Doctors' rounds - page 2

Hi guys - I guess I just feel the need to vent a little and I'm sure you all feel the same way at times. I work on a crazy busy surgical/trauma floor in an inner city teaching hospital as a new grad... Read More

  1. by   all4schwa
    Quote from cardiacRN2006
    I walk right in with them and stand on the opposite side of the bed. In fact, this is how I developed my sense of self confidence at work.
    i just wasn't sure if i should be doing that or not. i don't want to be intrusive, but sometimes the patients dont know what to point out. the doc asks how much pain have you had? not much. me: well, actually....
  2. by   GrnHonu99
    Quote from all4schwa
    i just wasn't sure if i should be doing that or not. i don't want to be intrusive, but sometimes the patients dont know what to point out. the doc asks how much pain have you had? not much. me: well, actually....
    yes you should! I see it as i am advocating for my patient. I do agree, it does depend on where you work but, for me, in the neuro ICU, I go right in and stand on the oppisite side of the bed. I couldnt imagine NOT rounding with the docs. However, I only see one set of docs usuallly, neurology or neuro surg...Anyway, I stand on the oppisite side of the bed and watch the doc do their neuro exam, make sure it is the same as I have been getting all night. The doc usually starts out asking me, what is your best exam? I tell them as I have been the one examining them alllll night long. Neuro pts are funny too, sometimes they pick and choose who they want to respond too...i'll have a pt who wont do anything for me all night long and along comes the doc with the deep voice and go figure that pt starts following verbal commands for the doc or sometimes vice versa. This morning one of my pts wouldnt asnwer the docs questions at all, all he would do was mumble. However, I know he can follow verbal and atleast tell the doc his name and where he was. She shouted at him for about 10 minutes before I interevened and the pt responded to me, I have never had a doc tell me im over stepping my boundries by doing something like that, I think they see it as helpful. We work together as a team and they depend on us. In the same visit the doc usually gives me verbal orders and that is my time to ask for whatever I want, get my VOs signed..etc. Its very valuable time. Although I realize that its different in different areas of nursing.
  3. by   all4schwa
    Quote from ELKMNin06
    Neuro pts are funny too, sometimes they pick and choose who they want to respond too...i'll have a pt who wont do anything for me all night long and along comes the doc with the deep voice and go figure that pt starts following verbal commands for the doc or sometimes vice versa.
    i do neuro step down and you sure are right about that!!
  4. by   1Tulip
    We have a rigidly set "stroke rounds" at 0800 every AM. Absolutely worst time in the world for this and we are expected to know everything about our strokes, what the CAT showed, has the MRI with/without been read, what anti-thrombotics have been started, what was the presenting NIH stroke score, did they get TPA, why not...

    When it's my first day after several off, I come in 45 minutes early to prepare.

    As it relates to non-stroke patients, one of two things can happen:
    1.
  5. by   1Tulip
    We have a rigidly set "stroke rounds" at 0800 every AM. Absolutely worst time in the world for this and we are expected to know everything about our strokes, what the CAT showed, has the MRI with/without been read, what anti-thrombotics have been started, what was the presenting NIH stroke score, did the pt. get a carotid ultrasound, is a TEE appropriate, did the pt get TPA, why not...

    When it's my first day after several off, I come in 45 minutes early to prepare. The best offense is a good defense.

    The nurses were initially upset with this, but I'll tell you, stuff rarely gets overlooked. Now we're pretty much all into it. The bad thing is that 0800 is THE WORST time and it's been chosen because it fits with the MD's schedule. To heck with ours. But whatever....
  6. by   RNSacht
    Quote from meandmythree
    i figure it also depends on what area of nursing you are working. I mean, if you are in medsurg with 6-8 patients, i don't see how one rounds with all the docs and residents alike. You can, sometimes but not all the time. ICU nurses has 2-3 patients and can afford to round with everybody. at most they are either at one pt's room or the next and no other to really call for pain med,change a beeping IV pump or some crazy calls from other patients. It's all different depending on the area you work...
    I totally agree, I am on a busy telemetry floor and it is not unusual for our patients to have between 4 and 8 consults, How could you possibly go with all the dr to round???????? And we have between 4 (rare) and 6 patients. I wish we could but it is just not possible.

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