In almost every situation I can think about....the nurses just know!
I use the term 'nurses' very loosely here to encompass all of our Healthcare assistants and more - because, guess what? They know too!
I might be the one who leads the big resuscitations and takes on the most challenging cases. Sometimes because they are funnelled to me, sometimes they are handed over to me and somehow some just seem to find me! We have an actual term and triage category for some of these patients in our department - Sharryn Specials - and that will be a whole other post!
When I'm not quite on the right track or worse considering doing something really dumb the nurses will gently steer me right. This is no accident, it comes from creating a safe space and trust. I joined a Department 17 years ago that already had this and was largely nurse-led. I have done my best to help keep that environment intact. We know it is because doctors in training describe being with us as working in a family and our trainee nurses rotating through all want to stay.
This post was prompted by a thread on Twitter about nurses knowing the bad and good doctors though I think it really overstated how common bad ones are. So most doctors I see are good doctors, sometimes constrained by a challenged system. Still, nurses often have fairly strong instincts as to who they might choose to avoid. Equally they will endeavour to make sure that they doctors they do rate are the ones to see their own family.
The moral of this is to look for where nurses take their own family.
I count myself privileged to be one of the docs they seek out - some have kindly left a testimonial here.
(I'll do a post on VocalReference Testimonials too. They are pretty awesome!)