A hospitalist's clash with a PA and NP

Nurses General Nursing

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I've been reading some of the blogs here and I truly love them. They are funny, insightful, and sometimes humbling. So I would like to share my story of an event I had with a PA and NP.

It was 2 years ago.I got my first hospitalist job when I was 26. I've been working as a hospitalist for 4 years now and I truly love it. I work 12 hours a day in a hospital and get the following 7 days off. So my schedule is basically 7 on/7 off. I make about 225k a year and I can moonlight during my days off. (Wanted to inform you of what a hospitalist is since people always ask me what I do and how much I make) :rolleyes:

It was my first year of being a hospitalist. I was 26 at the time and I worked with absolutely AWESOME NP's and PA's that made my job so much more easier. Normally I would see about 10-18 patient a day, spending about 40 minutes in total with the hospitalized patients. They were 2 PA's and 2 NP's in our team, each of which were atleast 5-20 years older than me.

At first I felt insecure to them-with good reason, seeing as the men stood at about 6'2 ( with the women an exception of 5'6) and I almost seeming to be squatting at a 5'11.haha. But they were experienced and very sweet and caring, except for a certain PA and a Certain NP. These two men were close to eachother and shared their beliefs. I honestly did not care much as long as we were doing our job and getting good results. The two would always want to argue with me instead of trying to come to an understanding, this bother me but again they were good at their jobs, but I also felt like they should let me do mine.

Ofcourse in the end, I had the final say and they were angered that someone the age of their children told them what they could and could not do. At the end of the his shift he would leave furious with his grey beard swaying with the wind. Ofcourse he would order uneccessary tests for patients who didn't need them to somehow make me angry at him. Haha I would however stay and still look over the tests and sometimes even find interesting things. Thanks!

So one day, a patient was hospitalized with severe pain on her foot. We saw what seem to be a sore, and they NP's and PA's just dismissed it as a mild infection but I was eerie and told them to run some blood tests and Blah blah blah. The PA and NP were just about 100% sure they were correct and we were wasting our time with the patient, but once again, it was not their place to decide. After reviewing her xyz tests, I went home.

The next day I came to the hospital abit late- My wife was getting lonely :D. So when i got there a nurse informed me that the the patient was given the dose of blah blah I ordered, and I did no such thing. 20 mins later the patient had a complication with the drugs they had given her and went into shock. After some paddles and resuscitation she was stable.

I asked the nurse exactly who asked her and she said "Dr.****, and Dr. ****. I asked her to describe what they looked like- and I guess I was abit angry seeing as she looked like she was about to pass out from my presence. She described the NP and PA in my team. So I went to them and asked them "Did you give her the drugs I told you specifically not to" And this is what I got.

" You f**** doctors think your the ***** huh?

"I have an infinite amout of experience, and because you wasted your life doing the MCAT, Medical school, and residency, you think your better than me?"

The second man went on to say:

I am just as skilled as any god ***** M.D. I know more about patient and medicine than you will ever know, and you and all the ******** so called "doctors" out there. You f******* idiots just walk in so proud and smug of your damn M.D. degree. We are just as smart. We are just as knowledgable and we should be paid just as much."

Mind you while this was happening the other two NP's were just in complete awe at what these men were saying.

I looked at them and said "Are you finished with your temper tantrum. I do not care what you view me as. I am a Medical doctor, my only concern is with the patient. You are a Physician assistant. I am liable for your actions. You DO NOT have the authority to do those test without my consent and you lied to the patient by claiming to be a Do-

He interupts me by saying " I AM A F****** DOCTOR. I HAVE MY DOCTORATE"

I continued by saying: Doctor of Medicine. They both quieted down after that.

You two are no longer needed today. Go home. I then called security and they screamed at the security office saying they were doctors but then the security noticed their badges and rightfully took them out of the hospital. :rolleyes:

I went back to the patient and called a dermatologist because I believed the sore to be skin cancer. The dermatologist confirmed my diagnosis and thank god, was able to save her life. Funny thing is after I sent the two men home, they came back to the hospital so sue me for "Degrading and harsh treatment and language". No so suprising they lost the case and even lost their practicing rights.. Sad seeing as I just wanted them to take a break and get their minds right. Talk about karma?. :cool:

I was very shocked at the language used by those proffesionals but glad I was able to remain calm in the situation. Have any of you guys had similar stories?

