Will nurses really give med students a hard time?

[gimghoul]

4 years of medical school? You worked with nurses as a MS1 and MS2?

You don't? We didn't have a ton of clinical time, but I definitely spent time in hospital and clinic settings with nurses.

---

Members don't see this ad.

 

[gimghoul]

How to get along with nurses:

"Please"
"Thank you"
"Hey, sorry to bother you, but..."
"If it's not too much trouble..."
"This is definitely not urgent, but do you mind _________ when you get a chance"
"I really appreciate your help."
"Thank you so much."
"I have no idea what I'm doing here. Do you mind helping me out?"
"I would definitely do this by myself, but I'm afraid I'll just end up making a mess of your _________. Do you mind showing me what to do?"
"Thanks a lot, that was a huge help - I really hope it wasn't too much trouble."
"I'm on my way to get some coffee, would you like some?"
"Please"
"Thank you"


On the rare occasion that you actually do have something important or urgent to ask of the nurses, you can and should be firm and stand your ground if needed, but always, always, always be polite.
I once had a nurse give me an unreal amount of pushback when I asked her to get a repeat FSBG after some fluid on a patient whose initial blood sugar was ~500. She all but yelled at me, insisting it wouldn't be any different because the patient hadn't gotten any insulin yet. I stayed insistent, told her I appreciated her input, but that I would still really like the number. It came back around 250, and she was clearly sheepish about reporting it. I just said "Thanks, I really appreciate you doing that for me - sorry for being so insistent" and moved on.
I don't remember the exact clinical situation, but suffice it to say the number changed our management. In the end, she did what was asked without me creating a long-term problem by being rude about the asking or the result.

If it comes to a pissing match between you and a nurse, you lose every time.

 

[jl lin]

Eh, there are some bad and lazy nurses out there too, and a lot of passive aggressive behavior out there too.

It is never wise to get into a conflict with nurses unless you absolutely have to do it (ie they are doing something that is directly compromising patient care and/or jeopardizing pt safety).

Nurses can cause hell for you in many subtle and not so subtle ways. Do not cause trouble.

Most will be much better than you at practical stuff like blood draws and IVs (which always made my attempts to place one after nursing failed an exercise in futility), and you should also trust their judgments about when a pt is looking bad since they've been around a lot longer and have a better feel for it than you might.

ICU nurses are usually particularly good, and you should always listen to them.

This is true MS3, MS4, even intern year.

I am a RN...and I am not saying this b/c I am an ICU nurse...lol, but there can be a lot of truth to the whole passive-agressive thing in nursing. Seriously. And there definitely are some lazy ones. These kinds of nurses make it hell for just about everyone, so don't feel pregnant, so to speak.

 

[jl lin]

What I say now may be controversial, but I think its true - Be nice, but don't be too nice. If you're the type who's too nice, I guarantee they will see you as someone who can be walked on and will often treat you as such. If you can be very confident (not cocky like others have mentioned) and be nice at the same time, then you will get far. If something needs to be done, you need to say it in a confident way or you can bet it won't get done. In downtime, its not a bad idea to strike up conversation or a simple "good morning, how are you" can go a long way.

Re: listening to nurses. I actually disagree. Many nurses say incredibly wrong things. This includes ICU nurses. Many experienced ones will say it with a confidence which will have you believe they know what they're talking about, but when you sit down and think, it would be untrue.

You should listen when they feel someone is taking a turn for the worse. How to do a procedure, more practical things. Don't listen to the medicine stuff they may try to tell you, because your job is to think. You need to formulate a differential diagnosis and not come to conclusions which exactly the opposite a nurse will do - see a problem and immediate come to a conclusion. As a medical student thats the worse thing you can do.

Well, I make it my business to back up what I have seen-patient spikes and trends, with multiple pieces of data, for the most part. I try to limit any commentary, unless I think it will make a difference, or unless you are a cool dude or dudette that is trying to have a positive academic discussion. Of course, depending on what's going on, I may not have time for that. Otherwise, I have stuff to do, and I need to get to my other jobs, one of which is school.

I know it's my goal to get to ms, but really, the implication is that it's not the critical care nurse's job to think. Wow. Very untrue, but whatever. Some nurses think better than others--just like some docs think better than others. IDK. That just seems really, well, wow. I guess you have had a bad run with some ICU nurses. Generalizations can suck.

 

[45408]

Well, I make it my business to back up what I have seen-patient spikes and trends, with multiple pieces of data, for the most part. I try to limit any commentary, unless I think it will make a difference, or unless you are a cool dude or dudette that is trying to have a positive academic discussion. Of course, depending on what's going on, I may not have time for that. Otherwise, I have stuff to do, and I need to get to my other jobs, one of which is school.

