The Doctor oncall told me not to call him - page 4
I want to know if anyone can help me handle this situation. I work in a small 3 bed ICU where I am the ONLY nurse. I recently had two critically ill patients. One had been on the floor (I had worked... Read More
Jan 13, '03Sounds to me like you were the only person in the hospital who didn't know the patient was dying and was only going to get end of life care.
Jan 13, '03Originally posted by catrn10
There is only one doctor in the hospital at night, the ER Doctor, and He wasn't Checked off to do central lines.
An ER Doctor that can't do central lines?????
Do they have electricity there or do you do everything by candlelight????
Sounds like you had a real mess on your hands....I personally would have kept calling the doctor until he didn't answer me anymore.... then I would have called the doctor in charge of the ICU. If that all does not work.....the thing that is the worse thing to do..... but seems to work most of the time..... Push the little blue button on the wall and call a code.... sounds bad to do but then you are involving another doctor who HAS to take responsiblity for this crashing patient.
Also charting charting charting......and I would also fill out an incident report....just telling your supervisor is not enough... risk management needs to get involved with this mess.
It might also be a good time to start researching into standing protocols for your ICU. If you have a good MD in charge of your ICU then this should not be a problem.
Jan 13, '03Originally posted by SCB
Did the patient live? If not I would see a lawyer, and the family of the patient. All be da-- if I would this jerk get away with this. That could be you, me, or a loved one in that sick bed. I would most definitaly not let this one die down. This MD is dangerous.
Old saying...... stuff that comes from rectum rolls down hill....
<---speaking from experience
Jan 13, '03Originally posted by Brownms46
I had a neurosurgeon scream at me in the chilling voice I have ever heard in my life. He admitted a GSW to the head to the ICU and I was assigned this pt. The little boy was on a vent, and had an NS IV at KVO. His head was wrapped in an ace, and brain matter was coming from his nose. The Neuro has sent verbal orders via the transferring ER nurse, to not call him! Of course this There were NO orders at all...NONE except. His B/P started to fall...and you guess it...I called him!! I have never heard anyone scream in such a manner and the way he did except on some fright nite show! I hung up on him, and called the supervisor. This was back in 1997 and I don't remember what else happened. I just remember hearing the way he screamed...telling me HE's DEEEEAAAAAADDDD! Don't YOU get it??? He's DEAAAAAAD! Then why was he placed in an ICU bed on a vent with no figging orders at all???
The little boy was supposedly 14 yrs old and had a license, but he looked like he was about 8 or 9! He father was killed at the scene by a transient. His sister was found in shock by neighbors.
Jan 14, '03"Did the patient live? If not I would see a lawyer, and the family of the patient. All be da-- if I would this jerk get away with this. That could be you, me, or a loved one in that sick bed. I would most definitaly not let this one die down. This MD is dangerous"
Be real careful of doing anything like this. Your SBON would consider it a breach of confidentiality and you'd get your license pulled. You don't discuss the doctor's actions or patient outcomes with *anyone* outside those who are immediately responsible for the care.
Jan 14, '03We have to remember that our licenses do not cover practicing medicine, which means we cannot write orders on our own. Most of us know enough that we could just about write every order ever given by an md, but we follow the rules because we know thats the way it has to be done.
You could be just as liable if you write pages of orders that you feel are appropriate for that pt without the md's actual order.
If the md is a jerk to tell you not to call, he'll probably be the same way when it comes to siging the orders. Lets say you ordered something inappropriate or missed something, then he might just say "i didnt give this order" and then you'd be in more trouble than before.
Jan 14, '03Carazzzy thread...especially for a newbie, like me!! I understand this MD needed to see his client...but....How come these MD's don't have a fax at the bedside for orders?? Is faxing not allowed?
Ps: Bless you for your efforts!!
Jan 14, '03CatRN,
You have my empathy. My heart goes out to you. Like you, I live in an area where are hard to come by.
But, no job is worth the kind of terrible situation you were put in by an immoral "doctor" and ignorant, unqualified adm.
You could lose your license or be sued because of the consequences of the abominable working condions at that "hospital."
I hope you get another job.
Jan 16, '03Our ER docs are not allowed to do central lines, either. I work for a small facility and the ER doc is the only one in house after about 5pm most nights. If the ER doc was up putting a central line in a floor patient and something emergent came through the ER door, crap would hit the fan. If we need a central line that bad, we call the family doc who will give us an order to contact a surgeon for a central line. Our docs are usually pretty decent to us. Yeah, they get grumpy once in awhile, but I have never had any of our family docs yell like that. If they did, I would be having a serious discussion with the unit manager, pronto. Our facility policy is to notify the pt's family doc (or his on-call group) and let them know what is going on. I have even told the doc straight out "you need to come in and see this patient." If any of our docs ever told me to stop calling them, that would just be the fuel to the fire for me. I would call them every time the person blinked, just to really honk them off. Like most of the other posters have stated, the docs get compensated very well to be on call... If I need to call a doc, I will call. Period. I have a duty to my patient to give the best NURSING care I can and a duty to myself to be able to have a clear conscience when the shift ends....
Will your agency work with you on this? My gut feeling is the hospital is going to give you some static because you are an agency and not their employee. Make sure you document EVERYTHING to CYA. I would even go as far as getting a witness if you run into this problem again with this doctor...have a second nurse listen in to make sure the story doesn't get "changed." I have done that before. We had one elderly doctor who should have retired 20 years before he did and I did not trust him any farther than I can throw a stick. Anytime I would get telephone orders for something more than Tylenol or MOM, I would have a second nurse listen in to verify the order. He wasn't above coming in and denying he gave those orders...CYA is the name of the game....
Jan 16, '03I agree with just about everything that was said. Unfortunately, I think any one who has been a nurse over a year or two has been screamed at at least once or twice, and certainly made to feel as though she is "bothering" doctors with a call. This was a shock to me when I was first out of. I asked my father, who was a practicing physician in another state, why a doctor would try to get a nurse to be afraid to report problems with a patient. He said that if the nurse is afraid to call, if the patient tanks, it's the nurse's fault, not the doctor's, and some doctors, like some nurses, really don't care about the patients. (Yes, I was idealistic and innocent.)
However, the times they are a-changing. Our facility has adopted a no-tolerance policy towards abuse by doctors. One reason is that it's the right thing to do. Another reason, however, may be that there are now laws against creating a hostile work environment, and I am told that hospital and physician insurance policies will not cover intentional infliction of distress. So go get a lawyer and discuss how these doctors are abusing you and compromising the performance of your professional duties. If the hospital tries to fire you after you have engaged an attorney, they are even dumber than they appear to be. Don't ever, ever, give up on a patient. You can lose your license, and you will lose your nursing soul. If the hospital won't listen, go to an attorney. Do it for yourself, for your patients, for future patients, and for our profession.
Jan 16, '03Allways call him/her, if YOU think it's necessary and it also would be preferable to tape the phonecall.