Question from a reader:
What is the relationship supposed to be between nurses and residents in a large teaching hospital? During a lengthy stay for a surgery, I noticed a tension between these two groups, especially between junior residents and highly experienced nurses. Perhaps it is inevitable?It wasn't that long ago that Doctor D was a resident in a teaching hospital and he can still recollect old days of being a young doc fresh out of med school and working beside experienced nurses...
The rules of medicine say that the doctor should call the shots, but this can be problematic when a new doc with no experience is giving orders to nurses who have been taking care of patients for years. There will always be some tension. It's like a captain just out of military academy taking command of a group of battle-hardened veterans. The captain may have an officer's rank and a head full of military theory, but the foot soldiers are the only ones who know what it's like to get shot at.
Ideally, this tension will make the team better. The young doctor learns a lot from working with experienced nurses, and the fresh ideas from the newly-educated residents improves the care the nurses give.
Unfortunately people who should be working together sometimes go to fighting amongst themselves. When inflated egos of new doctors or experienced nurses cause trouble and it is patients who can get hurt. Any doctor who doesn't listen to experienced nurses is headed for disaster, and any nurses who abuse new doctors are harming both patient care and medical education. Once the battle gets going, however, it is hard for either side to back down.
The best strategy is to start out on friendly terms and work to stay there. When Doctor D started residency the first advice his attending gave him was, "Be good to the nurses and you'll do well."
Mutual respect and open-communication works best for everyone, including patients. I can tell you it is hard to be nice when an older nurse is giving you shit just for being young. I'm sure nurses can attest that it's equally difficult to refrain from kicking the ass of a cocky resident with a big god-complex and zero inexperience. I have found, however, that if I bite my tongue and act respectful the obnoxious behavior of insecure nurses and doctors usually subsides to a tolerable level.
If you are a patient in a hospital where the tension between residents and nurses has broken into open warfare this is a bad sign. I would advise you appeal to a higher power to intervene, such as an attending physician or head of nursing. Don't take sides--trust me you don't want a part of that battle. Just tell them that you as a patient are worried by the animosity. Usually the responsible authorities can sort out who needs to have "come to Jesus" talk so that both sides can calm down and start playing nice together.
Have you ever witnessed (or been a part of) an interesting Nurse VS. Resident conflict? How was it resolved? I would love to hear your stories in the comments.