In all instances, the physician must be kept apprised of the patient's condition. Any changes need to be communicated. Negative changes or worsening conditions need to be communicated immediately. Some instances of improvement such as someone awakening from a coma would necessitate immediate notification as well. Other changes, by common sense, can wait for a convenient time unless the physician has requested otherwise.

The one thing to keep in mind in communicating with physicians is that they are busy and almost always just want the facts. They will want a specific picture of the situation. Never call the M.D. when you don't have a recent set of vital signs and an assessment to provide. Always have your facts in front of you, and not where you have to dig to find them. Make notes and compose your thoughts. Listen to their orders, read them back, and ask for verification of what you read back. Be concise, accurate, honest, and up front. If you are unfamiliar with something, say so and ask for a simple explanation or clarification. Identify yourself and state your credentials (R.N. or LVN). Clearly identify where you are calling from and which patient it is about.

There was a time when nurses were considered to be handmaidens or just simply assistants to physicians. Nurses have evolved as professionals and have firmly established their own essential roles in health care. They complement the physician's care, but both are vital, primary members of the health care team. The nurse-doctor relationship has evolved along with nursing roles. Respect physicians and expect them to respect you.

As gender becomes less of an issue for both nurses as well as doctors, both professions have grown in respect for each other. Realizing that each is a profession and not a gender has opened many avenues of communication and respect. New doctors and nurses have brought to their respective professions a new sense of teamwork and camaraderie that has broken down a number of barriers and achieved a more equal relationship.

As a new nurse, introduce yourself to the physicians. As with any of your team members, smile, use direct eye contact, and shake their hands. Make a positive first impression. Let them know that you look forward to working with them. Take the time to get to know them and to build a rapport. Ask appropriate questions, and let them teach you. Most doctors love to teach.

Show them that they can trust you and that you will provide the care they expect for their patients. This will go a long way in the event that you have a question about an order, or when there has been an error. They will usually go that extra little bit to explain, teach, or clarify something without an attitude of indignation. And if there is an error, although they may be angry or disappointed, they will have an understanding that you are human and will do the right thing to correct it.

If you question an order, remember that doctors are human and could have made a mistake. They could also have good reason for something. If you use an approach such as, “I've never seen that dose for that medication; can you tell me why you're ordering such a high dose for this patient?” you're more likely to get a nice answer than if you put them on the spot and say, “That's not the normal dose.”