Anyone have hospitalists that are just plain dangerous Docs?

  1. I am fairly new to nursing (3mos) on the floor. We have a hospitalist that is downright dangerous. Daily, he comes in and changes the pts meds, treatments, d/c pt that really need to be transferred to another facility or are not ready to go. and gets extremely angry when you simply ask why did you decide to go that way. He usually mutters something under his breath and dances around the answer like a politician. You get an order to d/c a med only to get an order 30 minutes later to reinstate it!! I don't think that he can explain what he is doing b/c he doesn't know!! I am always having to check the meds that he prescribes to make sure they are compatible b/c I have found several times where he has made dangerous choices combining drugs and when you try to let him know that this can't be given together he gets really mad!! Then retaliates with changing all the orders again!! Everybody on the floor knows that he is dangerous and vindictive to the nurses including the nurse manager but upper management won't do anything about it!! I make sure in my nurse notes that I CMA b/c he also lies about the things that nurses do!! And forget the DON standing up for us!! She's about worthless too!!

    I am always trying to remain calm around him all the while I am having thoughts about poking pencils in his eyes.

    Any suggestions on how we nurses can get him outta there?
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  2. 21 Comments

  3. by   AttagirlRN
    I'm sorry to hear of this lousy doctor. Most internists are NOT cut out to be Hospitalists, and certainly this guy is one of them. It's a hard job, long hours, and incredibly high stress.

    All hospitals are required to have a mode of communicating problems. You need to file a complaint, but how you do it depends on a few things: If the Hospitalists are employed by the hospital, nurses have alot of input on how they perform and interact with staff. There should be a method of event reporting in your hospital, bypass your manager and call your Risk Management office, they will direct you. If the Hospitalists are employed as an LLC (a privately owned group of physicians), they are still on staff so follow the same complaint route. And finally, if they are employed by a Hospitalist company that provides physician staff to the hospital, again use the same complaint method but you might also feel compelled to write to the Hospitalist staffing company. In addition, set up an appointment with your Risk officer, he/she is required to listen to your concerns. If your complaints are legitimate and this doc is truly a danger to your patients, they will listen and help the documentation get to the right people. Believe me, written complaints/event reports are recognized by administration as a red flag. It just takes ongoing documentation to get a physician reprimanded and/or fired. No hospital wants a dangerous doctor due to increased liability, but admin needs proof...they rely upon nurses to let them know what's going on. Please continue to document what you see and report this physician.

    On a personal note, I feel Hospitalists are the best thing that's ever happened to hospital medicine, and have been a godsend to nurses and improved patient care. In my hospital they run the code blues, are there in an instant when a patient crumps, and nurses don't spend 3 hours paging a clinic doc trying to get a simple order. They admit the homeless, indigent, uninsured, ETOH w/d, OD's etc., where most of the other docs in the community refuse because they won't get reimbursed. With that said, I know not all Hospitalist programs are alike, but the ones run well make a mediocre hospital into a 5-star facility.


    AttagirlRN, BSN
  4. by   jnette
    Quote from grinnurse
    I am always trying to remain calm around him all the while I am having thoughts about poking pencils in his eyes.


    Any suggestions on how we nurses can get him outta there?
    ermm.............poke pencils in his eyes?

    OK.. so just what IS a hospitalist, anyway? I don't work in a hospital, so this is something I've not come across.. a new term to me. Just what do they do?
  5. by   Spidey's mom
    Quote from jnette




    ermm.............poke pencils in his eyes?

    OK.. so just what IS a hospitalist, anyway? I don't work in a hospital, so this is something I've not come across.. a new term to me. Just what do they do?
    I work in a hospital and have NO idea what a hospitalist is either. It is even hard to say the word.:uhoh21:

    steph
  6. by   jnette
    Quote from stevielynn
    I work in a hospital and have NO idea what a hospitalist is either. It is even hard to say the word.:uhoh21:

    steph
    Whew ! Thanx, Steph!

    I was almost afraid to ask and show my ignorance publicly.

    Glad to know I'm not the only one who doesn't understand this title or the responsibilities of the position. Thought I was either a real antique, or just plain stupid. Heh.

    I have heard the term thrown around in the past, but too ashamed to ask...:imbar

    So now... we want to know !!! Do tell !!!
  7. by   Spidey's mom
    Quote from jnette
    Whew ! Thanx, Steph!

    I was almost afraid to ask and show my ignorance publicly.

    Glad to know I'm not the only one who doesn't understand this title or the responsibilities of the position. Thought I was either a real antique, or just plain stupid. Heh.

