Why do medical students/residents/attendings hate nurses?

[jellyboo]

It's funny - this is my first post here ever. I googled, "doctors hate nurses" and got this.

I'm a 2nd year resident and I get along with most health care staff, including nurses. However, I absolutely no respect and a lot of disgust with some nurses, and it has absolutely affected how I practice.

We are not your servants. We do not want to harm the patient. We have more knowledge than you do about a lot of things, so if you want to question an order, do so with respect. We've likely ordered something different for a reason.

I generally work in the OR and the RNs there are generally good, and helpful, so I don't have any complaints with them. But I absolutely loathe a lot of the labour and delivery nurses I am forced to work with and this opinion is shared by all the other doctors on the floor. For these witches, I have just stopped speaking to them altogether and it's made my life a lot happier. It's so interesting that day-to-day you will say demeaning, condescending things to us in front of the patient, or demand epidurals of us within minutes, despite the fact that we are busy and doing other things or act as though you are the only ones who cares about the patient, UNTIL SOMETHING GOES WRONG! How quickly you turn into actual nurses, who finally carry out orders quickly and stand by your side to assist you.

And btw, to the nurse who thinks that she is an anaesthetist... Perhaps you should poll the public as to who they want in their surgery and saving their life... an MD or an RN???

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[toofache32]

And btw, to the nurse who thinks that she is an anaesthetist... Perhaps you should poll the public as to who they want in their surgery and saving their life... an MD or an RN???

I think it's funny when physicians throw out the MD as some mighty trump card, when in fact it is a very generic degree which, in itself, doesn't qualify you to really do anything except chase down xrays for your residents and do H&Ps. It's your residency where you learn to do your craft, not med school.

My point is this....a Psychiatrist has an MD, but that does not qualify him to pass gas. To poll the public on the question you asked, they will always say MD. But this does not present the actual facts so they can make an informed decision. A more accurate question is "Who do you want to run your anesthesia...the person who actually does it all day and is always there with you, or the guy who normally just drinks coffee in the lounge and then shows up when it's time to extubate?"

Either way, they should understand the anesthesiologist is somewhere nearby.

 

[njbmd]

Hi there,
I am a general surgery resident in my third year of post graduate training. I have always subscribed to the team approach to care of my patients and I appreciate the input of nurses, respiratory therapists and other health care personnel. I don't hate nurses or anyone else that I work with.

Nursing and medicine, while we work along side each other, have different approaches to the care of the patient. There is no need for "who is the most important?" dialogues because we do different things that are critical to getting the patient back to health. In short, if all team members are strong, the patient does nothing but benefit.

Many of my colleagues resent any question of their orders. They feel as if a nurse or any other health care personnel questioning anything that they write on a chart as a threat. I am happy to explain anything that I write because the more information that we all share, the better for the patient. I have no use for "ego massaging" or job dissatisfaction entering into the care of patients.

I love my job and my patients are my only concern. I respect my colleagues and attempt to treat them with respect. Everyone has a bad day now and again, myself included, and I will generally give you the benefit of the doubt but I do find that job frustration gets the best of all of us on both the medical and non-medical side. Patient care is just hard work in today's climate.

Healthcare is changing and patient's are sicker. We all feel the pressures but until I walk in another's shoes, I do not judge them. My feelings about nursing will have no impact on my training and with limited time, I tend to place my energies on things that further excellence in my training and further the health of my patients.

I am very fortunate to have a career that I totally love and I love to work with nurses and other health care personnel who share my feelings. I strive to be a total professional at all times and in all things. Our patients demand nothing less and put great trust in all of us.

I have little respect for anyone who finds the necessity to "HATE" anyone or anything. There are too many other jobs and careers out there to stay in a profession where one finds the need to "HATE".

njbmd

 

[zenman]

It's funny - this is my first post here ever. I googled, "doctors hate nurses" and got this.

But I absolutely loathe a lot of the labour and delivery nurses I am forced to work with and this opinion is shared by all the other doctors on the floor. For these witches, I have just stopped speaking to them altogether and it's made my life a lot happier. It's so interesting that day-to-day you will say demeaning, condescending things to us in front of the patient, or demand epidurals of us within minutes, despite the fact that we are busy and doing other things or act as though you are the only ones who cares about the patient, UNTIL SOMETHING GOES WRONG!

Why don't you not only write these nurses up but pull them aside and explain to them that you will not tolerate their behavior, especially in front of patients.

 

[50960]

Hi there,
I am a general surgery resident in my third year of post graduate training. I have always subscribed to the team approach to care of my patients and I appreciate the input of nurses, respiratory therapists and other health care personnel. I don't hate nurses or anyone else that I work with.

Nursing and medicine, while we work along side each other, have different approaches to the care of the patient. There is no need for "who is the most important?" dialogues because we do different things that are critical to getting the patient back to health. In short, if all team members are strong, the patient does nothing but benefit.

Many of my colleagues resent any question of their orders. They feel as if a nurse or any other health care personnel questioning anything that they write on a chart as a threat. I am happy to explain anything that I write because the more information that we all share, the better for the patient. I have no use for "ego massaging" or job dissatisfaction entering into the care of patients.

I love my job and my patients are my only concern. I respect my colleagues and attempt to treat them with respect. Everyone has a bad day now and again, myself included, and I will generally give you the benefit of the doubt but I do find that job frustration gets the best of all of us on both the medical and non-medical side. Patient care is just hard work in today's climate.

Healthcare is changing and patient's are sicker. We all feel the pressures but until I walk in another's shoes, I do not judge them. My feelings about nursing will have no impact on my training and with limited time, I tend to place my energies on things that further excellence in my training and further the health of my patients.

