By Tye Murray, RN, Nurse Liaison
Nineteen years ago, I remember my first shift as a nurse. 531* was the code I anxiously keyed into the pad that opened the door to the ED. Nervous and scared don’t begin to describe my feelings as I entered that ED, where my role suddenly changed from ER tech only 12 hours ago, to RN. I entered the room of my first patient. She reminded me so much of my grandmother, “Tee-Taw”. She said, “Are you the doctor?” I’m sure my eyes were gigantic, I know my palms were sweaty. I quickly replied, “No, ma’am, I am just the nurse!” It almost gave me the pass to leave the room and get the doctor. I could walk out, take a deep breath and start all over. But I didn’t. You see, she was a former nurse, and her words of wisdom will stay with me forever: “Honey, do not let yourself ever become just a nurse!”
I will never forget that sweet lady who armored me with all the reasons I was not “just a nurse”. She prepared me for what her expectations of the nursing profession were and how it should be a calling, not a career. Her definition of nursing was nothing I received in nursing 101, but it was one that I quickly implemented into my practice.
My career flourished in that small rural hospital. I attribute my continued success and passion for nursing to all the mentors who believed in me, invested in me, taught me and allowed me to grow. Among many skills I quickly picked up was showing respect to and collaborating with our physician counterparts. Respect to physicians was very prominent at this hospital, and for me, it always will be.
When the physician entered the room, we always offered our seat. As they worked countless hours on end, from clinic to ED, we offered to pick up their lunch or dinner from the cafeteria. We had patients ready to be examined. Lacerations, no problem. Suture trays were on the mayo. Preference of lidocaine, suture size and glove size were all ready. Kick bucket, stool and goose neck lamp – no issue, gotcha covered. Having the blue pad positioned perfectly was never a request; that was automatic. Guess what – we were actually in the room to hang your coat on the hook for you, and offer any assistance during the procedure. When we called you for a problem, we presented you with a complete set of vitals and most recent lab work. Finally, regardless of your age or gender, you were addressed as doctor.
Fast forward 10 years. This level of respect to most physicians is history. At best, we send them to room 3 for suturing, offering remote assistance as we point to the supply cart where they can gather their own supplies. Pushing the sleeves of a sweatshirt up to start an IV is standard practice, but ordering a urine specimen is thought to be a suggestion. We interrupt the physician’s train of thought for a report that can wait when we are acutely aware they are focusing on the care of a critical patient. All so we can chart, “MD notified.” Really? At this juncture, you are definitely defining yourself as “just a nurse”. Physicians do not expect to have the red carpet rolled out, but they have earned a professional level of respect and we need to deliver.
Indeed, many doctors feel that nursing has declared war on them—and both physicians and patients are the losers. Almost every physician in healthcare has a story to tell about being the recipient of disrespectful nursing behavior. These behaviors are clearly learned, tolerated and reinforced in both healthcare and culture. To follow, we have a huge surge of new nurse graduates entering the profession who feel that they have no choice but to join the practice. This disrespectful behavior has become a survival strategy – you have to be aggressive enough to discourage anyone from coming after you. Our system is broken. This type of professional interaction with physicians and advanced practice providers is not congruent with my professional values. As many seasoned nurses know, this is not how we were taught. Why are we allowing this to be a part of our practice style?
It’s not surprising that many doctors want out. Medical students opt for high-paying specialties so they can retire as quickly as possible. Physician MBA programs—that promise doctors a way into management—are flourishing. In fact, physicians are so bummed out that 9 out of 10 doctors would discourage anyone from entering the profession. Daily, these physicians are being fired as a result of a nurse-driven reprimand, with little to no substance. As nurses, we have to understand what it’s like to be a physician. At the beginning and end of the day, they are the captain of our ship. The lives of our closest family members will be in their hands at any given moment. They have devoted, at minimum, 12 years of their life to their calling, and they deserve to be respected. Understand the difference between respect and reverence. It’s not reverence physicians are looking for.
Four years ago, the ED medical director where I was working saw my true north and completely invested in me. During our journey (that’s a whole separate blog post!), I have seen the struggles first hand of what physicians today are challenged with. I urge my nurse colleagues to find your true north. So what is your true north? It’s fundamentally a question of who you are as a professional and a human being. Once you discover it, you’ll find that are you not just a nurse. As a nursing professional, you make a difference each and every day. It feels wonderful to have a physician thank you for your hard work at the end of the shift!
When I leave my nursing career, my hope is that I have left a legacy that others will want to follow and remember. A legacy noted by true respect to and from physicians and nursing colleagues alike, with marked love for my patients. Be that person that you would want taking care of “Tee-Taw”. Enter the circle of care–don’t position yourself in the outfield. Show your colleagues that you are not “just a nurse”.