What would you have said to this??

  1. 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 reply with, "Ok, and if it doesn't stop...." Doc then takes over and says, "If it doesn't stop, I'll care...Hmmm...Maybe when hell freezes over."

    I can't wait until I have more experience!!!
    :spin:
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  2. 48 Comments

  3. by   ptadvocate81
    Doc stated this?! I would have written it up in an incident report and reported it to my charge nurse. Then, when it didn't clear up, I'd have called him again. Sometimes they are animals, but be persistant and look out for your pt's best interest. If they yell, curse, or cry blow it off- that is why they are getting the big bucks. Use nursing judgement- irrigate it, keep an eye on it, then call. So sorry about your day- tomorrow will be better.
  4. by   Ruby Vee
    [font="comic sans ms"]mention to him that you wonder how this will look in the order book. at the very least, you'll be entertained thinking about it!
  5. by   neneRN
    Just ask innocently, "Should I write that as an order?'
  6. by   BrnEyedGirl
    I'm with nene,......I've heard so pretty cold things from a few Doc's,.but wow,..can't believe he actually said that!!!!
  7. by   ckben
    in all honesty, i probably would have just said, "okay thank you." then i would have gone straight to my nurses noted immediately and charted what he said, using direct quotes.

    what a jerk.
  8. by   UM Review RN
    Quote from neneRN
    Just ask innocently, "Should I write that as an order?'
    I've done that. It really does get results. Of course, if I expect a response like that, I won't even ask, I'll just write it like he said it.

    "DC Foley due to hematuria"

    Then if we have to call him 7 hours later with a retaining patient whose bladder scan = 900 ml's, well, he asked for it. Maybe then he'll order a ua/c&s and a uro consult while he's at it.
  9. by   caliotter3
    We had a doctor make similar statements one time, something to the effect of accusing the nurses and facility of "just wanting to cover your a****" along with other choice sentences. The nurse on our end of the phone con, documented his statements in the nurses' notes, word for word, using quotation marks.
  10. by   Ruby Vee
    [font="comic sans ms"]whether you write it as an order, or document it in nurse's notes using quotes, i'm pretty sure that peer pressure will take care of the problem in short order. in a private hospital, the guy's partners will deal with him. in a teaching hospital, it will go up the chain of command until someone higher than him deals with it. ask your peers what they would do -- is it more common to put that sort of thing on an order sheet or in the notes?

    ruby, who once wrote a verbal order stating "yes i do want you to stick this patient every 1 hour for abgs even though all labs and meds have been d/c'd, even though she's a dnar and even though i've ordered you not to call me with the results, no matter how abnormal." long story.
    Last edit by Ruby Vee on Feb 8, '07 : Reason: Creative signature
  11. by   GardenDove
    :roll :chuckle

    I usually say something like "How do you want me to write that order"

    That doc is obviously burnt out, he needs to become a patholigist.
  12. by   kcalohagirl
    Quote from ruby vee
    ruby, who once wrote a verbal order stating "yes i do want you to stick this patient every 1 hour for abgs even though all labs and meds have been d/c'd, even though she's a dnar and even though i've ordered you not to call me with the results, no matter how abnormal." long story.
    i remember reading that story. . . . . .had a similar situation here a few weeks ago. only we weren't at quite q1hour for abg's, but for 3 days after putting the pt on "comfort measures" (for some reason palliative care was a nasty word) the mds kept ordering test after test and invasive procedure after invasive procedure.

    what part of "comfort" or "palliative" did the docs not understand?
  13. by   mellendis
    Incident report. I have gone the route of charting in the narrative word for word what the MD said, only to have found myself written up. Make it an incident report.
  14. by   matchstickxx
    We have to read back all verbal and telephone orders to the physician. So I guess I would read back...
    1. Discontinue foley catheter due to hematuria.
    2. If hematuria continues, call when Hell freezes over.
    Anything else, doctor?

    Why does the patient have a foley in the first place? If she is post op, did she have a surgery where there was a potential for bladder or ureter trauma/laceration?

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