I am very fortunate to have a career that I totally love and I love to work with nurses and other health care personnel who share my feelings. I strive to be a total professional at all times and in all things. Our patients demand nothing less and put great trust in all of us.

I have little respect for anyone who finds the necessity to "HATE" anyone or anything. There are too many other jobs and careers out there to stay in a profession where one finds the need to "HATE".

njbmd

A great post doc...thanks for being reasonable, and normal!

s

 

[toofache32]

Why don't you not only write these nurses up but pull them aside and explain to them that you will not tolerate their behavior, especially in front of patients.

Not tolerate? What are you...their employer? No. This is the kind of pompous attitude that fosters the "them vs. us" environment we are talking about here. Write them up? Acting this way gives them plenty of reason to write you up as well and makes no sense.

Grow up.

 

[FoughtFyr]

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.

See, that is the problem. BNP is not always acceptable in the situation you describe. The residents have to maintain their knowledge of the latest studies and decide if a given test is appropriate. BNP can be useful to differentiate CHF from other sources of dyspnea. In the patient you describe, the possible MI and the resultant failure makes the BNP not necessary. But thanks for the help. Nursing is nursing, and medicine is medicine. I appriciate the input, but the decisions (and the liability) are mine. BTW - before you turn on the flame thrower I spent the first two and a half years of undergrad in Nursing school. I do know the difference between nursing and medicine. That is why I left nursing and went to medical school - it was a better fit for me. And yes, I am an EM resident.

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.

I agree, an ADN is very adequate to be a nurse. But I disagree that your job is to "save a doc's butt". It isn't. Your job is to treat the patient and see to their nursing needs within the scope of your practice. If a doctor asks you to perform a procedure or pass a med that would result in patient harm, your job is to make them aware of it. As it is our to make you aware of the potential harm in any of your actions.

So much for the team approach.

Yep, so much for it. It amazes me how many people scream "team approach" at the first sign of any challenge. Every team I have been on has had a captain or coach that called the plays. Like it or not, agree with it or not, someone has to be in charge of every team. In medicine, that individual is usually the doctor. In sports, not every player always agrees with every call made, but the good ones always support the team none the less.

- H

 

[zenman]

Not tolerate? What are you...their employer? No. This is the kind of pompous attitude that fosters the "them vs. us" environment we are talking about here. Write them up? Acting this way gives them plenty of reason to write you up as well and makes no sense.

Grow up.

I'm very grown up thank you and have extensive clinical and management experience in healthcare. Now, you are complaining yet want to do nothing. Being their employer has nothing to do with anything. You are in the same work environment and if you do not like what is happening, pull them aside, as a person, and tell them how you feel about their behavior. That, in most cases will take care of the problem. If not, see their manager and if that does not work start writing them up. It's not about "us vs them." It's about behavior that should not be happening. And what would they have to write you up for? If you don't want to change anything, stop bitching about it.

 

[mwbeah]

It's funny - this is my first post here ever. I googled, "doctors hate nurses" and got this.

I'm a 2nd year resident and I get along with most health care staff, including nurses. However, I absolutely no respect and a lot of disgust with some nurses, and it has absolutely affected how I practice.

We are not your servants. We do not want to harm the patient. We have more knowledge than you do about a lot of things, so if you want to question an order, do so with respect. We've likely ordered something different for a reason.

I generally work in the OR and the RNs there are generally good, and helpful, so I don't have any complaints with them. But I absolutely loathe a lot of the labour and delivery nurses I am forced to work with and this opinion is shared by all the other doctors on the floor. For these witches, I have just stopped speaking to them altogether and it's made my life a lot happier. It's so interesting that day-to-day you will say demeaning, condescending things to us in front of the patient, or demand epidurals of us within minutes, despite the fact that we are busy and doing other things or act as though you are the only ones who cares about the patient, UNTIL SOMETHING GOES WRONG! How quickly you turn into actual nurses, who finally carry out orders quickly and stand by your side to assist you.

And btw, to the nurse who thinks that she is an anaesthetist... Perhaps you should poll the public as to who they want in their surgery and saving their life... an MD or an RN???

Just wanted to clarify that 65% of the anesthetics in America each year are performed by nurses who ARE anesthetists, they are called CRNAs. Thanks

 

[NoAngel]

See, that is the problem. BNP is not always acceptable in the situation you describe. The residents have to maintain their knowledge of the latest studies and decide if a given test is appropriate. BNP can be useful to differentiate CHF from other sources of dyspnea. In the patient you describe, the possible MI and the resultant failure makes the BNP not necessary. But thanks for the help. Nursing is nursing, and medicine is medicine. I appriciate the input, but the decisions (and the liability) are mine. BTW - before you turn on the flame thrower I spent the first two and a half years of undergrad in Nursing school. I do know the difference between nursing and medicine. That is why I left nursing and went to medical school - it was a better fit for me. And yes, I am an EM resident.




I agree, an ADN is very adequate to be a nurse. But I disagree that your job is to "save a doc's butt". It isn't. Your job is to treat the patient and see to their nursing needs within the scope of your practice. If a doctor asks you to perform a procedure or pass a med that would result in patient harm, your job is to make them aware of it. As it is our to make you aware of the potential harm in any of your actions.



Yep, so much for it. It amazes me how many people scream "team approach" at the first sign of any challenge. Every team I have been on has had a captain or coach that called the plays. Like it or not, agree with it or not, someone has to be in charge of every team. In medicine, that individual is usually the doctor. In sports, not every player always agrees with every call made, but the good ones always support the team none the less.

