Help, MD not removing polyps

  1. Hello. I usually lurk for a long time before I post but, this is pretty important. I have been a nurse for 16yrs an endo nurse for 10. My last job was in a hospital for about 20 years. I started working in a surgi center 6 months ago as a endo nurse. There is a colorectal surgeon that does 7 minute colons and sometimes leaves polyps behind, some of which are snareable. He had a patient that had colon cancer twice and had a snareable polyp and a poor prep. At the end of the procedure he tells the patient that everything was fine. No follow up colon. I don't know how to handle this. I spoke with my charge nurse and she says that management knows. I feel horrible for my patients.
    •  
  2. 11 Comments

  3. by   SFCardiacRN
    For good or bad, determining treatments is the realm of MD's. Every OR has good and bad surgeons. It is not our job to second guess their job. Now if someone were to ask for a referral, you know where NOT to send them.
  4. by   shishirenee
    thank you so much for your reply. I totally understand about him being the doctor. It is just that these patients go through a prep the night before which is horrendous and this is what these patients are here for, to remove or biopsy polyps and treat areas which need treating. I worked with a doctor that if he wasn't able to remove a polyp, he would send him to another physician. When this physician hasn't removed a polyp, I ask him for the postop dx., he says, normal colon. That is what I have a problem with. He is lying to the patients.
  5. by   SFCardiacRN
    I feel your pain. Some surgeons seem to be absolute psychopaths. I don't know how they sleep at night. Sometimes I pray that someday they are operated on by a surgeon as horrible as they are!
  6. by   Nurse Ratched
    Is he a person you can approach with (out of earshot of the pt) "I noticed there appeared to be a polyp - could you help educate me as to why that one wouldn't be removed?"

    Do you feel this is a question of outright incompetence, laziness, or fraud?
  7. by   shishirenee
    Thank you so much for your responses. I have asked him about what makes him remove a polyp or not . We had just finished a colon with a poor prep and he says that he couldnt remove a polyp now because the patient was dirty and left it at that. No follow up. He just told the patient that he was good for 2 years. Mind you the patient already had colon cancer twice. I want to know what I can do without loosing my job and not being blackballed. I feel that this is a question of rushing. To do a 7 minute colon speaks for itself. When he attempted to get this one polyp out and couldn't he didn't send the patient to another doc. He told the patient that everything is fine. He has his own schedule that he likes to adhere to in his mind.
    Last edit by shishirenee on Jan 1, '06
  8. by   SFCardiacRN
    Leave it alone, for now. Admin and other MD's will back him up at your expense. Anesthesiologists are about the only people (other than lawyers) that can affect a surgeons practice. And they usually wait for extreme circumstances before they refuse to provide anesthesia. We had a new surgeon with 4 deaths in 8 cases before anesthesia got rid of him by refusing to provide care.
  9. by   nycid
    Quote from shishirenee
    Hello. I usually lurk for a long time before I post but, this is pretty important. I have been a nurse for 16yrs an endo nurse for 10. My last job was in a hospital for about 20 years. I started working in a surgi center 6 months ago as a endo nurse. There is a colorectal surgeon that does 7 minute colons and sometimes leaves polyps behind, some of which are snareable. He had a patient that had colon cancer twice and had a snareable polyp and a poor prep. At the end of the procedure he tells the patient that everything was fine. No follow up colon. I don't know how to handle this. I spoke with my charge nurse and she says that management knows. I feel horrible for my patients.
    What he is doing is malpractice and should be addressed. You mention management knows but does this mean they are in the process of doing something or nothing? As you know polyps can become cancerous. Do you want that on your conscious? Easy for me to say but I realize it is not easy to do. You may want to at least confront him. Sometimes that is all it takes to wake them up. Good luck
  10. by   sirI
    I will have to disagree with confronting the MD with this. You already asked in a way to appear as if you were "gathering" information about how to tx polyps. You would be, as a nurse, questioning he, the MD and, probably he would take offense and possibly make trouble for you. Stay away. IMHO>

    Now, you need to take the next step. That might include "blowing the whistle" to the federal government. If he is being reimbursed by Medicare/medicaid, then, you can call their offices to turn him in. They pay him to treat "their" patients and would dearly love to hear that he is not practicing in the patients best interest.

    You can also call the AMA.

    If you truly believe, and, I believe you do, that he is practicing negligent medicine, committing malpractice and, placing the health and welfare of the patient at risk, you really have a moral and ethical obligation.
  11. by   shishirenee
    I agree with you about having an obligation. This causing some pretty bad anxiety in me. My husband doesn't want me to do anything because he doesn't want me to loose my job. I understand this too. I have a family to support. I want to take steps but, the right steps.
  12. by   SFCardiacRN
    You might also be wrong. Polyps are not always removed. Unless you are prepared to find another job, you should proceed with caution. Malpractice is a strong word and can be tricky to prove in treatment decisions. Malpractice is usually based on outcomes.
  13. by   tonka3
    i understand what you are going thru, I am having issues with my Dr. as well, but different, he gets the nurse to close the snare over the polyps and "cut" them per ther speed of his instruction to "cut-cut-cut" if i go too slow will i burn a hole or too fast and make a hole or bleed. i wonder if this is within the scope of paractice for me to do? he has even gotten me to actually place the snare over the polyp by turning the colonscope itself with only my hand guiding it, i'm flattered he considers me able to be a gastro doc with only 3 wks. training and 2 polypectomies under my belt to turn the scope over to my hands but i am an lpn not a dr.

close