What would you have said to this?? - page 4

This afternoon I called to inform a doc that pt whose urine has been amber now has gross hematuria. Doc asks if pt has foley, I say yes and he says "well, d/c it. Maybe it will stop." I start to... Read More

  1. by   natsfanrn
    Okay doc...just to clarify the order so we don't disturb you unnecessarily... Is that when Hell freezes over solid, when there's just patches of ice, or if it's just sleeting? Can you leave a number so Satan can page you directly if that occurs?
  2. by   blueheaven
    I did this with one particularly nasty doctor. When I called him to obtain the reason for an X-Ray he said "because I said so". I put it in direct quotes on the x-ray request. Talk about someone getting in major hot water!! It wasn't me by the way....LOL
  3. by   allantiques4me
    I think I would have made light of it and say something like OK DR. now seriously,could I please have a more specific order on what to do if the hematuria continues.??(Im usually really good at diffusing a difficult situation.)
  4. by   Agnus
    Do not chart in the pt's chart that the MD stated he did not care. Do chart that he ordered Foley DC'd after reporting the hematurea to him.

    Do doucument on an incident report or what ever form your facility uses to document misbehavior by physicians. Definately write this up but never on a ptaient's chart.
    This is an internal matter involving staff behavior (yes technically MD is not staff but in this case it is treated as such) and does not belong on the pt's chart. There are so many ways this could back fire on you, the facility, etc if you put it in the pt's chart. It simply does not belong there. This is as wrong as a doctor writing an order for the nurse to "write an incident report."
  5. by   mamason
    I would have documented in the nurse's notes exactly what he said. That way,your butt is covered on that matter. THen, I would have informed the charge or supervisor of the situation and let them handle it. They have ways of getting things done.
  6. by   Ginger35
    Quote from natsfanrn
    Okay doc...just to clarify the order so we don't disturb you unnecessarily... Is that when Hell freezes over solid, when there's just patches of ice, or if it's just sleeting? Can you leave a number so Satan can page you directly if that occurs?

    I LOVE THIS SENSE OF HUMOR!!! :roll :roll :roll Especially when you feel like you are doing this :smiley_ab for a patient to advocate for them

    I say cover your arse - put it in the nursing notes in quotes, make an incident report, and follow the chain of command to follow through and advocate for the patient.
  7. by   lupin
    According to my supervisor, (at least where I work) chart exactly what was said in the nurses' notes, write what the nurse did to follow up (ie: D/c'd Foley per doctor's order, above incident reported to charge nurse, or physician incident report created d/t above statements, etc) then fill out an incident report or physician incident report, whatever and send it to your uppers. Oh, and let the shift leader or charge nurse know.
    I say this because I had an incident this weekend happen where I had a pt throwing things at the staff and her family and screaming at the top of her lungs that we would give her whatever pain meds she wanted or she would leave (Geez, go right the f**k ahead, I'll go get the w/c.). The doc on call for her surgeon said that he was not to be bothered, he was on call for emergencies only and he was not giving out any orders for this pt. My manager was with me at the time, saw the pt's behavior, heard me reiterate what the doc was saying, and walked me through what to do since I had never had that happen before. Oh, and then we called security to come and sit on her for a while until I could get another doctor (she had five) to write me a sedation and restraint order. I don't know if anything will come of it but at least it is documented. My manager said that that is part of the charting since there was a "change" in the pt's condition and we have to show the we did something about it. In this case the follow up/response/plan was that a patient had to have security handle her instead of the staff because the doctor would not give any orders.
  8. by   NicoleRN07
    I would have said, "Thank you", and gone straight to my nursing notes, and charted it word for word, and then I would have notified my charge nurse and nursing supervisor.
  9. by   jslo
    we actually had a doc write an order in the patients chart to make sure there were blank progress notes so he can do his charting! How absurd!!!!! But while we do have to cover our a**, we are to use our nursing judgement, I personnally would've asked how he wanted the order written
  10. by   jill48
    I would go directly to my nurses notes and chart word for word what that turd said, in quotations, and then call the medical director and request another doctor take over that patient's care. I would probably get in a great deal of trouble for that but oh well; wouldn't be the first time I got in trouble for making sure my patients are adequately taken care off.

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