- H

Actually, I was bang-on with my decision to draw the BNP. This patient ended up with a massive MI one week prior to treatment, resulting in failure now, and ended up in our ICU.

You may have more education, but I have experience to back me up. And if you think that patients only present as your books say they will, well, you'll see how you act in a few years.

The point is that while you may have superior education, if your approach is "I'm right I'm the doc" you are going to alienate a lot of valuable, experienced coworkers. I go to work every shift and I expect three things: to learn something, to teach something, and for my co-workers to treat me with respect.

 

[FoughtFyr]

Actually, I was bang-on with my decision to draw the BNP. This patient ended up with a massive MI one week prior to treatment, resulting in failure now, and ended up in our ICU.

Actually, you weren't. The BNP was not needed to determine failure. Read the articles. Failure was clear and plain to see clinically. There was no need to distinguish failure from other causes of dyspnea (which is what a BNP is designed to do). A BNP would not, and I am sure did not, change the management of the patient at all.

BNP not that useful in ED settings:
http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=15175210

BNP useful to detect failure in COPD patients (not the clinical picture you posted):
http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=12615582

And the original study, whose text, more than the abstract, suggested the use of BNP for cases of dyspnea from unknown cause:
http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=12124404

In short, BNP is a good tool to use if the cause of the dyspnea is unknown. The case you presented was clear-cut CHF. No BNP needed.

You may have more education, but I have experience to back me up. And if you think that patients only present as your books say they will, well, you'll see how you act in a few years.

I have 10+ years as a firefighter/paramedic and paramedic instructor. I have plenty of experience, both with patients and with nurses who believe they know it all.

The point is that while you may have superior education, if your approach is "I'm right I'm the doc" you are going to alienate a lot of valuable, experienced coworkers. I go to work every shift and I expect three things: to learn something, to teach something, and for my co-workers to treat me with respect.

I treat everyone with respect. And I expect the same. Your post painted a picture of residents as buffoons who wouldn't know what to order or what to do if you were not there to "save their butts". And that is simply not true. You are there to provide nursing care. Excellent nursing care I'm sure. I am there to provide medical care. Excellent medical care I hope. Together, we can do some good for our patients. Now, you promise not to lecture me on the nuances of ordering tests, and I'll not correct your ADL assessments o.k.?

- H

 

[toughlife]

and when they get out of hand I just slap them on the face with my big schlong and tell them not to question my orders.

 

[fang]

Apparently there is a difference in outcome between anesthesia performed by "certified registered nurse practitioners" (CRNA's) with and without physician supervision--

www.upenn.edu/ldi/issuebrief6_2.pdf

results:

• Compared to the directed group, the undirected group had a higher mortality rate, accounting for 2.5 excess deaths per 1,000 cases, and an even higher failure-to-rescue rate, accounting for 6.9 excess deaths per 1,000 cases with complications.

• The complication rate was similar in the groups, consistent with previous researchindicating that complications are poorly recorded in Medicare claims, and are apoor indicator of quality of care.

• The results were unchanged when the investigators considered only billed cases,non-emergency cases, or when they adjusted for the individual hospital and thesize of its metropolitan area. These and other analyses suggest that the results do not reflect differences in overall hospital quality, in severity of illness, or in howhospitals assigned cases to be directed or undirected (selection bias).

• Besides anesthesiologist direction, two other factors were related to lowermortality and failure-to-rescue rates: larger hospital size and a higher registerednurse-to-bed ratio. This is consistent with other studies that highlight the importance of nurse staffing in patient outcomes

 

[Dr. Rosenrose]

I got to get in here. I worked in allied health b4 I went to med school. The truth is that nurses do not hate the res or the doc or intern anymore than they hate EVERYONE ELSE! Nurses hate other nurses they hate puppies and children. They hate when you are right and they act like they hate when you are wrong (even though you can hear multiple high fives behind your back regardless of the patient outcome). NICU is a ring of hell that Dante forgot about.

 

[NoAngel]

Actually, you weren't. The BNP was not needed to determine failure. Read the articles. Failure was clear and plain to see clinically. There was no need to distinguish failure from other causes of dyspnea (which is what a BNP is designed to do). A BNP would not, and I am sure did not, change the management of the patient at all.

BNP not that useful in ED settings:
http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=15175210

BNP useful to detect failure in COPD patients (not the clinical picture you posted):
http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=12615582

And the original study, whose text, more than the abstract, suggested the use of BNP for cases of dyspnea from unknown cause:
http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=12124404

In short, BNP is a good tool to use if the cause of the dyspnea is unknown. The case you presented was clear-cut CHF. No BNP needed.



I have 10+ years as a firefighter/paramedic and paramedic instructor. I have plenty of experience, both with patients and with nurses who believe they know it all.



I treat everyone with respect. And I expect the same. Your post painted a picture of residents as buffoons who wouldn't know what to order or what to do if you were not there to "save their butts". And that is simply not true. You are there to provide nursing care. Excellent nursing care I'm sure. I am there to provide medical care. Excellent medical care I hope. Together, we can do some good for our patients. Now, you promise not to lecture me on the nuances of ordering tests, and I'll not correct your ADL assessments o.k.?

- H

As you weren't present for the case I'm going to assume that you're going on your extensive book learning and not, of course, assessing patient presentation. I'm not a doctor; I don't play one on TV, I respect and get along with the residents and attendings that I work with. However, you can cite all the studies you want, you can denegrate my experience and 'instinct' all you want, but the fact of the matter is is that BNP was important to the patient's treatment. The presented as an unusual case, and the resident was simply flummoxed until he presented this to the attending physician. The attending physician asked for the BNP after seeing the patient and I told her it was already in the lab. I don't make up orders; I don't write my own orders; I simply anticipate what the patient may need. What difference does it make to draw one tube of blood for a specific test when you have a fairly high suspicion of a disease process?