I know it's my goal to get to ms, but really, the implication is that it's not the critical care nurse's job to think. Wow. Very untrue, but whatever. Some nurses think better than others--just like some docs think better than others. IDK. That just seems really, well, wow. I guess you have had a bad run with some ICU nurses. Generalizations can suck.

ICU nurses should definitely be thinking, but it's not their job make a diagnosis. With that said, I very very very much appreciate the nurses who have the insight to realize that they have a lot of control with all their drips, sedatives and narcotics. The patient might be (insert abnormal vital sign) because they need more of something, less of something else, and might just need some specific cares. Standing at the bedside for 12 hours provides a lot of information that I just can't really obtain by looking at the chart and a recent set of vitals.

How to get along with nurses:

"Please"
"Thank you"_____ when you get a chance"
"I really appreciate your help."
"Thank you so much."
"Thanks a lot, that was a huge help - I really hope it wasn't too much trouble."
"Please"
"Thank you"

Pretty much. Most nurses will do a lot of things for you if you ask nicely. Now, I have more pull as a third year resident than a third year student, so it is a bit different, but if I take down some complicated dressing and don't have time to put it all back together, it goes a long ways to call the nurse and say "Hey Mary, we took down bed 3's dressing, when you have a minute, would you please dress it back up? Thanks!"

I once had a nurse give me an unreal amount of pushback when I asked her to get a repeat FSBG after some fluid on a patient whose initial blood sugar was ~500. She all but yelled at me, insisting it wouldn't be any different because the patient hadn't gotten any insulin yet. I stayed insistent, told her I appreciated her input, but that I would still really like the number. It came back around 250, and she was clearly sheepish about reporting it. I just said "Thanks, I really appreciate you doing that for me - sorry for being so insistent" and moved on.
I don't remember the exact clinical situation, but suffice it to say the number changed our management. In the end, she did what was asked without me creating a long-term problem by being rude about the asking or the result.

If it comes to a pissing match between you and a nurse, you lose every time.

Sometimes you just have to hold your ground. I once ordered a test that the nurse thought was ridiculous and would not change our management. She did it anyway, and I was right, she was wrong.

Another time, I ordered something that was going to be challenging to do, and the nurse was pretty mad at me (even though my chief insisted on the test as well). She grumped about it quite a bit, but she ended up calling me later to apologize.

 

[username456789]

You don't? We didn't have a ton of clinical time, but I definitely spent time in hospital and clinic settings with nurses.

Nobody works in any meaningful capacity for any significant amount of time with nurses in the hospital during the first two years of medical school, regardless of your curriculum.

At most, at your stage in the game you've "worked with nurses" for about 15-18 months (depending on when you guys start 3rd year curriculum).

 

[evilbooyaa]

Nobody works in any meaningful capacity for any significant amount of time with nurses in the hospital during the first two years of medical school, regardless of your curriculum.

At most, at your stage in the game you've "worked with nurses" for about 15-18 months (depending on when you guys start 3rd year curriculum).

This. Might've had an interaction or two when we spent a few hours in the hospital as a MS1/MS2, but I wouldn't consider that 'working with them' since there always an attending there to lead us around (that plus we didn't know anything/weren't allowed to do anything to the patient beyond a simple H&P)

 

[peteB]

You don't? We didn't have a ton of clinical time, but I definitely spent time in hospital and clinic settings with nurses.

That's really strange. We did not even enter the hospital at all MS1 or MS2.

 

[mzarrowsmith]

Nurses seem to be especially moody every 28 days or so, especially the female ones. Does anyone know why?

 

[gimghoul]

Nobody works in any meaningful capacity for any significant amount of time with nurses in the hospital during the first two years of medical school, regardless of your curriculum.

At most, at your stage in the game you've "worked with nurses" for about 15-18 months (depending on when you guys start 3rd year curriculum).

I was a non-trad applicant from another health profession, so I've "worked with nurses" for quite a few years more than that.

 

[username456789]

I was a non-trad applicant from another health profession, so I've "worked with nurses" for quite a few years more than that.

That's fine, so did I. Just don't pretend that any medical student spends 4 years "working with nurses" in medical school.

 

[gimghoul]

That's fine, so did I. Just don't pretend that any medical student spends 4 years "working with nurses" in medical school.

Not to parse too many hairs grammatically, but that one has spent all four years working extensively with nurses as a medical student is not a necessary consequence of the statement "the nurses that I've worked with in 4 years of med school." It's not even implied given that everyone here knows that the first two years of school contribute no more than a couple months of interaction to the time spent working with nurses. Grammatically, it serves to include those months into the sample.

 

[SpecterGT260]

That's fine, so did I. Just don't pretend that any medical student spends 4 years "working with nurses" in medical school.

The "oh no no no, you were supposed to know that my sweeping generalization applies only to me" defense.

 

[username456789]

The "oh no no no, you were supposed to know that my sweeping generalization applies only to me" defense.

