MD refusing nursing

  1. I'm hoping some of you have come across this....


    An MD that states "I don't want so and so to take care of my patient anymore ......."!

    It seems easier when it's a patient or family... if you wish you can take the assignment and try to repair the relationship....

    But since WHEN does an MD delegate assignments?

    Our MOST senior RN left a vented patient on 18 mg/hr of versed unrestrained (she required the dosing due to size).... patient suddenly woke up, responsive and self extubated and the MD was livid!!! no harm to the patient, reintubated without incident.

    If you were in charge, or it was you... what would be your response?

    THis nurse said she didn't care, yet she was the best person suited to care for this very sick patient, plus,,,, it would REALLY hurt my ego and feelings if it was me!

    thanks
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  2. 22 Comments

  3. by   mother/babyRN
    I would remind the md that he has nothing to say about nursing. And, if the clinical manager was in favor of him, as they often are, without listening to the point of view of the nurse in question, I would seriously consider another position. I would have a heart to heart talk with the doc and mention that these things happen and no one is infallible, including him or her...
  4. by   canoehead
    Sh1t happens, and he has to learn his pts are not immune. He has no say over nursing, although we do take suggestions. When he takes orders from us we'll take them from him.
  5. by   fergus51
    Tell him it is not burger king.
  6. by   nurs4kids
    I've seen them throw tantrums like this..

    let it pass and he will be over it soon..
    as for the nurse..
    if it were me..
    i'd be relieved that i didn't have to take care of some A$$ hole's patients.
  7. by   K O'Malley
    I remember a few years ago we had a pt that everyone had burnt out on except for one nurse. She wouldn't give up on this pt who didn't want to do anything for herself. The nurse insisted that she turn, take her medicine, get cleaned-up, etc. The pt told the doc that she didn't want that nurse anymore. The doc told the nurse manager, the nurse manager told him to butt out. Eventually the pt got well and went home.
  8. by   traumaRUs
    These things happen. It's not the MD's place to assign nurses.
  9. by   DIPLOMATICRN4HIRE
    Doesnt the Dr realize that the patient has the right to extubate themselves...... If the Nurse was tenative as it sounds like she was then its something that happens and it sounds as if it was rectified within minutes of what occured. The Dr needs to understand that its is impossible to keep a eye on the patient 24-7 unless there is One nurse who is willing to stand at bedside and Ignore her other patients inwhich she is responsible for.
    The Nurse Manager should have a one to one sit down with the MD.
    Zoe
  10. by   On-z-go-nurse
    A Dr ordered SCD stockings on a post-op pt on a particularly hectic day. When he came up to check on her 30 min later the stockings still hadnt come up to the floor. He was furious demending to know who was responsible and that he didnt want that person taking care of HIS patients anymore. The charge nurse said, WEll Im in charge I guess its my fault." The nurse next to her said, "No I admitted her , its my fault." Another nurse said, "No I feel responsible, its my fault." ANd the next one also... He was out of nurses to care for his pts. What was he going to do...take them home and care for them himself? He muttered "well just make sure she has them on soon" and left. There is strength in numbers...how quickly we forget that sometimes...
  11. by   Q.
    Originally posted by fergus51
    Tell him it is not burger king.
    Rock on.
  12. by   P_RN
    Yep I had a doc tell me to "get some labs" on a lady who was spiking up to 104. After my asking WHAT labs.....he hung up on me. When I called back I got the on call doc who said get a CBC and a Chem 3. The next shift told me that when the A&&**** doc came by he said he hadn't ordered those labs, *I* was NOT to take care of any of his patients again and to tell me there are plenty of jobs in "food service."

    Hmmmm couple of weeks later, one of the new grads came running to me (I was chg that day) saying Dr. A&& post op hip BP was in the basement, pt cold and clammy and when she had called Dr. A&& he said to GET P STAT(me) because P could take care of the situation til he could get there........ OH that was sooooo sweet.

    Good thing that MY hosp and MY NM didn't take his suggestion that I not be allowed to care for his patients......

    And there have been many times that I was sorely tempted to become the cashier at Kroger...I love that doot doot sound the scanner makes.
  13. by   nurspract
    It is times like these that I am grateful that Nurse Managers stand up for their nursing staff and the profession itself!!!
  14. by   capgirl
    We have a "doogie howser" surgeon at our hospital, and sometimes he tries to blow smoke.... One day he was complaining about nursing..... He told the sup that he wanted the best nurse in the hospital to care for his patient. The house supervisor looked him in the eye and said "ALL of the nurses here are the BEST nurses in the hospital" It was a wonderful moment.

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