec....Fortunately, the majority of nurses are not that ridiculous. Just a warning for you MDs, I know nurses who have called a physician at 2 am with something they KNEW could wait because the MD was a total A** to everyone. It was their little revenge for poor treatment......just something to keep in mind!
.

 

[UCLA_MSN]

Well, hopefully the nursing lecture you listened to was an LVN program lecture and NOT an one for the RN program. During my undergrad years, I remember my A&P and pathophys book to be quite heavy!! <Those are two seperate books now!!> Unfortunately, errr fortunately, we had to read the whole darn book!!! My mother taught a couple of semesters in the LVN program and I have to admit, the information given was quite superficial.

As for the poster presentations, I have never heard of hand washing topics!!! =)

Honestly it's statements like this that go a long way toward explaining some of the resentment of nurses by doctors.

I've stood outside a nursing lecture while waiting for an elevator and the door was open to I had to listen in. The science was so superficial and dumbed down that I almost started laughing.

I worked as a nurses aide for a year before starting medical school and nursing students rotated through the hospital. I gathered that part of their rigourous education was lots of poster presentations about hand washing with the obligatory plate of home baked cookies for everyone when they were finished with the talk.

Giving meds does involve some math skills am I not correct? Should it seriously concern me then that I've witnessed two nurses (one of them the charge nurse) running around trying to find a calculator so that they can convert 220 lbs. into kilograms? If you don't see the problem with that scenario then you are just as guilty. Or how about the charge nurse who told a group of high school students when teaching them how to take vital signs that 17 times 4 was 72.

I have a lot of respect for nurses. I saw what they did for the year I was a nurses aide on a med-surg unit. I got along really well with the vast majority of them. I also got treated like dirt by a few. The charge nurse was one of the most arrogant, sarcastic, and disrespectful people I've ever met.

That is something I've never really seen addressed on these boards. The nurses always complain about the doctors treating them bad, yet some (usually the most vocal about the doctors) are far worse with their aides and fellow nurses. I've witnessed this firsthand and it smells of hypocricy.

Compared to a PhD's training medical school classes are very broad but not as deep. We both learn physiology (for example) though, so which would be more arrogant?
a. For me to say my knowledge of physiology is equal to the PhD even though we have taken different courses that cover the material in different levels of detail (after all he's had physiology classes and so have I, it must be the same).
b. For the PhD to set me straight and tell me that my physiology education is not as detailed as his

 

[RN BSN]

I have no doubt that the nursing students think their programs our difficult. I hear them griping everyday on the shuttle bus. Just because Forrest Gump thinks algebra is difficult doesn't mean it is.

I find your statement to be degrading and uncalled for.

 

[Noeljan]

Oh my gosh Orthoman

 

[Noeljan]

First of all orthoman
I never said nursing sciences were equivalent to medical school sciences. I think it is ignorance to think that it is true. The only think I ever said, having been both a BSN AND biology major was that nursing prereqs are on the same level as the premed reqs (as someone who has first hand experience bc I have done it both).
Second,
The NCLEX is not anything like you imagine I am sure. You cannot just cram for a month having never been in a nursing program. I will tell you why, it is not based on intelligence or simple scientific fact (ex there are no questions asking what the steps of glycolysis, or even ana/physio like what is the fx of this and that) The MAJORITY of the questions were about priority and the 5 steps of the nursing process (Asses, diag, planning, implementation, evaluation). A TON about delegation (what task would you assign to the LPN/CNA in this situation, etc). I assure you that you need to have nursing experience, and have done the 5000 care plans, and nursing theori=y drilled into your pretty little head for 2 years, lol. Hahaha most med students I know often don't even know the differences between CNAs, LPNs, and RNs, lol. So I find it very hard to believe they would be able to pass NCLEX so easily. It's the format in which they use.
Anyways, back to my reply....orthoman

 

[Hope4Ava]

There are many people for whom nursing is a second career who
have degrees in a variety of other disciplines. So your thinking that nursing is for the less intelligent is flawed in so many ways.

I'm glad you think so highly of yourself. If you think this poorly about nurses, I can't imagine what you think and how you treat your patients who aren't on your level.


You are one of those people that until something bad happens nothing will change your attitude and that's unfortunate.

It's no wonder healthcare is the way it is.

