What do doctors want? “Efficiency.”
A Scrubs Exclusive: We pit Dr. Brady Pregerson, our favorite ER Doc, against Nurse Rebekah Child, our favorite sassy RN. They answer the question: “What Do Doctors Want?”
He said: While most questions from a good nurse help to prevent errors and optimize care, unnecessary questions may cause delays and therefore become a source of aggravation. It’s always preferable to help keep the doctor more efficient by problem-solving on your own whenever appropriate, as long as patient safety won’t be affected.
Here are a few good examples: For a medication question, consider calling the pharmacist first to try to avoid interrupting the doctor. If you still end up needing to ask the doctor, you can at least tell him or her that you tried the pharmacist first. Before asking a disposition question, check to make sure the vitals are up to date and all test results are back.
Also, ascertain if the patient is able to walk and drink normally, and that symptoms such as pain, vomiting or weakness are resolved or adequately controlled. Another way to improve physician efficiency is to make suggestions if important testing or treatments seem to have been forgotten. Good examples include drug levels for Coumadin and seizure medications, or giving aspirin after a negative head CT in a TIA or stroke patient.
She said: The old adage “Give a man a fish and he will eat for a day; teach a man to fish and he will eat for a lifetime” kind of applies here. Basically, think for yourself! Eighty percent of the time, through a little Sherlock-ian investigation, you can find out the answer to your own question.
Questions to MDs should be like using the 911 system: We all know people who will call 911 for any little emergency, but the people who are going to get the best attention are those who use it in a real emergency! It’s also more fun to get your way, right? So if you really want that super annoying drunk patient to be discharged home (get out of your hair and stop peeing in the bed!), then make sure his labs are normal, he can walk in a semi-straight line, his vitals are stable and that the only thing he needs is a dispo home.
There are few things more embarrassing than making your case for a patient to go home/upstairs/to the morgue and finding out that he needs some important tasks to be completed first. Use that spherical object directly above your neck—your head! This keeps patients safe, RNs content and MDs happily continuing to write illegal antibiotic prescriptions for us for our UTIs (please, ladies and gentlemen—try to make it to the restroom at least once during your 12-hour shift!).
Brady Pregerson, MD, a returned Peace Corps volunteer and winner of the 1995 Wise Preventive Medicine Scholarship, completed his medical school at the University of California, San Diego, and his residency at Los Angeles County General Hospital. He has authored three medical pocket books for nurses and doctors, as well as the educational web sites erpocketbooks.com and gotsafety.org.
Dr. Pregerson currently works as an emergency physician in Southern California. He writes, "Although the ED environment may be quite different from working on the hospital floor or in an office setting, I am hopeful that you can take these tips and apply them to your own specific work situation." You can buy his books on lessons from the ER, including Don't Try This At Home: Lessons from the Emergency Department and Think Twice: More Lessons from the ER, at amazon.com.
By Brady Pregerson, MD