While many practical nursing online programs say that they have excellent relationships with 83 physicians, most of the nurses I interviewed have had some experience with a physician who throws a temper tantrum, screams, and humiliates the nurse in front of patients, family members, physicians, and other cli-niacin’s. “You call because you’ve identified a problem,” said a nurse from western Massachusetts, “and what you often get is a very demeaning attitude.” A nurse at the Royal Victoria Hospital in Montreal recently asked a female surgeon to clarify an order. “I don’t need to repeat the orders for you,” the surgeon snapped. “You’re only here because we need you. I wish that one day we won’t need you.”
Nurses say they are particularly at risk for this kind of abusive behavior if they try to teach patients how to cope with their illnesses or if they question physicians about an order, a potential mistake, or a chosen treatment plan.
A major part of nurses’ role is to educate patients about their treatments, their procedures, and changes in lifestyle, diet, exercise, how to cope with an illness, and how to deal with medications and other treatments when they are discharged home. Many physicians understand and value this function. “The nurses’ role in educating patients,” says Dr. Glenn Bubbly, an oncologist and prostate cancer researcher at the Beth Israel Deaconess Medical Center, “is of paramount importance. Patient education cannot be done by doctors alone. Nurses and doctors both try to reinforce what the side effects of the drugs are. So if I tell a patient a drug could cause thrombocytopenia (low platelets) and therefore may lead to bleeding, I usually rely on the nurse to reinforce this message. This is a potentially dire effect, and patients absolutely need to hear this from more than the physician.”
“Patients often pretend that they understand things when talking to their doctor,” Bubbly explains, “yet they sometimes get greater comprehension when talking to the nurse. Very many patients, especially older patients, feel more at ease asking a nurse questions than they do asking their doctor, particularly regarding those side effects that are potentially life threatening.”
Bubbly states the case eloquently. Some doctors, however, seem to interpret this kind of teaching as an unwanted interference, as meddling in “medical” issues or trespassing on “medical” turf.
In Florida, Connie Barden described a recent experience. Barden has been a critical care nurse for years. She was the president of the American Association of Critical Care Nurses and is a cardiovascular clinical specialist at a hospital in Florida. Her job is to help nurses and doctors deal with complex cases. One of these patients was an eighty-three-year-old