Nursing is not medicine. Medicine is not nursing. They are allied fields, and work together for the benefit of the patient, but they have different focuses and different bodies of knowledge. It may seem to you that nurses don't know things that you consider pretty basic. I bet you don't know a tenth of what they do about safe administration of potentially incompatible IV medications, though, among dozens of other practical skills and technical details that are incredibly important to not killing your patient, but that med students never learn because those things are not within the domain of medicine, but rather of nursing.
Also, there is the "Nurse Game." Nurses have had to work in a hierarchy where physicians have much more power and clout, and some physicians really enjoy putting other professionals "in their place" if they get too uppity and start making open recommendations for patient care. "Stay in your lane" is wise advice for everyone, but I have seen some attendings (and even brand new interns!) use it as a cudgel when a nurse speaks up to make a recommendation for patient care. So, part of the unwritten curriculum for nursing is playing the Nurse Game, as I call it.
It works like this. As the nurse, you know, very well, that the intern / resident / attending meant to do something or would mean to do that thing if they didn't have 10,000 other things on their plate. But, you also know that this particular one may have a personality disorder and/or a chip on their shoulder about nurses being too assertive. So, you don't say "Doctor, please put in an order to recheck the potassium." They will dress you down if you say it like that. So, you couch it as a question... "Gee, Doctor. I noticed that our patient's potassium came back at 5.8. I see you made some medication changes and there were some funny beats on the monitor just now.... Like, do you think we should just wait until AM labs and see if that makes a difference or....."
In many of the (admittedly kind of malignant) settings where I have worked, nurses play dumb like that so that the brilliant physician can be the one who had the good idea and we can all get on with the day. Playing the Nurse Game to make oblique suggestions dressed as questions is a very traditionally female communication pattern. It is passive, and honestly pretty pathological... but it is effective when dealing with fragile egos in a high stakes environment where what matters is outcomes, not how we get there.
When I explained it to one of my mentors, he kind of freaked out a little. He realized that nurses do this to him and other docs all the time. Up until then, I think he had assumed that a lot more nurses were really dumb enough to ask such obvious questions. Now, he hears them as the suggestions that they are and takes a moment to step back and re-engage in the conversation with more respect for what the other person is really trying to say. I've seen it lead to a lot more productive conversation in clinical environments... but it takes the person with the more power in the situation to have the maturity and emotional intelligence to listen to meta communication, rather than just taking everything at face value.
That isn't too common, alas.
