Why do doctors ask the nurse? - page 2
by BSNbeDONE, BSN, RN | 5,397 Views | 17 Comments
I'm busy trying to be in 3 places at once so that the patients will stay happy. It is the middle of the night, not one of the patients are asleep because they might actually sleep through the next dose of Dilaudid. People are... Read More
- 0Feb 15, '13 by KelRN215, BSN, RNQuote from brithooverOnce had a neurosurgery patient who started seizing. The code light went off and the Neurosurgery Resident was the one overseeing the patient... he called for ativan and we said "how much?" The response was "the usual dose." Fortunately the Neurology resident was right behind him and gave the appropriate order.Or some docs:
Me: Pt X has bad mouth sores. Can I get some nystatin ordered please?
Doc: Sure. What's the dose?
- 0Feb 15, '13 by KelRN215, BSN, RNQuote from ninjagoWhen I worked in the hospital, usually only the MD's covering the patient's service were allowed to write orders. There were some exceptions (like only Oncology could write chemo orders, so if the patient was in the ICU or on the surgical service, Onc would still be writing/overseeing those orders) but overall, if a consulting physician wanted to order something, he had to speak with the MD covering the patient who would then enter the order. It made it easier in some ways... so you didn't doctors competing with orders and dc'ing each others... but also made it more complicated with the nurse being the go-between... Endocrine wants to give more ddAVP to this patient so now I need to make sure Neurosurgery actually orders it...I was just thinking about what OP said, one doctor orders a med and another doctor d/c it only to have the other doctor order it again.
so here's the scenario:
nurse: Mr X, here is the new medicine doctor A order for you. (gives med to pt to take)
patient: ok.....(leaning to his table to get some water). Putting the pill in his tongue and about to take a gulp of water when....
nurse realized in the computer the order has been changed to d/c.
nurse: ooops, sorry MrX but doctor B does not want you to take the pill. Spit it out, please.
Patient: are you sure?
nurse: yes, there is a new order here to discontinue it. so please spit it out.
patient: okay(spits out the pill)
nurse: Thank you. Let me just review in my computer if I have given you all the meds you're supposed to take this morning.
(reviewing....reviewing....) seems okay.......hey wait a minute! New order to give the pill. Mr X, seems like there is another new order to give the pill you just spat earlier.
Patient: well, nurse make up your mind! do I take the pill or not?
- 2Feb 15, '13 by veggie530Quote from Nurse_I don't get this. I don't mind getting yelled at for screwing up because I deserve it, but if I'm doing my job I'd be irritated if I was yelled at. They need an octagon shaped cage in the basement of hospitals!Most of the doctors in where I work call their own consults. However, I still follow-up with it. When the patient is admitted on night shift, even if the night nurse told me she paged/left/called the doctor, I still follow it up just to make sure and chart it.
I don't mind getting yelled at for doing my job. My job is to ensure the care of my patient. What I hate is getting yelled at for being blindsided and being accused of not doing my job because I forget to follow up and assumed someone did it.
Also, if I see a doctor, I make sure to inform him of what had happen that day and who've seen the patient. Call me irritating, but I'd rather the message gets across than falling into the spaces. That's what we are, nurses are the bridge for these disciplines.
- 0Feb 16, '13 by gcupidQuote from Nurse_And this ladies and gentleman, is why the nursing profession is abused...Most of the doctors in where I work call their own consults. However, I still follow-up with it. When the patient is admitted on night shift, even if the night nurse told me she paged/left/called the doctor, I still follow it up just to make sure and chart it.I don't mind getting yelled at for doing my job. My job is to ensure the care of my patient. What I hate is getting yelled at for being blindsided and being accused of not doing my job because I forget to follow up and assumed someone did it. Also, if I see a doctor, I make sure to inform him of what had happen that day and who've seen the patient. Call me irritating, but I'd rather the message gets across than falling into the spaces. That's what we are, nurses are the bridge for these disciplines.
- 0Feb 17, '13 by Jenni811Had a cardiology patient who was to go to the Cath lab. Per the cardiology team i get an order: Hold patients morning heparin.
Ok...i held it. So Primary team comes around "Why did you hold the mornig heparin? i didn't give orders for this."
"Cardiology told me to hold it for his heart cath."
"You don't need to hold heparin for a heart catheterization. Give the heparin."
So i call cardiology "Just an FYI, primary is telling me to give heparin. If you want this held can you talk to Dr____"
"Well call primary and tell them i want it held, i don't have time for this."
i call primary and say "Cardiology wants heparin held. If you want me to give it, you need to talk to Dr____"
"Well call him back and tell him that i want the heparin give it."
i ended up holding the heparin and i say to primary "If you want the heparin given then YOU give the heparin. Im following cardiology's orders because this is their procedure"
then they come back with "Well this is my patient and i am primary, they are consulting. i want the heparin given now."
STUPID HEPARIN. im not getting caught in the middle of that crap...no way! They need to communicate better and stop using the nurse as the messanger beause that saying "Don't kill the messanger" does NOT apply to doctors apparently, beause they do kill me everytime i get caught in the middle like that.
- 0Feb 18, '13 by turnforthenurseRNI had a patient who kept having runs of v-tach...called the hospitalist to let him know, he told me to consult cardiology. I asked who, and he said "anyone, whoever is on call." This was at around 0000. I was still very new and didn't know how the consults worked, really...I asked the monitor tech and the charge nurse about it and they told me to call. So I called the cardiologist and told him what was going on....and he just tells me to stop and says, "this is highly inappropriate." I apologized, I told him I was new, the hospitalist told me to call him...the cardiologist says it's okay (I think he meant it was inappropriate of the hospitalist to have me call him) and says to me, "tell him (the hospitalist) to call me." He hangs up, but then calls me back and says, "actually nevermind, I will just call him myself."
I don't understand why doctors cannot just COMMUNICATE with each other.
- 0Mar 10, '13 by DeVonna32RN-BSNOh my!! LYNDAA, I thought I was having flashbacks reading your post!! Very annoying, I agree!!
I get irritated when one doctor decides he doesn't want to use Dr. X as his consultant on the case, BUT he wants you to call and cancel the consult and provide an explanation to Dr. X........
When you have a patient that is crashing and burning.......the hospitalist didn't consult the intensivist or cardiologist when the patient was transferred........but then at when the patient is going into cardiac distress and needs to be emergently intubated @ 0100, no one wants to accept the patient...........ummm the last time I checked, if the patient dies, SOMEONE will be held responsible........and IT WON'T BE ME!!!!