Thomas C Liske MD FCCP
As occurs in all walks of life, people who work together develop relationships. Some are positive, some are negative. Some organizations or departments become like family. In the hospital it becomes a mixed bag. Nurses tend to pick and choose their favorite doctors as well as their least favorites. Doctors frequently choose nurses whom they believe they can trust. Sometimes this belief may be based on personality rather than competence. These relationships may lead to increased risk for the patients.
Phone calls during the night can become a nightmare. I know of a surgeon who routinely berated the nurses whenever they called him during the night usually using foul language. Some of the less confidant nurses became afraid to call him. Thus only the most critical changes warranted that call. The problem was that early changes in the patient’s condition would go unreported putting the patient at greater risk. One very professional nurse addressed this problem very effectively and passed it on to her colleagues. “Doctor, you seem to be very upset. I am going to hang up now to allow you to wake up and get yourself together. I will call you back in two minutes so we can discuss your patient’s condition.” She then hung up and called him back usually getting a better response.
Then there is the problem with the nurses liking a doctor too much. It is common in the intensive care unit for the nurses to select physicians whom they both respect and like personally. There was a gentleman in ICU for noncardiac reasons. At 1:30 AM he complained of feeling some chest pain. The nurse reassured him and went about her business. This was one of the better nurses in that unit. However, the physician on the case was a “gold standard” doc. When he arrived to make rounds, the patient told him he had been having chest pain all night. On further testing it was determined he was having an acute heart attack. The nurse reported that she didn’t want to disturb the doctor apparently putting his welfare ahead of the patient’s.
Again, when people work together they develop friendships which can lead to conversations, banter, and occasional quarreling on the job. This is a common challenge in the specialty care areas. Families have complained about loud conversation, laughing, arguments occurring in the nurse’s station in the ICU. Nurses, therapists and aides frequently forget that although to them this is another work day, to patients and families this is a major life crisis demanding respect and compassion. Fortunately, this issue has been addressed in most units today.
Another situation occurred when a nurse called the physician in the early morning hours. Shortly after he answered she heard snoring on his end. Despite her shouting into the phone she was unable to arouse him. Since it was in regard to a significant patient issue, the nurse called the police to go to his home and awaken him. Much chagrined, he promptly called her back.
Yes, health care professionals are human too!