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A Funny Thing Happened on the Way to the Nurses' Station
The hospital environment includes many different people with many different titles. As medical students, most of our interactions are with doctors and nurses. The relationship between doctors and medical students is well defined. We are in training for the job that they perform every day. Also, the doctors and residents evaluate us and dictate a final grade.
The relationship between nurses and medical students is less easy to define. Although we are both in the medical field, we’re not entirely in the same line of work. Of course, all people should be treated with respect and in a professional manner, but what exactly is the working relationship between medical students and nurses?
So far during third year, I have met many nurses. Some of them have been extremely helpful and nice to me, going out of their way to show me the inner workings of the hospital. Others have been less polite.
Once, as I was standing in the hall looking at the Labor and Delivery board to determine which patient I needed to see next, a nurse I had never met walked up to me, held out a stack of papers, and said in a demanding voice, “Take this to 8A.” Reflexively, I reached out my hands for the papers, and the nurse turned around and walked off. No “please,” no “thank you,” no “Hi, I’m so-and-so, would you mind….”
On another occasion, I was sitting at a work station with my intern, and I overheard two nurses discussing a patient who was getting an IVC filter. “What does IVC stand for?” one of them said. She walked around the nurses’ station to my intern, who was on the phone. She tapped the intern on the shoulder and repeated the question, “What does IVC stand for?” The intern, on the phone with our attending, didn’t respond. Since I was less than two feet away from this interaction, I felt it was ok for me to answer the question. “It stands for Inferior Vena Cava,” I said, loud enough to hear. The nurse looked at me, rolled her eyes, and went back to the nurses’ station. When the intern hung up the phone, again the question was posed, “What does IVC stand for?” The intern answered, “Inferior Vena Cava.” “Oh,” came the response from the nurse.
I am 99.9% sure that these examples are exceptions, and that it was the personalities of these two particular people that caused them to act in this manner. But, I can’t help wondering if I’m missing something -- some unspoken dynamic that exists between nurses and medical students. I haven’t had similar experiences with the residents that I’ve worked with. Am I giving off an “I have a negative attitude” vibe? Do I exude the “I’m somewhat clueless” signal so strongly that everyone senses it, and treats me accordingly? Any nurses in the readership have an opinion on this matter?
October 1, 2007 in Anna Burkhead | Permalink
Comments
How so very sad that a nurse feels she has to prove herself to you! Unfortunately it's not just you that they pick on, those types pick on everyone even some of their own. Don't take it to heart, they just need an attitude adjustment. I kind of like having the med students around personally, they are usually very friendly and are pretty much willing to do anything to help! So ignore the bad seeds, we're not all like that!
Posted by: colby | Oct 1, 2007 1:24:40 PM
My experience is that you're never much in an experience nurse's eyes until you have gone through a gauntlet. They have a lot on their minds and plate, and don't have much time for possibly dubious information.
My suggestion is to try the methylene blue in the coffee trick.
Posted by: Jared | Oct 1, 2007 5:06:20 PM
yeah, there's definitely a medical hierarchy going on. I think the nurse preferred to ask the intern because he/she knew that this intern was fully a doctor. As nurses, they have to be absolutely sure of their procedures and medications. I am not saying this nurse wrote you off as incompotent, but nurses may not know how far you are in your medical clincals. Therefore, I believe they may ask the 'full' doctors. It's CYA more than anything else, honestly, but it is sad that healthcare can get so stressful that compassion for one's co-workers is the first casuality. Just try to let these bad experiences go, talk to your friends, and remember the nurses, techs, etc. who truly helped further your training.
Posted by: katie | Oct 2, 2007 6:38:04 PM
I am a medical student and my sister-in-law is a nurse (an excellent one with years of experience). We have always had a wonderful relationship, but when it comes to medical discussions, I feel like she is almost condescendingly angry with me as a representative of all medical students. "Do they call you a 'Short Coat'?" she asked, apparently revealing to me that it is an obvious slam. "Students don't know anything. We try to ignore them, but if we think a student is particularly inept, we'll block them from doing a procedure or whatever until we can get an attending to reassign it." As she is talking, her defensive posture is becoming more apparent. Where does this aggression come from? It came as a huge shock to me, especially from my sister. My theory is that this behavior relates to gravitational action on feces (rolling downhill). True, medical students have limited clinical experience and may appear lost at times when first learning how to apply knowledge. But you'd think that in health care where areas of expertise are so diverse, there can be mutual respect for the strengths and weaknesses of the players -- keeping in mind that today's medical student is tomorrow's attending (OK, several years away).
