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Why do doctors think so little of nurses?

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What do they teach medical students in school?  Obviously there isn’t a class for common sense.  No class for copier/fax usage.  Penmanship, bedside manner, courtesy?

Today I had a physician call me from another floor to ask me to do an incident report on a mistake one of his residents made.  First thing I asked him was why he didn’t come talk to me when he was on my unit right outside my door five minutes before he called me.  No answer.  I told him that incident reports were to be completed by the person that finds the error; it is not just a nursing job.  He stated to me he did not have enough time.  “Excuse me Dr. but you had time to call me about this when you could have completed the report by now.”  No Answer.

I don’t know why physicians think so little of nurses, but at the same time rely on us so much.  We talk about critical thinking from day one in nursing school and work on developing those skills throughout our education and career.  Then you come to work and meet a physician with years and years of education that can’t think their way out of a paper sack.

Granted, working in a teaching hospital can be much worse when dealing with this type of nonsense.  Between the medical students, residents, fellows, attending and all the mid-level practitioners, it is exhausting teaching them all how to print a document and then fax it.

Maybe it is too much education that causes them to not think anymore.  Maybe it is the long hours of residency that rots the brain.  Who knows, but you would think that people that smart could figure it out.

By the way…….I didn’t do that incident report.  Score one for nursing!

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Rob Cameron

Rob Cameron is currently a staff nurse in a level II trauma center. He has primarily been an ED nurse for most of his career, but he has also been a nurse manager for Surgical Trauma and Telemetry unit. He has worked in Med/Surg, Critical Care, Hospice, Rehab, an extremely busy cardiology clinic and pretty much anywhere he's been needed. Prior to his career in nursing, Rob worked in healthcare finance and management. Rob feels this experience has given him a perspective on nursing that many never see. He loves nursing because of all the options he has within the field. He is currently a grad student working on an MSN in nursing leadership, and teaches clinicals at a local university. Away from work, Rob spends all of his time with his wife and daughter. He enjoys cycling and Crossfit. He is a die hard NASCAR fan. Sundays you can find Rob watching the race with his daughter.
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12 Responses to Why do doctors think so little of nurses?

  1. Nikki

    Nice…. I’ve got to say, I’ve experienced this type of scenario even before I was an actual nurse. I worked surgery, trauma, the E.R, and many other positions in more of a support role before attending and receiving my nursing license…. I’ve seen physicians getting into nurses faces, reports that were never filled out because they were “too busy” which ended up having admin get involved, and downright hostility on the Doctors side towards nursing staff…. I honestly dont get it either… if it wasnt for nursing, the labs wouldnt get ran, the xrays wouldnt happen and heaven forbid they have to come in and search the patients chart for the information they need when they can just pick our brains for that information that we seem to know immediately. There is alot to say for the “nursing model” as opposed to the “medical model”. It would be of great benefit if physicians were required to work as a staff nurse for a period of time before med school.

  2. Paul_APN

    I am one of those “mid-Level Practitioners” a term I detest because it implies we are less than functional in our lives. Frankly having spent 37 years (32 As RN 10 APN) in the health care system held positions from orderly (the old term for male nurses aid – but we got paid better) through now being a Primary Care Nurse Practitioner I have earned a bit more respect than your comment indicates. I made many stops in my professional career from GN in SICU, CCU, ED, ED/Trauma manager for may of those area, even ran the hosiptal Information system for a bit of time before teaching informatics, acute care NP students, and developing an emergency preparedness plan for the school of nursing at a university nursing school, spent some time in Jail health as the health administrator while in the US ARMY Reserve.

    The Attitude you display in your comment about the Doctor and the incident report reminds me of some of my unfortunate behaviors as a manager. It shows a loss of focus on or prime mission PATIENT CARE and the proper management of behavior to optimize the delivery of care to the PATIENT.

    The story you relay here shows a loss of focus on the patient – likely based on the frustrations of the middle manager role, all the responsibility but little authority – choosing to enter into an unwinnable turf war.

    Incident reports in a system managed correctly are not about who’s job, who gets spanked or who wins they are about finding glitches in the system, evaluating the root cause and creating a functional solution to prevent the problem in the future.

    Your response made a potential process improvement ally into, at best an aloof person, and at worst someone who will vex you for your career at this institution while allowing a patient care issue to go unreported and uncorrected..then crowing about it.

    I know now what kind of crazy stuff goes through a providers head each day – and I am only in an ambulatory primary care setting – it is very easy to get distracted by patient issues and miss the important adminstrative issues that should be touched upon at the right time. The fact the provider even bothered to call demonstrates his interest in procedure and desire to make a difference…at least that time …he will think twice before talking to you about needing to insure an incident is logged. He will avoid reporting or will go to your supervisor next time and tell them the problem because you were unresponsive to his concern this time.

    I suggest you contact the physician sit down over a cup of coffee and see how you can iron out a way to let him decide you can work well with him to improve patient care if not you will likely have a short rocky career as a Nurse Manager.