    I have heard the term thrown around in the past, but too ashamed to ask...:imbar

    So now... we want to know !!! Do tell !!!
    We are beautiful antiques.

    steph
  8. by   jnette
    Quote from stevielynn
    We are beautiful antiques.

    steph


    Don't know about "beautiful"............ I'll take "cute".. but beautiful, well actually, you have a point... beautiful on the inside for SURE !!!

    Good compromise.
  9. by   Spidey's mom
    Quote from jnette


    Don't know about "beautiful"............ I'll take "cute".. but beautiful, well actually, you have a point... beautiful on the inside for SURE !!!

    Good compromise.
    I meant on the inside . . .although you are pretty darn cute. :hatparty:

    Speaking of that and off-topic . . . .recently my son asked me "were you afraid of dinosaurs when they were alive" I'm not that old honey. My daughter told me on the way to the theatre "no offense mom, but have you thought about having microdermabrasion - your pores are kinda big".

    steph
  10. by   AttagirlRN
    [OK.. so just what IS a hospitalist, anyway? I don't work in a hospital, so this is something I've not come across.. a new term to me. Just what do they do?[/QUOTE]

    Hospitalists are usually Internists (in small hospitals they often use GP's) that specialize in hospital medicine. In my hospital, clinic physicians, NP's, PA's, etc. sign up for these physicians to cover their patients should they need to be admitted to the hospital. The Hospitalists will admit, round on, and discharge these patients on behalf of the clinic docs. The clinic docs will receive a faxed admission notice (that their patients have been admitted to the hospital) and a d/c summary (telling them what happened during their patient's hospital stay and any outpatient followup needed). The patient then follows up with their clinic doc for routine care following their hospitalization. The Hospitalists are in the hospital 24/7, round and re-round of the patients as needed, and the nurses have them at their fingertips if the patient starts to fail or needs additional orders. The Hospitalists at my hospital work 7 days on (12 hrs) then 7 days off. The clinic docs love it as it gives them a life (they're not on call at night or weekends), and they still get their patients back after their hospital stay. Our program is so well known, patients actually come to our hospital because of the Hospitalists.

    Hospitalist is a fairly new term, though it's been around on the east and west coasts for about 10 years, and now only finding it's way into middle America.
    None of the 9 Hospitalists I work with have their own clinic practice (though patients ask me how they can make an appointment to see "that great doctor who took care of me").

    They are in hot demand though the burnout rate is high. They have to be a specialist in everything, and they usually carry a census of around 20 patients a day. Alot of physicians who get into Hospitalist medicine find out it's not for them, and usually go back to either clinic work or find a fellowship. For the doctors who do excel at this high-paced high-stress life, they are worth their weight in gold. If you look through any New England Journal of Medicine, 90% of the jobs are recruiting for Hospitalists.

    Attagirl RN, BSN
  11. by   jnette
    Quote from stevielynn
    i meant on the inside . . .although you are pretty darn cute. :hatparty:

    speaking of that and off-topic . . . .recently my son asked me "were you afraid of dinosaurs when they were alive" i'm not that old honey. my daughter told me on the way to the theatre "no offense mom, but have you thought about having microdermabrasion - your pores are kinda big".

    steph
    (the little man's comment... too funny !)

    as for dd................. "no offense, honey, but have you considered what it would feel like to be grounded 'til your pores start looking like mine ?" :chuckle

    yeh, steph... we are pretty darn cute. we. :d

    attagirlrn...
    thank you !!! wow... i agree it sounds like a marvelous thing. pretty neat, indeed. kinda makes you wonder how the docs survived without them in the past .. and many still do.

    i appreciate the info. do the patients ever ask where "their doctor" is, when rounded by the hospitalist instead? i know my mom would...heh.
    just curious.
  12. by   smk1
    Quote from stevielynn
    I meant on the inside . . .although you are pretty darn cute. :hatparty:

    Speaking of that and off-topic . . . .recently my son asked me "were you afraid of dinosaurs when they were alive" I'm not that old honey. My daughter told me on the way to the theatre "no offense mom, but have you thought about having microdermabrasion - your pores are kinda big".

    steph
    aren't the little ones fun!
  13. by   Spidey's mom
    Quote from SMK1
    aren't the little ones fun!
    The little one was funny . . . the 16 year old was not.

    steph
  14. by   jnette
    Quote from stevielynn
    The little one was funny . . . the 16 year old was not.

    steph


    My thoughts exactly....

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