OK - I'll play along...

Most nurses here could relate with similar problems with CNA's. Do a search, it's a popular topic. That's about it.

Curious as to why an "MD" would be seeking support on a nursing forum. Maybe you would be better received on a "doctor" forum.

I'll look into the topic.

I was actually in a doctor forum, but there were nurses who would come and give their stories about doctors doing stupid and unprofessional things and would be greeted normally without any biased comments. I believed this site would be the same, but as you can see, I was sadly mistaken.

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At first I felt insecure to them-with good reason, seeing as the men stood at about 6'2 ( with the women an exception of 5'6) and I almost seeming to be squatting at a 5'11.haha.

So, despite all your so-called advanced training, you are intimidated by someone taller than you? Why is this even relevant?

Ofcourse he would order uneccessary tests for patients who didn't need them to somehow make me angry at him. Haha I would however stay and still look over the tests and sometimes even find interesting things. Thanks!

Unnecessary tests=insurance fraud. I'm sure some bean counter somewhere would have flagged this.

So one day, a patient was hospitalized with severe pain on her foot. We saw what seem to be a sore, and they NP's and PA's just dismissed it as a mild infection but I was eerie and told them to run some blood tests and Blah blah blah. The PA and NP were just about 100% sure they were correct and we were wasting our time with the patient, but once again, it was not their place to decide. After reviewing her xyz tests, I went home.

What tests? I'm interested as to which "blood test" would diagnose skin cancer. Of course, a biopsy might make more sense.

The next day I came to the hospital abit late- My wife was getting lonely :D.

With all the additional tests that were being ordered, and with you "staying late" and "finding interesting things", no wonder your wife was getting lonely.

So when i got there a nurse informed me that the the patient was given the dose of blah blah I ordered, and I did no such thing. 20 mins later the patient had a complication with the drugs they had given her and went into shock. After some paddles and resuscitation she was stable.

I asked the nurse exactly who asked her and she said "Dr.****, and Dr. ****. I asked her to describe what they looked like- and I guess I was abit angry seeing as she looked like she was about to pass out from my presence. She described the NP and PA in my team. So I went to them and asked them "Did you give her the drugs I told you specifically not to" And this is what I got.

" You f**** doctors think your the ***** huh?

"I have an infinite amout of experience, and because you wasted your life doing the MCAT, Medical school, and residency, you think your better than me?"

The second man went on to say:

I am just as skilled as any god ***** M.D. I know more about patient and medicine than you will ever know, and you and all the ******** so called "doctors" out there. You f******* idiots just walk in so proud and smug of your damn M.D. degree. We are just as smart. We are just as knowledgable and we should be paid just as much."

Mind you while this was happening the other two NP's were just in complete awe at what these men were saying.

I looked at them and said "Are you finished with your temper tantrum. I do not care what you view me as. I am a Medical doctor, my only concern is with the patient. You are a Physician assistant, and you are a Nurse Practitioner.I am liable for your actions. You DO NOT have the authority to do those test without my consent and you lied to the patient by claiming to be a Do-

This is where you should have thought a bit more about this. You said up above that you had two (2) PA's, and two (2) NP's. Now, are there 3 NP's?

He interupts me by saying " I AM A F****** DOCTOR. I HAVE MY DOCTORATE"

I continued by saying: Doctor of Medicine. They both quieted down after that.

You two are no longer needed today. Go home. I then called security and they screamed at the security office saying they were doctors but then the security noticed their badges and rightfully took them out of the hospital. :rolleyes:

Excellent. So, they ordered meds under your name, and the only thing you did was call the hospital security? Both NP's and PA's can write their own orders, so by doing it under your name, it was illegal.

