As I have repeatedly alluded to my house officers before, becoming a competent and reasonably knowledgeable doctor is a tough ticket to get, at least not without going through a rather eventful learning curve. There's definitely no such thing as 'Cinderella effect', whereby one can become a super consultant overnight by wearing a pair of magic glass slippers! Of late, I had a disagreement with my ward nurses over the issue of 'informing house officers first' versus 'bypassing the house officers and informing SHO straightaway'.
Basically I have no objection on the notion of informing SHOs in the first place if the urgency of decision on management is going to alter the course of clinical outcome. One good example would be a collapsed patient needing acute medical attention. Any doctors at hands should rush to the scene to resuscitate the patient. The SHO, being more experienced than his junior counterpart, would be of role in carrying out important decision making. Making him available would thus be a wise choice.
On the other hand, house officers should not be deprived of any chance in attaining clinical experience just because they are less experienced!
As recalled from my conversation with my ward nurses, one of them had shamelessly said so:" Aiyo doctor, housemen cannot make decision one. So why not call you straightaway. Later call the houseman, he also need to call you..." I said:"OK, I'm here now, please call the house officer along." She answered:"You're here already, no need to call him. Let him rest."
I couldn't have disagreed (and been disgusted) more.
Luckily, only one particular ward nurses behaved in such a way, other wards are still manageable. Well, I did think it over and try to put myself in their shoes. I think it's really tempting to 'settle' things as soon as possible. After all, they'll probably need to pick up the phone the second time (to call me) if the house officer can't come up to a solution. Extra work always means 'no good' to them :(
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