Defense? If you're referring to me, you're barking up the wrong tree here.

 

[PikminOC]

The VA is the only place I've had issues with the nursing staff. The female med students and interns seemed to have much more trouble than us guys though.

Wholeheartedly agree. I know for a fact some nurses scope out the new residents as possible husbands and are particularly nice to those guys. No reason to be nice to the women. No gain.

 

[SpecterGT260]

Defense? If you're referring to me, you're barking up the wrong tree here.

I was agreeing with you.

 

[username456789]

I was agreeing with you.

Haha, sorry, wasn't sure. I've been working nights and am sleep deprived.

 

[SpecterGT260]

In your defense, I recognize that I am at the upper end of argumentative. It isn't the first time someone has interpreted a post as antagonistic when I don't directly say "+1" or something to that effect

 

[jl lin]

Sometimes you just have to hold your ground. I once ordered a test that the nurse thought was ridiculous and would not change our management. She did it anyway, and I was right, she was wrong.

Another time, I ordered something that was going to be challenging to do, and the nurse was pretty mad at me (even though my chief insisted on the test as well). She grumped about it quite a bit, but she ended up calling me later to apologize.

You do realize that nurses have these kinds of stories about docs too.
Of course for some of us, it's not about being right or wrong, but for advocating for the patient. You can tell pretty quickly who is primarily on "team patient" and who has other issues. When we're all on the same page, or at least working toward that end for the pt, things usually go better all the way around.

 

[jl lin]

Nurses seem to be especially moody every 28 days or so, especially the female ones. Does anyone know why?

Lol...even the guys?

 

[evilbooyaa]

Not to parse too many hairs grammatically, but that one has spent all four years working extensively with nurses as a medical student is not a necessary consequence of the statement "the nurses that I've worked with in 4 years of med school." It's not even implied given that everyone here knows that the first two years of school contribute no more than a couple months of interaction to the time spent working with nurses. Grammatically, it serves to include those months into the sample.

C'mon man.

That's not what you meant, lol.

Whatever.

As for OP - My experience with nurses has been mostly positive.

 

[mzarrowsmith]

Lol...even the guys?

Rep. Todd Akin (R-MO) told me that gay men menstruate too. So just the women and the gay guys. Not the straight ones.

 

[TarHeelEMT]

Hmm

 

[SpecterGT260]

Rep. Todd Akin (R-MO) told me that gay men menstruate too. So just the women and the gay guys. Not the straight ones.

So THAT's how they reproduce..... I was wondering where they keep coming from...

 

[todds]

Well, I make it my business to back up what I have seen-patient spikes and trends, with multiple pieces of data, for the most part. I try to limit any commentary, unless I think it will make a difference, or unless you are a cool dude or dudette that is trying to have a positive academic discussion. Of course, depending on what's going on, I may not have time for that. Otherwise, I have stuff to do, and I need to get to my other jobs, one of which is school.

I know it's my goal to get to ms, but really, the implication is that it's not the critical care nurse's job to think. Wow. Very untrue, but whatever. Some nurses think better than others--just like some docs think better than others. IDK. That just seems really, well, wow. I guess you have had a bad run with some ICU nurses. Generalizations can suck.

What I mean by being the medical students job to think - in that he/she has to think of in-depth differential diagnosis, be careful with how much you trust the information your are obtaining. Then after obtaining a diagnosis, ask again WHY, and then go deeper. Its necessary to think of the case in its entirety to a significant degree of depth.

I'm sorry if thats offended you, but that level of in depth analysis necessary for patient care is simply not in the training of non-MD colleagues. Thats why medical students need to train to look and think at the case in sufficient depth from the very beginning to get practice of it so it can be second nature by the time they are done training.

I'm not trying to knock ICU nurses, they do their job, we have to do ours. I didn't say ICU nurses sucked in my experience, its just they often made suggestions to junior residents for which they had experience of, but happened to be totally wrong. Thats just an example of "not knowing what you don't know". Thats not knock on the profession, that just not knowing how deep a particular issues goes. The exact same problem occurs within the medical profession. For example, MDs thinking they can read their own imaging when they don't understand/realize the details and physics of how imaging occurs and thus they don't know the factors affecting their interpretation of an image - another example of "not knowing what they don't know". Another example is of surgeons thinking they can take care of any number of medical issues but often think about them on such a superficial level that they end up making things worse. This is not just nursing thing, its amongst all of us.

ICU nurse training requires thinking about issues that I'm not talking about. Ours happens to be thinking in incredible depth of what, how and why the particular medical issues occurred and treat the underlying problem, then anticipate issues in regards to a treatment plan - at least that is the goal. Its difficult to really appreciate even at the medical student level what I'm talking about until you see someone take you through it and you start doing it yourself. I agree many MDs don't get to that level, but that is a requirement.

