When nurses should argue with the doctor

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Most of our daily problems, including common annoyances such as arguments with coworkers, are dismissed as not life or death.

However, when nurses and doctors are involved, it can be a matter of life or death.

Egos need to be left outside the hospital by the professionals entrusted with the health and safety of the patients they care for, which sometimes means nurses must argue with doctors.

The problem is that a hospital isn’t really conducive to arguing. And doctors aren’t like lawyers, who argue for a living. They’re used to having everyone accept their opinions as gospel, and can take it as a personal affront when anyone disagrees with them.

Unfortunately, doctors are people and people make mistakes. With nurse practitioners and RNs taking on more duties, nurses and doctors butting heads is becoming increasingly common.

Here are four times when it’s OK to argue with your doctor.

1. When the doctor isn’t listening to you or the patient

Nurses often have more contact with patients than doctors do leading up to surgeries or consultations. It’s during those interactions that nurses often find out relevant information about a patient’s condition that may not be obvious otherwise. If you have something to add and the doctor blows you off, it’s probably a good idea to take them aside and let them know that they shouldn’t ignore the information you’re conveying.

2. When the doctor is belittling you

Most doctors are professional, respectful, and courteous. There are some bad apples, though. Doctors who make you sound stupid in front of patients and/or coworkers need to be told that what they’re doing isn’t acceptable. Otherwise your ability to do your job will be compromised.

3. When the patient’s safety is in danger

If the doctor is showing any signs of incompetency — be it poor decision making or even signs of intoxication — it’s a must that you take it up with the doctor involved before he or she does something harmful to the patient. If that doesn’t work, tell your superior immediately.

4. When the doctor isn’t letting you do your job

Sometimes nurses assist or even handle some surgical procedures, including anesthetizing patients. If a doctor comes in, pulls the whole, “I’ll take it from here” routine, and tries to keep you from handling your duties, you should say something to him or her. Otherwise, he or she is likely to keep pushing you aside.

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One Response to When nurses should argue with the doctor

  1. jysting@uq.edu.au

    I suggest you have a look at
    Invitation to a Dialogue: Arguing with Doctors, Aug 21 2012, in the New York Times regarding patients challenging doctors, and my response below…

    I disagree with Rebecca Dresser’s contention that “argument is a legitimate part of shared decision making” in achieving better-informed patient-focused health care. A medical consultation that adopts an adversaria posture erodes the mutual trust and respect necessary to attaining the best evidence-based recommendations tailored to the preferences and personal circumstances of the patient. Self-advocacy framed by argument rather than informed discussion and debate risks inciting confrontation between doctor and patient, diverting precious physical and emotional energy from recuperation, being viewed as demanding and difficult, prejudicing future care and severing ties altogether. For the sake of keeping the peace, a more pliant physician could let argument dictate demand- and satisfaction-led care, resulting in excessive testing and ill-informed treatment. Consultations, like any worthwhile conversation, are premised on civility, the need to listen and be heard. After all, doctor and patient are not combatants on a battle field.