what would you do?

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Specializes in ICU;CCU;Telemetry;L&D;Hospice;ER/Trauma;.

Hi Kids!

This is similar to other threads about lazy doctors and nurses.....but this issue is with a twist....and I wonder what your opinions are on this.

I took care of a head inj. patient who also has intract. pain. He was given a pain managment consult by a pain specialist MD. This doctor after initially seeing the pat. placed the pt. on continuous pain medication. TWO DAYS later, he CALLS by phone and says:

"how is "so-and-so" doing?"

I explained due to head. inj. it was diff. to surmise the level of pain control due to memory disfunction, etc....but that the pt. did have periods of rest that was seemingly comfortable."

"well, please note in the chart that I called, and that the patient is comfortable, will you??"

EXCUUUUSE ME??? This is your "consult"??? This is how you treat a person's pain?? Have the bedside nurse give you the "picture" and then have the bedside nurse indicate that you "called", rather than actually have to spend time seeing the patient....or evaluating the patient YOURSELF??

I JUST HATE THIS!!

I get phone calls like this often....from dieticians who are supposed to come to the bedside themselves and evaluate whether or not the patient is being adequately nourished to speech therapists who want to know if the patient is "awake enough to talk".

Why am I, the bedside nurse, the one who is ENORMOUSLY busy with patient care being asked to look up lab values for them, when they have little portable computers they carry around with them anyway? Why do I have to re-write their "recommendations" to the doctors so then the doctor can order what they recommend? Why don't they just do their OWN work, instead of making me their lady-in-waiting?? It's bad enough I get 15 phone calls a day on a patient from everyone from their cousin twice removed to the xray tech wanting to know if they can come and take a picture!!

I'll be doggone if I will chart for a doctor that he "called to inquire" about the patient's pain relief!! Was I bad to just "forget" to do this???

It wasn't exactly on my priority list....since I had alot of stuff going on at the time with a non-draining EVD and a cranky neuro-surgeon....

but, the truth is....I simply think doing other people's jobs is just plain wrong.....

Do I look like a door-mat, mule, beast of burden, multi-tasking nurse to you??? ugh!

crni

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Do I look like a door-mat, mule, beast of burden, multi-tasking nurse to you??? ugh!

crni

Yeah, you do. Sorry, maybe not door mat or mule.

Did this dr ever come see his pt? Never comes in but yet I'm sure he's going to charge hundreds of dollars for this so called consult. I think it's unsafe what's going on.

I would bring this up with your NM. And next time someone asks you to chart something for them tell them they have two hands and they ain't painted on.

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Specializes in ICU;CCU;Telemetry;L&D;Hospice;ER/Trauma;.

no...this dr. did not come in to see the patient....

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no...this dr. did not come in to see the patient....

Beyond the fact that this is just wrong, it could also be considered insurance fraud if he charges this patient for a consult.

I'd contact risk management. Stuff like this could get your facility in deep trouble...

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Specializes in ER, Occupational Health, Cardiology.

The only place that it would be appropriate to chart that you spoke with this Dr. is in your Nursing Notes. Something like "1015 Gave update on pt assessment to Dr. Goldbrick who called to inquire about pt's condition. No orders received."

That ought to fix his lazy tail!

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Specializes in Educator, OB, Critical Care.
The only place that it would be appropriate to chart that you spoke with this Dr. is in your Nursing Notes. Something like "1015 Gave update on pt assessment to Dr. Goldbrick who called to inquire about pt's condition. No orders received."

That ought to fix his lazy tail!

I agree with charting this. Your NM also needs to be notified, due to possible fraud, committed by this Dr.; especially if he is charging the patient, via phone calls thru the nurse.

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Specializes in LTC,Hospice/palliative care,acute care.
I agree with charting this. Your NM also needs to be notified, due to possible fraud, committed by this Dr.; especially if he is charging the patient, via phone calls thru the nurse.

FRAUD FRAUD FRAUD if he is billing for an exam....Report this asap.We have a staff dr that makes monthly rounds in the ltc and does not even pretend to touch anyone.I realize that with the sheer numbers of residents these guys see plus the low re-imbursments they receive they are going to be somewhat limited BUT I never chart "monthly exam by dr so and so"because there was NO exam... I always chart "monthly visit" I'll stand by that in court..

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Specializes in IM/Critical Care/Cardiology.

CRNI,

I agree don't put your butt on the line, cause that Doc isn't going to swim a stroke for you if anything legal were to happen. As far as the other "professionals" calling you go, I agree and tell them you have your own work to do. If it isn't stopped for you/with you, you know it will continue. You don't deserve to let others drop their own ball.

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"Please note in the chart that I called, and that the patient is comfortable"

Telephone order read back and verified, Iam Lazy MD/Nancy Nurse, RN:devil::lol2:

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There is still the issue of the patient's pain.

There is a scale for nonverbal patients called the PAINAD. Here's the URL.

It is similar to one used for infants (but don't use that one--one of the boxes indicates that a smile can be an expression of pain: maybe in a baby, but not anybody else!).

It measures pain with observable (and therefore pretty darned objective) criteria, on a scale of 0 to 10, just like for the rest of us.

Good luck with your patient.

And I hope the doctor, well, never mind. :angryfire

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i must be missing something.

i didn't find the request all that outrageous.

besides, i would be charting anyway, that the md called to check on pt status.

it's not as if i'm doing anything extra.

leslie

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I think the problem here is that the Dr requested that the nurse document that he called and...that the underlying meaning of this was that that was the only assessment/documentation that the Md was going to do for that pt.

It's kind of scary if thats his idea of a "follow up" especially if he is planning on charging for it.

Not referring to the original poster at all but, what if the nurse taking care of the pt was also lazy or substandard? And the pain consult was then only based on their assessment?

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