Doctor as a patient

[love-d-OR]

Both my patient's last week were both doctor's. One was a retired family practice doctor and the other was a nephrologist. Now, this is not my first time having taken care of patients who work in the health field, but it was the first time they got preferrential treatment from the staff (including MD's) for their profession.

I addressed both patients as Mr A and Mr B, while everyone else called them doctor. Now, that created some confusion for me because here I have people calling me to ask how Dr. so and so is doing or if Dr so and so has been extubated...Uh okay. Some of the nurses would go into their rooms and start by saying Mr and then catch themselves mid sentence and say " Oh I'm sorry Doctor." Anyway, at the end of the day if they felt the need to call them doctor that's their choice.

What really got on my nerve though was the fact that Mr/Dr A was basically writing his own orders. He demanded to be extubated, and even though he failed weaning he got extubated. During weaning one of the doctors told me to stand by him because he was going apneic for more than 30 seconds. So I told him to put him back on a rate until the sedation I had just turned off an hr ago wore off and the patient was more alert. So what does doctor do, he sits there watching. Mind you this is a busy place and the reason I could not do it was because I had to take Mr/Dr B to CT. So Dr. A gets extubated and then demands to have his NGT taken out (this is 1st day post op abd surgery), when they tell me not to he takes it out himself. Still lethargic he demands a PCA even though he spends most of the day sleeping, so of course he gets an order for 0.9 MS q10mins (they started at 0.5mg but increased everytime he asked them to). Two days later he is advanced to clears, but my doctor patient says "no, put me back as NPO I'm scared I'm going to vomit if I drink." That same daythey tell him he is getting transferred to the floor, and he refuses. He speaks to the atteding and tells him he feels he is not ready to leave the ICU (mind you this guy is stable from an ICU standpoint), so he now has orders to stay for another two days.

So to cut it all short, how do you guys feel about having doctor/patients. What is your experience? I'm all for having patients having an input on their care but I have to say I had a pretty heavy day with these two (I did not want to go into Mr B, but his wife (pharmacist) and daughters (MD) also made me feel like a glorified maid)

[dishes, BSN, RN]

I have looked after six different patients who are doctors, I addressed them by their first names, none every gave me any indication they wanted to be called doctor. I did not find the experience much different from looking after a lay person, except, that they wanted detailed responses to their questions, but that was ok because I enjoy answering questions about my specialty.

[blondy2061h, MSN, RN]

Any patient can "refuse" an NGT or to remain intubated. It sounds like your MD patients were not only doctors but jerks.

[vivacious1healer]

Have taken care of several doctor patients, and I've found that asking them if they prefer to be called doctor, Mr.?Mrs. or by their first name usually clears up any confusion.

Sounds like the attending docs needed to have a frank discussion with this patient that although his input is important and will be taken into consideration, it does not deem him well to be placing his own orders, especially if he has been sedated with the medication that was provided. His judgement is impaired.

There was a story of a doctor patient in a local hospital that got 'permission' to leave the floor to go to his office....after being gone for an hour, they found this doc in the OR performing a procedure while hooked up to his IV of heparin since he had a carotid dissection that caused his stroke symptoms! YIKES!!!!

You had your hands full with those 2 patients! Glad you made it!!

[nurturing_angel]

I have taken care of several doctors also and had a good experience with all. My most irritating, PITB, prima dona pt was the wife of an anesthesiologist. What a pain she was to care for.

[ONCRN84]

I had a doctor patient once. I asked him what he wanted to be addressed as and he said "as a normal patient." So I called him by Mr a couple times then his first name. When he needed an antiemetic, he said "well maybe some (insert antiemetic here). I don't know. Whatever (Dr. OnCall) says." He was very kind and very thankful for our help. After being a patient, he was so much easier to deal with as a doctor.

I guess it depends on the physician. Some have a complex that I fear they'd carry on as a patient.

[Tait, MSN, RN]

I have taken care of a few. Generally we ask what they preferred to be called and then proceed as such. All of the ones I have had so far generally don't care, but I give them due recognition for thier hard work by calling them Dr. So-and-so.

I only had one that was a bit of hyper PITA, and later discovered he was a chiropractor...but that is a whole other can of proverbial worms.

Tait

[Tweety, BSN, RN]

Most doctors I've taken care of have been very decent. I don't mind calling them "Dr."...I choose my battles. I have called a doctor patient "Mr. when calling his primary about something and the primary corrected me with arrogance...'that's Dr. Patient' Well excuse me, he's still a Mr. LOL

Now doctors as family members of a patient.........that's another rant altogether.

[traumaRUs, MSN, APRN]

I have had two physicians on dialysis and both were extremely nice, polite, compliant and a joy to care for.

Sounds like your pts would have been a pain whether they were doctors or not.

[WalkieTalkie, RN]

I call my patients who have PhDs in other areas Mr. and Mrs., so why is it necessary to call someone "doctor" unless they specifically request it? I don't want to be referred to as Nurse so and so when I'm a patient. Just my

[mskate]

I had a doc as a patient once. He was one of the heads of a department in the hospital - he was also a nightmare. Demanded to stay in the ICU *and* with 1:1 care, he worked for anesthesia and we had BIG issues with his friends coming up from the OR and medicating him, changing his PCA, messing with his gtts, etc... and just walking away - everyone denying that it was "them" that did it. He even tried to bully some new grads into taking verbal orders for narcs for himself. He was there for a very suspicious infection in a very odd place with extremely high tolerance for narcotics and ended up getting investigated due to nurses reporting how much he was taking. He was SO badly behaved that the medical director of the ICU that he was on refused to take any more of his cases or deal with him on a professional level in the hospital!!

He was the ONLY patient I ever had demand x number of washcloths, count seconds that you let the hot water run, demand to be washed a certain way - his hands were FULLY functional, demand that you buy him a newspaper out of your own pocket money, etc.... and have management BACK HIM saying "well, the 50 cents a paper costs wont kill you." "someone of his status deserves the extra TLC..." - grrrrrrrrrr!!!

the only good thing that came of it was my developed DEEP respect for another attending in the hospital who apparently was one of the patient's students years and years ago. This attending set up camp in his room in the ICU when he heard rumors of how much trouble he was causes the nurses staff and HE catered to his needs. He repositioned him, changed his linens, got him water, helped him with his meds, stopped other docs from medicating him and referred everyone who wanted to give him meds to the nurse. He would poke his head and out say "when you have a second, i just need a new pillowcase?" it was "thank you" "please" and "don't worry, i'll do it." He is - to date - my favorite doctor ever. Even when he would round, he would make sure his interns and residents ALWAYS asked the nurse - "do you need any orders? While I'm here, do you need a boost or a turn?"

sometimes - one good apple cancels out the bad one!

[tymatt2]

I believe that Dr is their surname/title (?) now. Just like Mr/Mrs/Miss. I know they say that you address wedding invitations as Dr and Mrs...... Pick your battles.