By Laurie Marbas, MD, MBA
https://substack.com/@lauriemarbasmdmba/note/c-271912596?r=4sg6ff
I was young family medicine resident and I didn't know anything. I had a degree. I had a white coat. I had a title. I had almost no idea what I was doing. The nurses knew. They always knew.
They didn't say it out loud. They said it sideways. "Did you want to check that dose again, doctor?" That wasn't a question. That was a save. I was about to make a mistake and a nurse who'd been doing this for 15 years found a way to stop me without embarrassing me in front of the patient.
They taught me how to start an IV when the textbook couldn't. They taught me what a patient looks like right before they crash, not what the monitor says, what the person looks like. They taught me to trust what I was seeing before the labs came back. That's not in any curriculum. That's a nurse standing next to you saying "something's off with this one" and being right every single time.
They stayed for the whole shift. Not the part of the shift where you round and make decisions and move on to the next room. The whole shift. The 3am part. The part where the patient is scared and the family is calling and nobody else is in the hallway. The nurse was there for that part.
They held hands that I didn't have time to hold. They explained things I explained too fast. They translated what I said in medical language into what the patient actually needed to hear in human language. They cleaned up what nobody else wanted to clean up and they did it without a speech about it.
They knew which patient was about to fall apart before the chart did. They knew which family member needed to be talked to separately. They knew when to call me and when to handle it themselves and the ratio leaned heavily toward handling it themselves.
They protected me when I was too new to know I needed protecting. From attendings, from families, from my own overconfidence. A good nurse can redirect a new doctor so smoothly the doctor doesn't even realize they were headed in the wrong direction.
They ate lunch in 4 minutes or not at all. They held their bladder for hours because there wasn't time. They worked 12-hour shifts that turned into 14 because the next shift was short and somebody had to stay. Somebody always had to stay. It was always them.
They cried in the break room and came back out with a straight face. They lost patients they'd been caring for all week and walked into the next room and introduced themselves like their heart wasn't breaking. That is a skill that doesn't have a name and it should.
They were my lifeline in residency. Not the textbooks, not the lectures, not the attendings. The nurses. The ones who stood next to me when I was terrified and too proud to say it. The ones who caught what I missed. The ones who made me a better doctor by showing me what it looked like to actually take care of people.
Nurses don't get a white coat ceremony. They don't get called "doctor." They don't get the title or the authority or the salary. They get the 3am phone call, the 12-hour shift, the patient who won't remember their name, and the knowledge that without them the whole system falls apart. Because it does. Without them it absolutely does.
If you know a nurse, tell them today. Not during nurses week. Today. They won't ask for it. They never ask for it. That's part of the problem.
