Why do Doctors Ignore Nurses?

By Maggie Ortiz MSN RN

When a #nurse calls a doctor to come to the bedside…go to the bedside.

This simple directive encapsulates a crucial principle in #healthcare: a nurse’s call for attention can be vital to #patientsafety. This truth was underscored by a recent #medicalmalpractice case review I saw posted by a #physician expert witness post, where a nurse’s advocacy, empowered by education and an understanding of her role, made a significant difference in the patient’s care.??

A Case Study in Advocacy and Education

In the medical malpractice case, a nurse exemplified outstanding use of the chain of command—a crucial element of the Nurse Practice Act (#NPA) that is frequently misunderstood or overlooked by many #physicians and #healthcareorganizations. The patient’s condition had been assessed by a senior physician, who determined that no immediate intervention was necessary. However, hours later, the nurse, sensing a potential issue, took a courageous step by using the chain of command and calling another physician, fully adhering to her professional nursing #duty.

This action was not merely procedural; it represented a powerful display of integrity and bravery in a system that often fails to support such proactive advocacy, despite its necessity and legality. The nurse’s decisive intervention identified an error in the initial assessment, leading to prompt and appropriate treatment and ultimately resulting in a positive outcome for the #patient. This case underscores the essential role of education in empowering nurses to act with both confidence and professionalism, ensuring that patient care is always prioritized.

Texas Nurse Practice Act Position Statement:

“15.14 Duty of a Nurse in Any Practice Setting

Establishes that a nurse has a responsibility and duty to a patient to provide and coordinate the delivery of safe, effective nursing care, through the NPA and Board Rules. This duty supersedes any facility policy or physician order.” (1983)

The Power of Education in Empowering Healthcare Professionals

Education is at the heart of empowerment. It equips nurses, physicians, and healthcare organizations with the knowledge and tools needed to navigate complex situations and advocate effectively for the highest level of care in a fast past environment for patient safety. My work—through speaking engagements, detailed courses, and countless educational resources—aims to bridge the gap between clinical practice and the broader systems impacting healthcare professionals.

#Helathcare #Education extends far beyond just the clinical skills. It includes understanding legal responsibilities, institutional protocols, and professional boundaries - something not taught and or focused enough in school and how it dictates one's practice. By providing this education and scripted language on how to use it in a professional respectful manner, I help nurses, doctors, leaders, and other healthcare professionals to excel in their roles and advocate effectively not only for their patients but themselves, thereby enhancing the overall quality of care and protecting their professional license - their livelihood.?

Kathleen Bartholomew, RN, one of my #nursingmentors, underscores the significant impact that hierarchical structures have on communication within healthcare settings. In her enlightening TED Talk, “Ending the Silent Treatment”, Kathleen examines how these hierarchies often impede effective communication, leading to detrimental consequences for patient safety.

Communication gaps are not abstract issues; they have concrete, life-threatening implications. Prior to the COVID-19 pandemic, healthcare-related injury and or death basically in my opinion, failures in communication, were the third leading cause of death in the U.S., escalating to sentinel events and subsequent litigation. Despite the introduction of measures like Core Measures and National Patient Safety Goals (NPSGs), the root causes of healthcare failures remain insufficiently addressed and underreported. The World Health Organization (WHO) and Congress have frequently addressed these concerns, but comprehensive educational solutions are still lacking - WHY?!

Drawing from my experience working alongside my beloved active-duty #militarypersonnel at Level I trauma centers in #SanAntonio, #Texas, I observed a starkly different dynamic. In these military settings, a culture of mutual respect and professionalism fostered open communication and accountability, significantly enhancing patient outcomes. Everyone, regardless of rank, worked up to their highest potential and scope, contributing to an environment where every team member was valued and communication flowed seamlessly.

In contrast, civilian healthcare settings often struggle with hierarchical barriers and toxic environments that stifle important communication. Many leaders in these settings lack a thorough understanding of regulatory implications and the professional scopes of practice, complicating efforts to improve communication and patient care. This gap in understanding can result in poor patient outcomes and endanger both lives and professional licenses.

My role is to address these communication gaps through targeted education and advocacy. By providing organizational training and group sessions, I bridge these divides, equipping healthcare professionals with the tools they need to navigate complex situations and providing tools and resources to support communication challenges effectively. My background as a former investigator, civil expert, and administrative consultant has highlighted the severe consequences of communication failures and the necessity for robust solutions.

The goal is to foster a culture of respect and collaboration, where every professional operates within their scope of practice and communicates openly. Addressing these gaps is crucial for improving patient safety and ensuring that communication and professional standards are upheld. Through my work, I am dedicated to empowering healthcare professionals and all #healthcareorganizations to enhance communication, improve patient care, and protect both lives and professional licenses.