 

[Docgeorge]

I'm not trying to pick a fight. I respect and admire nurses esp. the good ones, which I believe that the vast majority of nurses fall into. One of my closest friends was in the BSN program at my undergrad school. One day we were both at borders studying and when he was takeing an NCLEX practice test, I took it with him, and guess what I passed. I did'nt get a really high score, but I did pass. It was'nt that hard there was some basic phys and anatomy, but most of it was pretty commonsense stuff. Now granted I've worked in a hospital setting in one form or another since I was 18 so that might have contruibuted to me passing.

 

[UCLA_MSN]

Oh come now, comparing books is a little childish, don't you think. It's like comparing who's privates are bigger!!!

As for that nursing school, why couldn't they make us do stuff like that at UCLA. Stupid UCLA for wanting us to learn important things just to be at the top 10 in the nation.

No, the school in question was a Top 25 (according to U.S. News and World Reports) R.N. Nursing school.

I don't think the weight of a textbook is the best measure of it's difficulty. If you want to compare textbooks though I'd be happy to. Anatomy and Physiology (1 textbook) would be covered by 5 separate textbooks in medical school (gross antomy, histology, embryology, neuroanatomy, and physiology).

As for the hand washing poster presentations, it might have been the LPN program that rotated though that hospital. I'm just not sure because I seem to remember the woman that did the presentation working as an RN there a few months later after graduation.

I have no doubt that the nursing students think their programs are difficult. I hear them griping everyday on the shuttle bus. Just because Forrest Gump thinks algebra is difficult doesn't mean it is.

 

[southerndoc]

You are absolutely right, for me to compare the mental capabilities of most nursing students I know to a man with an IQ of 75 is very unfair to Forrest Gump.

You know, the joke among other physicians is that the ortho guys are the dumbest of our bunch. How does that make you feel? Seriously, how much knowledge is required to be a bone carpenter?

(This coming from an emergency medicine resident, who is also the subject of many jokes by other specialties. Yep, I'm a triage doc.)

 

[Noeljan]

Hey guys/gals
My point about NCLEX was not that is was easy or difficult, but rather tricky in the sense that you could be way up there with your anat/physio etc, and still not do well. The test is all about priority and psychosocial material which can get very confusing. I can't explain it unless you have taken it, you know what I mean. Also, there is no set passing percentage or anything like that. It is a CAT system in which everyone gets a certain amount right and wrong. The computer picks the next question based upon if you answered the previous one right or wrong. Basically, you can really screw yourself with a few wrong in a row which may be on something you have never encountered (it's not as straight forward studying/facts as one might think). I know people who have failed that were excellent students, then pass three months later with the same exact number of questions by just going over the question types over and over. The questions are often luck of the draw on NCLEX.

 

[orthoman5000]

I'm an idiot and I need to apologize. You will find that I deleted my posts on this thread (although some have been saved for posterity by quotes) because they were wrong.

I took a practice NCLEX test online and only got 49% correct. The questions were incredibly ambiguous and I had no idea what they were looking for. The occasional pathophysiology question was a breath of fresh air. I would much rather take the USMLE Step 1 than that thing. So I was totally wrong about a medical student being able to pass it without studying. I can see now why some nurses fail it on multiple attempts.

 

[Noeljan]

Oh my gosh it is soooo ambigous. I was surprised I pulled it off, but barely doing so. You can be a genius and still do terribly on that thing. I wish it were all anatomy and physio haha. At least then it would be more straight forward. The problem is a lot of people have never learned these things (book wise). It is like no other nursing test you have had in school, unless your school has some sort of prep for it. I have seen many A students who were on top of their game in all of their courses do really bad on NCLEX or even preparing for it. It is hard bc often all the answers are right, but you have to chose what has been referenced in two nursing sources as most correct. Also, there are tricks to it in other ways. Also, many fresh out of school students have not had much experience in team leading or dealing with LPN's and CNAs other than clinicals. I know for a fact I did vitals as a CNA, and know the CNAs I have worked with do vitals....BUT in one NCLEX review book it said to never let a CNA assess which would include vitals!! I was like what???? I mean I could see inital vitals or critical, but none at all? But then in another NCLEX review book the correct answer included a CNA doing vitals. I tell you that thing is wayyyyyy to tricky for me to have to even think about again You have no idea what questions you will get.

