I have been a nurse now for about a year and in that short time, I've found some things that I find to be VERY irritating about my job. I work in a very large hospital that has made it onto lists of "top hospitals" in the US so we must be doing something right but there are little things that really chap my cheeks.
Doctors: I hate when I get a patient admitted with a raging UTI and there is no pyridium or anything else ordered. Only once can I remember this medication already ordered. How about some relief, doc? So, then I'm having to call them to get an order for something that, in my opinion, should have already been in place. The same with Tylenol for fevers, etc.
I once had a fresh post op patient, foot amputation, and he had only Tylenol for pain. Really?
These are just examples. I've had many patients who are without orders on things they need. I have them come from ER with only half their home meds ordered. So then, they're mad at me because I don't have their anti-seizure medication that they MUST take every day.
Why do doctors put in notification orders if they're going to get ticked when they're notified? To me, a post op patient who has a steadily increasing fever over 24 hours that isn't being touched by APAP is cause for concern. I was concerned, the patient was concerned, the family was concerned, even the CNA was concerned. When I called about it, the doctor said "Why are you calling me about this?" Hello. There is an order to notify.
That is only one example. I could go on and on. Just the other night I called about a very elevated BP. The doctor didn't even let me finish the sentence before he said "Thanks" and slammed down the phone.
Pharmacy: I am so SICK of being out of medications in the Pyxis and having the pharmacy refusing to send them because they say "its in the Pyxis".
I can't tell you how many times I've needed a medication, sometimes critically, and the pharmacy wants to play Its In The Pyxis Phone Tag for ages before they just send it.
I once needed tubes for a blood draw and went though the same dog and pony show with the lab.
JUST SEND IT.
Patient transfers: This is something I've been hearing a lot of griping about from other nurses lately. We often, of course, get patients transferred from the ER or the observation unit. There have been many, MANY times I've gotten patients with STAT or NOW orders that were written 8 hours before but were never done. Or maybe they had medications scheduled while they were in the ER but the nurse doesn't bother to give them. I've even had ER and OBS nurses tell me in report that they are going to give meds/start fluids/do something ordered before they send them up and surprise! they come up without those things being done. Why say you will do it if you aren't?
I know if I went home without doing orders or giving meds that were ordered, I'm sure I'd be written up. Or worse.
Quote from gcupid
Address the ER physician thanks
Ordering medications is outside my scope of practice.... Or set up a protocol list....
That's what I mean...
It is the physician, unless the nurse is not advocating this need and trying to move the patient out....
I am just not sure which one is the issue...
Last edit by TopsDrop on May 23, '13