Building relationships with physicians can be tricky. It can also lead to great patient care.
As a new grad, “calling the doctor” can be almost one of the single most terrifying things you could do. Go help your new GI bleed to the bathroom? No problem! Call the doctor to clarify an order? YIKES!
When we graduate nursing school, we are so green. We know we have so much to learn, but c’mon, you studied those abnormal lab charts front and back. “I got this!” you think. You’re done with hospital orientation (yes, thank you. You can now locate all 137 fire hydrants) but you’re ready to bunker down and get into the good stuff. You’re all hopped up on coffee and you have your orientation binder; you’re ready for the real world. And then reality sets in. Having and maintaining a mutually respectful relationship with a physician isn’t something that’s even talked about in nursing school, but those first terrifying days as a RN, you sure wish there was a course “How To Talk To the Doctor” that you had passed. Or at least taken good notes.
Speaking from experience, there’s always that one thing you go into your first RN job that you’re terrified of. For me, giving nursing report made me so nervous. I had to get over that quickly. You get and give report every day, every shift you’ll ever work as a bedside nurse. I got over it by just telling the nurse I was giving report to “bare with me…I’ve only done this once or twice” and usually it wasn’t that awful. However, the way I started building relationships with physicians was way different.
First of all, you have to understand how imperative it is that the physician respects you as a strong nurse. That needs to be your goal. You should hope to think that the doctor says when he or she see’s you “OK ________ is taking car of my patient, she/he is perceptive, thorough and capable.” Getting there isn’t going to happen over night. The biggest turn off to fellow nurses and doctors are new grads who act like there’s nothing left to learn, that they know it all. Quite is the opposite of a respected member of a team trying to treat someone. Keep your mind open when a doctor is talking to you about something. When you have no idea what in the heck they are talking about, don’t smile and nod and think “I’ll Google this later…” Say something like “could you educate me on what __________ is? ” Physicians are educators by nature. Think about that- they love to teach. They want to share their knowledge with you. This is an important step in building a good, strong foundation with a physician.
Secondly, it’s important for you to gather your information and use the tools you have before calling the physician. Imagine being in their shoes, when they have 40, 50, 60 patients they are rounding on, consulting on, admitting and discharging. They take a call from you, anxious and excited to update and inform them that your patients potassium is 3.1. Now imagine as they try, and likely fail, to hold back their frustration to tell you that the patient who you’re speaking of already has a potassium replacement protocol ordered. Be a stronger nurse than that. Use the tools you have. Gather information, and understand the correlation between things. Then make your phone call.
The greatest compliment I was paid by a physician was a few months after I moved across the state and took a new job. That was a huge decision, not just to move to a new hospital and become a new nurse, but I had to now build relationships with doctors again. They didn’t know me from Adam. I worked everyday, every shift, every interaction. I wanted them to feel confident in my ability to take care of their patient. I was calling a physician to recommend we electively intubate my patient. I gathered my facts, all of my information. His neuro status was rapidly declining, his oxygen requirements were rapidly increasing. I called respiratory therapy to the bedside, they suggested the same. I called portable x-ray and asked them to be on standby. Then I called the physician, I asked him to come immediately to the bedside, assess the patient. I gave him my facts, my numbers, my assessment. He asked to have intubation supplies set up by the time he got there. Because we were able to intubate this patient in a controlled situation, we saved brain function, and potentially his life. The doctor said to me “When you call me, I listen. You ask me to come, I know you mean business.” That was one of my proudest days as a nurse.
Physicians can be intimidating, but remember, they’re people too. They have lives, families and had to start out on the low end of the totem pole somewhere along the line. Don’t be frightened to approach them, just for any old educational topic, or to simply ask “how was your holiday weekend?” You’ll be surprised how well someone will open up to you, when they know that you’re just as open.
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