Being a Nurse Sometimes Means Disagreeing with the Physician. Loudly.

I don’t often devote a single blog post to pointing out another blog post at another blog, but here’s an exception: an enormously thought provoking article by Theresa Brown RN on the New York Times Well blog. Money quote:

Obviously, doctors and nurses have different roles in the hospital. Our training is different, and so are our responsibilities. It’s also true that patients choose their doctor and only end up with a particular nurse through the luck of the draw. But when a doctor and a nurse disagree over patient care, should the doctor always prevail?

Many of the nurses I know could share their own, dramatic stories of rescuing patients or catching frightening errors by other health care workers, including doctors. In fact, the same day the doctor cornered me at the nursing station, I had caught a potentially risky medication prescribing error by a doctor in training. I took my care question to a clinical pharmacist and the attending physician to insure that my patient was given the right treatment. Nurses don’t have the power to make certain types of care decisions, but they do have the power -– and the responsibility — to go up the ladder until they are satisfied that good decisions are being made.


So is the doctor-patient relationship really more sacrosanct than the nurse-patient relationship? I don’t think so. Physicians have the ultimate responsibility for treatment decisions, but because nurses spend so much more time with hospital patients than doctors do, we have a unique view of how the patient is really doing. And at times, patients present very different faces to nurses and to doctors — complaining to a nurse in a way they never would to a doctor.

Thank you, and amen. In a way, this represents the core — and ideal — of intentional, thoughtful nursing practice. And as always, the comments following the post are enlightening and revealing; the condescension, misinformation and hostility contained therein are remarkable.


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  1. #1 by Jenn Jilks on Thursday 14 October 2010 - 1636

    That was good reading. This is why Ontario is doing well by having a Family Health Team. We all are needed to participate. I think some physicians act like movie stars or sports stars. Inflated egos. Not all, of course.

    In your case, in emerg. you are speaking of high intensity, quick decisions…this is why the entire staff is so important. I recall hubby having a nose bleed, over days, and him blacking out. I stepped back as the wonderful nurse stepped forward. Meekly sitting in a chair. I knew he was in good hands as buttons were pushed; bells rang as people rushed to assist.

    This sense of a team approach has become more common in education (my expertise) and yet some are threatened. I would think that those threatened are the ones with the most to lose!
    Pat-on-the-back to all of you!

  2. #2 by mog on Friday 15 October 2010 - 1118

    In the UK’s NHS hospitals have Multi Disciplinary Teams. MDT meetings are held for the different specialities such as oncology, breast care, endocrine and patient care is discussed along with specific cases. The teams comprise nurses, radiographers, physiotherapists, oh and doctors. All members contribute to the discussions. In my opinion and practice a good doctor listens to the information relayed to him by the nurses and technologists if she or he’s too arrogant to listen then they are eliminating an important part of the patient care chain.

    BTW the set up of the NHS is different to North American ones, Doctors are employees of the hospital and out patients are seen in the hospital building not in scattered private offices around the town. The patient’s chart/notes are one integral folder, again not scattered all over the town, Imaging in done in one place. In my opinion it makes for more complete care.

  3. #3 by friv on Tuesday 13 September 2016 - 1415

    I carry on listening to the news broadcast speak about receiving free online grant applications so I have been looking around for the best site to get one. Could you advise me please, everywhere could i get some?

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