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Reflections of a PA Student

Working With Nurses

Published August 26, 2009 10:18 AM by Timothy Loerke
The hospital can be a hostile environment if you are not aware of whose house it really is. Right now, I am taking a class called Supervised Practice where we spend one day per week in a clinical setting. The other day I performed rounds in the hospital with a PA who was doing GI consults. It felt like a foreign land, being that we were far away from the base clinic. There, we entered the territory of the nursing staff, the true keepers of the realm. These were the people who cared for the patients day in and day out. These were the people who knew the efficient methods that offered the hospital a successful atmosphere. These were the people who accommodate the needs of the visiting physicians and PAs. 

It seems understandable that we were confronted with a "territorial" attitude. We were in their space and they could not do anything about it. So it was apparent to me that gratitude woudl be my best friend when entering the hospital. Nurses begin to warm up when they know you respect their place and are grateful for their help. 

This concept seems rudimentary but often is neglected. The hospital is where we can easily forget who is on our team and what roles they play. When we are in a position of being mostly in charge, we must never forget the people who make patient care possible. 

7 comments

Thank you so much for recognizing that nurses are at the center of patient care. I try and help new staff and students as much as possible. There are nurses who are hard to "crack". I'm sure there are as many reasons as there are nurses. I know for myself and some others where I work every day there is another new person and some days all we want to do is our work and have one day free of teaching or dealing with new people. To you, this floor is your first experience. For the experienced nurse you are one of hundreds they've seen. I'm not saying it's right, but perhaps this might shed a little light for you. Continue to be kind and recognize the nurses for the experts they are and you'll do fine. Many thanks for your comments.

gloria, Peds OR - RN, Cincinnati Childrens September 12, 2009 11:25 AM
Cincinnati OH

Christine, great post!  You are right about not being able to please everyone.  You have to treat them the same and roll with it.  You brought up a great point about past students paving the way for destruction.  We must continue to keep this in mind when we are in the battlefield.  Even though we may not be able to change the setting immediately, we can hopefully begin the process of loosening the soil.  Keep it up!  Many students who sit in the classroom will benefit from your efforts.

Tim Loerke, PA-S August 31, 2009 3:05 PM
Dallas TX

Here's a physician assistant student getting his career off on the right foot. Read the nice things he

August 31, 2009 2:18 PM

I'm glad to hear that another PA student out there has taken the same approach as I have, but I'm wondering if you ever encounter nurses or CNAs who simply will not give you the time of day.

I get thrown into my rotations with little (if any) introduction in how things work or where to find things.  I find myself alone in a strange place with strange faces and a list of patients to see.  

Because I know that I am a guest on the nurses' turf, I make every effort to be as gracious and cordial as possible.  I say please and thank you.  I apologize for interrupting and slowing them down for a moment, and I try to wait for an opportune time.  I do everything I can to stay on their good sides, but I have come across a fair few who give me looks that I'm surprised have not, in fact, killed me then and there.  Others blatantly ignore me, and some take their aggression and frustration out on me.  It is unfortunately the minority who show any kind of patience, not to mention friendliness toward me.

While I'm sure that it is my short white coat which gives me away, I still wonder if the way has been primed by students before me who offended the staff in some way or another, thus making them hate all students forever.  I often feel that I start out as the scum of the earth, and that there is nothing I can do which will redeem me in their eyes.  

I am not demanding that they take orders from me or even respect me.  I understand that they have work to do, and that they really don't want to take the moment to answer my question.  I understand that, and I try everything I can before asking.  I have been nothing but respectful of their needs, yet there is no acknowledgement of mine.

These statements don't apply to ALL nurses I've met, but to a certain subset.  I don't hate nurses.  I hate when my attempts at civility are responded to with hostility.

Christine, Medicine - PA Student August 30, 2009 7:26 PM
Long Island NY

Thanks, Mary!  With my mom being a nurse and my background as support staff for nurses, I will forever be appreciative of the people who make patient care possible.  My recent time in the hospital was the first time I noticed how nurses can be misunderstood.  Thankfully I saw the person behind the attitude.  Thanks for reading the blog!

Tim Loerke, PA-S August 28, 2009 6:47 AM
Dallas TX

Oh my goodness, what a breath of fresh air your comments are.  Thanks for listening to us,  for showing gratitude, for caring what we have to say and think.  Most of all, thanks for the respect.  The hardest thing about being a nurse is caring, trying really hard, and then....no respect.  It doesn't happen very often but when it does the territorial thing rises up.  You described it well.  You're becoming a great PA.

Mary May, nursing - RN, KU Hospital August 27, 2009 12:05 PM
Kansas City MO

oh my goodness.  What a fresh breeze your posting was to tired ears.  Thanks for the encouragement to nurses everywhere.  Thanks for understanding, thanks for being kind, grateful and open to us.  Not too many folks are these days.  We get down too. You are becoming a wonderful PA!  Am enjoying these posts.

Mary May, nursing - RN, KU Hospital August 27, 2009 11:47 AM
Kansas City KS

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