So I work on a surgical floor (our med & surg is separate) and I'm feeling a bit irritated. I feel that communication basically sucks and information is being lost all the time. A perfect example of this what happened with my patient tonight. Dr.X did a lap choley on my patient and consulted primary dr.Y for medical management. Dr. X says to continue home meds, I call Dr. Y do get further orders because of some abnormal lab values unrelated to surgery. Dr.Y calls and is on the phone with another nurse about her patient. The other nurse turns around to me and says "Do you need Dr. Y still? She's in a very big hurry" I tell that nurse (who was also my preceptor a month ago while I was in orientation) what I was needing. She asks the dr. Herself and while she was still on the phone, she writes on a paper what to do in response to my question and also writes to make sure we get a dig. Level. I tell that nurse "we are getting a dig level in the am" she is still on the phone but nods an ok. She hangs up and walks away. At this point I have only a couple of labs on her-- no dig level until the am though. The digoxin was due so I gave it because dr.X said to continue the dig. Dr. Y comes in on the end of my shift and says "Oh this is wrong! I told dr. X to hold dig, this pt is dig toxic I said to hold this!" of course I fessed up and told her it had already been given I told her I was standing by the phone when she talked to the other nurse and I thought I might of heard her say dig toxic through the phone but all I was told was to get a level which we are doing in the am. I thought she had just said "pt. has a history of dig tox so make sure we are getting those levels" The dr. Was clearly frustrated with me and says "no no no no!" I just don't know what to do... I don't know how I could have handled this differently. Clearly I should have taken the call myself but when everyone is so rushed there isn't really time to assert myself in a situation like this the dr. Would have hung up before I could get on the phone. Plus I trust that nurse very much since she was my preceptor and also one of our charge nurses. No one, I repeat No one, told me she was dig toxic! In the chart? Nope. How was I supposed to know? I just feel like stuff gets missed a lot, I feel like I spend countless hours looking for information and stuff still gets missed. I feel irritated that I bust my butt all night for hours and at some point it always comes back to one of my coworkers or a dr. Looking at me like I'm a freakin idiot. I'm frustrated!!! Is it ever going to get better?
May 24, '12
by tokmom, BSN, RN
If the other doc hangs up before you could get to the phone, you call them back anyway. It's your butt, and the pt's safety on the line.
Where do you keep labs? Aren't results under tabs in the chart or on a computer? I agree. You should not have to dig for hours. It sounds to me your system is a bit broken.
You will get the hang of it. It's difficult when you have a lot of Md's on a case. One orders a med and another comes along and dc's the order. Ugh
Last edit by tokmom on May 25, '12