When it comes to doctor- nurse interactions, when is enough, enough?

Recently, I dealt with an upsetting situation involving a physician and nurse. A little background: The nurse has been working on our unit for years (since it first opened). She is very smart and savvy when it comes to nursing. She constantly gets feedback from the patients as being one of the kindest, most thorough nurses. I look up to her in many ways.

The physician, also notable, one of the few physicians in this specific program. I always say if I ever need a doctor in this specialty, I would go to him. He is unbelievably thorough and great with patients.

She was approached by a physician wondering why the blood pressure medications of a certain patient were being held over the past few days and he was not notified. This nurse, being very diplomatic, offered a response to the physcian, “I’m not sure, I didn’t even know that happened, let me look into it for you and get back to you.”

Unrelenting, the physician pressed farther: “There’s no need for you to look into it further, I’ve been sitting her for 20 minutes looking at the blood pressures and medications given–and it makes no sense.” Getting louder with each word.

Knowing she could offer nothing useful in this conversation with it escalating, she simply walked away saying, “I don’t know, I’ve literally taken care of this patient for 4 hours.”

The nurse pulled me aside to talk it out–she was worried she had done something wrong. At this point, we are both thinking, honestly, we do not get paid enough to deal with this type of interaction.

Physicians come with a full picture of the patient that they’ve known over months to years. Nurses come in and get a snap shot of the patient that the previous nurse discloses. Over the first four hours of our shift, while we are running around attempting to maintain sanity, we may not get a chance to look back over specific details for individual patients.

I think bigger questions come to light in the midst of these types of interactions:

• Where is the mutual respect among colleagues here?
• Where is the team work? If we continue to treat each other (and this goes both ways–not just physician to nurse) in this way, it undoubtedly will be to the detriment of patient care.

I understand this occurs both ways, and my intention here is not to bash physicians. I simply want to shed light on a problem that needs addressing.

Sarah Beth Cowherd is a nurse who blogs at SaraBethRN.com.

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