 

[NurseDaisy]

Wow - I havent checked this thread in a quite a while ...

Orthoman: I sincerely hope that someday you find inner peace within your self. You obviously have a bunch of hate and you are expressing it in an unhealthly way on this board towards nurses. And by the way, I would much rather be compared to forrest gump than nearly anyone else. Atleast forrest gump had consideration for others, was always trying to help out all of his friends, and never had a swollen sense of pride. Can you say that orthoman?

The NCLEX: All i can say is JESUS CHRIST. There is no studying for that damn test. It draws upon your knowledge in nursing school and involves critical thinking skills and prioritizing that sometimes is common sense, and at other times a crap shoot. Additionally, Im not surprised that someone mentioned that they took a practice test of their friends and barely passed. The NCLEX is to test for the MINIMUM basic requirements to be a nurse. MINIMUM. not MAXIMUM. That is why all different educations of nurses take the same test. It tests for the minimum basic requirements.

It also seems that my comments about paging a doctor in the middle of the night have been discussed. I stand by my word. If I see that it is indeed needed for my patients care - then I will page. If it is not emergent or important and can wait until morning, then I will tell the doc in the morning. As a part of my education and licensure, I *AM* allowed to make critical thinking decisions. I understand you may have more pressing issues, but please - take a deep breath, call us back as soon as you can and calm down. Prioritize your patients as well and then there should be no problem. Its not just your license on the line.

ONE MORE THING - something all of you med students out there should be aware of. Our hospital just announced they arent letting residents sleep during oncall hours. Even if nothing is going on for like five hours. CRUEL.....make sure the hospital you work at isnt doing that.

Thats it! I gotta get ready for work.

NurseDaisy

 

[Docgeorge]

What hospital do you work at? I will be sure to steer clear of that place.

 

[Werry]

To answer the original question, maybe because scrub nurses love to torture the med students and harrass them. When those med students become attendings they reciprocate and then the nurses take it out on the new batch of students. It's cyclical.

 

[deuist]

Well said. I'm a pre-med and decided to work as a CNA to gain some clinical experience before applying to medical school. After six months of hearing about how hard the NCLEX is, I decided to try my luck at a questions from an online practice exam. I got every question wrong, including the "What would you do in this situation" prompt. I then tried a few questions from the USMLE Step I and got everyone of them right. The moral of the story is that while nurses do a lot of routine work such as giving meds and charting behavior, there is a great deal of work involved in getting to that position.

First of all orthoman
I never said nursing sciences were equivalent to medical school sciences. I think it is ignorance to think that it is true. The only think I ever said, having been both a BSN AND biology major was that nursing prereqs are on the same level as the premed reqs (as someone who has first hand experience bc I have done it both).
Second,
The NCLEX is not anything like you imagine I am sure. You cannot just cram for a month having never been in a nursing program. I will tell you why, it is not based on intelligence or simple scientific fact (ex there are no questions asking what the steps of glycolysis, or even ana/physio like what is the fx of this and that) The MAJORITY of the questions were about priority and the 5 steps of the nursing process (Asses, diag, planning, implementation, evaluation). A TON about delegation (what task would you assign to the LPN/CNA in this situation, etc). I assure you that you need to have nursing experience, and have done the 5000 care plans, and nursing theori=y drilled into your pretty little head for 2 years, lol. Hahaha most med students I know often don't even know the differences between CNAs, LPNs, and RNs, lol. So I find it very hard to believe they would be able to pass NCLEX so easily. It's the format in which they use.
Anyways, back to my reply....orthoman

 

[NurseDaisy]

I think it is an excellent idea to work as a CNA to gain clinical experience during med school! You will become a well rounded doctor as a result. CNAs do a very hard job and are an integral part of the medical field.

I applaud your decision to gain experience in this fashion!

NurseDaisy

 

[Mr_Money]

I hate most nurses because they are cynical, rude, ignornant pain in the ass bitches who like to take out their frustrations on those who will ultimately be much more successful than them. Not to mention the fact that the majority of them are at a severe risk of developing decubitus ulcers from sitting on their fat asses all day. I'd be the same way if someone 20 years younger than me were telling me what to do. Let's face it.......I write an order, you do it! Now that's power, baby.

