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Breaking the Wall With Nurses

Respect and Communication Between Nurses and Physicians

Most medical students about to embark on their clinical clerkships are simultaneously excited and mildly terrified. This is for good reason, as rotations are an unfamiliar landscape with an added level of responsibility. Up until this point it has been, in large part, a lot of didactics with patient interactions sprinkled throughout. If during the first two years of medical school a student learns all they can, it appears that the next two years are spent finding out how truly little they really do know. 

All that being said, it is important to understand the chain of command in a clinical setting and how each cog fits into the wheel. To be effective and maximize learning, a medical student must engage with, communicate with, respect, and learn from both nursing staff members and mid-level providers, because they are indeed the patients’ first line of contact and often the parties responsible for the bulk of the caretaking.

Generals command an army while the non-commissioned officers actually run it. -Unknown

This statement could not be more true with regard to the hospital setting. Although a physician is the one devising the strategy for patient care, it often falls on nurses to carry out the specific duties. Thus, due to their intimate knowledge of direct patient care, there is a wealth of wisdom that can be obtained from them. To benefit from the wisdom, the medical student must remain humble and willing to learn. Above all though, they must respect and acknowledge the hard work that these nurses are putting in on a daily basis.

My own personal experiences with nurses began on my first rotation, which was OB/GYN. The nursing staff was less than thrilled by the arrival of my group of fresh medical students bound for our six-week rotation.

Rightfully so: if one thinks about it, an extra set of inexperienced hands can cause more harm than good to an already well-oiled machine.

I vividly remember using improper scrubbing techniques before entering a scheduled C-section one day. Deservedly, I was berated by the nursing staff. I could easily have let this get to me but I remained humble and embraced the opportunity to improve, taking initiative to ask questions: 

“What can I do differently?” 

“What can you teach me?” 

Acknowledging that I was indeed an outsider in their “world,” I swallowed my pride and deferred to their expertise. The welcome response I received was extremely gracious and appreciative. I began to believe it was uncommon for these nurses to encounter a student so willing to take their advice.

After the successful C-section, two of the nurses took 30 minutes from their busy days to teach me to properly gown myself, apply sterile gloves, and handle various surgical equipment.

Beside myself with appreciation, I could not get enough of the priceless information. 

From that day, I decided to actively engage the nurses. I greeted each separate wing on the floor in the mornings, asked how their days were going, took a general interest in both their lives and work, and even brought in baked goods on Fridays. They always returned my consideration in spades!

Among other things, I was taught to look for specifics that could speed my patient diagnoses, was shown the quickest way to get a venous catheter in, and was often brought in on interesting cases I would have otherwise missed out on. The attention I received from the nurses granted me a distinct advantage over the other medical students.

As time passed, I also began to notice that in addition to the skills and knowledge I was obtaining, I was having much more fun than the colleagues of mine who had not employed my tactics. The staff became like family members and I was excited to see them each day. Granted, I am still a fledgling medical student, but so far I have found my experiences with the nursing staff and other providers to be absolutely invaluable. 

Too often does there seem to be unneeded separation or feelings of superiority with regard to position. It’s critical to realize we are all on the same team, working toward a combined effort.

Verna, Rachel, Stephanie, Lisa, Brittany, Sarah, Clarissa, Naomi, and all the others out there that helped me… thank you! Thank you for what you do, the way you teach others, the caring hearts you possess, and the healing hands you use. Without you, healthcare would not be possible. 

I hope that more students interact with and solicit advice from nurses in the future. There are countless reasons to do so, not the least of which that when they eventually become attending physicians they will have an added level of respect for and a better understanding of those working under them.

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