Doctor vs Nurse - page 5

I work in a nsg skilled facility and rehab at the same time. Our medical director always orders continue to monitor when I report something to him. One time I reported an extremely high blood glucose level of our hospice pt.he... Read More

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    As much as I want to call 911, my hands are tied with sending the resident out cause we do have a policy that the md should give an order first before sending the patient out. hence the md ordered cxr. I know it is unethical and unlawful.

    As a novice nurse i carried out the md's order. hoping the resident will be fine. Until now I am monitoring the resident. Maybe the md will actually visit the resident when he goes to the facility for which he do not do.

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    Quote from brittne

    When a patient usually is 'fighting for her life' or improving, doesn't that mean they usually go off hospice care? Honest question...no sarcasm attached.
    That is what I dont really get. I need to study more in depth about hospice for it is confusing for me.
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    Calling 911 in LTC is an extreme step. It's for emergencies. As in a code. I've coded a resident twice in my career so far and that's also the number of times I've told the CNA to call 911. How is your resident now? Did the wheeziness resolve? If the situation was such that you felt calling 911 was indicated, then why did the resident deny any distress. Is she demented? In my experience, if she was really in acute, dire distress she would have been pretty panicky. I still feel like I don't understand what was going on with this pt.
    SionainnRN likes this.
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    As described by the resident's daughter, the resident does not complain or say anything. The resident tend to keep everything on her own.

    Last month I saw the resident grimacing appearing as if in agony of pain. I assessed the resident but the resident denies anything.

    Maybe if the resident was not wheezing audibly we would not treated her and she would have been discharge.
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    We can treat wheezes in long term care. A wheeze in and of itself is not a reason to send someone out 911.This discussion makes me appreciate MY medical director even more. He is polite, listens to the nurses, and is quite reasonable when ordering (or not ordering) interventions.
    wooh and ~*Stargazer*~ like this.
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    This is the first time I had seen a doctor who does not order labs or xray or other exams. All he ever order is continue to monitor the patient.
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    I thought he ordered a CXR and ABX....
    wooh, psu_213, and SionainnRN like this.
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    He ordered that cxr and abt after I told him that I really think and the other nurse-happens to be the resident's daughter- thinks the resident should be sent out to the hospital.

    We have a low census and that doctor is running out of residents in the facility because the resident asks for another md to tend to them since he does not even visit them. He gives new medication to the resident without seeing them, no labs to confer it to. The residents asked for discharged because of his actions.

    Sorry if I did not fully describe the circumstances here for I am so tired from work thinking and trying to keep the residents alive and satisfied with their care since they do not like how the md works for them.
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    Quote from anne919
    As much as I want to call 911, my hands are tied with sending the resident out cause we do have a policy that the md should give an order first before sending the patient out. hence the md ordered cxr. I know it is unethical and unlawful.

    As a novice nurse i carried out the md's order. hoping the resident will be fine. Until now I am monitoring the resident. Maybe the md will actually visit the resident when he goes to the facility for which he do not do.
    Why in the world would you call 911 for wheezes??? As another ED RN that is an extreme reaction. Your patient has wheezes and poss pneumonia on an CXR, and guess what? The MD started abx and breathing treatments and O2. What in the world do you think we could do that isn't being done? The only reason to call 911 in this case is if the pt couldn't maintain their O2 sats and was going into resp distress. Otherwise give the abx some time to start working, geez.
    And this is in NO WAY unethical or unlawful. It seems to me you have your panties in a bunch about the doctor and are trying to find anything you can to make them look bad.
    BrnEyedGirl, ♪♫ in my ♥, and wooh like this.
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    Initially he did not order abt neither cxr. His only order was monitor the pt. He would not o rder anthing besides monitor.


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