 

[fuegorama]

I hate most nurses because they are cynical, rude, ignornant pain in the ass bitches who like to take out their frustrations on those who will ultimately be much more successful than them. Not to mention the fact that the majority of them are at a severe risk of developing decubitus ulcers from sitting on their fat asses all day. I'd be the same way if someone 20 years younger than me were telling me what to do. Let's face it.......I write an order, you do it! Now that's power, baby.

Hey look everybody. There's a new ZERO in town.
F

 

[deltamed]

Here's my take on the whole matter:

Healthcare in the US has developed into an odd system. Fifty years ago, physicians ran most hospitals and clinics. They were both healthcare and administrative bosses. Just like any other industry, they were the leaders, and had the right to not only regulate patient care, but also to regulate staff. That means like any boss at the office, could fire a nurse if that person was insubordinate.

Now there is a weird dynamic where the physicians make the healthcare decisions but not the staffing ones (at least at hospitals). This means they are the leaders and give the orders, but cannot discipline the employees working under them. In no other industry do you see this anaomaly. Imagine a lawyer who couldn't fire his paralegal, or a CEO who couldn't fire his workers. As a result, nurses don't feel any obligation to take s*it from doctors the way a paralegal would take it from their lawyer. As a result, doctors feel that nurses are being insubordinate but they cannot do anything about it.

This is why you probably won't hear nurses working in a private practice giving **** to the attendings and as a result the physicians like their nurses better. Since they control the staffing in this setting, the relationship is clear and there are no misunderstandings.

Just my 2 cents.

 

[SMW83]

Excellent use of NANDA format (hee hee). After I got that down, careplans were a breeze Just a thought: What will be your interventions for your diagnosis?

NANDA.........????????

what's NANDA....??????

 

[SMW83]

heres a website that might interest you:

www.nclex-pass.com

 

[fab4fan]

Here's my take on the whole matter:

Healthcare in the US has developed into an odd system. Fifty years ago, physicians ran most hospitals and clinics. They were both healthcare and administrative bosses. Just like any other industry, they were the leaders, and had the right to not only regulate patient care, but also to regulate staff. That means like any boss at the office, could fire a nurse if that person was insubordinate.

Now there is a weird dynamic where the physicians make the healthcare decisions but not the staffing ones (at least at hospitals). This means they are the leaders and give the orders, but cannot discipline the employees working under them. In no other industry do you see this anaomaly. Imagine a lawyer who couldn't fire his paralegal, or a CEO who couldn't fire his workers. As a result, nurses don't feel any obligation to take s*it from doctors the way a paralegal would take it from their lawyer. As a result, doctors feel that nurses are being insubordinate but they cannot do anything about it.

This is why you probably won't hear nurses working in a private practice giving **** to the attendings and as a result the physicians like their nurses better. Since they control the staffing in this setting, the relationship is clear and there are no misunderstandings.

Just my 2 cents.

Why should anyone feel an obligation to tolerate abusive behavior? Is it really that hard to behave in a professional manner?

Most doctors staff their offices with MAs, not nurses. And I find it a little creepy that you refer to nurses as if they are some sort of posession. Scary, very scary.

 

[ang19]

I hate most nurses because they are cynical, rude, ignornant pain in the ass bitches who like to take out their frustrations on those who will ultimately be much more successful than them. Not to mention the fact that the majority of them are at a severe risk of developing decubitus ulcers from sitting on their fat asses all day. I'd be the same way if someone 20 years younger than me were telling me what to do. Let's face it.......I write an order, you do it! Now that's power, baby.

i know that you write this post to be condescending and mean but i actually feel sorry for you because fortunately there are ALOT of nurses and doctors that work really well together as a team and are not subjected to people like you. i personally have no problem with a young doc giving me orders. THAT IS THEIR JOB. i don't know if you are a real doc yet or not, but if you are you need to readjust your attitude and once you do you will find that most people are willing to work with you insead of against you.

 

[deltamed]

Why should anyone feel an obligation to tolerate abusive behavior? Is it really that hard to behave in a professional manner?

Most doctors staff their offices with MAs, not nurses. And I find it a little creepy that you refer to nurses as if they are some sort of posession. Scary, very scary.

No one has to tolerate abusive behavior and I wasn't suggesting that nurses should. All I was saying is there is no longer a clear "boss" - "employee" relationship between nurses and doctors and this is creating a lot of the tension that this thread refers to. In addition, I am suggesting *in my opinion* the system would work better with a clear relationship like any other workplace.

