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When Doctors And Nurses Don’t Get Along

What do you do when doctors and nurses don’t get along? A reader asks for my advice:

Hi Happy,

I have this problem and wanted some advice from someone with more experience dealing with this.

I have been bashed by nurses because they expect me to know all the bureaucratic issues, when you don’t have more than a month in the hospital. I have noticed that nurses get mad, when you give them an instruction  they don’t understand, or they aren’t used to, not because you are wrong, but instead, their lack of ignorance, or their narrow process of thought. One example of this is when they laugh at me cause i prescribed a generic medication of a common drug that they weren’t familiar with the generic name.

Days ago, a first-year family doctor was yelled at badly by some nurse because she filled in the prescription chart where she shouldn’t — she didn’t know because no one told her. I have seen that attitude several times from different nurses — they yell in a very unproper manner.

They even try to make unreasonable suggestions, when they haven’t talked with patients, maybe because some other doctor did something similar, in a “similar” patient. they always be there, when no one asked for their opinion. They have very well defined where their tasks end, but not when they have to keep from making opinions they aren’t supposed to do.

I have come to the conclusion that nurses receive more respect from doctors (at least from me), than they actually give (me), specially to young doctors, even doctors share more respect themselves, that nurses  for medical profession.

I don’t want to make generalizations,  not all of them are like this. but I assume there is some sort of tendency. because same things repeats over and over.

I’m not a nurse hater, I get along well with nurses, I’m very grateful for all the help they can provide, I have to thank many times the nurses for the advice, in changes of the patient status, but I feel I get more respect from my medical staff than nurses. Is this similar at your hospital?

What do I have to do in order to stop some nurses from being nasty?  Sometimes I feel if I confront them it can get worse. My attitude is to avoid confrontation, I just keep silent.

You find yourself in an interesting set of circumstances, unless you have worked at a veteran’s hospital where my experience with many nurses was one of self-absorbed power struggles. They had a federal job with little to no risk of ever getting fired. Ever. What’s the difference between a VA nurse and a gun? You can fire a gun.

In fact, one resident physician often referred to the VA nurses as grey back gorillas. The longer the VA nurse worked, the larger they got and the more powerful they became. As the hair on their back turned grey, they became the grey back gorrilla leaders of their clan. They were in charge of molding all the young VA gorilla nurses into future grey backs. These were the obstructive nurses who did everything they could to make the doctor’s life difficult while compromising patient care.

But what could you do? You as a doctor were only there for a few short years before moving on to real life medicine. The VA grey back gorillas were  there for life. As a resident, you just had to deal with it. Some learned to integrate amongst them. Some learned to avoid them. You learned whom you could trust and whom you could lean on for support. Ultimately, taking the higher road made you a better person that day. You have to learn not to care what other people think of you. I expect a lot from people around me. What I hate is laziness. I hate seeing people take the path of least resistance because that says to me they don’t care. I am constantly educating nurses about my expectation in our mutual care of patients. I expect them to think like the professionals they are, not like robots. If they want to act like a robot, they are going to get treated like a robot.

I couldn’t care less whether a nurse or a doctor or a patient respected me. I have no interest in trying to gain respect. What others think of me is inconsequential. I have no interest in trying to seek the approval of others. I do what’s right for my patients and I let my outcomes speak for themselves. Stop worrying about how you can change others and just focus on what you can do to make yourself better. If respect is what you’re looking for, you’re much more likely to get it by placing those around you on their own pedestal, by the actions you choose for yourself. When a nurse is being mean to you, tell them what a great job they did carrying for your patients. The grey backs never expect it, but they’ll remember you as the doctor who said something nice. And they are going to remember it for a very long time.

*This blog post was originally published at The Happy Hospitalist*

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