Posted by: Elizabeth | Oct 2, 2007 7:27:01 PM
I know what u mean Ann,I don't know where this old enmity between nurses and doctors/medical student came from?And I don't see why they feel satisfied when they make a med student fee stupid.
Maybe that's because their job is too hard and they're never payed enough.Of course not all the nurses are like that,some of them help a lot when you ask them for help,but generally the relationships between nurses and doctors should have been a lot better.
Posted by: Innocence_e1 | Oct 3, 2007 5:07:23 AM
Hi Anna,
I did my nursing training in a big teaching hospital in Australia. The 'anti-med.student' attitude seemed to be part of nursing culture. From the first day, I sensed the resentment towards medical students. I was led to believe that all medical students were arrogant and useless and, most importantly, condescending towards nurses, even though I rarely saw this for myself. A collective groan emminated from the nursing station when the new herd of frightened med. students arrived, trailing after their consultant, to destroy our routine, wake up our patients and undo all our dressings. If a student dared to ask a question of a nurse or, God forbid!!, come to the ward in their own time, they were often given a very cold response. Basically, they were a huge nuisance!
Now, I'm a 2nd-year medical student and I am often in that same hospital for clinical sessions. And now, I'm the nuisance! When I was accepted into medical school, I vowed I would always be polite and respectful to the nurses and I would value their vast experience and knowledge, thinking that the resentment must stem from previous encounters with pushy, arrogant students. Disappointingly, the attitude started the moment I said "medical "student. It had nothing to do with me personally. I even naively thought my past experience a nurse would help but, if anything, it made matters worse. I had gone over to the "other side". One nurse even snidely said, "So nursing wasn't good enough for you?", implying that I regarded being a nurse as a "lesser" version of being a doctor. The 2 professions are very different and both are vitally important to the health care team. I am very proudly a nurse and hopefully, one day, will proudly be a doctor.
Unfortunately, this whole process pertetuates itself. Resentment breeds resentment, and it is all so unnecessary.
It's disappointing to be treated rudely, especially by someone you have never even met and who simply has a preconceived idea of your "type". However, as you have probably found, most nurses are excellent teachers and, though run off their feet and seriously underpaid, are usually prepared to rescue a floundering med. student. There will always be the occasional nurse with attitude (usually when you least need it, like at the end of a really bad day!), just as there will always be some arrogant medical students. But hopefully things are changing and maybe, one day, there won't be so much of an "us-and-them" attitude.
Posted by: Maddy | Oct 3, 2007 2:06:13 PM
i'm now an intern but two years ago, on my third year as a medical student, i will never forget some of the nurses who have been particularly bad not only to me but to my former classmates... but the thing is, there have been more nurses who have been nice... especially when you were still at lost in the hospital setting... the thing is, as said by maddy, some of them think of med students as nuisance, since as students we still have much to learn and lacking the skills that we need... (i mean, we wouldn't be exposed there if we know everything we have to learn, right?)they think that having us, the students, around are like additional burden to them... there was one time when i was hurrying up to finish my progress report on like gazillions of patients before the rounds and this nurse wouldn't let me use the charts because she was also hurrying to do her nurses notes... and she was also being a b*tch about it... .. i had to suck it up and go on... and cried about it the whole night... i just charged it to experience... i know that i wouldn't be better than her if i will also act in a manner that will make me bad person...
Posted by: ninette_umpa | Oct 3, 2007 10:30:34 PM
Being treated rudely and being made to feel stupid is wrong in any field, it does however seem prevalent in the medical field. Med Students, Residents and even Docs can all treat each other badly, its a viscous circle and nurses are not immune or innocent of it. We are overworked and underpaid and, yes, our feet kill after working a 12-hour shift, but before you start forming a bad opinion of all nurses, think of things from our point of view:
If we are having a bad day, it could be because we feel that a Dr. is not giving our patients a fair shake. We are at the pts bedside 24/7 and we know exactly what our patients need/don't need, ask us, our opinion counts too!
Yes, we hate having to call you at 2 in the morning for orders, but don't be snippy with us, we can't help that a pts status changed after your bedtime.
