PRINTTales from the front lines of care
Columbia nurses provide an insider’s view on working with doctors
December 18, 2008 | 12:00 a.m. CST
When people walk into a hospital or a physician’s waiting room, they voluntarily put themselves at the mercy of the men and women trained to heal them. Except for their families, no one knows doctors better than the professionals who work closest with them — nurses. At their best, doctors and nurses labor seamlessly together. Yet with health and lives at stake, conflicts arise.
Take the experience of Julie Brown, RN and research coordinator at University Hospital. A group of doctors and nurses had been working to save a 4-year-old girl who had been in a car accident. The surgeons
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worked for hours trying to stop the bleeding, but their efforts were proving futile. When one of the surgeons yelled for a particular tool, Brown responded that they didn’t have it, couldn’t get it and that it was time to call off their fruitless efforts. As Brown walked away to fill out the patient’s chart, she felt something hit her
back. She turned around to see the surgeon hurling bloody sponges at her like bits of shrapnel. When the barrage finally ended, the nurse looked the doctor in the eye and said: “You and me. Out in the hallway.
Now!” The doctor quickly apologized, and Brown said she understood why he was so upset but that his actions were unprofessional. “Doctors and surgeons are human,” she says. “And they certainly don’t like
feeling that they failed.”
The recent surge in the demand for nurses and other medical professionals means it’s more important that doctors treat them well. Despite the occasional flare-up, both sides know that cooperation is the only path toward healing. “It’s not so much my-way-or-the-highway type of thinking,” says Cindy Feutz, a clinical nurse specialist in cardiology at University Hospital. “The doctors are much more team-oriented and appreciating of nurses and what they can contribute.” To Janice Templemire, a registered nurse at Ellis Fischel Cancer Center in Columbia, effective teamwork is a result of a combination of factors. “Open communication
is very important,” she explains. Doctors have the final say, but nurses bring different skills to the table. “A nurse sometimes has more time to sit and talk with someone,” Templemire says. That extra time allows them to read situations. “Nurses are there eight, 10 or 12 hours at the bedside,” Feutz says. “They see how patients cope.”
When problems among doctors and nurses arise, issues can often be attributed to one thing: “poor or ineffective communication,” says Anne Heine, an RN and instructor of clinical nursing at the University of Missouri. One Columbia nurse learned this lesson the hard way. When stomach pains landed her in the hospital last year, she expected a short stay. But her situation escalated quickly. Some 16 doctors and surgeons poked and prodded, but they couldn’t figure out what was wrong. No one seemed willing to take responsibility for her case. Days later her appendix ruptured, and she was rushed off to surgery and then to the intensive care unit. “This was just a dreadful example of very, very poor communication between doctors and surgeons,” the nurse explains. She eventually recovered. When she returned to work, she was bombarded with apologies and explanations. But the experience led her to a conclusion: “If I ever get sick again, I would go to a different hospital.”
As with all relationships, there can be disagreements. But with medical care, the first priority is patient safety. Feutz explains that if nurses believe a doctor’s order is unsafe, they can refuse to carry it out. Nurses are held accountable, too, and should perform all procedures safely, she adds. Yet the nurses also realize if they’re
wrong, there can be legal ramifications. Even when there is a disagreement, strained relationships can be avoided by keeping the patient at the center. “I truly can’t think of something that we haven’t been able to work out,” Feutz says. Of course, when a medical team works effectively, everyone wins. Just before Christmas, a little boy lay in a coma at University Hospital. The boy’s parents told the doctor that all their son wanted for Christmas was a red, remote-controlled jeep. But because of their hospital bills, they couldn’t afford one.
After the parents left, the doctor sat next to the patient’s bed telling the comatose boy that if he pulled through, he would buy him that jeep. With the nurses attending through the night, the boy made it until morning, recovered and was discharged a few days before Christmas. True to his word, the doctor showed up at the boy’s house on Christmas Eve with the new jeep in hand.
Whatever their common ground or differences, this is just the kind of happy ending that every doctor and nurse hopes for — that the care they give can indeed make a difference.
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