 Hey guys and welcome back to this video as you can see by the title this is a long-awaited video that you guys have been requesting and I've been trying to do so as you can see this is Dr. Prater and he is one of the ICU docs at the hospital that I work at and yeah so we're just going to start by why don't you introduce yourself. Hi I'm Dean Prater one of the intensivists here in Phoenix Arizona. I currently work with Ashley and I've worked with Ashley for about four months obviously within the ICU. I started out as a chiropractor here in Phoenix and then about four years into that decided I wanted to advance my career do something different something way different than you know chiropractic more than the traditional realm of medicine versus you know naturopathic. I went back to medical school and graduated medical school then went to Oklahoma did internship and then back to Phoenix for residency and after residency worked as a hospitals for a while still decided I wanted to do something more a little more exciting so I went back to fellowship for pulmonary and critical care finished that did private practice for three years and then decided I really wanted to focus on just bedside care in the ICU setting and that's where I've been since. Here you are. Bam. Boom. So before we get too serious let's talk about some of your hobbies and things you like to do outside of work. Well our family is very involved in racing which at this point takes up a large portion of our time but when we have downtime we will generally be outside whether it's camping or playing football with my son or jumping on the trampoline with my little girl. So part of the bribery for me to get Dr. Prater to do this video was I promised to help him out with a YouTube channel that he's starting for his son and his racing so his YouTube channel is called Prater Racing I will leave the link in the description down below make sure you go check it out and subscribe give him a little bit of love because it's a new channel and leave a comment saying that you came from this channel yeah so that way make him feel loved because he doesn't feel enough love. So the whole purpose behind this video is I want to talk more about nurse doctor communication because I feel like there's this big stigma that doctors are these big scary people and that nurses should like fear you guys coming in the hospital and I think that puts a barrier between nurses communicating with doctors. So Dr. Prater is a great doctor and he has a great mindset when it comes to communication so why don't you talk more about your mindset when it comes to communicating with nurses and other staff. Yeah I think a large portion of the day that I spend as a physician really is communicating with the nurses. There are go to there are front eyes they are the ones that are at bedside all the time where we are more in and out so for us to have a open relationship where we can really talk about what's going on and bounce ideas off of each other really facilitates care and optimizes you know what we need to get done throughout the day. Yeah and I think we've talked about this but you know we come to you guys for a lot of things you know questions or things that are happening but you guys also come to us for things and want information and so it really is a two-way street not just a one-way street. Yeah I agree it's important that you guys also know the things that we're looking for when we come to you and generally we need kind of this quick answer as hey what's going on with this or what's my vitals what's my urinary output been and for us to get those quick things it tells us whatever process or whatever plan we had laid out for the day we know that it's going that way even though we don't have to come back and you know watch the urinary output every hour but we can least call you guys and you're like yeah it's you know 100 an hour or whatever. And there's got to be that mutual like trust and respect you know what I mean like you trust that word what we're saying is correct and obviously we have to trust no matter what you say it's correct because you're ordering it. So what are some ways that you like to be approached by nurses or just ways that you don't like what are things that have worked and things that don't work? I think the most important thing is clear and concise information and communication unfortunately sometimes we're you know thinking about another process or another patient and so we it's tough to break that and then you know switch over to whatever question or concern that you have so waiting just a few minutes for us to finish whatever we're working on or typing or communicating and then allow for that communication for your problem that's going on is really critical because then we're not feeling rushed or kind of bombarded with multiple things going on at the one time. So you're saying don't interrupt you? I'm saying that if it's important absolutely you got to interrupt us but if it can wait or if you can compile a list of concerns or questions that you have and then if you could write it down and give it to us say hey when you have a minute these are the three or four things I'd really like to talk with you about and get them you know handled. I'm a big list person I know personally something that I like to do is like I may have a need or something I recognize maybe this patient needs speech therapy I think but that's not necessarily something that needs I need to come interrupt you about so I'll usually write down that or maybe I notice that they need potassium protocol or something like that and I usually