Doctors are not 'better' than nurses

The nurse keeps up with compressions, “hard and fast,” knowing these are her patient’s last few moments. It's 30 minutes in, and she feels two of his ribs crack under her hands. The ER physician finally calls the time of death. The nurse talks with the family, performs post-mortem care, places her patient in a body bag, and quickly walks to see a new patient, who arrives holding a Del Taco bag and a large soda, complaining of ear pain and a cough. “It took you long enough!" he screams. "I have been waiting for two hours. This ER is horrible.” 

This scenario may seem extreme, but sadly, this type of treatment of nurses is not uncommon.

Having a positive relationship with nurses is invaluable

During my last year of residency, I was working nights, which meant I was responsible for floor patients, labor and delivery patients, and ICU patients. On one of my busiest night shifts, I had multiple ICU admissions and two deliveries back to back, and I told one of the ICU nurses that I was going to lie down and try to sleep for an hour.

Every 15 minutes, my pager would go off with a call about a patient’s blood sugar that was just above the upper limits. After the fourth page about blood sugar, the ICU nurse kindly asked me if I wanted her to treat the sugars accordingly so I could sleep while there was a little bit of downtime. I thanked her profusely and slept for 30 minutes before another stream of ICU admissions came my way.

When I first entered into my clinical rotations as a medical student, one of the first things I was told by other students, residents, and attending physicians was to “be nice to the nurses.” I thought this was an odd statement—in general, I think it is a good rule of thumb to be nice to everyone you encounter—but I quickly learned why this advice is given.

But there seems to be some sort of ingrained power struggle that exists and has existed for decades. This unhealthy power struggle goes both ways: I have seen my fair share of doctors screaming at nurses, nurses reporting doctors for poor behavior, and nurses undermining doctors.

Nurses are the “bread and butter” of bedside care 

Nurses become cranky, and so do doctors. We are both overworked and stressed and experience burnout. Although physicians are in charge and ultimately responsible for patient care, nurses spend hours during their shift administering meds, changing out IVs, coordinating patient care among other healthcare professionals, bathing and dressing patients, and talking with family members. 

Without nurses, physicians cannot do their jobs, and within the next two years, it is estimated there will be a shortage of more than 120,000 doctors and a need for 450,000 more nurses.^[] Additionally, seasoned nurses are being replaced by new grads, meaning these new nurses will need time to gain experience. 

Nurses are some of our best teachers 

Seasoned nurses have a vast wealth of knowledge about patient care, medicine, communicating with families, and how to navigate the nuances of the hospital system.

What if we spent a few minutes each day asking nurses how they are doing, asking about their families, or simply thanking them for caring for our patients? What if we spent time asking them about our patients, or asking them questions about aspects of nursing care we do not know? As physicians, we may have a deeper, more intricate understanding of medicine in terms of pathology and pharmacology, but that doesn’t mean we necessarily “know more” than nurses. 

How many of us physicians can change an IV, or a bedside catheter, or turn off beeping bedside alarms, or administer meds? 

Nurses need to feel supported

As physicians, we are focused on finding solutions to dealing with our own burnout. We advocate for more time off, put caps on residency training hours, and are quick to transition out of working full-time. 

Nurses need to feel supported at work, they need ample time off to decompress, and they need access to mental health resources, and physicians can help by offering support. We are all on the same team, and hopefully, by mending our relationship with nurses, we can take positive steps toward fixing our broken healthcare system.