Regarding your comment about nurses being a posession, I merely used the word "their" nurses as I would use "their resident," "their patient" or "their physician." No need to jump to conclusions.

 

[NoAngel]

No one has to tolerate abusive behavior and I wasn't suggesting that nurses should. All I was saying is there is no longer a clear "boss" - "employee" relationship between nurses and doctors and this is creating a lot of the tension that this thread refers to. In addition, I am suggesting *in my opinion* the system would work better with a clear relationship like any other workplace.

Regarding your comment about nurses being a posession, I merely used the word "their" nurses as I would use "their resident," "their patient" or "their physician." No need to jump to conclusions.

Ok, jumping into the fray: there is a CLEAR and DEFINITE 'relationship' in the world of nursing: it's the charge nurse. You have a problem, go see him/her.

Or, be professional -- calmly and respectfully handle the issue at hand between the parties involved!

There is something young docs don't seem to consider: nursing is about advocating for the patient. I have an example below.

I, for one, enjoy working with med students and residents. I can ask questions and pick their brains, which in turn, makes my depth of understanding more complete and focused on my patient. At the same time, I encourage residents, especially interns, to see the patient first, to actually talk to her/him and put your hands on that person.

Why? I had a patient who had an obvious aspiration pneumonia, but her CC was CP, so he ordered a CP workup. Not a big deal, except for the nitro, which was ordered, which I objected to, and which may or may not have contributed to her plummeting blood pressure from her overwhelming infection -- a white count of 33M. I didn't have to wait for the CBC or the CXR to come back -- she had swallowing difficulties, a facial droop and RLL crackles, and came from a nursing home. She may as well have been wearing a sign that said ASPIRATION PNEUMONIA.

So you see, nurses who have clinical experience on their side CAN and DO affect patient care outcomes. As for sitting around on an ample behind, yes, some RN's do. So do some docs/residnets/MSIV's that I've observed. I wouldn't let them any of them take care of my tomato plants.

The work ethic comes from within, not from your "medical deity" degree. If you treat people well, meaning nurses, techs, unit clerks and even housekeeping/cafeteria workers, you see that people in healthcare aren't on loan from hell but care about what they are doing. Or are working their way to a better position. Why should anyone have any reason to give them grief for it? I'm interested in PA school next, or maybe a joint degree in NP/JD/MSW from Loyola. While I'm doing what I'm doing , I intend to make the best of it. That's why I'm here. And if a kind and concerned MSIV or intern is interested in helping me along, I'd be crazy not to take advantage of the opportunity.

 

[deltamed]

Ok, jumping into the fray: there is a CLEAR and DEFINITE 'relationship' in the world of nursing: it's the charge nurse. You have a problem, go see him/her.

I was saying there isn't a clear relationship between 2 and only 2 parties: physicians and nurses that work together. I wasn't saying that nurses don't have a boss / charge nurse. The problem is that docs are ordering medical decisions to be followed by nurses, but they don't have any authority over them. This creates tension. What other industry do you ever see this murky relationship?

Or, be professional -- calmly and respectfully handle the issue at hand between the parties involved!

NoAngel, you may be professional and courteous. I may be. But there are many - nurses AND physicians - that are not. This is a fact of life. The rules and relationships in a workplace, the administrative process, is created partly because we realize there will be "those" people who cannot act as you describe. We cannot pretend we work in utopia.

As for your story, I realize and most physicians realize that nurses have a very important function. What does that have to do with my point?

 

[BigRedPingpong]

As an ingoing medical student, I vow to treat all nurses with the same honor, dignity, and respect that I would treat an MD. Especially the hot ones.

 

[NoAngel]

I was saying there isn't a clear relationship between 2 and only 2 parties: physicians and nurses that work together. I wasn't saying that nurses don't have a boss / charge nurse. The problem is that docs are ordering medical decisions to be followed by nurses, but they don't have any authority over them. This creates tension. What other industry do you ever see this murky relationship?




NoAngel, you may be professional and courteous. I may be. But there are many - nurses AND physicians - that are not. This is a fact of life. The rules and relationships in a workplace, the administrative process, is created partly because we realize there will be "those" people who cannot act as you describe. We cannot pretend we work in utopia.