Don't ignore us, we will keep paging you, We page 911 for a reason, if we page you, we actually need you!
Listen to us and trust our judgment, we are all looking out for the pts best interest.
Learn to write legibly, we are not code breakers, we need to be able to read what you write.
Don't yell at us, or be rude to us. We all want to be treated with respect.
You were not born a Dr. or a nurse. It took years of schooling and practice. Remember we all had to start somewhere!
Posted by: colby | Oct 4, 2007 11:43:23 AM
I want to thank "Maddy" and "Colby" for their comments,It's great that those things were said here,I wish all nurses and med student who work together could have such a conversation.
Next time I walk into the nurse station to look for something , I will have a better feeling,because now I understand them a bit more.
Posted by: Innocence_e1 | Oct 6, 2007 10:39:37 AM
You know, in general, people who don't have a clue about something usually shouldn't be picky about who volunteers to help them with information--I'm just sayin'...
Sh*t rolls downhill, and there's usually no one (other than housekeeping and nurse's aides) underneath a nurse to unload onto. The problem with this is that such unprofessional conduct fosters and perpetuates the problem; nurses who are collegial with students (and pull rank when they need to, no problem there), get things off to a good start when the tables are turned and 1-2 years later that student is the doctor giving orders.
And to the nurses (I assume) that replied above: yes, you are the ones at the bedside, and yes, you know what the patient _preferences_ are, but make no mistake--we are the ones that give the orders and are *responsible* for them. Nurses are responsible for carrying them out, but it's a vast difference between following a given recipe and making one. Physicians should always listen and take nurse's opinions into account, but there's a CRAPLOAD more going on upstairs than you could imagine, so pardon me if I don't lay out the tx plan in a way that makes you comfortable 100% of the time.
Posted by: Peon | Oct 9, 2007 2:12:43 PM
anna- dont discount the fact that you're a woman and many of the nurses you will deal with are often women...i was a professional in a different field before medical school and felt the same tension with secretaries and administrative assistants that my male counterparts didnt experience as much. As a medical student I just tried to use the golden rule, and as for the people who didnt treat me the way i would like to be treated, I assumed they had some reason that had nothing to do with me. Maybe a snotty med student or a thousand in years' past, maybe not. You'll never know. As a 3rd yr and again as an intern, try to not personalize if you can- you will feel better! The us vs them needs to stop, we're all here for the patients and most nurses and healthcare workers get that. The ones that want to make you feel bad or ignore you, well, you can only change your actions & reactions, not theirs.
Posted by: dr mom | Oct 9, 2007 2:13:20 PM
Nurses being mean to med students?
Welcome to med school. You're paying $200 a day to get yelled at and they get paid $40 an hour to do it.
Just wait until residency.
Posted by: Anony-mouse | Oct 9, 2007 2:20:14 PM
It's funny that we have all experienced something similar to this. There is a heirarchy in medicine, whether we want to admit it or not. We each have roles that we are allowed and not allowed to do. As physicians, we have several roles that often dictate what others must do. I have found that some of my most challenging interactions with nurses have been those that are older than me (by several years) and lived in the era in which nurses stood when a physician entered the room. I think these nurses have problems with younger physicians, especially women, for reasons only a sociologist/psychiatrist/psychologist can truly understand!
Posted by: EMD | Oct 9, 2007 2:57:53 PM
Hmmm...
I have several thoughts regarding RNs and Med Students, although I have to admit I have to admit I don't work with MD students... My facility limits the MD training contact to interns and residents. Regardless, I believe my thoughts regarding respect among the professions are paramount. While my experience and education as an ICU nurse have profoundly different foci than those for an MD in training, there are a number of area in which we need to respect each others' education or experience, let alone collaborate in the patient's treatment plan.
It's my personal opinion that it's inappropriate to reject a health professional's opinion/finding based only on experience, or lack thereof, etc, ... LIkewise, it's similarly innappropriate to reject an assessment or findng based upon only somenone's title.
The overriding factors are patient safety and patient care. So, for the MD student, in the most part, respect your RN's assessment of the patient's current situation; they really are your "eyes and ears." Similarly, RNs need to respect the difference between MD and Nursing education; there are substantive and material differences in the focus of the training and care. We both need to understand amd appreciate the differences.
Respectfully submitted, 10.07.2007.
