Doctor-Nurse Relationship

The relationship between the doctor and nurse can have a difference in the care of  a patient.  Nurses are generally the ones who see what is going on with a patient. They are at the bedside giving the care, noticing changes and communicating these findings to the doctor.  Hopefully the doctor utilizes the expertise of the nurse to treat their patients.  However, in my many years of nursing I have found some doctors really don't respect nurses at all which puts a strain on the respect a nurse has for the doctor and jeopardizes the care a patient gets.  Nurses are advocates for their patients and when they feel a plan of treatment is not right for the patient, doctors should at least listen to why they feel this way.  Doctors and nurses will not always agree but we must show enough respect to each other and discuss it professionally for the best outcome for the patient.

I work in a teaching hospital and one of the best advice an attending can give a medical student is to listen to and befriend the nurses.  We love doctors who will at least listen whether they agree with us or not.  Then you have the doctors who know it all and think nurses only do anything they can to get out of working.  These are the doctors who will jeopardize patient care because the nurse can't assist someone who knows it all already. 

It is important to note that the doctor-nurse relationship is sacrosanct and building a professional relationship is essential. Patient care should not be a tug-of-war between nurses and doctors, but instead it should be about professionals working together for the good of the patients. The medical team of doctors, nurses and other medical professionals that engage and respect each other will create a positive working environment and perform at an elevated level which can produce quality patient care with exceptional patient outcomes. This is the ultimate goal. 

What do you think? Share your thoughts and concerns. 

It's So Hard to Say Goodbye

Many times families struggle with letting their loved ones go.  It is easy to say what we want to happen to our family member and not examine what he or she would want for themselves. Working in the ICU, I see this on a regular basis.  A patient merely exists because their family selfishly keeps them alive when all odds are against their survival.  They say God will give us a miracle!  I too believe in God and his miracles but he also gave us common sense to know when it is time to let go.  If it is his will for he or she to survive, they will.  I don't know many people who would want to live their life and not be able to enjoy it.  We must look at "quality" of life and not "quantity".  When your family is lying in that bed, put yourself in their shoes.  Ask yourself is this how I would want to live the rest of my life?  Love them enough to let go and enjoy the happy times you had with them.  I would hope my family loved me enough to not let me suffer that way if all hope for a life of quality was  nonexistent.

What would your wishes be?  What would you do? Share your thoughts, comments or experiences.

Has the use of Milk of Amnesia (Propofol) been tarnished?

Ever since Propofol has been introduced to the public by the death of Michael Jackson, people are afraid of having it used on their loved one in the intensive care setting. Propofol has been safely used in this setting for years. What people need to realize is that when used properly in the correct setting it is as safe a drug as Tylenol. Propofol is used to sedate individuals who are receiving mechanical ventilation. In critically ill patients it has been found to be superior to lorazepam (Ativan) both in effectiveness as well as overall cost; as a result, the use of Propofol for this indication is now encouraged whereas the use of Lorazepam for this indication is discouraged. Propofol is also used for sedation, for example, prior to endoscopic procedures, and has been found to have less prolonged sedation and a faster recovery time compared to midazolam (Versed). When used for sedation on mechanical ventilation patients, they wake up faster because the drug's duration of clinical effect is much shorter. This is mainly because Propofol is rapidly distributed into peripheral tissues. Since patients and their families use the internet to try and dictate their care, why not use the resource to educate yourselves on the use of Propofol and how safe it really is!