The first thing you have to learn about your relationship with a doctor is what stage of your relationship to doctors you are in. Every nurse goes through certain stages of reacting to physicians, and not necessarily in the same order.
There is the subservient, slightly scared stage, where you are too intimidated to approach most physicians with questions or concerns.
There is the awe stage, where you are in awe of their vast knowledge and intellect, and you tend to go along with any orders or anything they say blindly, almost worshipful.
It’s Not My Problem
This stage is usually quickly followed by the “It’s not my problem, I am not the doctor phase” where you realize that doctors make errors, but you have washed your hands of the whole thing since they are at a higher pay grade.
“Us” vs. “Them”
Then there is the “us” versus “them” mentality that develops, where the nurse feels superior to the doctor because of mis-judgements she or he has seen the doctor make, and she or he becomes focused on questioning everything the doctor does.
Friendliness and Respect Wins
The second thing you have to realize is that none of these attitudes are helpful to you or your patient, and can actually be quite harmful. I have been pondering the nurse-doctor relationship for a long time now, and I have come to the conclusion that the best one is a friendly and respectful interchange between peers and coworkers. That being said, you have to look at your own behavior and beliefs to get to that stage. There are always going to be difficult doctors, but with the correct approach, you can usually work with them.
And the great thing is that if a doctor is particularly abusive or nasty (which is rare) chances are administration already knows about it. Also, there are always methods in place to report such unprofessional behavior. I had a surgeon who was particularly rude to me on the phone, and my nurse manager took the incident to HR. This doctor still has a job, but this was his third incident and his privileges were revoked for a period of time (which means no pay). Money talks, and his behavior improved.
Such situations are very rare these days. Where I have found the most issues arise is a disagreement with the doctor about the severity of a patient’s condition. Not to brag, but usually if there is a patient I feel is headed to the ICU or cardiac arrest, I am usually correct. I originally thought it was because I was crazy intelligent and overly qualified to do basically anything, let alone a nurse, but then I realized it was because I spend more time with the patients than the physician and I have a healthy level of common sense.
This attitude adjustment has served me well. I still get what I want from the doctor in terms of treating our patients, but it is a lot less work and energy. A collaborative, cooperative approach is always more successful than a confrontational, diffident or subservient approach.
What about you? Where are you at in your working relationships with doctors, and how can it be improved? I’d love to hear from you in the comments below.
About the Author
Rebecca Kinnebrew, RN is currently employed at a large southeastern hospital, working in a busy cardiac unit. Her previous experiences include geriatric and maternal nursing. Almost all of her family works in healthcare, either as doctors or nurses, so at a young age she has been exposed to the real issues facing healthcare workers and patients. When she is not saving lives or holding the hand of those easing out of this life, she writes about her experiences and observations, as well as other topics. When she isn’t juggling her work hats, she plays tennis obsessively, works in her yard, and cares for her stepson, husband, and her little furball.