Posted by: bob | Oct 9, 2007 3:27:03 PM
Hi,
I'm an "older" nurse and this is my third career, the first two being teacher and then stay home mom. After a few years of nursing, here is what I have observed personally. Some nurses are not very nice and/or not very competent. They don't treat anyone with much respect. Also, if nurses have been around for 30 or so years, they have been underpaid, understaffed, over worked, and yelled at by doctors (who get away with it) for way too long. There are other nurses who consider themselves professionals and expect to be treated as such by their colleagues, whether physicians, PTs, OTs, RTs, nurses, med students, etc. Believe it or not, if you have a physician that is nasty to you, a medical student, you can believe they are just as mean to nurses. I respect physicians who are competent and treat me with respect. However, when they malign me behind my back, or worse, yell at me in front of patients, residents, interns, med students, and other nurses, I will not go out of my way to help them. In fact, I will attempt to keep them as far away from my patients as possible.
Let me give you two examples. I had just come from report, and was just going to see my first patient (I am a neuro nurse - and love it) when a doctor twice my size, followed by his "entourage" (he never went anywhere without them), yelled at me about something that had not been done. I told him "I just arrived. I've never met this patient. If you would like to speak to me in a civil tone, I would be glad to listen to what you would like done". I later reported him and discovered that he had twice lost his privileges - for similar behavior - and had been in jail for spousal abuse, AND STILL HAD HIS LICENSE!!!!
Second event. I had a patient c/o left sided parasthesia and weakness (remember this is a neuro floor, and I knew the neurologists), loss of left peripheral vision, and inability to ambulate - a change from previously. This neurologist told me "this is not neuro" and wanted her discharged. (I had problems with him many other times over either inappropriate admissions (i.e., belonged on med psych for D.Ts) or in correct diagnoses. After he left, I searched her chart, called another doctor of record (internist) who came to see her. He said it was definitely neuro, "good call", and, without involving me, spoke with the neurologist. He backed down, the patient eventually fired him, after she found out she had been having tiny strokes (not TIAs) for 2 weeks. Because of this reasonalble internist and THE NURSE, this patient was saved from either debilitation and possible death.
When you receive years of abuse from physicians (many of whom do NOT see you all as part of a team but the nurse as their subordinate), a person can become jaded toward anyone in that profession. A good nurse will take each physician/resident/intern/med student individually and treat them as they are shown respect.
Last of all, I wanted to tell you that often, the attitude I have seen is one of superiority - I was told by a peds resident that I "wasn't following her orders for this child for regular feedings/snacks". I pointed out that, yes, I was. Look in her chart. I had to walk her through the chart to see where these things were documented (this was pre computer days). She never apologized and walked off in a huff. I also read in this blog once - written by a med student - that he "couldn't wait until he was a full doctor so he could tell these b---hes what to do". Well, that's not appropriate. Nurses (in hospital) do not work for the doctors. They are a team. It would be lovely if the doctors took the time to teach when asked and collaborate. Nurses have as much responsibility as physicians at 1/5 to 1/4 the pay.
Please understand this. You will be paid a great deal of money, eventually. I love medicine and nursing (I CHOSE nursing rather than medical school - it took a lot of soul searching but I thought my personality and desires matched better with nursing. So it wasn't that I couldn't "make it" as a doctor.) and continually seek to learn. Treat nurses as you wish to be treated, and you'll be amazed at the difference. However, realize that, just as there are physicians who are jerks, so there are nurses that are jerks.
Thanks for listening to a nurse's point of view.
Posted by: RNMPV | Oct 9, 2007 3:40:43 PM
"And to the nurses (I assume) that replied above: yes, you are the ones at the bedside, and yes, you know what the patient _preferences_ are, but make no mistake--we are the ones that give the orders and are *responsible* for them. Nurses are responsible for carrying them out, but it's a vast difference between following a given recipe and making one. Physicians should always listen and take nurse's opinions into account, but there's a CRAPLOAD more going on upstairs than you could imagine, so pardon me if I don't lay out the tx plan in a way that makes you comfortable 100% of the time."
