I got written up and it's bringing me down

[porterwoman]

I got written up by a surgeon for contacting the primary medical practice instead of the surgical practice. The pt is okay, no bad outcome. I talked to my charge nurse and another more senior nurse who takes charge several nights a week to get their input on which to call; both suggested I call the primary.

I'm new, only licensed 6 mos. This is my first time getting written up, and I'm dwelling on it heavily. I even had a dream in which the surgeon asked me, "Why did you call Dr. X instead of me??" I need to let this go!

This happens, right? We pick ourselves up and learn from it and go on, right?

I'd like someone to tell me that getting written up is just part of the job and that I shouldn't let it eat at me.

tx, porterwoman

[ZASHAGALKA, RN]

Incident reports aren't the same as being 'written up' by your supervisor. Incident reports don't mean ANYTHING unless your supervisor says they do.

They're like lawsuits. I can sue anybody for any reason, but unless the judge and jury agree, it don't mean a thing. Your judge and jury is your manager.

Besides, a good manager will 'yes, sir' some jerk doc with his/her tirade, and then blow him/her off the sec they're out the door. . .

But, that doc now gets called first every time and for every little reason. "I know it's 2am, but the pt's temp is 100.6, and the orders say to call for >100.5, and you did want me to call you first, RIGHT?"

We had a doc that used to say 'oh just write it and I'll sign later'. Until he found an order he didn't like, and wrote the nurse up. OH NO YOU DIDN'T! Well 2 weeks, ~14 nurses, and ~200 calls later (about every half hour at night, all night, every one of his call nights), and she got a huge 'No Mas!' apology. . .

I've always said that I can ALWAYS find a reason to write up any nurse I follow, as they can me. It's kind of Mutually Assured Destruction. But you know what? I can also ALWAYS find a reason to call a doc at 3am. . .

After the first night, he was in the manager's office: 'six of your nurses purposely called me and kept me up all night last night!'

'Well I did relay your concerns that you weren't being called. I'm glad my nurses took my counseling to heart. Ummmm, that is what you want, right?"

~faith,

Timothy.

[wincha]

yep docs like that need to get called for every little thing even in the middle of the night. you checked with your charge nurse which you should have especially since you are knew. there should be no consequence to this. there will be no law suit as no damage was done. the pmd could have always said to call the surgeon also which i am surprised the pmd did not and accepted responsibility for this surgical patient

[porterwoman]

In fact, the primary said something like, perhaps you should call the surgeon about this (uncontrolled nausea/some vomiting in bowel surgery pt). I said, do you think I should go ahead and call the surgeon? and primary replied, "no, don't wake ____ up too." :stone

Thanks, wincha and zashagalka for your quick replies.

[ZASHAGALKA, RN]

In fact, the primary said something like, perhaps you should call the surgeon about this (uncontrolled nausea/some vomiting in bowel surgery pt). I said, do you think I should go ahead and call the surgeon? and primary replied, "no, don't wake ____ up too." :stone

Thanks, wincha and zashagalka for your quick replies.

I can undestand the surgeon pulling you aside and requesting that you call him first in a similar situation.

If he had a cow, well, that's his cow to tend to. You don't have to feed, water, or milk it.

If you used your proper chain, your manager should back you.

~faith,

Timothy.

[Lorie P.]

hey don't let this get to you, you did no harm to your pt, and remember some surgeons think they are god!!.

like you said pick yourself up, wipe the dirt off and continue on. remember all us have been written up for something at one time or another.

just to prove my point, i got a nasty gram as i call them , just yesterday, had a pt refuse his meds and charted so, make the correct dcocumentation on the mar and guess what this doc got hot cause the pt's temp spiked at 101.8 and he didn't get his tylenol so the day shift charge wrote me up, and my nasty gram came from nm and my reply" did anyone check my nurses note to see why he didn't get his tylenol?" no of course not, but hey i didn't let it bother me cause i did no harm or wrong to my pt. can't make open and swallow now can i??

just remember no one is perfect!

[LPN1974, LPN]

I would not worry about it.

That doctor must have one big ego, and on a power trip. Don't even give it another thought.

And you had your charge nurse and another nurse giving you advice so this shouldn't go anywhere.

I wouldn't lose any sleep over it.

[KatieBell]

I can undestand the surgeon pulling you aside and requesting that you call him first in a similar situation.

If he had a cow, well, that's his cow to tend to. You don't have to feed, water, or milk it.

If you used your proper chain, your manager should back you.

~faith,

Timothy.

OMG too funny, about the cow.

Really, you consulted your senior and they suggested you call the primary, the primary told you NOT to call the surgeon. While the surgeon wants to waste a lot a paper, I'd just call him each time your patient needs parecetamol...each and every time, and don't bundle the calls either, just one every ten minutes after Midnight...

Ok seriously, thats just a nice fantasy, it would be unprofessional.

But really, give yourself a break. The patient is FINE, it is the surgeon who needs an attitude adjustment.

[TazziRN, RN]

Hey, if the surgeon thinks you called the wrong physician, too bad. At least you did what you were supposed to do and called a physician. Who was the primary admitting MD? That's the one that should have been called. If the surgeon is the consult, unless he specifically wrote "Call ME if ______" then I would have called the primary too.

[porterwoman]

call him each time your patient needs parecetamol...each and every time, and don't bundle the calls either, just one every ten minutes after Midnight...

:yeahthat:

Thanks, you guys. You're the best.

[clee1]

1) You should have documented that you asked the charge who to call.

2) You should have documented that the primary told you not to bother the surgeon.

3) This "surgeon" just wanted to bill a huge "after hours phone consultation".

4) Payback could be really sweet with this yoyo. He can bite the big one IMHO.

[wincha]

Uncontrolled n/v with bowel surgery.... I am very surprised the charge nurse told you to call the primary. However when I worked on the floors I worked on surgical floors and we always called the surgeons never saw the primary. However you did ask, you are a new grad. the charge nurse should have known. Also the primary should have turfed this to the surgeon so he would not be liable for any complications due to the surgery.