Nurses Are Entitled to Respect from Physicians

A physician stormed out of the medical-surgical ward after screaming, “This M.D. after my name stands for ‘Makes Decisions!’  Your R.N. stands for ‘read the (expletive) note!’”  I was shocked and disgusted when I heard a resident say that to one of our nurses when I was an intern.  This physician was notorious for such outrageous outbursts, but this crossed a line that I never imagined could even exist.  

After the nurse had a chance to gather herself back together, I went over to make sure she was ok.  The look of shame and sadness on her face was soul-crushing.  I tried to offer what comfort I could by telling her that he was an ignoramus who was so bad at his job that he puts others down due to his own inferiority complex, but it didn’t help much.  How does one shake off a confrontation like that?  It was horrifying to watch.  

My confrontation with that resident later demanding he apologize to her didn’t go very well either.  It turned out, his attending physician heard about the encounter and took him to task for it later, but I’m sure that nurse still carries an emotional scar from that terrible exchange.  

Nurses are valuable team members

All too often, physicians and even patients regard nurses as “extras” or “helpers,” failing to account for their years of education, training, and on-the-job experience.  As with all professionals, nurses have varying degrees of excellence, and there is the occasional person who just isn’t very good, but I’ve found that to be the rare exception rather than the rule.  

The vast majority of the nurses I’ve worked with have been extraordinarily qualified.  They have been empathic with patients, respectful of my position, and exemplary in the performance of their duties.  I’m supremely confident that I wouldn’t be where I am today were it not for the kindness and coaching I have received from my nursing team over the years.  

Nurses go through rigorous courses of study in college and nursing school, plus advanced training in certain fields like nurse practitioners or nurse anesthetists.  It’s true that their level of schooling is less than that of physicians on average, but it’s wrong to conflate that with lower qualifications or lower standards.  

When I was a resident, I spent a lot of time working with nurses in our hospital, many of whom had 15-20 years of clinical experience, and I learned a tremendous amount from them.  I work with nurses every day, and I can say without a doubt that I couldn’t possibly do my job well without an outstanding nursing team working with me.  

Why is there so much doctor-nurse conflict?

There are a lot of articles and posts about the male doctor vs female nurse being largely a gender inequality issue.  Interestingly, I haven’t found that to be as consistent as social media and popular opinion would have us believe.  I have heard female doctors complain bitterly about and curse at female nurses and I’ve seen both male and female nurses more qualified than both male and female doctors, especially during the early years of physician training.  

I think the line is more between physician and nurse, rather than male and female.  That said, I think it is right for nurses, regardless of gender, to expect that both male and female physicians will treat them with respect and professionalism.  

There’s a very unfortunate progression that happens between nurses and physicians, beginning in the early training years.  During the early years of medical and surgical residency, the physician trainees clearly have less clinical experience than the nurses that work with them.  This can lead to an inferiority complex in the physicians and a superiority complex in the nurses.  Combine this with the reality that the physicians are writing the orders that guide the patients’ care, and you create a complex dichotomy where the inexperienced physicians are leading the more experienced nurses.  This is unavoidable in the training world, but it creates extremely complex interpersonal dynamics.  

Most physicians and nurses find ways to navigate this relationship with grace and mutual respect, but there are some who inappropriately lash out, criticize, or put down their colleagues.  These interactions often leave scars that last for years, or even decades.  As physician trainees begin to surpass the education and experience levels of their nursing team, they sometimes forget how little they knew at the beginning and how much their nurses helped them.  This leads them to treat nurses with less deference and respect, which justifiably causes nurses to resent them.  It’s a tough cycle to break, and as physicians, it’s up to us to break it.  

How do we make it better?

Physicians are in a position to break this cycle, and we MUST.  We absolutely depend on nurses to take care of patients.  One of my mentors is fond of saying, “Doctors don’t get patients well.  Nurses get patients well, and the doctors aim the nurses.”  I think that’s a good perspective.  Physicians have to hold each other accountable for enforcing the idea that nurses are invaluable members of the health care team, not just order-takers.  

I can tell you anecdotally that happy nurses will take better care of their patients.  I have observed that patients under the care of brash and overbearing physicians get visited less often by the nurses.  The nurses are also understandably more reluctant to call the physician about potential problems early, which leads to missed opportunities for early intervention in many cases.  

So, Doc, if you want your patients to receive excellent care, you owe it to your patients to be nice to their nurses.  At least once a shift, go out of your way to teach one of your nurses something, or say something kind, or tell their supervisor about how great a job they’re doing taking care of their patients.   

Nurses, you are entitled to respect from physicians.  You are not second-class citizens.  You are valuable.  Physicians need you.  Your patients need you.  It’s not enough to get some cake during Nurse Appreciation Week.  You should be revered for the work you do, the sacrifices you make, and the diligence you display in caring for your patients.  Thank you for working with us and beside us.  We couldn’t possibly do our jobs without you.  

Physicians: Leave a comment below and tell us about a time when a nurse really saved you from making a mistake or just went above and beyond in caring for one of your patients.

Nurses: Leave a comment below and tell us about a time when a physician made you feel valued.  What are some ways that physicians can show you the respect you deserve? 

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