Stubborn Docs, New Docs - page 3

I'm wondering if anyone has encountered experienced doctors who will never change their orders, even after you explain to them why and how their orders are inappropriate - nicely, courteously,... Read More

  1. Visit  GrnTea profile page
    5
    "perfect example of a brand new doctor thinking he is a hot shot, being sadistic(in my opinion) with his orders, let alone chewing me out at the nurses station in front of my colleagues, patients and their families. i have a steel spine so i wasn't embarrassed at all, which made this doctor even madder. what kind of a doctor gets off on embarrassing and belittling nurses?"

    one of the best attendings i ever worked with took the new house staff around on the first of july every year and told them, in full hearing of all of us, "these are the best nurses you will ever work with. if one of them tells you to do something, you do it. if i ever hear of you abusing one of them, you are finished on my service." (and since this was the service of its kind in the country, nobody wanted to screw that up.) he also made sure there were no instruments thrown in the or, and no patient/family care that wasn't absolutely compassionate and expert.

    if this md is being a jerk, there are a few options open to you. one, speak to your hospital risk manager. i can promise you s/he will be interested in this story, because this md's behavior exposes the institution to risk. two, sidle up to his superior (attending, senior partner, whatever) one day and tell him about this little incident. i would be willing to bet that you will have no more trouble, and more to the point, your patients will be safer.
    not.done.yet, DogWmn, carolmaccas66, and 2 others like this.
  2. Visit  noahsmama profile page
    8
    Quote from Munch
    You can't make this stuff up. I will admit he is a good looking guy, one bat of his eyelashes is all it takes. The patient care associates either get starbucks for him when they are on their break(which is fine) OR when the charge nurse is not around(not fine)...and they all stick up for each other. If I am looking for Patient care associate So and So another will step up and make an excuse as to why they aren't around and volunteer to help me. People seem to forget I received my BA from John Jay college of criminal justice before I changed my mind and decided to go into nursing...I have the eye of a detective.
    The PCAs need to be told that they will be written up for patient abandonment if they continue to leave the floor to get this doctor his Starbucks. I don't care how good looking he is, or how much he bats his eyelashes. If they want to go get him coffee on their breaks, that's their choice (although a pretty stupid choice, IMO), but it's NOT ok for the hospital to be paying a PCA to fetch coffee for Dr. Hotshot when they're supposed to actually be doing patient care.

    The doctor is a jerk for asking, but the PCAs are grown ups and are responsible for their own choices. If they choose to leave the floor when they're not on break, there should be consequences.

    BTW, in the hospital I used to work in, if any doctor had ever asked a PCA to leave the building, or even the floor to go to the cafeteria to fetch coffee, the PCAs would have looked at the doctor like he had two heads, and then they would have laughed at him.
  3. Visit  DizzyLizzyNurse profile page
    1
    Maybe the PCAs are hoping to land a good looking dr by serving him() . The dr at my last place was awesome. He was very short with me the first time I had to call him for something and then I was scared to talk to him. The other nurse said I should talk to him about it, so I did. He felt so bad he must have apologized 100 times and told me to speak up right away if he ever did that again. I would have picked him up a Starbucks! (If I was on my way and on break of course!
    Maggie09 likes this.
  4. Visit  Munch profile page
    0
    Quote from noahsmama
    The PCAs need to be told that they will be written up for patient abandonment if they continue to leave the floor to get this doctor his Starbucks. I don't care how good looking he is, or how much he bats his eyelashes. If they want to go get him coffee on their breaks, that's their choice (although a pretty stupid choice, IMO), but it's NOT ok for the hospital to be paying a PCA to fetch coffee for Dr. Hotshot when they're supposed to actually be doing patient care.

    The doctor is a jerk for asking, but the PCAs are grown ups and are responsible for their own choices. If they choose to leave the floor when they're not on break, there should be consequences.

    BTW, in the hospital I used to work in, if any doctor had ever asked a PCA to leave the building, or even the floor to go to the cafeteria to fetch coffee, the PCAs would have looked at the doctor like he had two heads, and then they would have laughed at him.
    Oh I completely agree with you. First of all I don't know how he landed on the neurology/neurosurgery floor to begin with. This doctor would be better on the unemployment line. Crani patients(especially if they had a tumor removed-benign, (cancerous brain tumors get removed on the oncology unit) need a lot of care, pain control, decadron, and at times muscle relaxants and or sedatives. This doctor that I am taking about is extremely conservative no matter how high a patients tolerance is. Oh and he ABSOLUTELY refuses to put a patient on a PCA pump whether the patient is a chronic pain patient or not. One more stunt like putting a patient with an injury that is known to cause extreme pain like a skull fracture or major brain surgery patient on our floor and the patient doesn't have a PCA and he orders 1-2mgs of morphine every 3-4 hours and I myself am going to the chief of neurology or neurosurgery myself. Oh and yeah if he wants to chew me out in front of everyone(like I really care anyway) we have a policy that if someone needs to be reprimanded than an office or an empty conference room would be more suitable says hospital policy anyway(most nurses ignore Dr chintzy anyway) but one time he made a nurse on her first day cry in front of everyone. Anymore of the rules according Dr chintzy and I am going to the head of the neurosurgery AND HR...then we will have to see what Dr power-trip has to say about that.huh...1mg of morphine every 4 hours with a serious skull fracture.
  5. Visit  DogWmn profile page
    0
    OP I feel your pain, years ago I worked in a University Family Practice Clinic that was the training ground for the interns/residents. But we were fortunate enough to have a GREAT Dept. Head and he really lowered the boom when they came in saying something very similar to Ruby's guy. Even so we'd get some real stinkers and they either shaped up or shipped out. A perfect example is Dr. nitwhit just came from a seminar on IUD's and wanted to give it a whirl on a woman with chronic PID ...we had one go around - he was insistant even though I refused to do the set up..he's rumaging around trying to find the supplies on his own, my head nurse comes to assist and I catch her eye and shake my head and I show her the chart and she's like. I go down the hall to the dept. head and tell him what's happening and ...oooooooohhh boy did he get a new one.

