The nurse-doctor relationship!

[Waxbaro!]

The disciplines of nursing and medicine are expected to work in unusually close proximity to one another, not just practicing side by side but interacting with one another to achieve a common good: the health and well-being of patients.

Due to this close interaction, the nurses and doctors relationship has gone through many definitions in history, which most of them are unfair and very disappointing.

One of the wrong definitions said that the nurse is an instrument by whom the doctor gets his instructions carried out; & she occupies no independent position in the treatment of the sick person.!!!

In 1917 a Nurse called Sarah Dock defined this relationship as: ‘No matter how gifted the nurse may be, she will never become a reliable nurse until she can obey without question. The first and most helpful criticism I ever received from a doctor was when he told me I was supposed to be simply an intelligent machine for the purpose of carrying out his orders.’!!!

It is a regret to admit that some of these backward thinkers are still existed in this world...

I would like to hear your opinions about this relationship, how do you define it and how do you see it?
How can we make this relationship full of respect & responsibility?

If I start with my self:

In reality, however, the nurse spends much more time with patients and often knows a lot that the doctor does not. Somehow the nurse needs to be able to communicate essential knowledge to the doctor, in the patient’s presence, without appearing to undermine the doctor’s ‘omniscient’ status. & they can achieve this through playing ‘the doctor–nurse game’.

The cardinal rule of the game is that open disagreement must be avoided at all cost. Thus, the nurse can communicate her recommendation without appearing to be making a recommendation statement. The physician, in requesting a recommendation from a nurse, must do so without appearing to ask for it.

In this way nurses and physicians are working together cooperatively to achieve shared problem solving, conflict resolution, decision making, communication and coordination.

Collaborative nurse-physician relationships are associated with improved patient, nurse and physician outcomes.
Waxbaro!

[Diagnostic]

This is important topic & I think others should join this debate!

I agree with you my brother Waxbaro that absence of relationship full of respect & responsibility has negative impact on the quality of health care delivery.

My view of this relationship is:
This relationships between doctors and nurses must be smooth one, and this can be achieved by playing the game mentioned by waxbaro!
Buy I believe that the level of education of the doctor and nurse control this relationship.
Diagnostic

[Waxbaro!]

Thanks diagnostic.

What is the effect of Gender on this relationship?

Ex: If the doctor is female & the nurse is female?
     If the doctor is female & the nurse is male?
     If the doctor is male & the nurse is female?
     If the doctor is male & the nurse is male?

[Diagnostic]

Sure, the doctor-nurse relationship is influenced by the doctor's gender

The doctor-nurse relationship has traditionally been a man-woman relationship. However, in recent years, the number of women studying medicine has increased.

"Female doctors often find that they are met with less respect and confidence and are given less help than their male colleagues. The doctors' own interpretation of this is partly that the nurses' wish to reduce status differences between the two groups affects female doctors more than male, and partly that there is an "erotic game" taking place between male doctors and female nurses. In order to tackle the experience of differential treatment, the strategies chosen by female doctors include doing as much as possible themselves and making friends with the nurses."

The above paragraph was a conclusion of a study examines what happens to the doctor-nurse relationship when both are women: how do female doctors experience their relationship to female nurses? It is based on two sets of data, qualitative interviews with 15 doctors and a nationwide survey of 3589 doctors.
Diagnostic

[Sumaya]

This indeed is a very important topic. I do believe good communication through working hard together on the  goal of achieving positive patient outcome is the bases of positive doctor-nurse relationship. Being a nurse, I have seen some doctors who seem to see nurses nothing more than an "instrument that carries out orders." On the other hand, most doctors do value the input of the nurse given the fact that the nurse is at the bedside and is able to visually observe clinical patterns. I don't think education as some of you stated should be the biggest thing that defines the nurse-doctor relationship. The nurse should be competent and should have good critical thinking skills. The nurse should be advocate of the patient and should use his/her judgment and effectively communicate with others in the interdisciplinary team. Having been a nurse for a year, after reporting something to a doctor, the doctor would say "what do you think? or "should we do that"? And I do  give recommendations, although the ultimate decision is made by the doctor.   I would not carry on an order that based on my judgment, would have an adverse effect on the patient.  All and all, as a nurse, I think communicating as a team with the doctor without transpassing my scope of practice is important in building positive nurse-doctor relationship.
 

[Waxbaro!]