write those few things down none of them are urgent but they're things I want to get taken care of so that's kind of my method I like to you know write things on a list and go and talk to the doc. Right. Do you have any like pet peeves of things like specific things that nurses do that bother you? I can't say that I have a lot of pet peeves because every day or every situation is a little different I mean some people are a little more straightforward some are a little more laid back you know and some aren't maybe aggressive enough when they need to be but again it's working on the communication and the building those relationships you know that nurse and you know that if she's coming up to me then she probably really needs something or she says hey prater I really need you then she does it's not just a false alarm but developing that and understanding each other and learning how we work as a team you know with you guys at bedside and us kind of not being at bedside all the time it's very vital I agree and just like there's you know good and bad doctors there's good and bad nurses and it's just like a matter of learning each other's personalities and like who's serious who comes to you for every little thing right no you're absolutely right it's both of us and we all gotta learn each other's little twists and quirks and then from there you can learn how each other operates throughout the day and if you learn each other and you know how they're going to operate and think and it will really optimize the flow of the of the day so these are some questions that I actually got from a few people on instagram actually posted something like a week or two ago that said hey I've got a doctor coming on my channel like what questions do you want to ask you so these are actually specific questions that people asked me that I thought were really great and I'm reading from my phone here but so I like this one so as a new nurse we're afraid of doctors I think every new nurse is afraid of doctors but when you were a new doctor were you afraid of the seasoned nurses absolutely I can tell you one thing when I was a new doctor I went and found the most experienced nurses I could find on the floor and I literally hung to their pocket and I became their friends and I did whatever it meant if it meant bringing them coffee and donuts I would do it why don't you do that now it's your pain but those are the nurses that when it really came crunch time and someone was sick and I frankly didn't have the experience to get through the situation those are the ones that would be at my pocket and helping me out tell me do this and do that so I have learned to respect my nurses and make sure they feel appreciated and welcomed because they will get you out of a lot of bad sticky situations I agree see why I brought them on here the next question I thought was good because I think everyone runs into this what's the best way to build a relationship with a doctor that you don't get along with and I think it could be vice versa it could be with a nurse you don't get along with as well you don't need advice for that I think understanding each other and understanding their personalities or maybe their likes or dislikes and how to work that initially so develop the what works and what doesn't work and then really boil it down to find something of personal interest with each other whether it's like for us you know outdoor stuff racing or you know oh you have kids I have kids too the same age so I think developing that individual personal relationship with each nurse know one thing about them that they like and one thing that will make their day and if you can do that with a physician too then that's how you start to build the friendship and the relationship because yeah it's got to be a physician nurse relationship but really we're one big team up there and we're a family and we spend a lot of time throughout the days together 12 hours we get to know each other on multiple levels so anytime you can act as one family one unity the whole unit will run better so calling doctors late at night I know you don't have this as much with the job now but this is a big thing for nurses especially night shift nurses they're afraid to call doctors at night and I'm sure you've been in situations where you've had been called at night so what how do you like that to be handled or approached that's a huge issue with especially private practice physicians now fortunately for most critical care physicians at shift work so we're on work you know and then we're at home or we're off so but when you call a private practice physician at night it's all about the presentation and the communication meaning know what's going on with that patient know a little bit about what the patient's there for this is John Doe he's here for chest pain and he had a change in his EKG and specifically know what questions you want to ask do you want me to get a you know stat set of troponins do you want me to change his vitals to q3 minutes do you want me to call the cardiologist you know so know what know what your questions are going to be what answers you want to find out and what is the next plan and that will really help that call at night yeah I think you kind of have to anticipate like you have to be calling because you need something kind of back if that makes sense you know else they're going to just be like why are you calling me I don't care and this is the time when you really got a call when you really need something if not that's where you can utilize your team leader your charge nurse to maybe trios some of these calls and