As for your story, I realize and most physicians realize that nurses have a very important function. What does that have to do with my point?

Maybe not entirely your point, but the point is that SOME nurses enjoy working with medical students/residents and have a very congenial relationship with them, and can even positively effect a patient outcome.

 

[fab4fan]

Most doctors really have no idea what nurses do. Nursing is much more than just following doctors' orders.

I am glad doctors don't have direct control over nurses. I can see how that kind of situation could be abused, big time. One of the main reasons nurses give for leaving the profession is abusive doctors. Giving doctors the authority to fire nurses would be a recipe for disaster. (As if there isn't already a shortage of nurses!)

 

[fab4fan]

Come to think of it, I don't know a single nurse who feels "tension" over not having a doctor supervise her/him. I think the uneasiness you describe is perhaps a problem for you and your physician colleagues.

 

[NoAngel]

Come to think of it, I don't know a single nurse who feels "tension" over not having a doctor supervise her/him. I think the uneasiness you describe is perhaps a problem for you and your physician colleagues.

I have to agree ... I'm much more intimidated by certain charge nurses than by most docs. Maybe it's because the CN will not hesitate to sell out your mistakes to the nurse manager to make him/herself look as if he/she is running a tight ship!

 

[Sage880]

Lets get the other end of it too. The other thread covers why nurses hate med students....so why do med students hate nurses ?(other than hating nurses because nurses hate them...)

I usually just try to be the one who puts an effort into the relationship. I just buy all the nurses coffee on the first day as a peace offering and then we all get off to a good start.

Small investment to make working fun and easy going. It's worked so far!

 

[deltamed]

Come to think of it, I don't know a single nurse who feels "tension" over not having a doctor supervise her/him. I think the uneasiness you describe is perhaps a problem for you and your physician colleagues.

Of course its tension on the physicians part. Lets pretend you take a large legal firm. You divide the lawyers and paralegals into 2 teams and call the business of law a "team approach." The paralegals obviously posess some skills the lawyers do not and vice versa. You tell the lawyers that they still direct the cases and give the paralegals orders; however, the paralegals are under the administrative care of a "paralegal manager" who determines their promotions, firing/hiring, and disipline. I'm sure the paralegals would feel happy. Their work is no longer accountable to the lawyer directing his case; instead he is accountable to a third party. On the other hand, the lawyer is frustrated since he is directing the legal care of these clients but other parts of the "team" are not accountable to him.

That is one reason the US healthcare system has run amok. All these third parties intervening in patient care... I'm sure nurses don't care and are happy they are not held to the fire any more by physicians. I'm not saying abusiveness should be tolerated -- there are plenty of controls in place to prevent this in a corporate environment. But I'm saying the old system was better for patients and the industry.

 

[fab4fan]

When would doctors even have the time to fairly evaluate nurses? You'd have to know if they'd kept current with CPR, mandatory inservices, etc. You'd have to read their documentation to make sure it complies with policy. You'd have to observe them performing skills (e.g. med admin., IVs, code participation). You'd have to keep track of attendance/tardiness. You'd also want to be present when they did pt teaching to make sure that their education was appropriate to the pt, accurate, and complete.

I'm sure there's plenty more...this is just off the top of my head. My guess is you're more interested in having the power to just fire someone on the spot if that person makes you angry. I doubt you really want to have to deal with all that goes into supervising someone.

You're sure that nurses are glad they are not "held to the fire" any more by physicians? Wow...that says it all right there.

 

[missyb]

My respect for nurses comes from working as a nurse's aid for three years during undergrad. As the person on the bottom of the medical "food chain," you really do learn how much work everyone does---so if there are any pre meds reading this, go out and get your CNA and you will get a very real education in hands on health care.

 

[truthseeker]

SNs) are always told that when we do our rotations, we are, in essence, in their way (docs and nurses). The hospital made an agreement with the school to allow us to do our rotations there. The hospital staff are employees and are not paid to train us or be nice to us.

However, with regard to medical students, this is not the case. Most of us are at teaching hospitals where part of the attendings job description is to train us. We are not to be considered in the way, we are there to learn and paying a significant amount to do so. We are also trying to learn as much as we can so that some day we can step into the shoes of the resident and the attending.

