Friction With Nurses

Cheeky title but everyone in their medical training starting with med school has had interactions with nurses and have been frustrated.

I've worked with nurses who really are exemplary and who set the standard for professionalism and great care. I've worked with nurses who actually guided me a lot in the ICU and who would never be inconvenienced with any request or emergent situation.  I've worked with nurses who would walk a stat lab through a minefield.

Then there are those who aren't as dedicated. This is in no way a generalization about nurses. This is to help med students and young doctors work better with nurses as a team.

I don't complain about things at work, but many of my colleagues do.

There have been many times I've had to remind nurses to draw the lab I ordered, or remind them to give a medicine I ordered while they sit and talk at the nurses station or as in one case, horsed around doing karate at the nurses station only to seem really bothered by me asking them politely if they had a chance to draw a lab.

I've had nurses talk back at me, literally yell loudly about a new lab being ordered so the whole unit could hear, and plenty of nurses who pressure me to do this and that while they decide that charting is more of a priority than taking that stat lab before it clots and becomes useless.

First thing, don't raise your voice or get antagonistic with anyone. Remain polite and give gentle reminders.  As physicians, we give orders to be followed, and you don't have to explode and go on a power trip.  To even do your best to minimize a delay in orders being fulfilled, emphasize how important it is for patient care and offer ways to expedite the lab or order being given. Some nurses might have many other things to do at once and not all will prioritize the most important thing first unless you tell them.  Usually I've only had that happen with new nurses who are really under pressure with so many things to do at once.

As for nurses who hammer page about extremely low priority things like an AM lab order or diet order while you're running a code or stabilizing a patient who will die without your help and then express anger with you, you just have to be polite and tell them. Some people may say don't explain yourself because you're the doctor, but I find it helps.  They even say things like they were busy with a patient themselves.

The last thing you want to do is make enemies as a resident, or make things harder for you.  Of course, don't be a pushover. You have to be firm or you'll be walked all over by everyone. Always be professional, even if those around you are not.