And above all else, why are you so threatened by an RN making a good judgement call? Your so-called team approach seems to need a little refining, in my book.

Best of luck with your career.

 

[FoughtFyr]

As you weren't present for the case I'm going to assume that you're going on your extensive book learning and not, of course, assessing patient presentation.

Nope, I'm basing it on your description, and I quote "Actually, I was bang-on with my decision to draw the BNP. This patient ended up with a massive MI one week prior to treatment, resulting in failure now, and ended up in our ICU." If failure was that plain to see, the BNP was not needed.

I'm not a doctor; I don't play one on TV, I respect and get along with the residents and attendings that I work with. However, you can cite all the studies you want, you can denegrate my experience and 'instinct' all you want, but the fact of the matter is is that BNP was important to the patient's treatment. The presented as an unusual case, and the resident was simply flummoxed until he presented this to the attending physician. The attending physician asked for the BNP after seeing the patient and I told her it was already in the lab. I don't make up orders; I don't write my own orders; I simply anticipate what the patient may need. What difference does it make to draw one tube of blood for a specific test when you have a fairly high suspicion of a disease process?

And above all else, why are you so threatened by an RN making a good judgement call? Your so-called team approach seems to need a little refining, in my book.

Best of luck with your career.

Given that my career has advanced far beyond transporting patients to LGH, Thanks!

Now, where I am a resident, had your decision to order the BNP been wrong, the resident would have been held responsible for ordering an unecessary test. They track that here. The problem with one little extra vial of blood is in the not so little extra bill attached. And based on the case as you presented it, it simply wasn't necessary. Now if you want to twist the facts in the face of evidence that runs counter to your call, feel free. I stand by my analysis of the facts as presented.

I cite studies not because of my "extensive" education, but because our practice, both in nursing and medicine, needs to be based in something other than "gut feeling" (as a rule). And I am not threatened by your judgement call, but I firmly believe it was the physician's call to make.

Now U of C has some sharp residents, and if their procedures are different with regard to EBM and cost-controlling, that is wonderful. But I am proud to learning from a place that has outstanding resources, but spares the patients the costs whenever possible.

And my "team approach" is excellent. I love our nurses, they are the most supportive and hard working folks I have ever met. They would have asked me about the BNP, and we would have discussed it - if there really was a clinical question, I would have ordered it. They teach us all the time, but they still let us do the doctor stuff.

Say "hi" to the Mount Prospect and Bensenville crews for me

- H

 

[FoughtFyr]

And above all else, why are you so threatened by an RN making a good judgement call? Your so-called team approach seems to need a little refining, in my book.

Let me see if I can explain my "team approach" to you. I see the ED as the offense of a football team. The attending is the coach, the resident is the quarterback, general services (internal medicine, surgery) are the backfield and specialists are the wide receivers. The patient's ED nurse is the center, and other ED nurses and techs make up the offensive line. The patient is the ball. Now, the center hikes the ball to the quarterback and then they and the offensive line block for the quarterback (by seeing to the basic needs of the patient) buying time for the play to develop (the resident deciding where to go with the ball). Sometimes the play is a simple handoff to a back (e.g., a CAP admit), other times the backs help block too (e.g., a patient with mesenteric ischemia being worked up for vascular surgery by general surg.). When everyone does his or her job, the play is successful.

Now certainly if the quarterback (resident) drops the ball, by all means pick it up and run with it. But don't fail to hike the ball in the first place, drop back yourself and pass it downfield – claiming it is o.k., since the pass was completed. Even if the pass is complete, you are still wrong.

See, my linemen (people) and I get along great. The coach or I call the play, and they execute to perfection. If they think I'm going to pass to the wrong person, they sometimes point and shout, and on occasion I even change my play because of them. But in the end, when I release the ball, they and I know that working together, we have done the best we could for that patient.

You on the other hand, by your own admission, run the play you think should've been called. Sometimes it might work, but other times it is a recipe for disaster. If you are too busy looking at what the quarterback is doing, you will miss a key block. In my opinion, regardless of the outcome in a single case, you are wrong in the big picture.

- H

 

[Cowboy DO]

I really like that analogy.

 

[ether_screen]

Fang,

Every one knows that the Sibler study regarding CRNA vs. MDA outcomes that you posted is flawed, and that there are in fact no studies that directly prove that one anesthesia provider delivers safer care than another. For the purposes of objectivity, however, the absence of data does not imply that there is in fact no difference, and furthermore I’M NOT CLAIMING THAT CRNA = MDA. If the study was taken as fact, then why are CRNAs continuing to gain footing in the anesthesia arena? Get a grip, and learn to co-exist.

Also, CRNAs have 2-3 years of intense graduate education in addition to several + years of critical care nursing experience, so that a comparison between CRNAs to RNs is truly out of touch with reality. Please don’t distort the facts.

 

[fang]

FoughtFyr--

sweet analogy!!

Fang,

Every one knows that the Sibler study regarding CRNA vs. MDA outcomes that you posted is flawed, and that there are in fact no studies that directly prove that one anesthesia provider delivers safer care than another. For the purposes of objectivity, however, the absence of data does not imply that there is in fact no difference, and furthermore I'M NOT CLAIMING THAT CRNA = MDA. If the study was taken as fact, then why are CRNAs continuing to gain footing in the anesthesia arena? Get a grip, and learn to co-exist.