The above was written by "Peon" and I would like to comment. You don't know half of what a nurse's job is. Where I work, I am responsible for what the LPNs and techs do (when they are working WITH me) as well as all the assessments, documentation, updates to my patients physicians (who could be different for each patient). In addition to "following your orders" (I think you need to look at that more as you write a treatment plan - we enable that plan to be carried out so you don't have to do all the work), we have to make sure there are no mistakes in your orders, especially for meds. The buck stops at the RN. She/he needs to make sure the drug is appropriate and does not conflict with other meds, needs to make sure the med is the correct dosage, makes sure it is available and okay to use on this unit, and needs to contact you for anything questionable. In addition, sometimes, physicians/med students don't know what dose a patient should get and the nurse can help he/she figure out what is best for the patient - or offers to check with the pharmacist. I have had that happen numerous times.
Please try to remember that we don't "just follow orders". We have many responsibilities about which you know NOTHING. You may write an "order" for heparin to be given but we must determine how much is to be given per hour, continually check INRs and PTTs and alert you to any changes. Does that sound like we have nothing to do but "follow orders"? If that were so, why would we need an education other than skills training? The value of a nurse is not in skills; it is in her or his intellect.
Posted by: RNMPV | Oct 9, 2007 4:03:42 PM
Anna, I'm a nursing student, and guess what? That has happened to me as well! Maybe it's the "student" thing. We talk about it among nurses and there's an old saying that "nurses eat their young". Maybe it has more to do with burn-out in general. I agree with some of the other people who posted that said some people are just that way. How unfortunate. A few of my fellow nursing students and I have vowed not to EVER be rude to nursing students. I'm going to share you story with them because really the "take home" is that there's just no need to be rude period.
Good luck Anna!
Posted by: kelle | Oct 9, 2007 5:08:15 PM
Do not take it too personal. I'm a nursing student and we get treated the same way. Actually, the ones that usually treat you like idiots seem to know the least. You should be proud of what you have accomplished and ignore those who look down on you. There are great nurses out there that love what they do and love for others to learn. Find them and hang on to them.
Posted by: Sarah | Oct 9, 2007 5:30:31 PM
Hello I am a new nurse, and I did most of my practicals and my cap stone at a teaching hospital. Most of my experiences with the students were much more appropriate than with the physicians and about half the residents. It seemed as the med. students got closer to graduation to full physician they forgot that nurses can think for themselves and spend more time with their patients than they do, we are not handmaidens for doctors like some seemed to believe.
Also there were many nurses that did hate it when the new med. student rotation on their floor began and some of them were none to nice to the med students these same nurses were none to nice to the nursing students either. And when I asked someone why I was told because for both the nursing and medical students the nurse puts her license on the line. If I make a mistake as a student the patient has the right to sue the nurse in charge of me and the hospital, if a med. student makes a mistake and the nurse doesn't catch it, if a nurse follows that order the patient can sue the nurse as well as file for revocation of her license in both instances. WE are the last "catch" for medical errors. And attitudes like Peon's only makes our work harder.
If the patient tries to sue and or get a doctor's license revoked a hospital will stand by them and help them in all ways and will even through the nurse under the bus to save the doctor. This is not the case if a patient goes after a nurse. Although the hospitals say they cover nurses for medical malpractice if a nurse has to go through such a case, the hospitals around where I live and work will find a way to fire the nurse rather than stand by him/her. Ever heard of that happening to a physician?? Not around where I live. So there is much pent up resentment towards doctors although not always appropriate.
Doctors with the arrogance of peon is exactly why med students also get treated poorly. Peon nurses do not follow some magic recipe. In my schooling I was taught to always critically think about every order and every lab value I am given and to think through what they mean for the patient. I was not taught to follow a recipe. I am a nurse not a cook.