    As long as you have a good back up, your safe and I'd also document document document every little thing when he steps over the line.
  6. Visit  TicAL profile page
    2
    I have to say that I have seen the flip side of this as well. Some experienced nurses will absolutely abuse new docs and treat them with a complete lack of respect. Speaking to a new doc with a demeaning voice and making demands is belittling to their training and often times sets up an antagonistic relationship which makes the work environment difficult. It all ends up being about ego. "Who is this kid that just got here that is writing my orders?"
    anotherone and Kooky Korky like this.
  7. Visit  Kooky Korky profile page
    0
    Quote from Munch
    That's the thing that enrages me the most! Dr "hotshot" doesn't get a damn about what the charge nurse has to say. I've talked to the charge nurse about this and she has told Dr "hotshot" multiple times that the patient care associates were hired to help the nurses and patients, not to be a gofer or his personal assistant. He just completely ignores whatever the nurses have to say, charge nurse or not. He always says well "when I was a resident at the Hospital I came from the nursing techs got me coffee, lunch and did personal favors for me all the time" (just want to say the hospital where he trained at was um...below par, the hospital was pretty much a free for all). Well this hospital doesn't operate that way. If he wants to get his own personal assistant then please by all means go ahead' I am sure he afford it now that he is an attending. He treats the nursing staff like we are there to serve HIS personal needs. No we carry out your chintzy orders and are here to take care of the patients and families needs and make sure the patients are as comfortable as possible.

    Another thing this doctor doesn't realize is that some of the patients on the floor have just had MAJOR brain surgery, they are in pain, they are scared and they are uncomfortable(I know it first hand, I had major brain surgery and I felt all of the above and more). The other patients that haven't had surgery but are on the floor because of many things; skull fractures, brain bleeds, brain swelling etc. How he landed on the neuro unit is beyond me. If he doesn't change his attitude very soon, I am going to the chief of neurosurgery, see what he has to say about this.
    The Charge Nurse needs to go over his head since he won't listen to her.
    Do all Neuro pts feel what you felt? Just asking, I don't really know. Not saying you're wrong, just I wonder.
    If you are as unhappy with him as you sound like, it is time to talk to him or his boss/your boss; maybe all staff who feel as you do need to get together and have a meeting with your boss and whoever oversees him and take it all the way to the top. You might need to seek other employment if you really can't abide him and he's not leaving.
  8. Visit  Kooky Korky profile page
    0
    Quote from DogWmn
    OP I feel your pain, years ago I worked in a University Family Practice Clinic that was the training ground for the interns/residents. But we were fortunate enough to have a GREAT Dept. Head and he really lowered the boom when they came in saying something very similar to Ruby's guy. Even so we'd get some real stinkers and they either shaped up or shipped out. A perfect example is Dr. nitwhit just came from a seminar on IUD's and wanted to give it a whirl on a woman with chronic PID ...we had one go around - he was insistant even though I refused to do the set up..he's rumaging around trying to find the supplies on his own, my head nurse comes to assist and I catch her eye and shake my head and I show her the chart and she's like. I go down the hall to the dept. head and tell him what's happening and ...oooooooohhh boy did he get a new one.

    As long as you have a good back up, your safe and I'd also document document document every little thing when he steps over the line.
    Wow!!!
  9. Visit  Kooky Korky profile page
    1
    Quote from DixieRedHead
    So I have this patient who is crashing and burning before my eyes. You know, the nurse eyes.

    I call Young Doctor so and so, and tell him to get his rear in gear, get over here, talk to family because this old guy is a full code and has so much wrong with him that he's never going to see the light of day.

    For once, he came, got the DNR. The guy dies 10 minutes later. Young Doctor says so quietly "How did you know he was going to die?" " I said "That's not the point, what made you think he wasn't?'
    Dummy me, I have to ask - how did you know and why didn't you just tell him how you knew? It was a teachable moment, wasn't it?
    DixieRedHead likes this.
  10. Visit  nursedanica profile page
    0
    They thinks like this: I'm a doctor, you're a nurse.. SO I AM YOUR MASTER HERE.
  11. Visit  GrnTea profile page
    0
    when i was a new grad i was in a pacu (great place to learn a lot!) and the chief of surgery brought in a guy with multiple abdominal drains and a periodic antibiotic irrigation to run into the middle of the mess. the fluid it was to be mixed in wasn't specified, but i figured that if there was infection in there, d5w was probably a bad idea so i mixed it in ns after checking with my boss (wonderful older nurse who had seen it all). she said, "good thinking," and told me to tell him when he came back to check on the guy.

    so an hour or two later he comes back, i tell him what i've done, and he gives me the hairy eyeball and stalks to the desk and writes that the irrigation should be mixed in d5w, slams down the chart and stalks out. we transfer the guy to the icu...and they tell me the next day that within about two minutes of my giving report and leaving him in their bay, doc runs in, grabs the chart, and changes it to ns before they hang the next bag. sheesh. (yeah, this was the same chief of surg who hung the intern out to dry on the carotid lady...)


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