Also, CRNAs have 2-3 years of intense graduate education in addition to several + years of critical care nursing experience, so that a comparison between CRNAs to RNs is truly out of touch with reality. Please don't distort the facts.

I posted that article because I thought it illustrated a good point-- we do better overall when we collaborate. The reason CRNA's can now be independent practitioners is that there aren't enough anesthesiologists in underserved areas. The study did not compare solo CRNA's to non-anestheiologist direction, so it doesn't help answer the question of whether supervision by a non-anesthesiologist physician is any better than a solo CRNA, which is what would happen in rural places. It does suggest that a team approach is better than solo.

I believe the study *did* look at CRNA's, not RN's.

 

[FoughtFyr]

FoughtFyr--

sweet analogy!!

Even more sweet - I, apparently, got in the last word in an argument with an ED nurse. How often does that happen?!?

- H

 

[TucsonDDS]

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.

Actually, for all of you doctors and CRNA's, anesthesioloy was origionally performed by dentists. You guys just found other uses for it.

 

[NoAngel]

and when they get out of hand I just slap them on the face with my big schlong and tell them not to question my orders.

Your maturity is a true credit to your "profession". No wonder doctors and nurses have such animosity towards each other. You use words like "schlong".

Must be some kind of compensation for something.

 

[NoAngel]

Even more sweet - I, apparently, got in the last word in an argument with an ED nurse. How often does that happen?!?

- H

Well, don't rest on your laurels yet. LGH is a great place to work and learn. But, since you mentioned it, I don't live anywhere near "Bensenville" and "Mount Prospect". My area is much further west.

The fact remains you were not present for the case, and at our hospital a BNP is a diagnostic tool used to assess the degree of failure and its progression.

So why don't we stop this useless argument? I made one good call; I've also asked/begged for intervention with attending and residents for different patients. I don't hate physicians; I actually enjoy working with most physicians. Learning from them is the best part of my job.

The fact is, residents who hate nurses make their own problems, and I don't feel sorry for them. Maturity should be a requirement for med school but appparently isn't after reading some of these posts in this forum. Residents who hate nurses will find their lives/shifts/call nights horrible. And they deserve it. RN's provide service and care to patients and spend much more time with those patients. Any doc who doesn't see how important an RN's assessment is, whether in Triage, or an initial assessment, should question their control issues.

You didn't get the last word in with this ED nurse because I was out of the country adopting two orphaned children in a country without internet access.

Do something with your life other than brag about your extensive book learning and bashing a nurse who made a good call. Argue with me all you want; you simply weren't in the situation and didn't hear the attending/resident actually say a kind word about a lucky, good call.

 

[phleebie]

wow--only a bitter nurse would have to get the last word in AFTER being called out on it.

 

[NurseyK]

I'm not going to get involved in the current pissing match here, but I just felt the need to post my antedotal story....which comes from (literally) having one foot in BOTH professions.

I constantly get treated as "another new dumba$$ Doc-to-be" in each hospital I have rotated in from New York to Pennsylvania (about 10 so far). Anything and everything that comes out of my mouth is questioned (which is fine if they were legit questions, these are just ball-busters); I get eye-rolls when I ask where supplies are located so I can do Ancillary work b/c I see Nursing is swamped and I can lend a hand b/c I'm not so busy being the "Doc" right now; and, I get "tisks" when I write orders and hand them in to get done. Heck, there are some days that I question whether I've gotten my name right with come of the nursing staff. BBBUUTTTT, once I lean over and quietly say the magical words, "Hey, I was you/an ED RN, before becoming a Doc" and that word spreads like wildfire around the current nursing station and then passed around in nursing report for the next 2 shifts (come on gals, I know how good gossip spreads ), my life is suddenly MUCH different. No more eye rolls, no more "tisks," no more ball-busting questions like, "Are you SSUURRREE you want this? This is a bullsh*t order" -- they are now, "So, Doctor-to-be NurseyK, why would you want this? I don't understand" and I gladly explain what I'm thinking, and follow up with the nurse re: explainations of the results. NOW WE HAVE LEARNING HAPPENING! *Suddenly* we are all on the same team!

Now I know that every new guy/gal is questioned and put under a microscope until they "prove" themselves. It happens among Nurses, Docs, cops (my hubby was one) -- you name the profession. Once you prove you've got a couple of brain cells that fire appropriately, everyone gets happy. That's fine. BUT, I have to say that I do notice that no matter how sound "my" decisions (we all know I'm working closely with an Attending here), they are ball-bustingly questioned and tisked and eye rolled UNTIL THE MAGIC WORDS ARE SPOKEN. Then I get treated better than my counterparts (not what I'm after, just an observation). I get invited out for drinks and movies, get requests for OMT......For the first 2-3 weeks of each rotation I am the beaten-down-dumba$$-little-bastard-step-child, THEN I'm a member of the team after the MAGIC WORDS "I used to be an ED RN" are spoken. I just don't get it.

So, with all this said...bottom line: I will continue to utter the magic words until I don't seem to need them anymore.

Just my $0.02 and not intending to flame anyone.


Kat

 

[Tenesma]

TUCSONDDS...

barbers used to do surgery and dentistry ... what is your point?

 

[MD'05]

The thing I hate the most about nurses is their self-righteous attitude about everything: they work harder, have more responsibility, have worked 20 years doing the same job thus know EVERYTHING, yada-yada-yada. If they work so freaking hard, why are they so damn fat?

The only people I hate more than nurses are the lazy unit clerks who refuse to enter orders into the computer. These people are a danger. Instead of paging the doctor to correct an order, they ignore the order regardless of its critical nature.

