Ultimate Ally: Doctor Carly Andler

doctor and nurse

We’re all aware of the misconceptions and stereotypes about doctor-nurse relationships. Interdisciplinary care is considered the gold standard for healthcare delivery.

Yet, it seems that seamless and sustainable execution is few and far between. So I decided to narrow in on one of my own positive experiences.

Everything about my experience working with Carly changed my expectations of what a physician-nurse relationship can look and feel like. Carly is a nurse’s ultimate ally.

It became very apparent in my time working with Carly that a well-oiled interdisciplinary relationship absolutely translates to safer, more efficient, more holistic, and higher quality care.
I mean, what’s more appealing to a patient and family than knowing two of the most important pieces in the game of their health are communicating, on the same page, and work well together?
I got the chance to pick Carly’s brain and even flipped the age-old & least favorite nursing question on her. She’s a gem and I wish I could clone her to take care of every single one of my patients. She’s vivacious, energetic, friendly, and always upbeat. Oh and get this – she does it all without an ounce of caffeine!

  “It definitely takes a special kind of person to be a nurse, and way more patience than I need to have every day for my job, but I’d like to think I would be able to do it.”

When did you decide to become a doctor? Why?

I actually don’t remember “deciding” to become one – I just kind of always knew I would be.  When I was a kid I was a “doctor” to all my stuffed animals and bandaged them with ace bandages or put stitches in them or gave them medicine (colored water or tic tacs)…and then when it came time to go to college it was like “yep, gotta take the classes to get into med school”.  Didn’t even think about the possibility of doing anything else.  

“Another is that I’m always learning – everyone has something to teach and there are no limits to what you need to know to do this job well.”

What’s your favorite part of being a doctor?

A few things!  The first is being able to fix things – I love the satisfaction of approaching a problem, thinking about it from different angles, getting input from other people, and then solving it.  Another is that I’m always learning – everyone has something to teach and there are no limits to what you need to know to do this job well.  I genuinely learn something new everyday, and I love that. I also get to work with some brilliant and hilarious and wonderful humans and they make it all worth it.

I have to ask it – Why didn’t you become a nurse? Do you think you could be one?

I’m not sure, to be honest.  Like I said before, there wasn’t a ton of decision making that consciously went on.  My parents were the world’s most supportive people and never pushed me one way or another, so it definitely didn’t come from them.  My grandmother was a nurse, so I was definitely exposed to nurses early on, but for some reason it wasn’t really on my radar.  Do I think I could be one? I’d like to think so!  It definitely takes a special kind of person to be a nurse, and way more patience than I need to have every day for my job, but I’d like to think I would be able to do it.

What were some of your first interactions with nurses like as a medical student or intern?

I don’t remember many of my interactions as a medical student – I think I was too focused on not looking like an idiot to the doctors who were evaluating me! As an intern though, they saved my butt.  I remember being so scared of making mistakes and so unsure of myself, and I relied on the nurses’ experiences a lot! There were also definitely some nurses I was (and still am) scared of!  So many nurses have been working for longer than I’ve been out of diapers, and they’ll call you out when you don’t know what you’re talking about or question your decision making.  I like that though – keeps me honest!

Do you perceive that the culture of nursing varies by patient population, setting, or facility?

I think so.  The extent to which nurses feel empowered to speak up, or do things on their own without input from the provider, differs a lot depending on the hospital.  I also think the type of patient the nurses are caring for is a significant factor – I’m a pediatrician but every now and then I interact with adult nurses and it is a WORLD of difference!

What impresses you most about nurses?

The amount of bullsh*t (I probably shouldn’t swear…you can edit this though right?) they have to take every day.  They are the first line for all of the complaints from the patient, the patient’s family, the lab, the pharmacy, the doctors – the list goes on!  Some will definitely speak up about it, but most nurses I’ve worked with accept that as part of their job, and handle most things without the doctor even knowing.  They definitely save me a lot of hassle day after day, and I appreciate it.  I’m also impressed by how many specific details they can hold in their brains – the specific ins and outs, the specific doses of meds, etc.

