An excerpt from You What?!: Humorous Stories, Cautionary Tales, and Unexpected Insights About A Career in Medicine.

The relationship between physicians and nurses is a complicated one.  We are both there to “Take care of the patient.”  Each has their own role.  Doctors are undeniably in charge of ‘their patient’s care.” Particularly in an operating room. Somebody has to be in charge when things are heading south. That is not the time for debate.

But this “power” more than occasionally goes to their head, and they don’t treat the nurses they work with very well.  And sometimes they are terrible to them!  This has been tolerated for a long time.  It’s not as bad as it was decades ago but is still more prevalent than it should be.

Why is this so?  I’m convinced that a lot of doctors, particularly surgeons,  are mean to everybody they work with because they try to make themselves feel bigger by belittling those around them. Probably because of insecurity.

For years doctors have had their bad behavior tolerated, particularly in the OR.  Whether it’s because they are “captain of the ship” (which they are), they take it to an extreme.   Throwing instruments, yelling, and being nasty to the staff.  There is no way this should be tolerated. “The OR is just so stressful” is not a legitimate reason.  It’s stressful for all Drs. and not all of them act this way.

Like most bullies, these doctors will back down when somebody actually challenges them. But it’s hard for the staff to do when you need your job. What needs to happen is the hospital administration and surgery center administrators need to back up their staff when they are abused and take away their admitting or operating privileges. Not long — just a week or two — and the surgeons will get the message.

 A lot of young surgeons seem arrogant.  Some of them really are.  It’s an ego thing.

 But some of them just don’t want to look like they don’t know what they are doing. If a nurse mentions something that might help, she is likely to get her head bitten off (“I’m the Dr. here — I don’t need any advice from a nurse”).  Or “I have seen Dr. Smith do it this way.” (Well, Dr. Smith  is not here now, is he?”)

Only somebody “realistically confident” can accept advice,  particularly in the OR.

That’s a partial explanation.  Not an excuse!

I have said for years that the best reflection of a person’s character is how they treat those around them that they think can’t do anything for them.  Lots of people are nice when there is something in it for them.

Who am I to spout off about this? I’m nobody.  I was just an everyday orthopedic surgeon.

But I did have a reputation as a doctor who treated the nurses well.  These were some of the comments from RN’s on my retirement card from the OR.

Brenda:  “Thank you for always remembering my name.”

Amy:  “You always treated us the very best”

Lynette:  “You always made me feel like a competent, important member of the team. Thank you for allowing me to eat lunch when you arrived for your cases.”

Little things — but they are important!

I learned very early that the nurses could be your friend!  How do I know that?

It’s July of 1980 and I have just started my internship.  The nurses in the surgical ICU have been very nice, very helpful. (Probably because I look to be 10 years old.)

I’m writing my notes and the nurses are bustling around doing their ICU tasks.

All of a sudden, the neurosurgeons barge into the ICU on rounds and immediately start barking orders.

This group is a notorious bunch of asses and very quickly reinforces that impression.

All the nurses disappear, suddenly busy with tasks that take them as far away as possible from these jerks.

I thought “There is a lesson to be learned here!”

There was many a time in my internship that experienced nurses took pity on me and told me what I needed to know — both clinically and how to handle a difficult situation.

I learned, “Be nice to the nurses. Don’t piss off the nurses.”  They will do their jobs as nurses because they are professionals and they care about the patients. But, if they don’t hate you, they can make your life much easier.

Throughout my career, I learned to listen to them, especially in the hospital.  We blast into the room and see the patients for 5 minutes tops, maybe.  They are with them all shift.  They get to know much more about the patient.  A good experienced nurse will pick up things going south on the patient well before it shows up on the chart, particularly with the stupid EMRs and their multitudes of irrelevant information.

(Complete total aside.  Do you know what an EMR and a nude beach have in common?  The idea sounds appealing, but when you see it actually in practice, it can be pretty ugly!)

All of that above is just self-preservation for the doctor.

But there is a better reason to be nice to the nurses and treat them decently and with respect — which a lot of doctors don’t. They are doing a vital job and generally do it very well.

It’s just the right thing to do.

John Chase is an orthopedic surgeon and author of You What?!: Humorous Stories, Cautionary Tales, and Unexpected Insights About A Career in Medicine.

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