Ok, so there's something that's been bothering me in The Pitt fandom, specifically in fanfiction, regarding the nurses.
I need people to understand that Robby and Abbot are Dana and Lena's colleagues, not their bosses. Nursing staff are not under the supervision of doctors - organizationally. Medically, yes, nurses carry out physician orders and report changes in patient assessment to physicians, etc. etc.
But Dana does not report to either of them as her supervisors. None of the nurses do. The nursing chain of command is:
Registered nurses (RNs), Licensed Professional/Vocational nurses (LPNs/LVNs), and certified nurse assistants (CNAs) all report to the charge nurse. The charge nurse changes by shift. You can be on shift and not be charge that day because you're not the most experienced charge trained nurse on the schedule, but then the next shift you are and you get the unfortunate distinguished punishment honor of being charge.
The charge nurse reports to the unit nurse manager. For the ER that would be the ER nurse manager. Dana could technically be the ER nurse manager and it just hasn't been mentioned yet. Often times when you are short-staffed the nurse manager will take on patients and act as charge nurse. Nurse managers generally work day shift during the week and have weekends off with some on call times.
The ER nurse manager reports to the Director of Nursing sometimes called VP of Nursing (lol vpn). The director often supervises multiple units, like in the children's hospital I worked at that was attached to an adult hospital, our DON was supervisor for all the children's hospital units (General Peds, Peds ICU, Peds Step-Down, Outpatient procedures, etc.), but she wasn't over the ER because our patients came through the adult ER (we were building a Peds ER at the time I left but didn't have one yet).
Director of Nursing reports to the Chief Nursing Officer.
Please note, at no point is any nurse supervised by a physician. We even have a separate chief, they have the Chief Medical Officer, we have the Chief Nursing Officer. If a physician has a complaint regarding a nurse, they will address it with the charge nurse and the charge nurse will either address the issue themselves or report it up to the unit nurse manager. Do physicians sometimes yell at nurses in the patient's room and then go complain to the charge nurse? Yes, especially surgeons because they are dicks who think they are God's gift to medicine (I may have had beef with a surgeon...)
I have seen things in fics, specifically in Emma Nolan fics where she is paired with Park the Shark, where the author talks about the nurse being "on x physician's service" which... Honey, no.
Nurses are not on any physician's "service." We work on a specific unit, sometimes float to other units or pick up an extra shift on another unit, but the physician you work with changes. If you're working on a med-surg or general peds unit, you can have three different doctors for your patient load. If you work ICU or ER, it depends which attendings and residents are on shift/call. If you're an OR nurse, you're assigned to a specific surgical team and can have one or two different surgeries you're assigned to scrub in on, but you may or may not have the same surgeon for them.
Anyway. That is my rant about nursing and the misogynistic, patriarchal way we are constantly, even in the year 2026, viewed as physicians little helpers rather than as our own healthcare profession.
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