The nurses I do respect are the ones that work hard, are sharp, and don't complain. Actually, they don't even have to be sharp, just work hard and don't complain. Of course the lazy-assed nurses dump on these nurses since they don't complain.

And nurses, it is totally inappropriate to curse and get into fist fights in front of patients. That is poor customer service.

 

[TucsonDDS]

The thing I hate the most about nurses is their self-righteous attitude about everything: they work harder, have more responsibility, have worked 20 years doing the same job thus know EVERYTHING, yada-yada-yada. If they work so freaking hard, why are they so damn fat?

The only people I hate more than nurses are the lazy unit clerks who refuse to enter orders into the computer. These people are a danger. Instead of paging the doctor to correct an order, they ignore the order regardless of its critical nature.

The nurses I do respect are the ones that work hard, are sharp, and don't complain. Actually, they don't even have to be sharp, just work hard and don't complain. Of course the lazy-assed nurses dump on these nurses since they don't complain.

And nurses, it is totally inappropriate to curse and get into fist fights in front of patients. That is poor customer service.

Point 1: Remember some of these nurses have been doing the same thing for 20 years so you should listen to their suggestions. Even if we don't neccessarily know the scientific bases for something we often know how it is done.

Point 2: There definitely are a lot of fat ass, lazy ass nurses out their that do dump on the other nurses. I can think of at least 10 to 15 of them that I work with on a daily basis.

Point 3: Nurses don't like those UA's any more than you do. They don't just not tell you that the order needs clarifying, they don't tell us nurses either and we just assume that since they signed it off that they called to schedule the CT scans, Ultrasounds, etc.

Point 4: You describe the majority of nurses that work hard and don't complain. Actually I take that back, some nurses love to complain about stupid, petty **** that doesn't even matter. These nurses usually are the fat ones.

Point 5: I agree 100%. You always have to act professional in front of the patients. It doesn't matter how crappy of a day you are having, it is almost always better than the patients. This holds true for the doctors as well though and I have seen some very non-professional doctors.


Just like every profession there are good people and piss-poor people. Unfortunately it is only that later that stand out and people remember.

 

[TucsonDDS]

TUCSONDDS...

barbers used to do surgery and dentistry ... what is your point?

I didn't really have a point. I just wanted to chime in an plug my new career path.

 

[NoAngel]

wow--only a bitter nurse would have to get the last word in AFTER being called out on it.

Whatever.

Your comments are the reasons that some nurses just can't stand their jobs. You can't run a hospital without nurses or without aids, or without unit clerks.

I can't imagine a doc actually cleaning a patient. Or god forbid, drawing blood or inserting an IV.

Comments such as above WILL, DO and HAVE contributed to nurses leaving the bedside, becoming legal nurse consultants, and finding ways to get types such as you far, far away from patient care.

I'm not bitter at all. Just very busy adopting two children in a country that didn't have internet access.

So please apologize for being judgemental and rude to someone who is participating in discussion. I don't deserve to be insulted for standing up for myself.

Your comments and behavior, though, prove my point that a. you didn't bother to read my entire post and b. maturity is not yet a requirement for medical school. One day, we can only hope it will be.

I see lots more docs playing on the internet at work than I ever do. I respect the docs and don't have a problem with the majority of the ones who actually seem to care about the patients that come to see them. I see lazy nurses who do minimum patient care and spend more time trying to become Mrs. MD (god only knows why) and I am one who picks up the slack, because I work my ass off at work. Even though I don't think I qualify as the 'hot' nurse that the residents actually seem to pay attention to.

I just do my job. I'm not there to make friends, be part of the group or go out for drinks. I work hard and I do my job quietly and correctly. I have a life outside of the hospital, and it just became lots more complicated by adopting twin girls from a foreign country.

I don't give a crap about what people say or don't say, like or don't like about my work ethic. I was raised to work hard, not sit on my ass as I see some MD's doing and reading/caring about football scores while doing minimally accepted work which will keep them out of court. Until, of course, I finish law school.

The ones I have a problem with are the insecure ones who freak because an experienced ED nurse might pick up on a problem and make one good call -- and the attendings/residents are grateful for that.

I've said it before about 6 times and if you had read the previous posts you would understand, I am grateful for the learning opportunities that come my way when I ask docs about orders. I ask because I want to know the rationale and scientific basis for unusual orders, not because I'm a bitter ED nurse. Far from it. I love my job. I just hate having to put up with the immature know-it-all don't-you-dare question me docs that make life in the ED difficult. We work as a team. Nothing more, nothing less. You need not lecture me about my work ethic. Examine your own.

 

[AF_PedsBoy]

Doctors who go in hating nurses do indeed deserve what they get; and nurses who go in hating doctors deserve, and will receive, what they get. I give every nurse I meet a couple of days as a gimmie, in case they're just having a bad day, and then after getting nothing but abuse in response to being polite and friendly, I happily begin the process of making their lives as miserable as mine. Sure they're still handing me ****, but me handing it right back makes me indescribably happy. And THAT is why I'm always smiling at the hospital, when people ask me.

 

[NoAngel]

The thing I hate the most about nurses is their self-righteous attitude about everything: they work harder, have more responsibility, have worked 20 years doing the same job thus know EVERYTHING, yada-yada-yada. If they work so freaking hard, why are they so damn fat?

The only people I hate more than nurses are the lazy unit clerks who refuse to enter orders into the computer. These people are a danger. Instead of paging the doctor to correct an order, they ignore the order regardless of its critical nature.

The nurses I do respect are the ones that work hard, are sharp, and don't complain. Actually, they don't even have to be sharp, just work hard and don't complain. Of course the lazy-assed nurses dump on these nurses since they don't complain.

