Rochester Medicine

Trading Places

Feb. 26, 2015

mentorsLast fall, leaders in the Department of Neurology began asking residents to shadow a nurse for a day.  Soon after, nurses in Strong Memorial Hospital’s neurological unit started spending a full day with a resident.  Natalie DiCesare, R.N. and third-year resident Peter Creigh, M.D., talked with each other about their experience.

Natalie DiCesare:  I wanted to know what you actually do.  I see doctors on the computers, but I’m not standing behind them looking at the screen.  I’m not on the phone with them, listening to what they are dealing with.   I’m usually off doing my work, you’re off doing yours.  I really had no idea what your day is like.

Peter Creigh:  And I didn’t realize how little I knew about your job, until I spent a day doing it.   I’m not usually there when you’re caring for patients and families, so I didn’t know how much time that takes.

ND:  We tried to give you the most difficult assignments.

PC:  You did?!

ND: Secretly, yes.  We wanted you to understand how busy we can get.  We’re not just filling the orders you put in.  We can spend a half hour taking a patient to the bathroom or calming a family member, while you’re wondering why we haven’t given another patient his medication yet.

PC: Yeah, that was a big eye-opener.  It would be great if everything was done immediately with the push of a button, but physicians need to recognize it doesn’t work that way.  Some patients, either because they were very sick or had a lot going on, really demanded your time and you couldn’t abandon them.   And when I ordered meds before, I never thought about what that means or how it works.  Those medications don’t just magically appear.  You have to go through a process and it takes time.

ND:  The same goes for you.  When you don’t respond to a page asking you do to something small, I used to wonder why and get annoyed.  It never occurred to me you were responding to a stroke or attending morning report.  And you have such a long day, getting up at four in the morning!

PC:  Not that early, but pretty early.

ND:  You look at your patients’ records before you leave home, get here at six and visit all of your patients, and then the head of Neurology quizzes you.  I was nervous for you, sitting at that conference table while he’s asking all these questions.  And it keeps going – you don’t even get to sit down and have a lunch like we do.  You’re listening to a lecture while you eat.  It amazed me how much you do on top of your patient load.

PC:  Hey, you guys do a lot of more, too.

ND:  Yeah, but we don’t have to go to school fulltime on top of taking care of patients.

PC:  We wouldn’t have the time or capability to oversee so many patients if we didn’t have good nurses who deal with the moment-by-moment issues.  You take care of some really important things, without even contacting us.  And you do really good exams.  I definitely have a level of respect and trust that was not there before.

ND:  I told a lot of my colleagues, you know, sometimes we get frustrated with the doctors, but these guys are brilliant.  I have a lot more respect for you.  I’m trying to get all of my requests in while you’re on the floor so I’m not paging you for one little thing after another.  I’m prioritizing what I need.

PC:  Me too.  I try to plan the night before, so I’m not ordering lab work after you’ve already drawn all of your labs at six in the morning.

ND:  That is the most chaotic time, with everybody waking up, going to the bathroom, showering, family members coming in.  It’s hard to draw more labs too.

PC:  It’s nice to understand your schedule, so I can see where it doesn’t mesh with mine.   I’m approaching things differently than I did before.  If I need a nurse to do something, I might gently say something -- but I’m certainly not going to pester you or ask you to leave a bedside if you are clearly dealing with a situation.

ND:  And now, whenever a doctor comes on the floor, I try to give up my seat.

PC:  Really?  Thanks.

ND:  My legs were so tired that day.  All you do is walk and stand.  You should sit down when you can.