Thanks Sumaya, your idea is clear!
Hope you succeed in your career

[MuslimDoc]

Collaborative nurse-physician relationships are associated with improved patient, nurse and physician outcomes. For example, significant patient outcomes which have been noted include: improved patient satisfaction; improved patient care or outcomes; and reduced medication errors. Nurse outcomes include decreased job associated stress and improved efficiency. Physician outcomes include improved job satisfaction and decreased job associated stress. Organizational outcomes associated include: decreased costs and improved efficiency of healthcare workers.
Barriers to nurse-physician collaboration are reported to occur due to: role misunderstanding; real and perceived differentials in power, position and respect; and varying perceptions of decision-making input and autonomy.
We can overcome this barriers by nurses and physicians working together cooperatively to achieve shared problem solving, conflict resolution, decision making, communication and coordination.
MuslimDoc

[Waxbaro!]

We can overcome this barriers by nurses and physicians working together cooperatively to achieve shared problem solving, conflict resolution, decision making, communication and coordination.
MuslimDoc

Thanks MuslimDoc for your participation & I agree with you

[Dr.keyf]

i don see wat the issue is here.doctors have their job to do n so do nurses.nurses shouldnt tell a doctor wat to do coz the doctor is responsible for the outcome,his decisions can save or kill a patient and therefore he or she is held responsible.everyone has their job cut out for them.i don see why nurses should be offended by tht,i mean cmon if they feel like their job is menial,they should become doctors right.besides nurses r fearless and treat doctors like shit.so wats there to defend when they defend their territory so well?!

[Dr.keyf]

Thanks diagnostic.

What is the effect of Gender on this relationship?

Ex: If the doctor is female & the nurse is female?
     If the doctor is female & the nurse is male?
     If the doctor is male & the nurse is female?
     If the doctor is male & the nurse is male?

well,am just providing a diff of opinion here since u all seem to agree.
if the doctor is female n nurse is female{all hell will break lose,cat fights et cetera}
if the doctor is female n nurse is male{harmony or quiet rivalry}
if the doctor is male n nurse is female{attraction+marriage+kids}
if the doctor is male n nurse is male{harmony+basketball}

loooooooooooooool i hope u enjoyed tht as much as i did,just bringing some humor to this topic,its all true by the way,ive seen it happen....

[Waxbaro!]

i don see wat the issue is here.doctors have their job to do n so do nurses.nurses shouldnt tell a doctor wat to do coz the doctor is responsible for the outcome,his decisions can save or kill a patient and therefore he or she is held responsible.everyone has their job cut out for them.i don see why nurses should be offended by tht,i mean cmon if they feel like their job is menial,they should become doctors right.besides nurses r fearless and treat doctors like shit.so wats there to defend when they defend their territory so well?!

Dr.keyf, hold on sister, don't blame nurses, when & how nurses treat doctors like shit?! I haven't seen such a nurse!

[Dr.keyf]

salaam waxbaro,it mustve sounded like i hv somethin against nurses bt thts not the case.u knw i have observed,n so hv many other doctors,thts doctors are actually afraid of nurses.n ive seen wid my own eyes so many times a female nurse arguing bitterly wid a male doctor abt some orders he gave her for the day.am telling u,they r quite expert at defending themselves.no one in their right mind messes wid nurses.n its a universal thing.if u watch medical dramas,u will notice the same thing.they don take crap from anyone.
so in my opinion ,the ppl to feel sorry for are the doctors coz they sometimes do the nurses work inorder to avoid confrontation.once again a doctor is already overworked,n has bickering at home by a spouse who misses him or her,n they hv to deal wid nurses n some irritating patients.so all in all,i really don see wat the issue is here...

[Amal]

mmmm its crazy!!
                       I always get the stereotyping when they see you in hospitals they think you are a nurse!!
                       I mean what world do they live in? don't they know there are more female in med-school than men in USA? Hello!! watch out......

[Dr.keyf]

hi amal,dont u wear lab coats as med students? n as ive seen in greys anatomy ,scrubs n dr.house,ER,dont doctors hv diff color of scrubs?if after tht they still confuse u wid a nurse,then daft ppl are everywhere.i don think u shud take offense.by the way,wat year are u in?must be exciting doing med in states.i envy u man!

[Amal]

 
Dr, Keyf,
              hahah here in America, even lab technician wear white lab coats! Funny rite!! most attending docs wear civilian clothes, but residence, med, students, nurses, lab techs, pharm all wear white lab coat. Some nurses wear scrubs. so unless  some one is close enough to read the tittle, a doc can easily come and ask you, about his patient thinking you are the nurse. No I don't get offended, I admire what nurses do, my heart goes out to them.
 thanks though for saying that but, I believe in "you will never accomplish anything in life if you are not a risk taker". Its not easy going to school when you are the only black person, thats even hard to accept it , but you learn to live with it and you get stronger day by day. for my people out there, don't get discouraged by being in white environment, face it with courage and its only for a season and a reason!!