In medicine that’s often not so. All too many doctors regard nurses as little more than hired hands who ought to do as they are told. I once heard a top surgeon describe an incident in which he obviously felt he didn’t need to explain to a nurse why the massive dose of morphine he was ordering wasn’t, in this particular case, an attempt to kill the child.

The result can be harmful. When I worked with children who had cancer and a child became terminal, the doctors often seem to disappear, not knowing what to do when no treatment options were left. The nurses were forced to insist that orders be changed, unnecessary procedures be dropped and attention focused on comfort.

Because they handle the sickest patients, hospitals in particular, need to focus on altering the relationship between physicians and nurses. And they shouldn’t adopt the easy-out policy of getting tough with young residents and ignoring the misbehavior of well-established attending physicians. That isn’t a way to bring about change. It merely teaches the residents, “When I get power, I won’t have to follow all these rules. I’ll be in charge.”