Difficult Doctors...Vent - page 3

Hi Everyone Early this morning, I called the MD to inform him that a resident had very low urine output (60 ml in about 6 hrs). The resident was very lethargic, distended abdomen, constipated. The... Read More

  1. by   xx--RN--xx
    Chart...chart ...chart!

    XYZ problem.
    Notified Dr. A of XYZ.
    Dr. A gave no new orders at this time.

    CYA so you can live to nurse another day!
  2. by   platon20
    Quote from carolmaccas66
    Can you call another doctor re the patient? A specialist maybe?
    No, this is inappropriate except in circumstances where a patient needs an ICU bed and the primary doctor wont call you back. Only in that circumstance is it OK to call another doctor (ICU doc).

    I'd be making a quick, anonymous call to the medical director about this - or get a few nurses together to complain - and get something done.
    I agree with this; best way to go.

    One of those patients is in acute renal failure and needs to be assessed.
    Call a nephrology doctor for a consult instead.
    NO, this is not acceptable. Nurses cant and shouldnt call for physician consults. A consult is specifically a physician to physician deal. First off, a specialist wont get paid for a consult thats called by a nurse. Secondly, most specialists would be rightly angry at a nurse calling a consult, ESPECIALLY in the middle of the night. Thirdly, consults generally require knowledge of pathophysiology that nurses dont have. If a nurse called a nephrologist in the middle of the night with a chief concern of "this patient is oligouric/anuric" thats not very helpful information in and of itself. Its incredibly rare that you need a nephrology consult in the middle of the night, even for a 100% anuric patient. Dialysis can usually wait till the AM, and nurses arent qualified to know when someone needs emergent dialysis or whether they just need conservative management until the primary doctor can talk to the specialist in the AM.
  3. by   bsveillon
    Well, all I can say is, something needs to be done. I can't tell you to do what I would do, because I don't know what your outcome would be! But I know, I've risked disciplinary action(and received it) to let a Dr. know how I feel. This has nothing to do with how he treated me, but he's not even paying attention to the pt.! I told him, if this was my grandmother in the hospital, and you showed this lack of concern, and something happened, you WOULD be sued. Why should I care less because instead of my grandmother, it's a pt. NO! Do your job that you get paid too much for! Do it or let someone else do it for you!

    Again, perhaps you aren't in a situation to do something that outspoken, but you must do something.