And nurses, it is totally inappropriate to curse and get into fist fights in front of patients. That is poor customer service.

Actually I think nurses in the ED do work harder on an hourly basis for a third of the money that the docs make. That's why the hospitals can't recruit nurses. Who wants to be abused, treated like an idiot by someone 10 years younger than you and get paid 22.00/hour? That's why nurses go per diem, or agency. You get paid more. Lots more. And when you decide to finish law school with an RN behind your JD, lots, lots more.

See you in court.

 

[NoAngel]

wow--only a bitter nurse would have to get the last word in AFTER being called out on it.

Wait, you just started medical school?

 

[MD'05]

Actually I think nurses in the ED do work harder on an hourly basis for a third of the money that the docs make. That's why the hospitals can't recruit nurses. Who wants to be abused, treated like an idiot by someone 10 years younger than you and get paid 22.00/hour? That's why nurses go per diem, or agency. You get paid more. Lots more. And when you decide to finish law school with an RN behind your JD, lots, lots more.

See you in court.

Hospitals can't recruit nurses because most want the money without working hard for it. If you don't want to be treated like an idiot, don't act like an idiot.

People like you are the reason the healthcare system is going down the tubes. You want to sue me, bring it on sister. I'll be cramming that JD up your fat ass.

 

[AF_PedsBoy]

Actually I think nurses in the ED do work harder on an hourly basis for a third of the money that the docs make. That's why the hospitals can't recruit nurses. Who wants to be abused, treated like an idiot by someone 10 years younger than you and get paid 22.00/hour? That's why nurses go per diem, or agency. You get paid more. Lots more. And when you decide to finish law school with an RN behind your JD, lots, lots more.

See you in court.

You know I loved most of the nurses in the ED but there was one nurse who would sit around gossiping all the time and then when I asked her to do something - and you KNOW that even as a fourth year you can't write orders without getting it okayed, so either a chief resident or an attending okayed it - she would roll her eyes, ask me, "Why do you want that?" and then say, "I'll get to it," which could be two minutes or twenty minutes. Every order I had to give her was like pulling teeth. Then after a while I'd start having fun with that and I'd just start to run up to her with a big smile on my face and say, "Hey! Is that lab drawn on the rule out sepsis done yet?" every two minutes - which is emminently unreasonable. How can anyone possibly get anything done if they're being pestered every few minutes? However there is a difference when A) you're trying to do something RIGHT, you feel terrible when a nurse chews you out and is all pissed off because you feel like a f**k up, even though you know you aren't; but, B) when you're being a f**k p because you know it annoys the hell out of them, then those evil looks and pissed off attitude isn't crushing, it's HILARIOUS! And mind you I wasn't doing this while she was drawing blood on someone, I did this while she was at the nurse's station jawing up about her Saturday night. It's a riot. I figure I won't have the time when I'm a resident but I'll have a medical student do it for me (but I'll have them precede each spurious request with, "My doc wanted me to find out if..." just so THEY don't feel bad about pestering the slack ass nurse.)

The upshot being, 80% of nurses are nice and will happily help you learn; 20% are bitches and deserve to be treated as such. Just make sure you don't hand the bitching out to an undeserved victim!

 

[NoAngel]

Hospitals can't recruit nurses because most want the money without working hard for it. If you don't want to be treated like an idiot, don't act like an idiot.

People like you are the reason the healthcare system is going down the tubes. You want to sue me, bring it on sister. I'll be cramming that JD up your fat ass.

Actually, I won't be the one suing you. I'll be the one who interprets the incredible arrogance of someone who would insult someone they don't even know. And oh, my oh my, I'll have fun doing it.

As for my fat ass, see, immaturity is just rampant amongst those who will become responsible for patient care in the future.

RESPONSIBLE: you WILL be the one served when you make some stupid mistake that could easily be avoided.

Docs and nurses, residents and medical students at the hospital where I work cannot believe the animosity that exists in this thread. And yet here it is again, and your bitterness and immaturity are showing clear as new glass.

I hope to God that I never run into the likes of you or anyone who feels similarly inclined. It is amazing to me that anyone with such disregard for a vital part of the healthcare team is actually allowed to write a prescription or make a diagnosis.

It sickens me to no end.

What happened? You couldn't make it into law school, so you went to med school instead?

And please apologize for blaming one person who refuses to take crap from others the entire downfall of the healthcare system. Doctors in other countries who really truly practice medicine do it for the love of serving others -- much as nurses here practice nursing. Of course, if you'd get your head out of your posterior for 10 seconds and actually see something of the world, you'd know of what I'm speaking. But you don't, you see yourself as someone with so much power and influence that you think you are going to run the show until you make a world class mistake and kill someone. And you will. Docs in other countries make pennies on the dollar compared to what they docs in the US make, and they do so happily, by talking to their patients, knowing them, respecting them and the team. But I'm obviously talking over your head here as you cannot for one second fathom that someone may actually have a point, and you're far more interested in a pissing match and insulting a hard working, caring, dedicated healthcare professsional. It's actually people like you who will ruin healthcare because your irresponsible attitude leads to higher malpractice insurance and I'm just waiting to get a piece of that from you, you incredible jerk.

 

[NoAngel]

Hospitals can't recruit nurses because most want the money without working hard for it. If you don't want to be treated like an idiot, don't act like an idiot.

People like you are the reason the healthcare system is going down the tubes. You want to sue me, bring it on sister. I'll be cramming that JD up your fat ass.

 

[MD'05]

Did you fall asleep after your rant?

