..and I don't mean the official type. I mean the type that gets you into FIGHTS!
Today, I was so studiously administering
80mg Lasix IV push over 8 minutes, and the patient's doctor walked in the room and told me to "just push it," in regards to the last 30mg (in 3mL), because he needed to assess the patient.
Now, I'm a nursing student. I can't even take REAL verbal orders from a doctor at this point, let alone administer something incorrectly because the doctor told me to. Whaaaat was going on here? I don't know if "just pushing" Lasix IV is something nurses do regularly, but I was pretty taken off guard by such a suggestion. What about deafness?? What about irritating the veins??
He added, "we don't do that in the real world." And he said, "real
world," like my administering lasix was the behavior of those in of la-la land, but specifically meaning that people don't actually follow a 10mg/min for Lasix IV. This is probably true to some extent, and if he's done that a million times and nothing bad happened, that's his b'ness, but I certainly wasn't going to take any chances.
My mind kind of blanked and I tried to explain, "I'm actually a nursing student and I can't take verbal orders, sooooo sorry." (as though this was *that* type of order).
He continued to get agitated and repeated, "Just push it!! Just push it!!" I didn't know what to say or do, but I knew I wasn't just going to push something incorrectly and hurt the patient. Again told me that this isn't how things work in the real world, in a really mean and frustrated tone.
I just told him, "I can push it over 2 minutes." (We'd already been arguing for one minute and 1 mL at that point).
Oh boy, was he MAAAAAAAD.
And just and added note to the story, this all occurred in front of the patient's family as well as the patient. The family later thanked me and expressed that they were frustrated that he'd been so impatient, and didn't know anything about what was going on with the patient.
After I gave the Lasix, the doctor listened to the patient's lungs from her back side, which was EASILY accessible to him the entire time and left...so I was pretty confused as to the purpose of our whole beef.
Anyway, the point of this huge post, aside from venting is: in hindsight, the best thing to do would probably have been to stop administering the med and continue after he assessed the patient, right?
I would have been open to that as a compromise, but I didn't even think of it at the time. I mean, this is about the 3rd time I've ever given it, and the first time I was ever pushed around by a doctor.
Any thoughts on how you've handled similar "orders," as experienced nurses?