R-E-S-P-E-C-T

This gem of a shot is by photographer Ewing Galloway.

This is exactly how I felt at work tonight. I had exactly four patients. Four. One was a 1:1 for 3.5 hours. Every one of them had the "short of breath = rectal sphincter discharge" syndrome. I haven't changed that many diapers since my 15-year-old was born. Someone snuck a puppy into the ER and he sniffed me once and growled.
I swear the olfactory ambiance of my room had permeated my clothing. I suspected my co-workers were avoiding the geographical area of my assignment, but it's pretty bad when a dog withdraws from you.

I'm pretty even-tempered but I daresay I was a bit snappy tonight (at the desk, never in front of my patients). So it is ironic that this photo describes me because when I first saw it I immediately thought of a cranky doctor! Actually, I thought of many cranky doctors. Then I realized that I had witnessed a trend over the years; a decrease in the number and intensity of cranky doctors. Why?

Here are a few factors that have contributed:

• Doctors and nurses have a more collegial relationship now. "ME-DOCTOR-you-nurse" is no longer the predominant attitude of either profession. This is likely due to:

• More women in medicine and more men in nursing. The old male/female paradigm has changed.

• The increased responsibilities nurses have in patient care. (Nursing: it's not just pill-passing anymore, folks!)

• The need to do more with less; doctors have to increasingly depend on nurses to be their eyes and ears at the bedside.

• The youth of the medical workforce. They've never known nurses any other way (see above). And it is just me, or are the doctors getting younger every day? When you are old enough to be the mother of a doctor you work with....well, it's very strange!
  

• The aging of the nursing workforce. A nurse who has been in the trenches for 30 years is not likely to put up with an attitude from anybody, including doctors (of any age).

• A mutual understanding that we are all working under the same health care system and that the frustrations that arise are due to the system, not each other.

On a personal level, I have developed an increasing amazement for what doctors have to accomplish to get to where they are. And you know what's funny? Space is at a premium in my department so I'll give a doctor who needs to chart my seat at the nursing station. Not because I have to, but out of civility and respect.

Cherry Ames would be proud.