 

[AF_PedsBoy]

Docs and nurses, residents and medical students at the hospital where I work cannot believe the animosity that exists in this thread. And yet here it is again, and your bitterness and immaturity are showing clear as new glass.

I hope to God that I never run into the likes of you or anyone who feels similarly inclined. It is amazing to me that anyone with such disregard for a vital part of the healthcare team is actually allowed to write a prescription or make a diagnosis.

It sickens me to no end.

What happened? You couldn't make it into law school, so you went to med school instead?

And please apologize for blaming one person who refuses to take crap from others the entire downfall of the healthcare system. Doctors in other countries who really truly practice medicine do it for the love of serving others -- much as nurses here practice nursing. Of course, if you'd get your head out of your posterior for 10 seconds and actually see something of the world, you'd know of what I'm speaking. But you don't, you see yourself as someone with so much power and influence that you think you are going to run the show until you make a world class mistake and kill someone. And you will. Docs in other countries make pennies on the dollar compared to what they docs in the US make, and they do so happily, by talking to their patients, knowing them, respecting them and the team. But I'm obviously talking over your head here as you cannot for one second fathom that someone may actually have a point, and you're far more interested in a pissing match and insulting a hard working, caring, dedicated healthcare professsional. It's actually people like you who will ruin healthcare because your irresponsible attitude leads to higher malpractice insurance and I'm just waiting to get a piece of that from you, you incredible jerk.

Er, it seems I'm sensing as much animosity from your end, Noangel - especially since it seems you're taking as many personal jabs as he is, if not more

Also doctors overseas may not be as deleiously happy as you may think - there was a rather depressing mini-series in London that followed doctors out of medical school and focused on how they liked practicing ...my friend's aunt showed us some of it when we were in London and many of them seemed to be very dissatisfied - however they *may* have just decided to film the angry doctors...?

But the grass is always greener on the other side - perhaps you may want to move overseas where all the doctors are noble and kind and never make mistakes...

 

[phleebie]

Wait, you just started medical school?

only a bitter nurse feels the need to justify the importance of her job with lengthy tirades on an anonymous message board.

For the record, I am one of those “hardworking healthcare professionals” you speak of: I’m currently working as a phlebotomist during my glide year before med school. So no, I wont start med school for another few months, but please don’t patronize me—I’m looking forward to fulfilling my dream.

I work alongside some of the most extraordinary nurses on a daily basis. However, there are plenty of bitter nurses, much like you, that I come in contact with as well—one’s who believe that that somehow they are the “victims” at the expense of other “lazy” coworkers.

As for your maturity, that too is questionable. So far, you have made condescending comments about other people’s lives, threatened (albeit jokingly) to take someone to court, and called someone a jerk.

I called you bitter because your rants implicitly reveal it--it’s painfully obvious. But I don’t blame you, I blame the system.

 

[phleebie]

on a lighter note, i do want to genuinely congratulate you on your new family additions.

i, myself, am a foreign born adoptee, so it's reassuring to hear of people providing homes for underprivileged children.

 

[MD'05]

We are not your servants. We do not want to harm the patient. We have more knowledge than you do about a lot of things, so if you want to question an order, do so with respect. We've likely ordered something different for a reason.

But I absolutely loathe a lot of the labour and delivery nurses I am forced to work with and this opinion is shared by all the other doctors on the floor.

OMG ... I just saw this and I so agree with you. CRNA's need to be crushed. They should not function as independent healthcare providers. One CRNA was totally inappropriate, ridiculing all the fat people in the hospital. I was appalled by her redneck behavior (thinking that she was a doctor). I was so relieved to find out that she was a CRNA.

Also, why is it that nurses can wear those funky, filthy nurses jackets into the OR, but residents and medical students are forced to take off their white coats. The nurses complain about the increasing rate of infection, but they need to take a look at those nasty jackets and not wear them into the OR.

As far as Labor and Delivery goes, everyone involved in OB/GYN are miserable, hateful beings from the attendings to the unit clerks.

 

[NoAngel]

Er, it seems I'm sensing as much animosity from your end, Noangel - especially since it seems you're taking as many personal jabs as he is, if not more

Also doctors overseas may not be as deleiously happy as you may think - there was a rather depressing mini-series in London that followed doctors out of medical school and focused on how they liked practicing ...my friend's aunt showed us some of it when we were in London and many of them seemed to be very dissatisfied - however they *may* have just decided to film the angry doctors...?

But the grass is always greener on the other side - perhaps you may want to move overseas where all the doctors are noble and kind and never make mistakes...

Well, never having met me, knowing how I work or treat medical students, residents and attendings, not knowing what I look like, where I practice or how I live my life, anyone referring to a 'fat ass' should be banned from this bored. This is, after all, rude, condescending and harrassment.

The docs I met weren't in London, although having traveled England and Scotland extensively, most of those I see do see a need for a change, but on the whole, feel extremely pleased at their career path.

I chose to adopt twins in an Eastern European country. Medical care there, as we know it, is a luxury. Doctors make house calls and actually talk to patients before writing a script and sending them on their way. Thank you for reading my post about our adoption.

I'm not bitter in the least. However, I see those who think that because an MD perhaps looms in the future for them, all will be right with the world. Had posters not referred to a "fat ass" or called me "bitter", perhaps the argument would not have escalated to the point where I will withdraw from this thread.

It is completely nonproductive.

 

[rdennisjr]

This has gotten past the point of silly and now has clearly stepped into childishness. This thread will be closed. I would ask that a new one however be opened and a civil discusion be held on how to get along with other members of the health care team as in the real world every one must treat each other respectfully - even if you can't stand the other person personally.

Dennis