What to do when a doctor won't let you read back an order - page 2

New nurse here. Had to call a doctor the other night after I followed hypoglycemia protocol and the patient wasn't responding to the treatment. He gave me his order and I began to read it back. He... Read More

  1. Visit  joanna73 profile page
    2
    One of our docs is notorious for hanging up. Your primary role is that of patient advocate. I don't worry about backlash from Doctors. I call back if I need to clarify, and document these incidents.
    not.done.yet and natnat122 like this.
  2. Visit  anotherone profile page
    1
    hmm i always say, "let me read that back to you..... !" dr listens and says, "yes, yeah, right" but i can see some of them going yeah yeah yeah yeah. hmm
    natnat122 likes this.
  3. Visit  Orange Tree profile page
    1
    If I didn't "get" the order the first time, I would call back to clarify. Otherwise, I would write the order and carry it out....especially for hypoglycemia and a patient who was not responding to protocol. I'd probably want to hurry things along, too.
    natnat122 likes this.
  4. Visit  WhereIsMyCallBell profile page
    2
    If I recall correctly," CYA 101" was covered through each semester of Nursing School. As you go along you will know better what to do in these situations.
    natnat122 and joanna73 like this.
  5. Visit  joanna73 profile page
    4
    Right. We are individually responsible for our practise. No Doctor is going to protect a nurse if anything is left in question, or goes to court. If you need clarification from a Doctor, ask. Don't worry about the attitude.
    not.done.yet, natnat122, Meriwhen, and 1 other like this.
  6. Visit  AtivanIM profile page
    5
    I would call them back. "Dr. ____ our phone call must have been disconnected. Give Mr.____ Ativan 2mg PO Q4 PRN, first dose NOW for anxiety, is that correct?" As he is doing his "yeah yeah yeah" dismissal, he is technically giving you consent 3 times.
    Esme12, natnat122, Dezy, and 2 others like this.
  7. Visit  Meriwhen profile page
    2
    Do not let the conversation end without it being confirmed. Whether you interrupt his "yeah, yeah" or call him/her back after he/she hangs up, you need the have it confirmed. I'd also let your NM know if the doctor gives you any problems.

    I tend to do it JBudd's way myself. That way any miscommunication is caught and corrected immediately.
    not.done.yet and natnat122 like this.
  8. Visit  RNGriffin profile page
    4
    New nurses please take note: Physicians are not your bosses and can not hire or fire you. If you document every time a physician is completely out of line, not every time you are offended, they too are credentialed to work in the hospital. The best backlash is a paper trail that doesn't renew contracts.
    ( I worked as the assistant director of H.I.M. for many years and handled the physician training & credentialing)


    Btw, next time notify your charge nurse, and if response is not quick enough call the Chief.
  9. Visit  Esme12 profile page
    0
    They know better.....and they know you are new......call him back with .....we must have been disconnectec....that was...and repeat the order. If he does it again notify the supervision.
  10. Visit  Tree5981 profile page
    0
    Quote from Syrenia
    I have actually interrupted a Dr. in the middle of his "yeah, yeah" with "I am not finished" Actually shut him up and he listened. For once. He's always real good at speed talking his order and hanging up.

    I've done this too!! hahaha love it!
  11. Visit  Bella'sMyBaby profile page
    1
    Quote from squatmunkie_RN
    I make sure I listen very very carefully the 1st time because this happens ALL the time. The backlash from what you're talking about doing is not worth it.
    I know a Nurse who had recently went in front of the Nursing Board because a Dr. refused to sign an order he claimed he "did not give"....
    Meriwhen likes this.
  12. Visit  gypsyd8 profile page
    1
    Quote from griffinchet
    New nurses please take note: Physicians are not your bosses and can not hire or fire you. If you document every time a physician is completely out of line, not every time you are offended, they too are credentialed to work in the hospital. The best backlash is a paper trail that doesn't renew contracts.
    ( I worked as the assistant director of H.I.M. for many years and handled the physician training & credentialing)


    Btw, next time notify your charge nurse, and if response is not quick enough call the Chief.
    MD's may not be able to hire or fire a nurse, but if a nurse ****** one off s/he will certainly get chewed out by the NM, written up, or worse. MD's make the money for a hospital. Most mgmt types bend over backwards not to **** them off. I have been 1)verbally counseled because I woke a MD from his beauty rest for a patient in respiratory distress 2) informed that when a certain physician rounds we will bring him coffee and all his patients charts 3) told to get up out of my chair and give it up to the MD making rounds, and 3) told explicitly not to upset the physicians because middle mgmt is sick of hearing them complain and will find a reason to write me up. Numbers 1 and 2 and 3 occurred at three separate facilities. Numbers 3 and 4 occurred at the same facility but with completely different NM's. All this "I'm not going to take that from a doctor" sounds just peachy in nursing school, but in the real world, where a nurse needs a job, is doesn't matter a hill of beans. The charge nurse may or may not be of assistance, and the Chief certainly does not care about the nurse, as s/he is replaceable. The Doctor isn't. In the real world, we explain what happened to any sympathetic ear and ask a senior nurse on the unit what to do in that particular situation with that particular doctor. Most of the time it comes down to taking the senior nurse's order and praying. Be sure to document everything that comes out of the physicians mouth, unless it implicates you, in which case don't.
    PureLifeRN likes this.
  13. Visit  carl5480 profile page
    1
    If that was me, and I'm being honest, I would have written down the order as I'd taken it and I WOULD have written TORB. You tried to do the right thing and he wouldn't let you. So CYA and let him deal with the consequences. The correct answer would be to call him back and get him to verify it verbally (and he's a jerk for not letting you do so in the first place), but this is the real world and who has the time to hold the doctor's hands and MAKE them do the right thing? I suppose some nurses might, but not on our unit, that's for sure.
    wooh likes this.


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