 

[gimghoul]

C'mon man.

That's not what you meant, lol.

Whatever.

As for OP - My experience with nurses has been mostly positive.

Then what do you propose I meant? That I attend a medical school with a radical curriculum that doesn't have preclinical years? That's absurd. I meant exactly what I said I meant.

 

[jl lin]

What I mean by being the medical students job to think - in that he/she has to think of in-depth differential diagnosis, be careful with how much you trust the information your are obtaining. Then after obtaining a diagnosis, ask again WHY, and then go deeper. Its necessary to think of the case in its entirety to a significant degree of depth.

I'm sorry if thats offended you, but that level of in depth analysis necessary for patient care is simply not in the training of non-MD colleagues. Thats why medical students need to train to look and think at the case in sufficient depth from the very beginning to get practice of it so it can be second nature by the time they are done training.

I'm not trying to knock ICU nurses, they do their job, we have to do ours. I didn't say ICU nurses sucked in my experience, its just they often made suggestions to junior residents for which they had experience of, but happened to be totally wrong. Thats just an example of "not knowing what you don't know". Thats not knock on the profession, that just not knowing how deep a particular issues goes. The exact same problem occurs within the medical profession. For example, MDs thinking they can read their own imaging when they don't understand/realize the details and physics of how imaging occurs and thus they don't know the factors affecting their interpretation of an image - another example of "not knowing what they don't know". Another example is of surgeons thinking they can take care of any number of medical issues but often think about them on such a superficial level that they end up making things worse. This is not just nursing thing, its amongst all of us.

ICU nurse training requires thinking about issues that I'm not talking about. Ours happens to be thinking in incredible depth of what, how and why the particular medical issues occurred and treat the underlying problem, then anticipate issues in regards to a treatment plan - at least that is the goal. Its difficult to really appreciate even at the medical student level what I'm talking about until you see someone take you through it and you start doing it yourself. I agree many MDs don't get to that level, but that is a requirement.

Nah. I am not offended. It's just that people are individuals. One nurse's understanding and insights can be significantly different from another. Everyone has their role. That's fine, but some nurses have a ton more of experience and understanding than others. Some of us do go deeper. I think it's just a matter of having to work with the particular nurses and docs to know. Like I said, it's better when everyone works together. I'm cool with not calling the shots in my current role. I only get upset when people are stubborn and the patient is adversely affected by needlessly obstinate attitudes or incompetence or carelessness. You will see it come from providers at all levels, and it will frustrate the life out of you.

 

[evilbooyaa]

Then what do you propose I meant? That I attend a medical school with a radical curriculum that doesn't have preclinical years? That's absurd. I meant exactly what I said I meant.

It would be 10x less confusing if you had just stated, "The nurses I worked with during my 2 clinical years were outstanding and non-judgemental, etc. etc."

Especially when you tried to justify it with your, "I worked with nurses before I joined medical school" statement.

How about this: "The nurses I worked with during my pre-medical and medical school years were oustanding and helpful, etc. etc."

But whatever. I don't really care. Pick your words to be as confusing as you want them to be.

 

[kpcrew]

Nurses seem to be especially moody every 28 days or so, especially the female ones. Does anyone know why?

It is painfully apparent that you lack experience with women.

 

[inmyslumber]

A lot of people don't know that "alot" is not a word.

I am glad you highlighted this common error. When I see "alot" in a personal statement or letter it makes me wonder if the writer lacks attention to detail or did not receive basic grammar education.

On a forum, I just hope the poster was in a rush and knows better....

 

[username456789]

I am glad you highlighted this common error. When I see "alot" in a personal statement or letter it makes me wonder if the writer lacks attention to detail or did not receive basic grammar education.

On a forum, I just hope the poster was in a rush and knows better....

The Alot is Better Than You at Everything.

 

[Siggy]

"Please," "Thank you," "Hi," "Good morning," "Would you mind if I steal that chart for a second?" [insert other pleasantries here] are all free, and should be used in abundance in everyday life, as well as at the hospital at 2am when a Rapid Response Team response is called for your team because the RN doesn't know how to trouble shoot a pulse ox on a patient with cold hands. Also, being a little proactive, such as helping prep your trauma patient in the OR if you aren't scrubbing in goes a long ways [you're probably sitting there anyways watching the show, why not get involved?].

Similarly, being in Southern California I get a lot of patients who don't speak English. If I need a nurse or CNA to translate, I try to make it as fast as possible and get them back to their job as quick as can be.

 

[jl lin]

... as well as at the hospital at 2am when a Rapid Response Team response is called for your team because the RN doesn't know how to trouble shoot a pulse ox on a patient with cold hands.

LOL. . .wow. I can't think of one place where I worked where anyone would EVER let such stupidity be forgotten. I guess the east coast is a little tougher. I'm talking pretty much merciless. Oh man. . .