Doctor Hassles - page 2

by ThislittleoneRN

3,698 Views | 24 Comments

Let me start off by saying I avoid this "nurse practitioner" like the bubonic plague. This "individual" constantly insults all nurses, myself included. This nurse practitioner is rude, unprofessional, and let's be honest, not... Read More


  1. 1
    Quote from BostonFNP
    I dont know this person and I am not trying to defend him/her. I hope the patient recovered well.

    Just because a provider doesn't do what the staff wants all the time doesn't make them a bad provider. A lot of the NP-RN relationship is based on trust. The NP needs to trust the assessment of the RN and the RN needs to trust the plan of the NP. It sounds like this trust is off between this provider and the RNs, on both sides.

    On the prescriber side I am cautious, especially in the elderly due to the pd and pk changes as well as polypharm. It sounds silly, but abx can save someone or kill them. I do, on the other hand, try and always remember that the nurse at his bedside knows him much better than I.
    I agree with you 100%. I have been working on trusting this individual for quite some time now. This is going to sound silly, but there are times when she will prescribe new medications or treatments and I consult with another practitioner or even MD prior to transcribing the order. This particular practitioner and the MD she works for can not practice at a local hospital that is very popular. On a side note, I do appreciate your feedback and honesty.
    Esme12 likes this.
  2. 3
    Quote from leslie :-D
    yep, i've worked with folks like *those* and the only way we resolved it was sharing concerns with DON and then we ALL had a meeting with the np.
    (ftr, her supervising physician was useless to deal with as well.)

    great call on consulting with med'l director.
    it seems many don't know that elderly do NOT present with textbook s/s....
    and that MANY remain afebrile until they are bordering sepsis.

    be very detailed in your nsg notes.
    describe your actions/interventions with this np, your subsequent call to med'l dir and the new order.
    also note abnormal labs from urine and new orders to "push fluids" per (fill in treater's name).

    that's the best you can do for now, until relations improve and/or she starts trusting nsg's input more.
    still, always write notes to show you weren't a passive bystander.

    leslie
    Thank you for your post! We have a meeting with our DON and administrator tomorrow regarding this matter. I charted on everything you stated and was second guessing myself until I saw your post. I greatly appreciate this. I am a new nurse and still learning the ropes.
    netglow, Esme12, and leslie :-D like this.
  3. 1
    Boston it according to the OP it seems like the NP does not communicate well with the staff to begin with. I agree that trusts must be built, however I think it could be possible that the NP needs an attitude adjustment.
    So far as the treatment plan: I can totally see why the NP ordered what she did. With the elderly we have to be careful with over prescribing.
    aknottedyarn likes this.
  4. 6
    I can understand the consertivive treatment the NP prefers for this patient. However, as someone else stated, it is the manner in which the NP is speaking that appears to be the problem. Instead of being so flippant, she could briefly educate the nurse (OP) on her rationale for her treatment of choice. It sounds like it could have been a great educational opportunity. We as nurses have to know why we are treating a patient the way we are right? I can imagine a family member crabbing at the nurse "why aren't you doing anything." In this case the nurse can only think to herself "um, because the NP said so." While instead she could learn the NPs rationale and then explain it to the family. I also take issue with the NP saying "he's half dead anyway." How crass. We may *think* these things, but holy cow, we don't SAY them!
  5. 3
    Quote from ThislittleoneRN
    The physician who she works under is just as bad as she is.
    I see that a lot. Either the MD advocates for their hire because they get along in the first place or the NP learned the style from the attending. Either way, rock and hard place.
  6. 2
    Quote from BostonFNP
    It seems like you have deeper seeded roots than this one interaction, and it is clearly effecting your working relationship. All else aside, I would suggest sitting down and having a direct talk with him/her: it may be bet for both you and the patient.

    A few questions, why the quotes around nurse practitioner? Is he/she a NP or not?
    I have worked with "so called" professionals who proclaim they actually went to school for medicine do I get the "nurse practitioner" quotes as emphasizing that the OP believes they are a "so called" professional.

    I too have worked with "professionals" that claim they "know" what they are doing along with that disparaging tone that is used to supposedly indicate strained tolerance and impatience....for they are far too busy and educated to be bothered by a lowly nurse.

    OP.....I would try to engage them....see what makes them tick. I would have this conversation in front of my manager to prevent a "he said she said" situation with you being on the loosing end of that conversation for I know this type to usually be vengeful and insecure.

    When all else fails.....I would do what you did...go around them.
    uRNmyway and prnqday like this.
  7. 3
    I had a provider like this who refused to speak to the floor nurses, and he was the medical director. Didn't matter if it was after business hours and we had a problem, if the floor nurses called him, our answer would be, 99% of the time,
    "Don't call me for this (his favorite expletive), I don't have time. Send them out if you're so freaked out about it."
    We ended up sending out an inordinate amount of patients to the ER, most of whom could have been easily treated in house. Of course this started messing with the facility's reimbursements. When the money started talking, our usually do-nothing supervisors decided to step in. The DNS and managers had a meeting with the medical director, and suddenly he was happy to treat issues in house, after hours, with no problem.
  8. 1
    Quote from NurseDirtyBird
    I had a provider like this who refused to speak to the floor nurses, and he was the medical director. Didn't matter if it was after business hours and we had a problem, if the floor nurses called him, our answer would be, 99% of the time,
    "Don't call me for this (his favorite expletive), I don't have time. Send them out if you're so freaked out about it."
    We ended up sending out an inordinate amount of patients to the ER, most of whom could have been easily treated in house. Of course this started messing with the facility's reimbursements. When the money started talking, our usually do-nothing supervisors decided to step in. The DNS and managers had a meeting with the medical director, and suddenly he was happy to treat issues in house, after hours, with no problem.
    Love it! Money Talks.
    NurseDirtyBird likes this.
  9. 3
    Quote from NurseDirtyBird
    I had a provider like this who refused to speak to the floor nurses, and he was the medical director. Didn't matter if it was after business hours and we had a problem, if the floor nurses called him, our answer would be, 99% of the time,
    "Don't call me for this (his favorite expletive), I don't have time. Send them out if you're so freaked out about it."
    I like to write quotes like that directly into my nurse's notes. Our notes print out on the 1-2 page "daily progress" sheet for each patient. They very much enjoy seeing their words in print at the bottom of the page. So does the chief of staff.
  10. 2
    Quote from ThislittleoneRN
    Let me start off by saying I avoid this "nurse practitioner" like the bubonic plague. This "individual" constantly insults all nurses, myself included. This nurse practitioner is rude, unprofessional, and let's be honest, not very good at her job.
    Wait, I think I recognize this person. Do they spend time on allnurses.com?

    All kidding aside, the comment "just as useless as every nurse I've worked with" violates behavioral standards and should be written up as such and complained about. I don't work to be abused.
    ThislittleoneRN and Aurora77 like this.


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