concerns through for instance you know you don't have to call Dr. Prater because I know that if you have a change in your in your monitor he's going to want troponins EKGs and whatever you know you may like but that's important too yeah and that all comes with time and experience like as a new nurse you're not necessarily going to know like oh if this happens like if a patient starts having chest pain like you were saying as an ICU nurse you automatically know well I'm going to do an EKG I'm going to want these labs this this and this and then I can go to you with the results but that's not something that you necessarily know right off the bat and when in doubt like you said use your charge nurse that's always a good thing because they have more experience than they can tell you or when in doubt I mean you might as well just call because in the end it's better to just get it I don't know you know what I mean absolutely it's better to call than not call if you're ever in doubt call but just make sure that you have a reason to call a reason but you have your what's the issue you know what what do you want me to do and what's our next follow-up you know I like the writing it down idea I'm all about writing it down but I do that too because else you hang up and then you're like I forgot to say this and then you're like gotta call back and it will be the doctor that you don't want to call back when you have to do that so maybe even rehearse the call first yeah it's not a bad idea when I was doing my preceptorship my preceptor she um we actually rehearsed a call before we called the doctor one time she's like okay so what are you gonna say how are you gonna say it you got to be brief because this is one that'll hang up on you if you don't yeah and I think every physician is a little different and some facilities I've known they've actually said okay these are the things that that physician's gonna want and so they will have a pre-made sheet and they'll just have the information on that sheet so when you call it's all right there so I like this one because doctors like to be right all the time so I'm sure you've ordered something by mistake or did something by mistake and a nurse has caught it how do you like to be approached when you've made a mistake because we're human we all make mistakes I make mistakes I'm sure well you're kind of perfect so you probably don't make a mistake no I make a lot of mistakes I think with critical care you're often managing so many different situations so many patients all at the same time and especially with the computerized charting it's so easy to get into one chart and then oh man I need to put in this order for someone else in this other chart but yet you didn't switch over to the charts but I think the best way to come up and just say hey hey prater you know you put in this order under my patient but that really isn't relative or are you sure you meant to do that and then I'll be like oh yeah I meant to put it under you know this other patient you know will you take it out or you know I'll fix it real quick but really it's just about the approach and making sure that you know yeah not coming off as like accusatory but like hey did you mean to do this right like just double checking right you know because what if you really did want that right then we look bad right but it happens I mean every day I probably put in something wrong on the wrong patient so whether it's a you know a written or a verbal order so that's always good to communicate and again it goes back to that communication thing is are you sure that's what you wanted on this patient you know no yes or whatever but that's part of being a safety mechanism too yeah and it's good that you have it's good that you have us it's good that you have I mean you know it's a team like you said it's good that we're looking out for you and you're looking out for us not and goes back to trust like you know I know you know my patients and I know I can trust you and and I know that if you're coming to me and like did you really mean to do this and I really need to think about like no I probably didn't mean to put that order in versus just like you know don't bother me and just do what I put in so okay last question ready for this who's your favorite nurse Ashley Adkins see now you know it's true all right so thank you guys for watching this video thank you Dr. Prater for coming on I know that it took a lot of coaxing and bribing and I'm going to be helping out with his YouTube channel so make sure you check it out and make sure you subscribe there's going to be lots of great videos that's going to be putting up and I'm excited about it so thank you guys for watching make sure you give this video a thumbs up and leave a comment down below on your favorite part leave him some love so he'll come back on for more videos all right and I'll see you guys in the next video come see us at the races ready yeah excited no okay ready let's do it all right started out as a chiropractor and I worked in the all right there's like two more questions three actually fire okay all right great I feel like I'm agreeing with a lot of things you're saying you should I'm older and wiser we've worked with each other for about a year four months all right you know this is John Doe he's here we'll care at the bedside I dig it I'm a natural doesn't work out tell you I'm cut that out that's a good idea I love to the camera will you shut up so I can do my part you want me to start over no okay you're struggling I know we got a lot to go no jellyfish um okay you should go get another drink I think so