“..never send a doctor to do a nurse’s job.”

How do nurses make your job easier?

Oh my gosh in too many ways to count.  There are a million and a half critically important things for patient care that nurses do on a daily basis that I have NO idea how to do, and it becomes pretty apparent any time I try to help reposition a patient, fix a dressing on a wound/line, fix a pump that is beeping, draw up a med or blood or anything else that might be vital in an emergency…never send a doctor to do a nurse’s job.  They’re smart too.  And most have just as much if not much more experience in the field than I do.  They sit by the patient all day, whereas I stop by only in spurts (unless they are super sick), so they will always know the patient and what’s going on better than I do.  We need to remember that, and really value their opinions when it comes to patient care.

 “I think some people presume doctors give nurses orders and they just carry them out – and that is not true at all!  I rely so much on nurses to tell me how they think patients are doing and what suggestions they might have because they are at the bedside all day.”

What’s something you didn’t know or weren’t able to appreciate about nurses until you became a doctor?

Hmm that’s a good question.  I don’t think I realized exactly how much patient care the nurses were responsible for before I was a doctor.  I think I presumed the doctors did a lot more of the direct patient care, but through the years of being a doctor I’ve realized we spend way less time with them than I thought we would.  Most often a nurse is the first one to alert me to a problem, and he or she has already taken some steps to solve that problem.   I think some people presume doctors give nurses orders and they just carry them out – and that is not true at all!  I rely so much on nurses to tell me how they think patients are doing and what suggestions they might have because they are at the bedside all day.

What’s one bit of advice you’d give a med student about a relationship with nurses?

Never think you are better than anyone, remember everyone has something to teach you, and remember everyone is trying to do their best to care for the patient.  Nurses can be your best friend or your worst enemy if you get on their bad side, and there is no reason you should get on their bad side.  They are an integral part of the team, and for the safety of the patient as well as your own sanity at work, why not make them your best friend?  There is nothing wrong with being firm in your conviction or having a disagreement with a nurse, just make sure you have considered their point of view, and taken the time to explain why you don’t want to do what they are asking of you.  

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Healthiest habit for work days: making sure to get enough sleep the night before, and getting exercise before or after work! Keeps my mind sharp and my body feeling healthy.  Exercise is my caffeine.
My work mornings usually start with… A shower to wake me up for the day, and some fruit/yogurt/granola to get me through the first few hours before I can eat second breakfast.
Go-to meal that I pack for work/buy at work:  Salads because they’re easy to prep ahead of time, don’t need to be heated up, and I can eat them with a fork (who knows where these hands have been)
Favorite thing to do on a day-off: Anything outside and active, especially if it involves playing soccer and spending time with friends
Favorite app: The thing that allows me to send gifs to people via text.  Gifs can say so much more than my words can.
Clogs or sneakers? sneakers! Those clogs are dangerous I’ve fallen off them more than once! Also maybe I am just clumsy.
Compression stockings, compression socks, or neither? Neither, prefer my legs nice and puffy at the end of a shift.  
Puke, poop, sputum, IV starts in babies, we’ve all got our aversion, what’s yours? Vomit.  Chain reactions may occur.
Go-to choice of caffeine? Haha I don’t actually drink caffeine! People are always shocked by this, but I guess I’ve never had coffee and never been a huge fan of soda so I never got hooked on it!
Sarah Gray
Sarah is a Pediatric Clinical Nurse III at UCSF Benioff Children's Hospital and a UCSF 2017 Evidence Based Practice Fellow. A New Jersey native, Sarah graduated from Penn Nursing and has been living in San Francisco ever since. She's been an athlete her whole life and continues to be passionate about health, fitness, and making the most of all opportunities. She continues to harness her passion for innovation and process improvement in her role as Founding Clinician at Trusted Health.