    I fought the fight for many years I won a lot but in the end I was fighting the entire medical staff – still won my points but it took a real toll on me.
    Paul

  3. Rob

    I agree with you about the purpose of an incident report, but that does not change the fact that it is not my charge nurses responsibiltiy to enter that for a physician. As I explained to her, it is the responsibility of the person that finds the problem to enter the report. The charge nurse knew nothing of the problem that occured other than the report she received from the physician. Who better to enter the information than the person that knows it best?

    Its not a frustration with middle management, it is a frustration with the managers before me that allowed this physician/practitioner and many, many others to pass their work off on to the nursing staff, and did not stand up for their staff. I will put a stop to it and ensure that it does not fall on nursing shoulders to pick up the grunt work that they do not want to do.

    I expect my nurses to perform their duties, and apparently the attending expects his residents and mid-levels to do the same since he backed me up in this incident.

    I am all for working together, as long as that does not mean nursing picks up the slack.

  4. PaulK_APN

    Thanks for the clarifications. I too have had to pick up entire staffs and retrain them after my predecessor wanted a buddies relationship with her unit members..it was a mess. I am glad you clarified your meaning because your post came off, to me at least, as a continuation of the old contunous warfare we all fought long ago.
    Paul

  5. in my experiences I have seen this with then older physicians. Many of them are unfamiliar and apprehensive with the newer technologies and because they don’t know how to do things or it’s not the way they’ve always done it, they lash out. Rather than be humble and ask for help it’s much more flattering to be little someone and take out frustrations on say a nurse rather than really focus on the issue, which is the need to personally improve.
    I think there is also superiority complexes and the “god complex”, and although. I can’t be for sure about this, I think there is a course/club in medical school that promotes the top dog behavior. The problem is that physicians have to be leaders, and many unfortunately, although incredibly intelligent and talented, lack leadership skills,. Barking orders is not leaderships, it’s arrogance and bossiness.
    Leadership requires understanding, commitment, ciritcal thinking, and compassion.

    We are all part of the medical team and we csannot work without each other. Just like the human body, we work as a factory, a system of parts that works together to achieve a common goal.
    We should try our best not to mangle any of the gears.

  6. Fresh Perspective-a "green" RN

    I work in an acute care setting in a large hospital. Our policy is the same: if you discover the incident (or made the mistake in some instances) you do the report. My understanding is this is because that person would have first hand knowledge of the incident in question and would be best fit to report it accurately. I have never seen this task delegated before.

    As we are a teaching hospital, many doctors and residents pass through the unit on varying consults. One of my biggest grievances may seem the smallest, but to many of my co-workers and myself, is a grave sign of disrespect. At the nursing station we all share computers and countertops. As nurses, it is an unwritten rule that if someone’s paperwork is sitting in front of a computer and a file on the computer is open, that space is taken and someone had to step away for a moment. We choose another space. On several occasions I have had to step away from what I am working on to care for a patient. When I return I find a doctor and/or resident is sitting at ‘my’ workspace, closed out my work on the computer, and piled paperwork on top of my own. Sometimes I even have difficulty when i try to retrieve my paperwork from beneath theirs for ‘disturbing their work’. On several occasions this has happened in a slow period when there is 8-9 open workspaces not in use. The total lack of respect and disregard for others has caused a resentment among nursing staff, and yet none of us has had the resolve to speak out against it for fear of retribution.

  7. Have been an R.N. working in an inner city acute care facility for over 50 yrs. The fact that a Physician asked you to write an incident report for something a Resident did sounds like he, the Physician, doesn’t know how to handle the situation. Saying he is “too busy” means nothing. I think the Physician may have been young and not too knowledge about dealing with this kind of a situation. And—-definately doesn’t want anyone to know this.

  8. Jill

    I second that, though about the older physicians being that way more than the younger ones. . . The other day I helped a physician during rounds perform a bedside procedure and he just kept saying, “Oh, Nurse? Please get me this. Oh, Nurse?” . . . I just said to him, ” Dr. ____, my name’s Jill.” I didn’t want to be so cocky in front of the patient so I giggled a bit and we all had a laugh, but I really did get sick of being called “Oh, Nurse.”

  9. Sandra MS RN

    As a senior registered nurse in a teaching hosital I have encountered many scenarios as in this article. I absolutely agree that it is important to let all doctors know they need to do their paper or computer work themselves, especially putting their own orders into the computer. I loved it when our hospital started fining the doctors for having the nurses do thier work. Hit them where it hurts, in their wallet.

  10. When we have to defend out profession so strongly as I read so often on this site, I wonder why I ever became a Nurse. Doctors are trained to be leaders. They are trained to write ‘orders’ and they expect those orders to be taken seriously. They are not there to coddle the nurses. If a Nurse is prepared and knowledgable Doctors respect that Nurse…

  11. mgee LPN

    I don’t expect to be coddled; I do expect to be treated like a human being and with a bit of decency . Its really not too much to ask.

  12. Nurse Rene RN

    For years I have been of the very strong opinion that potential MDs should be REQUIRED to spend a minimum of 5 years as a bedside RN in order to learn ‘the OTHER side of the fence!’
    Such experience would give the potential doctor a completely different perspective and a whole new set of skills for dealing with patients, families and other healthcare professionals.
    The BEST docs that I have ever worked with ‘did time’ as lab techs, nursing assistants and EMTs.