I need some advice as to how to handle the medical director at the LTC facility I work at... I work at a 150 bed LTC/acute rehab facility, in which there are 3 MDs (including the med. director, who is assigned 75% of the patients). He is from Africa, and I've had nothing but problems with him since the day I was hired. Let me list the issues I'm having, and you can just refer to the number in your replies...
He never comes into the facility - during a 'good' month, he might show up once a week, though I've seen him not come in for weeks at a time (I'm not just talking about my shift... he doesn't come in at all, on any shift.) Not to do new patient MD assessments or anything.
. He undermedicates people for pain, because it's an 'inconvienience' for him to have to write hard copies for the pharmacy. He actually told me to 'just give them some tylenol q4h' when I had a new 65 yr old patient (who was in a great deal of pain) in with a broken hip. Sometimes, he'll even refuse to give people orders for tylenol (for no good reason). I had a pt with a broken arm and broken humerus, and when I asked him to write an rx for pain meds, he said angrily, 'All you American women are the same... You can't handle any pain and it makes me sick', and hung up on me. I've had dozens of patients just moan and cry themselves to sleep every night because they're hurting so much and he refuses to do anything. From stage 4 terminal cancer to arthritis, he seems to have a MAJOR aversion to giving anything out. The more I ask, the more he seems to want to say 'no'. He also undermedicates for anxiety, but thats another story for another day.
. He refuses to return virtually ANY of his pages. (Its a 1:20 ratio.... not just with me, but with all of the nurses.) I work 2nd shift, and he once told me that unless it was the biggest emergency of my life, that I'd better not ever call him again after business hours. He then proceeded to curse me out and yell at me in a foreign language. His attitude is beyond unprofessional (which I can deal with), but it's to the point where I'm afraid to page him/call his office (even though I pretty much know he's not going to call back/reply) because he will scream and belittle you. I can handle it, but its very depressing, and has most every nurse I work with scared to call him, which is resulting in a much poorer quality of patient care.
I understand MDs are people too and everyone has a different personality. However, I feel like I'm stuck in a terrible situation where I can't take care of my patients, PARTICUARLY the ones in pain, because he just doesn't have time to be bothered with them. I had a 103 year old patient whos feet were rotting off from gangrene and she cried so much from the pain that I had to change her pillowcase at least 2 times a shift (because it was soaked with tears). I finally got her family to agree to hospice so she could get the relief she so desperately needed.
What can/should I do?? Even my immediate supervisor has said she's not going to be calling him ever again because of how rude he has always been to her. I don't want to be labeled a whistle-blower (though I have no problem doing so), but do any of you think this man is breaking the law somehow? He seems like some sort of closet sadist to me... he has no compassion for the elderly, and to refuse to help them makes me so depressed. I feel helpless and I want to do something... my patients are like my family and it kills me to see them abused like this, because of some LAZY/ANGRY/RUDE dr treating them like trash. (And just for clarification, I have a very large age range of pts... they're not all very old.)
Sorry this was so long, but I need ideas as to what to do. Is what he's doing something I should report to the medical board? I feel like keeping people in pain because you're too lazy to write the RX is ABUSE. (I know the majority of responders first instinct is to say 'Get another job!!', and I plan to do so in the spring when I get married (insurance reasons), but that still isn't going to solve the problem of him abusing his patients. I want it to STOP, and I need to know how to make it happen! I'm leery about writing nursing notes that allude to his indifference, etc, to my patients complaints, but if you all say it would be ok, I'll go for it. :-/
Thanks again for your help!!