And I do very much think the attitude definitely needs to change between the nursing and the doctor professions. Unfortunately it will probably be a long time comng and we will have to hope that the new doctors and new nurses coming into the professions don't buy into the old attitudes. Also to hope the fact that the good nurses are trying to change things rubs off on the old nurses and same for the doctors. It's a hard job either doctor or nurse this day in age especially with all the potential law suites but maybe if we work together we can provide a united front of caring for the patient and doing the best for each patient and maybe that will decrease the publics view of needing to sue if the outcome isn't as they want. Hopefully the number of unhelpful nurses and doctors will start to dwindle and then what will be left are those who respect and love the medical profession regardless of title. I hope as med. students you have way more helpful nurses than unhelpful ones and that you are given and give the respect earned. ~Amanda
Posted by: aemt137113 | Oct 9, 2007 8:56:59 PM
Hi Anna,
I have been a Professional Nurse (RN) for over twenty years. After reading about your experience I couldn't help but feel the DISRESPECT that is so prevalent in hospitals and medical establishments where there are many different people with many different titles all performing according to their education. I believe most of these people feel there is a hierachy: MD, Med Student,RN, LPN, CNA,OT, RT,PT, SLP, etc. I do not however, believe this to be true. To me, we are all equally who we are or are being educated to be. No one is above or below another. And everyone is continuously learning. We do not stop learning once we have reached our educational objective. Everyone is needed to enable total patient care to be executed for optimal health or goal oriented outcomes. We all have our title and for this reason no one is better than or not as good as the other. No one is "just a Med Student", or "just a LPN", or "just a Nurse", or "just a CNA", or "just an MD". We are all EQUALLY needed (or we wouldn't be there). We all learn something new everyday through the path WE CHOSE to take. Hopefully some of this learning involves therapeutic co-worker relationships, regardless of one being a student or not. As I read the above comments, it sounds as though we have our therapeutic patient relationship. Personally,I believe that needs work also. I do not believe we ever learn enough. Even though we keep learning, we have not learned the RESPECT we need for each other. There are too many Doctors and too many Nurses that do not have respect for each other. I do in fact know that there is a LACK OF RESPECT of Nurses to other Nurses and DOCTORS TO NURSES. I don't know what the Doctors have in thier heads, but DOCTORS AND NURSES NEED TO WORK TOGETHER.
I know at least where I am there is a real shortage of Nurses and Doctors. If we Nurses are truly the patient advocates as spoken, we would welcome and be willing to help the students of today that will be the medical and nursing staff of tomarrow.
Posted by: edge | Oct 9, 2007 10:23:35 PM
I think the majority of it is misunderstanding each others' roles -- and also a long history of top-down, hierarchical structure within hospitals. There is currently movement in health care to teach MD's what nurses really do and vice versa, as well as all the other many specialties within the hospital. There's a lot to squeeze in during our time in school, but I'm glad my school taught me about collegial relationships in the hospital and why sometimes that doesn't happen as easily as we think it should.
Posted by: kate | Oct 10, 2007 5:57:53 AM
As a medical student, one of the best pieces of advice ever given to me (by the nursing head of a neurosurgical department) was to always treat every member of the healthcare team as my equal or superior. One of the most helpful things I have done is, instead of asking nurses or techs to get something for me, ask where I can find it. Then, if they offer to get it for me, I ask to come along so I know where things are the next time and don't have to bother them. (Not only does this help then in the future, it helps me.) So far I've had good experience with most nurses and have encountered few that are truly mean, disrespectful, or resentful. When I do, I try to just ignore it and still deal kindly and respectfully with each person, usually offering any help that I can to make their job easier. Even more helpful is always making requests instead of demands.
Posted by: md08 | Oct 10, 2007 7:58:05 AM
You lot will make me cry, get over it
Posted by: Peter | Oct 10, 2007 12:39:19 PM
I think that the only problem that we have between the nurses vs. medical students is exactly this: "nurses" and "medical students". Can you mention the names of the nurses that are around where you work? If you can't then you will explain why the nurses may treat you like another medical student they dislike.
I tested this theory one morning when I walked to the nurses station and said "good morning". They replied in a soft mumble without even looking at me. Then, I asked for their names and tried to make a short conversation about daily events, making questions that didn't require yes/no/maybe answers. You could see their faces changed and they looked for my name in my lab coat.
I haven't had a lot of experience in hospitals, but I haven't had any of that tension that some of you have felt either. Try it.
Posted by: Soniely Lugo | Oct 10, 2007 2:49:26 PM
Hey. I'm a IMG and one thing i have to say the US trained doctors get ALOT of help from their nurses.In my country it is the doctor who resites the IVs and give the IV meds becaue the nurses claim they are not covered to do these things.Many of them graduate from nursing school and cannot do basic life support.However, i know several nurses who trained in england and the states and the general attitude of competence with them is amazing.I think the nurses who give the most attitude are usually the ones who know the least AND the same thing applies to the doctors.As doctors esp young doctors we have to remember we cannot do it alone thats why its a team effort.Just remember there are good and bad individuals who are doctors and nurses....dont make it a personal thing.And most of all dont turn it into an "Us against them thing".
Posted by: Dawn | Oct 10, 2007 2:49:43 PM
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