Two days in a row. For two days in a row now I have enjoyed the pleasure of dealing with pleasant physicians. Nothing makes a bedside procedure easier than working alongside someone who speaks their instructions rather than screaming them. On the contrary, nothing is worse than trying to perform efficiently under scrutiny and harsh working conditions.
Any nurse who has been on the receiving end of derogatory insults hurled by a cocky physician will tell you how difficult it is to maintain focus on patient care in such an environment, and even years into my seasoned career I’ve dealt with uncalled for interactions that take me back to being a little grunt in the military while an officer tapped my head and said, “good doggy.”
You would think that the downside of demeaning doctors would be the unfair treatment against nurses, and how no human being deserves to be spoken to like a dog. But sadly it goes beyond even that. Sure, I’ll be the first to admit that it sucks being a professional and being talked down to like I’m a child, but I have pretty tough skin. I shouldn’t have to, but years of abuse have done their deed.
So yesterday I had doctor’s orders to implement, much like any other shift, but as it came time to follow through I began to question if it was in the patient’s best interest. The patient’s changing condition warranted a different approach, and I was left with two options. I could either hold out as long as possible and then follow an order I didn’t agree with, or two, I could call the physician and question his order.
In the end, with my patient’s best interest in mind, I contacted the doctor and presented my case. Since my concerns were legitimate, based on my education and experience, he agreed and went with my suggestion. Yay! A win for the home team!
The thing was, I had no problem contacting him because I felt comfortable doing so. He treated me with mutual respect, and though his education and experience far exceeded mine, he was always open to my questions and opinions. He knew that I too had much to bring to the table. It was a perfect, professional relationship we shared. And guess who benefited? The patient.
So guess who is hurt when a professional, collaborating relationship isn’t afforded? That’s right. The patient.
While I’ll always do what’s best for my patient regardless of how a physician treats me, I have to be honest and admit that I probably question things a lot less when I know I’m gonna get an earful. If my patient’s health is at risk I’ll always do what’s right for them, but I certainly won’t be eager to suggest changes that I may consider more efficient for patient care if I know I’m going to be screamed at, ridiculed, or spoken to like I’m an idiot.
So while some physicians may be of the impression that to maintain a continued level of respect and admiration for themselves that demanding it is the way to go, they actually end up being seen in an unfavorable light by nursing staff when screaming tirades are the baseline norm. I’m a big fan of the belief that to be respected you must first give respect, but for many physicians I’ve encountered over the years that’s not common knowledge.
What I’ve noticed, though, is that most doctors who treat nurses like dirt could care less if they have a good working relationship or not. They don’t seem concerned in the least for the feelings of their nurse, but they might should consider patient outcome.
You see, the real downside to demeaning docs is patient care. When angry physicians refuse to hear a nurse’s concerns, the patient suffers. When a nurse dreads contacting a physician with a potential problem, the patient suffers. Nine times out of ten a nagging worry that could have been addressed earlier, if not for lack of communication, could possibly endanger a patient’s life in the end.
I know I’m going to call before the feces hits the fan, but what about the new nurse? Hopefully they’ll be as vigilant of an advocate.
But in the cases where physicians don’t wish to hear the concerns of a meager nurse, well, your vigilance won’t matter. The patient will suffer because an intact ego is more important than anything else. This should not be so.
I’d like to think that my experiences over the past two days are a foreshadowing of life in the future. I’d like to think that the old dogs who once ruled the coop are slowly dying out in favor of doctors who don’t have to demand respect, because they’ve earned it instead.
I suppose we shall see.