Listening to nurses is key to being a good doctor
By Harby Ongbay Abellanosa
I’m a doctor. We get all the glory. And credit. And guess what? We only deserve part of it. I started out in medicine in the mid-80′s, volunteering at an ER. And the biggest shock to me was learning how much of what happens in a hospital is nurse territory. Doctors will see you anywhere from 5 to 30 minutes a day, depending on how sick you are. And the rest is the nurses. They’re the ones making sure you get your pills and checking that your vital signs aren’t dropping. They make sure you don’t fall down and break something. If you start vomiting, doctors will run out of the room and the nurses will rush in. They change your wound dressings and start your IV line. They’ll bring you a warm blanket. And clean disgusting things off you. Even if you’re drunk. Or delirious. Or mean. And through all of this they try be friendly and positive. Even though you aren’t their only sick patient.
I respect nurses. I learned early on that they’re key to being a good doctor. You piss off the nursing staff, and you’ll have a miserable career at that hospital. Respect and treat them well, and you’ll never regret it. They’re as important to being a good doctor as your medical degree. Maybe more. If you come out of medical school with a chip on your shoulder against nurses, you better lose it fast. Because they will make or break your training, and often know more than you do. Be nice and they’ll teach you. A good neurology nurse is often a better inpatient neurologist than some doctors I’ve met. I remember a guy named Steve, who was an intern with me a long time ago. We were only a few months out of medical school, and as we were writing chart notes one morning a nurse came over and asked if he’d go listen to his patient’s heart. With icy contempt, and not even looking up from the chart, he said “I don’t have to listen to his heart, because I looked at his EKG.” They ain’t the same thing, dude. If he’d listened he might have noticed that the patient had developed a loud murmur in the last 24 hours.
When the attending caught it a few hours later, Steve got chewed out. If he’d taken the nurse’s advice, and listened, he wouldn’t have gotten reprimanded by the residency board. Here’s a quote from “Kill as Few Patients as Possible” by Oscar London, MD: “Working with a good nurse is one of the great joys of being a doctor. I cannot understand physicians who adopt an adversarial relationship with nurses. They are depriving themselves of an education in hospital wisdom.
” Those doctors are also depriving themselves of friends. On a difficult day on call, sometimes all it takes is a sympathetic nurse to temporarily add you to her patient list, steal you a Diet Coke from the fridge, and let you cry on her shoulder for 5 minutes. It doesn’t make the day any less busy, but helps you absorb the punishment better.
What got me started on this? While I was rounding this weekend, a grateful patient’s family brought the ICU nurses a box of donuts, and so the staff was picking through them. One said, “Oh, this kind is my favorite, it has cream filling.” And a patient in one of the rooms yelled, “Hey, babe, I got my own kind of cream-filled dessert in here! Come have a taste!”
You say that to a waitress, and you’d likely get your kicked out of the restaurant. You say that to a co-worker, and you’d be fired and/or sued for harassment.
You say that to a lady in a bar, and you’ll likely get a black eye.
And what did the nurse do? In spite of the patient said, she went in his room, turned off his beeping IV pump, and calmly told him that he would not talk to her that way.
And I admire that. Nursing is a damn tough job. And the people who do it are tougher. And somehow still remain saints.