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Workloads; Doctors vs Nurses.
Date Posted: 31/Aug/2013
 
This is not intended to be a gripe or a swipe at doctors. I love doctors (well most of them).
 
A few of them, I am in complete awe of. So, I don’t really know what this is. All I know is that I was thinking about it during a very, very busy shift.
 
Perhaps, it is simply a reflection on the respective PHYSICAL tasks (or the physical workload) a single nurse vs a single doctor perform on a typical emergency department patient.
 
Note: I will be the first to stand up and shout out that overall doctors work their arses off;
Long hours.
Mental fatigue.
Poor peer support networks.
Intense responsibility.
And when things get ugly, they are up to their uvulas in physicality.
 
This is just a snapshot of one nurse and one doctor caring for one patient in the ED. All tasks that involve direct patient contact have [BEDSIDE] next to them:
 
Doctors vs Nurses. Physical tasks and interventions.
80 year old female, slipped on driveway. Fractured L femur.
 
NURSE:
Introduction to patient.
Transfer patient from ambulance stretcher to bed. [BEDSIDE]
Assist with undressing patient.
Place clothes in hospital bags. [BEDSIDE]
Document and secure valuables in department safe.
Attach patient to monitor.
Enter patient data onto monitor. [BEDSIDE]
Perform physical assessment. [BEDSIDE]
Assist patient to use bedpan. [BEDSIDE]
Attach ID/Alerts bracelet. [BEDSIDE]
Contact patients next of kin.
Document nursing notes.
Patient history and observations.
Insert IV cannula (Paramedics cannula tissued).
Draw bloods. [BEDSIDE]
Commence IV fluids. [BEDSIDE]
Perform 12-lead ECG. [BEDSIDE]
Administer opioid analgesic.
Sign out of drug cupboard.
Draw up medications. [BEDSIDE]
Administer anti-emetic. [BEDSIDE]
Assist with patient transport to X-ray. [BEDSIDE]
Maintain regular documentation of observations.
Insert indwelling urinary catheter. [BEDSIDE]
Set up equipment for fascia iliaca block insertion.
Assist with procedure.
Commence local anaesthetic infusion via pump. [BEDSIDE]
Assist patient to use bedpan (number 2’s). [BEDSIDE]
Reposition patient. [BEDSIDE]
Apply skin traction. [BEDSIDE]
Perform pressure area care. [BEDSIDE]
Perform mouth hygiene. [BEDSIDE]
Move patient to another physical location within the department due to overcrowding. [BEDSIDE]
Complete nursing documentation.
Transfer patient to ward and handover. [BEDSIDE]
 
DOCTOR:
Introduce self to patient [BEDSIDE]
Perform history and physical exam. [BEDSIDE]
Review patients electronic medical notes.
Write notes.
Write drug and fluid and X-ray orders.
Write pathology order forms.
Review X-rays.
Contact orthopaedic registrar to review patient.
Insertion of fascia iliac block. [BEDSIDE]
Complete documentation.
 
 
Some Comments:
. Mims says:
 
Like many professions you get those who do and those who think they are above the “menial tasks”. I have heard a doctor say that he never studied at the university for 7 years to carry a bedpan. Well many nurses study that long as well and we don’t feel it’s beneath us. That aside we have a great bunch of doctors in my area too that will do whatever requires doing. They are the ones I applaud as we have others that have the nurse so scared of them that they yell obscenities at us if we phone them after hours for a phone order for one of their patients in pain. Well THAT IS one of the things they studied for at uni.
 
. Dr mel says:
 
I am lucky to work in an ED with a strong team ethic – I don’t think any jobs are a “nurse’s job” or beneath the dignity of the doctors or such rubbish. If something needs doing, whether it be bloods, a urinal, grabbing a vomit bowl or mopping the floor, it needs doing. If you’ve got time, just do it. I have nothing but respect for ED nurses who work their butts off day after day and keep coming back with a smile!
 
. phillip says:
 
Interesting comparison. I have had a few thoughts on this subject myself, but dare not put it writing.
 
Impactednurse

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