[nursesbca]

Just wondering if anyone else has the same problem as we do in our ICU. I worked there today and the doctor didn't show up to see his patient till 7:30pm in the evening. I waited all morning so finally I called to give a verbal update over the phone in the early afternoon. Anyone else experience this??
Makes me so frustrated at times!

[southernchickrn]

This happened to me on July 4th. The patient was admitted around 4pm, with hardly any orders for IV fluids or anything. Doc comes around at 7:30pm and writes a page of orders for an insulin drip, PICC line placement, IV fluids etc. Of course since it was a holiday, specials radiology doc would have to be called in by the doc himself, since the IV team couldn't put in the PICC line because the patient didn't have a vein they could use and specials would have to put in the PICC. Called the doc, he said just to wait till the morning. SO, got IV fluids started, insulin drip started and things went ok for the rest of the night. Then doc calls at 6am adn wants a heparin drip started as well! Lady only had two iv's; one for NS and the other for the insulin drip. Oh did I also mention, that I had to draw eight tubes of blood for her 4am draw and an ABG? TRied the ABG myself, no go. Was hoping I could get the ABG and blood tubes in one stick. Nope! Respiratory therapist was able to get just barely enough, and another nurse had to stick her for the blood tubes. I didn't dare try her NS IV because it looked too fragile to play around with. The lady was already a hard stick! It was the most frustrating morning that I've had so far. Oh and the heparin drip? The doc said to stop her NS and run the heparin through that. AUGHHHHHH! The thing that aggravated about me as much as the %^&$# lab draws was the fact that this particular doc likes things done right away, but he can wait 3 hours before giving us any orders for this lady.

Walk in love, walk in service and you will walk in honor.

[medicrnohio]

I work on a tele/stepdown floor and we actually have one doc who doesn't round until 2 - 3AM.

[ricki]

That is 1 of my big beefs too. One would think in this current managed care system that docs would want to keep things moving to get patients out of the icu setting, let alone and more importantly, getting the appropriate treatments to a person who is already in a compromised physical state

[Marie_LPN, RN]

One thing to keep in mind is where the doctor just came from, when they're making late rounds. Emergencies can happen.

Not saying that it doesn't happen for other reasons.

[PeachyOrthoRN]

We also have several of our docs both ortho and medical that don't round until late evening(7-8pm) and a few that don't round until 1-2 am.

[unknown99]

I work on an inpatient rehab floor. Our rehab doctor makes rounds at very odd hours. Many times he won't round until 10p.m. The patients get ticked. So do we!! He always writes a ton of orders AFTER he sees all his patients, and we are expected to get them taken off and initiated before change of shift at 11p.m.!!!!

[RoxanRN2003]

Our doctors make rounds throughout the day. Some in the morning, some in the afternoon and some in the evening. We are lucky enough to have an IV Team which can place PICCs and if they aren't possible, the in-house surgery residents come put in a CVL (but I also have the privilage of Level I Trauma Center staffing).

A question..... Why not piggy-back the insulin with the NS? We do that all the time. You probably need a carrier going anyway if the rate is <10ml/hr.

[sirI]

Unfortuately, this is a job hazard of which you will have to ammend to each situation. Physicians have reasons, some good, some not, for not making rounds until late. It is up to you to ensure that all information relating to the patients care is related in a timely manner. That includes securing orders. You will have to look at the big picture and anticipate what orders will be needed. We carry the burden too many times for our physicians lax attitudes.