Not to mention, that whole CYA thing is a bunch of malarkey, too. Nurses are trained to do things differently than docs, and that's fine. We are trained to be highly suspicious of the obvious for a variety of reasons. Luckily for this doctor, he did a more thorough evaluation, and was able to diagnose this patient's thoracic aortic dissection in a timely manner. He had ascending colangitis and was marked for death by the time he even walked in, but didn't start bleeding from every hole for about an hour and a half.
Doctors are the ones who have to be suspicious.
BUT, it only matter what I think is wrong with the patient, not what the nurse, or the cleaning lady, or the patient's family thinks is wrong with them. I'm covering my ass. All in all, most ER nurses are very good, very self confident, and love their jobs, and are a true pleasure to work with. When I was an intern, I decided to go into emergency medicine very much for this reason. I found ER and ICU nurses to be very friendly, and I think that comes from the fact that they have too many responsibilities already to worry about trying to be the doctor, too.