It's all in the presentation

  1. We have a patient who was vomiting what looked like fecal matter. My ADON asked me to review the chart to see if they'd missed something. (We are a spectacularly great team!) I reviewed the chart and saw that he had a history of colon cancer with a resection and chemo, a possible small bowel obstruction at the hospital, and many other co-morbidities. I hunted down his doctor in the building and told him we needed to get a KUB. He agreed and we booked the test.
    When I told the team nurse, she said "I told him that yesterday and he did nothing." So, I've been doing this for the better part of 32 years (yikes!). I told her it's all in the presentation. Some of these docs need to be jolted into action. I ran up to him while he was sitting at the computer and gesticulated wildly while describing the resident's symptoms and telling him we NEEDED a KUB. I told the nurse, who is wonderful but still relatively new, that she had to learn to ACT like some things were more of a problem than they actually are to get what we need for our residents. I guess all those theater classes in college paid off!
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  2. 16 Comments

  3. by   Sue Salisbury
    Great story, great advice, and your patients are fortunate to have such a creative nurse!

    Aloha, Sue Salisbury Maui Hawaii
  4. by   Esme12
    Yes they do! I couldn't cut it musical theater so I became a nurse!
  5. by   NurseNightOwl
    Quote from CapeCodMermaid
    We have a patient who was vomiting what looked like fecal matter. My ADON asked me to review the chart to see if they'd missed something. (We are a spectacularly great team!) I reviewed the chart and saw that he had a history of colon cancer with a resection and chemo, a possible small bowel obstruction at the hospital, and many other co-morbidities. I hunted down his doctor in the building and told him we needed to get a KUB. He agreed and we booked the test.
    When I told the team nurse, she said "I told him that yesterday and he did nothing." So, I've been doing this for the better part of 32 years (yikes!). I told her it's all in the presentation. Some of these docs need to be jolted into action. I ran up to him while he was sitting at the computer and gesticulated wildly while describing the resident's symptoms and telling him we NEEDED a KUB. I told the nurse, who is wonderful but still relatively new, that she had to learn to ACT like some things were more of a problem than they actually are to get what we need for our residents. I guess all those theater classes in college paid off!
    Great tip for a new LTC nurse Thank you!!
  6. by   CoffeeRTC
    So true.
  7. by   BrandonLPN
    Yeah, at this point I could get our physician to send a resident to the ER for a runny nose if I really wanted to(I don't want to, but still). No lies or fabrications necessary, just ham it up a little.
  8. by   IowaKaren
    Another crucial thought is repeating the addage old, "the family wants them checked out in the ER," or "level of consciuos change," works well BUT, it had better be the truth also and documented as such.
  9. by   CapeCodMermaid
    We don't send residents out unnecessarily so I never would say the family wanted them out unless it were true. We can do everything the hospital can do except hang blood and put someone on a ventilator. By the time my little old resident gets seen in the ER, we could have had stat labs and x-rays done with results and could have started at the very least a peripheral IV if not a Mid or PICC line.
  10. by   kungpoopanda
    I disagree. You should not have to put on an Oscar winning performance to get somebody to do the job they are being paid to do. If the doctor will not do their work, escalte it at a higher level. S/he whould be written up for this slackness.
  11. by   CapeCodMermaid
    Doctors should be receptive to what the nurse is saying, but we all know they aren't always. If I have to make a scene to get what the resident needs, so be it. Other than the medical director, I am the highest person to 'escalte' issues to. The word is escalate and, thank you, I always wanted to win an award for my acting.
    Last edit by CapeCodMermaid on Mar 16, '14 : Reason: Added smilies to avoid sounding snarky
  12. by   RpeNa
    Well said cape cod
  13. by   Spidey's mom
    Quote from kungpoopanda
    I disagree. You should not have to put on an Oscar winning performance to get somebody to do the job they are being paid to do. If the doctor will not do their work, escalte it at a higher level. S/he whould be written up for this slackness.
    I agree with you. I make sure I have all my ducks in a row, which means have all the info the doc needs at hand. Acting excited doesn't work for me. I want them to trust me.
  14. by   AdamantiteEnigma
    This story put a huge smile on my face - thank you for that!

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