As for nurses, I treat them with respect from the start. But I believe that someone can lose that respect. If you are the only person who can get my patient with oral mucocutaneous sloughing a yankeur suction cath from the pyxis and my job cannot be done until you get me one, because you are the only one with access to the pyxis, then I will stand there and wait for you to do so. And if I know for a fact you are not on your break, yet you are sitting there looking at professional wrestling on the internet and making me wait for no reason except that I'm not a high enough priority, then you're going to lose my respect. Or if my patient is sitting in feces and weighs three hundred pounds, yet needs to be taken down to an emergent surgery, don't sit on the phone and continue to talk about your daughter's dance recital, then put your hand over the phone, and say, you can change him. Yes, well, I would have, if I had access to the freaking pyxis to get what I needed. And if you are the nurse monitoring the telemetry beds, by all means talk on the phone all day long, so that when I am sitting on the computer next to you I can hear all about your children as you tell the same story to each relative that calls YOU at the hospital. Then when I need the phone to page a resident about a lab value, get angry at ME because you were using the hospitals phone for a personal call while working. Then act miffed when someone wants a printout of the tele strip or for you to pull up the wave form on someone with an abnormal rhythm. ALL of these reasons are why medical students dislike SOME nurses. We are assigned a patient or patients to take care of and a treatment plan is formulated by the team. Most of the time we are just trying to make sure a treatment plan is carried out to optimize treatment for the patient. Our ultimate goal is to get the patient better, but we are limited in what we can do. I could save a lot of time if I had access to a pyxis or the store room where everything is held, but at our hospital if you need anything, an order must be written and the NURSE has to get it. By all means, give me your pyxis code and I won't bother you one bit

I am kind of jumping in here after reading the posts. I am a PT and moved to a rural hospital after working in larger institutions where the majority of the nurses were BSNs and they did quite a bit of assessment. I have learned that it is possible to become an RN with much less education, and as such there is much less assessment done. I think that some of the doctors (and I assume medical students and residents) get upset with the nurses that don't do appropriate assessment (or do incorrect nursing assessment) and the profession loses respect because of it.

example: my wife is a speech path and when we first moved here, one of the RNs noticed that one of her patients had orange jello coming out of his stoma. She simply said to him that she would wipe it off and give him a new cover. Rather than identifying that the stoma is part of the airway and that jello SHOULD NEVER COME OUT OF IT. I think that the high demand for nurses has resulted in a pox on the profession because those in positions to make policy are allowing the credential "RN" to become diluted with people having inadequate skills.

 

[truthseeker]

i know that you write this post to be condescending and mean but i actually feel sorry for you because fortunately there are ALOT of nurses and doctors that work really well together as a team and are not subjected to people like you. i personally have no problem with a young doc giving me orders. THAT IS THEIR JOB. i don't know if you are a real doc yet or not, but if you are you need to readjust your attitude and once you do you will find that most people are willing to work with you insead of against you.

I think you take this jerk too seriously. He/it is probably a failed med student or an axe murderer

 

[NoAngel]

I am kind of jumping in here after reading the posts. I am a PT and moved to a rural hospital after working in larger institutions where the majority of the nurses were BSNs and they did quite a bit of assessment. I have learned that it is possible to become an RN with much less education, and as such there is much less assessment done. I think that some of the doctors (and I assume medical students and residents) get upset with the nurses that don't do appropriate assessment (or do incorrect nursing assessment) and the profession loses respect because of it.

example: my wife is a speech path and when we first moved here, one of the RNs noticed that one of her patients had orange jello coming out of his stoma. She simply said to him that she would wipe it off and give him a new cover. Rather than identifying that the stoma is part of the airway and that jello SHOULD NEVER COME OUT OF IT. I think that the high demand for nurses has resulted in a pox on the profession because those in positions to make policy are allowing the credential "RN" to become diluted with people having inadequate skills.

Wow, your post truly offended me, and on many levels. Are you one of those PT's who leaves a patient dirty for the RN to clean up, too?

I'm an RN w/an ADN from a community college and I save dr's from mistakes all the time in the ED. I save residents from making mistakes and I know when to push for important blood tests. (Crushing CP one week ago? Loss of appetite? +1 pitting edema to the legs? Yep, needs a BNP) I can anticipate what the attendings will order for the most part and therefore I am able to make a resident look good. Do they thank me, give me credit? Well, you figure it out.