All the hospitalists I know don't have time to read forums on the internet. Especially if they have wives. You're right, doctors (especially hospitalists) are super duper smart, and PA's and NP's are dumb. We get it. Thank god you got the blood tests and successfully saved the patient! I'm glad you are around!

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Since when did an MD have the ability to send an NP and a PA home?

They don't (atleast to my knowledge), but the NP and PA were causing so much noise and problems when I asked one of the cops to take them out, they did. It was because of what they were saying and the disturbance they were causing.

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

if it walks like a troll and quacks like a troll . . .

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So, despite all your so-called advanced training, you are intimidated by someone taller than you? Why is this even relevant?

Unnecessary tests=insurance fraud. I'm sure some bean counter somewhere would have flagged this.

What tests? I'm interested as to which "blood test" would diagnose skin cancer. Of course, a biopsy might make more sense.

With all the additional tests that were being ordered, and with you "staying late" and "finding interesting things", no wonder your wife was getting lonely.

This is where you should have thought a bit more about this. You said up above that you had two (2) PA's, and two (2) NP's. Now, are there 3 NP's?

Excellent. So, they ordered meds under your name, and the only thing you did was call the hospital security? Both NP's and PA's can write their own orders, so by doing it under your name, it was illegal.

All the hospitalists I know don't have time to read forums on the internet. Especially if they have wives. You're right, doctors (especially hospitalists) are super duper smart, and PA's and NP's are dumb. We get it. Thank god you got the blood tests and successfully saved the patient! I'm glad you are around!

1) I was trying to add some social qualities to the post. It would have stale and boring otherwise.

2)I was a new hospitalist, and they tests were unnecessary to me because we did not agree to do them, but they were still relevant to the patient.

3) The blood tests weren't to determine if it was skin cancer. As I stated, I did not know what it was and did a blood test to get a better understanding of what it could be and what it could not.

4) Why would they be 3? I said two and they were only of them.

5)My wive works too so I'm home with nothing to do, so why not? I could moonlight, but I do so last month and want a break.

6) *sigh* As I once again stated in my post. I love the Pa's and NP's. If I felt like I was smarter, I would not consider us to be a good team, and use terms like "we" now would I?

7) Oh and it wasn't the blood test that made me suspect cancer, it was the color and shape of the presumed sore and the fact the woman told me she tanned every year.

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if it walks like a troll and quacks like a troll . . .

atleast explain to me why you view me as a troll so i can help correct your assumptions.

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Maybe an MS1, but nothing more.

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Maybe an MS1, but nothing more.

Ahh yes, because a doctors worth and skill is determined by how he writes on the internet.

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No, it's that some MS1s still don't realize that this deal is more than just a game. They like to try on the big boy/big girl labcoat but it just doesn't fit yet, and everybody instantly notices except the MS1. In another year or two, it won't be funny anymore. You will either grow up, or be kicked out.

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No, it's that some MS1s still don't realize that this deal is more than just a game. They like to try on the big boy/big girl labcoat but it just doesn't fit yet, and everybody instantly notices except the MS1. In another year or two, it won't be funny anymore. You will either grow up, or be kicked out.

I'm 30 and still consider myself young, and I plan on enjoying life to the fullest. I came to a website to post on a topic that I've seen nurses post. I did not insult anyone or any group of people and I even tried to add some playful components so it would be more enjoyable to read. I have finished my training and I am board certified in Internal Medicine.

The people here have some kind of bent up hatred for me, or what I represent. I guess the NP's and PA's criticize others but when they are the point of criticism, something must be wrong. Is the fact that a NP and PA doing something unprofessional so hard to believe that I must be a troll for even thinking such a thing? Not one of the people who accuse me of trolling have given 1 solid proof of trolling. Why? Because I am not a troll, just a guy with some free time who wanted to post a topic and discuss.

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Specializes in Education, FP, LNC, Forensics, ED, OB.

Going to go ahead and close this thread as it's going nowhere fast.

OP, if you truly are a Physician and a Hospitalist, you have a lot of free time on your hands. Suggest you get a volunteer position somewhere to fill in the gaps.

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