dcotor asked me to leave room

[jam2007]

:angryfireI'm a new grad and all through my clinicals I was told to get in the room if the MD was in there. I also had great experiences with MD's who really wanted to teach. So now I'm an RN in a hospital (not a teaching hospital) and I'm in the room getting my VS and the MD comes in a asks me to leave the room so he can be with the patient. I looked at him dumbfounded and said "But I'm his nurse." To no avail.

Then it happened again with another MD; I didn't say anything but I did vent to my preceptor that it was unacceptable and the clinical leader told him that if the MD wants me to leave, then I leave "We have the pt all day, they're only in and out" which I totally get but aren't I supposed to be part of the team?

Anybody else run across this? What do you do? I'm having a hard time feeling like I don't count.

[TazziRN, RN]

I don't take it as a "dis" to nursing. Just like there are times when I need to talk with my pt without the dr's presence, so also the doctor may prefer to be alone with the pt. This does not mean the other party is being left out completely, the person in the room can pass on the info to the other person at the desk. There have been times when I wanted to talk to my physician alone, without anyone else in the room. I knew he would chart it and tell his staff later, but I didn't want anyone in the room at the moment that I was talking to him.

There have only been two occasions when I refused to leave the room: once was a new male MD (new to the hospital, not to medicine) who was about to examine a female's breasts and the female was known to the nursing staff to make false accusations, and another time when an ER MD was inappropriate with both female staff and female pts.....even the children. We collectively decided he would never be alone with a female pt unless the curtain was open.

[Dolce, RN]

Wow, I've never had that happen to me and would be a little startled if it did. One physician I knew always wanted a nurse in the room with him for anything--that was kind of a pain. If I get the opportunity I prefer to stay in the room if the doc is in there to give an update about the patient condition/problems/questions etc. Patients (especially the elderly) often have no idea what to ask their doc and having an advocate is exceptionally important. Obviously I wouldn't stay in the room if it was something like a gathering of patient's history or substance abuse use etc, but for an exam or during rounds I do like to be in the room.

[llg, PhD, RN]

I don't take it as a "dis" to nursing. Just like there are times when I need to talk with my pt without the dr's presence, so also the doctor may prefer to be alone with the pt. .

That's EXACTLY what I was going to say. I respect the patient's & physician's right to have a private conversation just as I would expect that other people would respect MY right to have a private conversation with a patient.

Respecting other people's right to privacy comes from a position of strength and self-confidence -- not from a position of submission. I am secure enough in myself as a professional that I am not threatened by someone else's desire for privacy. I don't NEED to be personally involved in every conversation to do my job well. For example, if I need more information, I can talk with the patient and the physician later.

[SusanKathleen, RN]

[it bears repeating: never trust a 35 weeker. ]

hi prmenrs,

so what's a "35 weeker"?? thanks!

[Tweety, BSN, RN]

You guys have got to be kidding! Whatever is going on with the patient ought to involve the nurse because if and when things change, how can the nurse maintain quality control of the patient's care if information about the patient is being hidden. What is the point anyway? The rationales for whatever a physician is doing for any patient can easily be gleaned from the progress notes, and, unless the physician is going to stay at the bedside and execute all the orders himself or herself, then such secrecy is just silly. The only exception I can think of when this would be appropriate is if the physician is a psychiatrist who is doing a highly specialized evaluation of the patient that involves very personal stuff that the nurse really doesn't need to hear. Otherwise, nursing needs to be involved. How else do you know when a development thats usually 'expected' for most patients is not what the physician wants for this particular patient?

I wouldn't take it personally but it is still a 'dis' to nursing. And proof of this is seen in the fact that whenever physicians show up on a unit to evaluate a patient with a group of medical students, privacy is hardly ever an issue, and no one says anything. Maybe its the white coat that makes the diff.

Docs and nurses round on their patients often. In fact when docs come to see my patients, I indeed usually want to be around, not necessary when the doc examines the patient but to tell the doc my assessment and my needs for the patient.

However, if a doc wants private time with his patient I don't see that as a dis. I can always stop the doc and ask questions or I can read his note. I do not need to be present for each and every exam and moment each doctor spends with each of my patients in order to provide holistic adequate care.

In my opinion of course. :)

[Spidey's mom, ADN, BSN, RN]

That's EXACTLY what I was going to say. I respect the patient's & physician's right to have a private conversation just as I would expect that other people would respect MY right to have a private conversation with a patient.

Respecting other people's right to privacy comes from a position of strength and self-confidence -- not from a position of submission. I am secure enough in myself as a professional that I am not threatened by someone else's desire for privacy. I don't NEED to be personally involved in every conversation to do my job well. For example, if I need more information, I can talk with the patient and the physician later.

I agree.

I try to go with the docs on rounds but I can't be in all the rooms at the same time. I do however make the docs aware of any concerns.

I respect their right to privacy with their patients. It is not a "dis".

This happens rarely though where I work.

steph

[RN28MD]

As a new grad I can see how this can make you feel as a personal attack but I have been a patient before and I can tell you that I had so many nurses that some were nice some where not that made me feel that if the Md wanted to talk to me i wanted them out. Sometimes as nurses we don't always have the time to get to know our pts as well as we like when they don't have acute illnesses. We end up in the pts room who are more acute. So what ends up happening is that the other pts don't have that bond with us.

I wouldn't mind if a doc as a nurse to leave. As a pt I wouldn't want them there. As a RN I don't see why a Md can't get his privacy. Good luck whith this. Don't take it personal.

[P_RN, ADN, RN]

I've been in the same situation several times. Once it was (I found out later) the patient wanted to tell the doc to stay away from his girlfriend. Another was they wanted to discuss duck hunting next season. Another was pure gossip about a neighbor. If I had offered to stay and was told not to, then just chart this nurse was requested by doctor and patient to step ou t of the room at xx time.

[Daytonite, BSN, RN]

I understand that you are feeling left out. However, the doctor has a confidential relationship with his patient and some doctors feel that an unknown nurse is an intrusion upon it. Keep in mind that in many cases, these doctors have known these patients for a long time and know many intimate things about them, more than you will ever know. When I have been a patient in the hospital, I personally don't care to have a hospital nurse present if I am having a discussion with my doctor that concerns things that I have talked with him about before involving my situation in life. I have asked a nurse to leave the room so I could speak with my doctor. I don't have a problem with the nurses being there to hear about the treatment, but I don't feel that anything else beyond that is anyone else's business. Sorry if that seems offensive to you, but I would be willing to bet that if you were a patient in a hospital bed, you might feel the same way.

[Natkat, BSN, MSN, RN]

It wouldn't bother me. I figure there has to be a good reason for it. Besides whatever transpired, I can read about it later on the consultation, in the progress notes, or whatever.

[GingerSue]

the doctor has a confidential relationship with his patient and some doctors feel that an unknown nurse is an intrusion upon it.

I personally don't care to have a hospital nurse present if I am having a discussion with my doctor that concerns things that I have talked with him about before involving my situation in life. I have asked a nurse to leave the room so I could speak with my doctor. I don't have a problem with the nurses being there to hear about the treatment, but I don't feel that anything else beyond that is anyone else's business. quote]

I agree with above.

[jam2007]

Thank you all for your insight! I think what bothered me the most was that it was an assessment b/c the pt was being d/c'd and I b/c I am always trying to learn, I thought it would be helpful for me (and the pt.) if I was present. I guess I'm a bit thin-skinned! Your reassurances have made me feel better and I'll have to learn not to take it personally!