The Broader Impact of Empowered Nursing

We often hear that we retain only about 10% of what we hear on the first pass, and need to hear information up to seven times before it truly sinks in. This statistic becomes particularly concerning when we consider the minimal education provided on the intricacies of regulatory frameworks the legal implications of holding a professional license and the long-term ramifications to one's life. For many healthcare professionals, the reality of practicing under multiple types of laws—administrative, civil, and criminal—becomes shockingly clear only when faced with litigation or a Board of investigations.

When we lack a thorough understanding of these rules and regulations and how evidence can be used against us, it’s not just a personal issue; it impacts the entire healthcare organization. #Physicians and other healthcare staff often fail to grasp the full extent of a nurse’s regulatory responsibilities compared to other roles like #radiologictechnologists or #medicalassistants.? Medical Assistants are not nurses and the use of the word nurse is protected and a violation for any provider to use it if that person does not meet the criteria.? Yet, most physicians and or healthcare organizations do not realize this legal implication.? The physician to their respective board as well as the Medical Assistant and or any staff who does not correct this misrepresentation of another healthcare provider which is mandated by law. This lack of awareness can lead to significant misunderstandings and complications that come to light only when it's too late, even for healthcare organizations.? This invites entities like boards and regulatory agencies like CMS into one's practice.??

This is why my focus on education is critical. From #medicalschools to #nursingschools, #studentnurseassociations, #nursingassociations, healthcare organizations, and quite frankly anyone who is interested in protecting their professional license.??

My mission is to fill this knowledge gap. Understanding rules regulations and scope ultimately improves things like communication that can prevent the costly mistakes and legal issues that arise from being uneducated and informed. Ultimately, this cultural shift towards empowering not only #nurses but #physicans #healthcareancillarystaff #healthcareorganizations and ensuring comprehensive education is essential for enhancing patient care, reducing costly errors, and supporting a more resilient healthcare system.

Conclusion

It’s not doctors alone, some of it we have to own as well as nurses but did you know that the lack of confidence, the right language, and being afraid of the physician can prevent a nurse from calling a doctor?? Often, nurses don't have the necessary tools and or what they feel is support and language and have no idea about or understanding of the long-term implications of their inactions. This gap can lead to patient harm and costly oversights and, when examined under the scrutiny of civil litigation, may expose systemic issues and potential gross negligence within a healthcare organization.

Why do doctors sometimes ignore nurses? It’s often due to culture, a lack of understanding and respect for the regulatory and professional responsibilities that nurses uphold as well as thinking that we somehow practice under their professional license like other disciplines. Physicians and organizations frequently overlook the critical role of nurses in the healthcare system, which can lead to serious and preventable errors.

This is why I’ve dedicated myself to bridging these gaps through comprehensive education and advocacy. I’ve built a business around creating impactful courses, engaging in speaking events, Nurse Approved, and contributing to platforms like Nurse.org’s (https://nurse.org/news/hlth-nurse/) Top 30 Nurse Innovators. My work includes consulting with academia, and healthcare organizations and developing continuing education courses.? I’ve created eBooks, and resources that integrate Core Measures to address things like documentation challenges, and it is still growing; especially with the integration of technology and science superseding rules and regulations by a decade - but that’s another article.?

Education is not just about acquiring knowledge—it’s about using that knowledge to drive meaningful change. If you’re in a healthcare space and want to ensure your practice is well-protected, I’m here to help. Let’s work together to enhance patient safety, strengthen our professional practice, and address the critical issues that arise when doctors overlook the crucial contributions of nurses. Reach out to see how I can support your healthcare organizations and or your professional practice in whatever capacity you work.? I am dedicated to navigating these complex systems and making a lasting impact in healthcare not only safeguarding the patient but the providers.

• Advocate Maggie MSN RN, The Nurse’s Advocate -

CEO Advocates for Nurses PLLC

References

1. Bartholomew, K. (2018). The hierarchy of healthcare: A TED talk on improving communication and collaboration. Retrieved from https://youtu.be/Qh4HW3yx00w?si=yUh-QD_aMMOayeP3
2. Cohen, J. J., & Cesta, T. G. (2020). The importance of understanding regulatory frameworks in nursing practice. Journal of Nursing Regulation, 11(3), 39-46. https://doi.org/10.1016/S2155-8256(20)30070-1
3. Harris, K. A., & Davis, M. K. (2021). The impact of communication failures on patient safety and legal consequences in healthcare settings. Journal of Healthcare Risk Management, 40(1), 15-22. https://doi.org/10.1002/jhrm.21361
4. The NCSBN 2023 Environmental Scan: Nursing at a Crossroads—An Opportunity for Action National Council of State Boards of Nursing, Journal of Nursing Regulation, Volume 13, Issue 4, S1 - S48
5. Texas Board of Nursing. (1983). Position Statement: Duty of a Nurse in Any Practice Setting. Retrieved from Texas Board of Nursing
6. This article was generated with the assistance of artificial intelligence (AI) tools. All content was reviewed and edited for accuracy and compliance with professional standards.