Lots of times I'm wrong, lots of times I'm right. But saying that an ADN prepared nurse is 'inadequate' is such an insult to those of us who use our brains and our assessment skills to help save lives, and a doc's butt in the process.

So if you're a PT I have to wonder if you think that bachelor-prepared PT's are somehow less able than the Master's now required for field entry. It's the same argument over and over again, and it's pointless and dull and nurses deserve better respect from someone in an allied health profession. Perhaps the nurse was inexperienced with trach care. You don't mention the details.

You have no idea how difficult it is to get your RN in two years and learn everything necessary. It is an astonishing amount of work and probably not the best way to prepare nurses, but RN's aren't stupid, and your comment about 'inadequacy' shows that you really lack respect for nurses.

So much for the team approach.

 

[NoAngel]

My respect for nurses comes from working as a nurse's aid for three years during undergrad. As the person on the bottom of the medical "food chain," you really do learn how much work everyone does---so if there are any pre meds reading this, go out and get your CNA and you will get a very real education in hands on health care.

You got that right. And you'll form better relationships and be more effective because of it. CNA's have the hardest job in the hospital, and anyone who says anything different hasn't walked in those shoes.

But still, a nurse's aid is not a nurse.

And there's still a lot of information, education and thinking that goes into being a good nurse.

 

[caroladybelle]

I was saying there isn't a clear relationship between 2 and only 2 parties: physicians and nurses that work together. I wasn't saying that nurses don't have a boss / charge nurse. The problem is that docs are ordering medical decisions to be followed by nurses, but they don't have any authority over them. This creates tension. What other industry do you ever see this murky relationship?

Well let's see. MD orders a xray. Radiology tech takes the xray, radiology reads the xray. Dept secretary faxes the results.

The MD is not "in charge" of any of those people, yet they work together.

MD orders a Physical Therapy consult. THe physical therapist reads the chart, and forms a therapy plan that best suits the patient's recovery.

The MD is not "in charge" of the PT, and they form a complementary team.

MD has a patient with necrosing fascitis. He orders some procedures, a pain control consult, a physical therapy consult, and a wound care consult. These individuals all give their input on meds, whirlpool and debriding methods. They then form an integrated plan using all of their complementary skills.

The MD is not "in charge" of the PT/pain control team/wound care team. They provide integrated care to the patient.

A licensed counseling social worker treats a teenager that is severely depressed. She sends the teen to her MD's office for a prescription for antidepressants.

Does that mean that the LCSW is "in charge" of the MD

So why is it so hard for you to conceive that Nurse's are in charge of nurses and MDs are in charge of MDs, and MDs are not needed to be "in charge" of nurses (especially since most MDs have little to no idea of our scope of practice).

If there is tension (I have never noticed any, unless an MD steps out of line), than perhaps y'all need to learn how to cope better. I believe that there are counselors for that.

 

[toofache32]

Let's face it.......I write an order, you do it! Now that's power, baby.

I hope you grow up soon.

 

[tupac_don]

any student ANY student that doesnt get out of a chair when a working professional needs it would get pounded in my er. Students, be it md/do/pa/np/rn or whatever are IN THE WAY. They should be humble and grateful. Get the hell up -- or get the hell out. Arrogant arrogant arrogant.

Two things here Big Bandit. One you work in the ER where it is very hectic and probably as a student you have to get out of the way, b/c it's life or death and the doctors, PA's, nurses are always on the move. Two if that is the expectation from the very get go, fine, nobody will complain.

However, I believe the poster was talking about being on the floor. Two probably the only reason why the nurse asked him for a chair, is b/c she knows she can and does so. She in essence has power over the student at that precarious point in med students career. However, be advised that if it was a resident and not a student, then she more than likely would have put up and shut up and go work standing. I agree it's unfortunate that people don't work together and regardless of the rank helpout, and some do. However, there is quite a lot that stick to the ranking and will treat those below them badly.

And for having an attitude like that, "get the hell out". Come on man. Yea I agree that student do get in the way, but you gotta have tolerance. Treat others how you like to be tx. If that behavior doesn't piss you off and you don't get touchy about it. Then that's diff story. But if you wouldn't like others to boss you around like that just b/c of their signority then you shouldn't do it either. I wonder are you a doctor or a nurse? See ya big bandit.