Inside Doctoring: Stages and Outcomes in the Professional Development of Physicians

By Robert H. Coombs; D. Scott May et al. | Go to book overview

The Doctor-Nurse Game

Leonard I. Stein

The relationship between the doctor and the nurse is a very special one. There are few professions where the degree of mutual respect and cooperation between co-workers is as intense as that between the doctor and nurse. Superficially, the stereotype of this relationship has been dramatized in many novels and television serials. When, however, it is observed carefully in an interactional framework, the relationship takes on a new dimension and has a special quality which fits a game model. The underlying attitudes which demand that this game be played are unfortunate. These attitudes create serious obstacles in the path of meaningful communications between the physicians and nonmedical professional groups.

The physician traditionally and appropriately has total responsibility for making the decisions regarding the management of his patients' treatment. To guide his decisions he considers data gleaned from several sources. He acquires a complete medical history, performs a thorough physical examination, interprets laboratory findings, and at times, obtains recommendations from physician- consultants. Another important factor in his decision-making are the recommendations he receives from the nurse. The interaction between doctor and nurse through which these recommendations are communicated and received is unique and interesting.


THE GAME

One rarely hears a nurse say, "Doctor I would recommend that you order a retention enema for Mrs. Brown." A physician, upon hearing a recommendation of that nature, would gape in amazement at the

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