Doctor won't back up his telephone orders!

[In_Chantress]

How do you deal with a surgeon who is angry when you call him in the middle of the night and just as angry when you don't... When he gives a telephone order, and then comes in the next day and denies that he ever said anything written in the order although he does sign off on it... won't even back up orders he wrote in the chart himself, calling you a "liar" until he's shown the page? FYI, this guy has made several big errors ( like complete transecting the bowel during a colonoscopy) causing us to already worry when we see that a post-surgical patient is one of his. How do you protect yourself and your license when dealing with such a weasel. HR says taping his telephone orders would be "too disruptive to the work process" and having two nurses listen to him on speaker phone and co-sign the order hasn't helped as he just says that both of us are idiots. Any and all advice will be appreciated!!

[BittyBabyGrower, MSN, RN]

I'd not only get another nurse, but I'd get the supervisor to listen in and sign. You have to start leaving a paper trail. Have you contacted legal about this issue? If he isn't signing off orders then that is a legality issue that could lead to some big problems.

[barefootlady, ADN, RN]

Agree with witness to all orders, agree that witness should sign orders, incident reports too. But...when are the nurses going to seek out the HN and inform the HN of the problem? After 3 or more incidents in a short time frame I would be calling in support troops. This doc needs to be accountable for his actions and soon.

[Runman1914, MSN, RN]

Sorry but there is absolutely nothing you can do? The hospital will back the surgeon no matter how many compliants from a thousand nurses. Just deal with it or find new job.

[jessiern, BSN, RN]

Sorry but there is absolutely nothing you can do? The hospital will back the surgeon no matter how many compliants from a thousand nurses. Just deal with it or find new job.

That's not true for all facilities, and may not be for hers.

As I said earilier, our facility has terminated a surgeon before because of compliants from nurses about the same things.

Usually when we complain to admin. about a docs attitude, the attitude changes. Our DON makes it known if we have a problem with docs, let them know and they will handle it.

[TazziRN, RN]

I'd be refusing to accept phone orders from him. I'd tell him he either has to come in and write the order NOW or you will notify the chief of staff.

[Psqrd]

I'd go to the HR department and explain that this Doctor is creating a hostile work enviorment...by law they have to investigate...I would not tolerate being called an idiot or liar by anyone.

P2

[Dalzac, LPN, LVN, RN]

I had a doc like that too. his last chance happened at night and when a pt crashed hard! he was impaired when I called him The pt was young and had an immense heart attack. I had colled the doc 4 times within 15 minutes and he was just too loaded and made no sense. I was desparate and I knew my patient was gonna die if I didn't do something quick. So I called the critical care medical director and told him everything that had happened. He screamed for a couple of minutes and I told him the pts age (35) adn the Medical director showed up within 5 minutes, We worked on this guy for 4 long hours to get him stable enough for a CABG.

Any way the drunk doc was fired within a week and he had been an attending. So there are many things you can do. Administration litterally hates paper but when you flood it with paper they will get busy. Having the Supervisor listen Is a really good idea.

[madwife2002, BSN, RN]

Nobody and I mean nobody stands up for the nurses in my hospital, Doctors bring in the work and they are supported. Fact

[tatarn2b2007]

In my previous job(not in nursing) all of our phone calls were recorded. We had to state that on every outgoing and incoming call we had. I am sure there is some law against it in the hospital setting, but I think it would be a great idea to do something similar if it was not against the law.

[freesia98]

Ahhh, another one of those self-absorbed MD's that needs to make sure that everyone within earshot knows they are the smartest person in the room! I've worked with a few-there is no mental issue here, just a big fat personality flaw!

Make sure you CYA at every turn and admin will eventually get tired of the hassel and get rid of him.

Yep, I've seen a few cut their own throat with this type of behavior!

Hang in there, it could get amusing!

[meandragonbrett]

I would file an incident report every single time. I would aslo ensure that another RN is given the order over the phone so that there are two RN signatures on the verbal order.

[APBT mom, LPN, RN]

I would document and report it to the nurse manager and the Medical Director of the facility.

My instructor told us a story about when she was working in the ICU and one of the MD's ordered a med because one of the pts labs had come back abnormal. Nurse gave the med and the pt had a reaction and coded (they brought him back). Next day when MD comes in for rounds and sees the incident report stating that after med was given within 5 mins pt reacted blah blah blah. The MD went to the charge and said that he didnt' order the med. The policy was two nurses had to listen to every phone order and it was documented not only by them but by the answering service the MD used saying he received a call from ____RN about pt X's blood work. They unit had a meeting about it (apparently it wasn't the first time) so the rule was whenever one of the MD's patient needed anything he would have to come down to the hospital and write and order for it even if it was a Tylenol. They would give him an hour after he called and if he wasn't in within that time he would get written up. This lasted for about 3 months until the MD finally admitted that he did order the med for that pt. They then returned his phone order privilages. Never had another problem with the MD up until he retired.