Sunday, April 13, 2008

Respect II

Overheard while performing the babysitting duty:

Nurse 1: "They went and ordered for [some test] on your patient".

Nurse 2: "Well, I told them that they needed to get that test...3 DAYS AGO!"

Nurse 1: "I guess they didn't feel it was needed at the time?"

Nurse 2: "Who knows what these docs are thinking? But, whateva...I'm just a lowly nurse anyway...don't know shit."

Nurse 3: "Who ever said you knew anything to begin with?"

Nurse 2: "Shut up, bitch!"

They then all proceeded to start laughing hysterically. I didn't get the joke, but the innuendo from the critical care nurses that they know more about how to take care of patients than the doctors (surgical, medical, attending, resident, or otherwise) is more than covertly spoken. But only when the docs aren't around - I apparently don't count.


Rory said...

Gotta love the brooding undercurrent of resentment just below the surface of nearly every person in medicine.
"Then some stupid resident did X"

"Those paramedics didn't even start an IV"

"The surgeons don't even know how to do sliding scale insulin"

Relax folks, it's a job, not a pissing contest.

pinkie said...

And these folks don't even have the doctorate in nursing yet. I bet the friction will escalate even more once NBME implements the licensing exam for nurses that is supposedly based on the USMLE Steps. By then, they will be even more vocal about the 'incompetent' docs whose Step scores were lower than their makeshift licensing boards.

Bostonian in NY said...

I get these sorts of stories relayed to me all the time at home from my mom...there's always a doc that did something wrong and the midlevels saved the day...

she also told me not to go to medical school, so you can tell how well I listen

MSG said...

Part of what I found interesting is that, yes, the nurse did suggest that we get a certain test done, but it wasn't indicated at the time she suggested it. There are parameters that we are following - however she apparently felt that everyone who had certain symptoms/ signs always was given test X for diagnosis Y. It's not that simple.

But at the same time you've got to give these nurses a lot of credit for everything they do well and how they make the physician's job easier (at times).

adventures in disaster said...

If you are listening during morning bedside rounds when the nurse gives her report you will hear the nurses recommendations. There isn't anything covert abut it. It's just that no one actually listens to the nurse when she is presenting the patient. Everybody present is thinking so hard about what they are going to say when it's their turn to present that no one is truly listening to anyone else. It's actually hilarious if you step back. I have given my patients all kinds of bizarre and wondrous symptoms and test results and in ten years only a few staff docs will get the joke.
I don't fight it anymore. I let the junior docs succeed or fail without my two cents. I just stay friendly and willing to help.Sometimes working in an ICU for many, many years can make you a little strange. Docs who rotate through don't have time to reach the cynical, permanently burned out state caused by watching an incredible amount of near misses, medical and nursing errors, bizarre experimental treatments and never ending death.
The secret is to never, ever lose your sense of humour and accept that everyone screws up and some people screw up on a near continuous basis.