Team-based care is a strong emphasis in the PA profession. We know how to work in collaboration with other professionals. But, sometimes, in the rush of a busy shift, we can forget our manners. No one knows this better than the nursing staff. They take verbal beatings and receive the wrath of stressed-out clinicians. Nurses are some of our best allies, and their profession can be belittled by the mighty practitioner. As a PA, the last thing I want to do is make enemies with the people who will help care for the complicated patients I manage in the ER.
We need to get a couple of things straight. There are some old stereotypes that are lingering in the medical field. The idea that nurses are just beautiful women walking around with their perfectly coiffed hair and pressed uniforms has got to go. The men and women who dedicate their lives to patient care don’t walk around batting their eyelashes, saying things like, “Yes, doctor, right away!”
It is true that, in my ER, there are some seriously good looking people running around! But that is where the stereotype falls apart. Nurses are intelligent people who make a large impact on patient care. The idea of nurses just following orders is archaic and kind of insulting.
Recently, I polled a group of nurses to see what they felt were the biggest issues when it came to working with PAs. OK, I actually talked to a bunch of my nursing friends on Facebook, but I think the outcomes would be the same. There were very familiar themes that seemed to come up over and over. Here is what I learned from this wonderfully open dialogue.
- Let’s acknowledge the fact that nurses are educated professionals. They have been around the proverbial block and know a thing or two about healthcare. When you are going in to evaluate a patient, a nurse’s perspective about the clinical situation is invaluable. Is this patient on the edge of a major catastrophe or are they malingering? Are there underlying psychosocial issues? A nurse’s clinical gestalt may save you from making a major mistake or going on a wild goose chase. Get their input!
- Communication is the cornerstone of good patient care. And it’s the small things that count. When nurses get orders via computer that are completely ridiculous, they get irritated. An example that was given was a common order I’ve used myself: “Feed patient.” This would take five seconds to actually communicate in person. Some nurses view this as demeaning—like we’re too important to take the time to talk about patient care. I know that when things get hectic these electronic orders are necessary. But don’t make a habit of it.
- When a nurse questions a plan of care or treatment for a patient, don’t view this as a personal attack. Sometimes, we get defensive, when in fact, the nurse is looking to better understand why we chose certain tests or therapies. They want to be in on the plan so that we can be a united team. It can be awkward if a patient has a question, and the nurse is completely in the dark. Nurses also are looking to further their clinical knowledge, and asking questions is a way of showing interest. Don’t blow them off!
- Don’t talk down to nurses … or anyone for that matter! Saying things like, “I went to way too much school to deal with that” is hurtful and really puts down the important roles that other people have in healthcare.
- Clean up after yourselves. Leaving your gloves and tongue depressors strewn on the floor is gross. Nurses were not hired to be your mommy/daddy and clean up your messes.
I know there are more ways to improve communication and relationships between healthcare professionals, but I think these are a good start. Nurses are part of the backbone of our healthcare system, and we need to treat them with respect. They are so much more than a pretty/handsome face.
Rachael Jarman, PA-C, is a supervisor for advanced practice providers within an urgent care clinic group in Minnesota. Recently, Rachael started a business as an admissions coach for pre-pa students, called PA Trek. And she (and her husband) are raising three “wild little girls,” with their free time spent zipping around in a vintage camper.
PAs Connect home page photo credit: Navy trauma nurse, 1960s. US Navy, Bureau of Medicine and Surgery