Doctors comments about not trusting his Nurses

buddiage · Feb 27, 2006

Seems to me that his comment would be the LAST thing a patient and family would need to hear, even if it were true.

And am I understanding that this wonderful doc was at church????

The hospital would probably want to know, because his comment is BAD to the BUSINESS, period, and the hospital would want to know, because God knows those people will be telling other people that "you can't trust the nurses."

What a jerk. Seems to me, he ought to read his own bible about gossip and naysayers.

babynurselsa, RN · Feb 27, 2006

I would only put objective info into a formal complaint. I WOULD include the statements made by the spouse and her concerns.

I would discuss this personally with your manager and at that point verbalize your ire at this statement.

No if it were me I would speak to this physician personally and ask him just why he would make a statement like this. I would also very carefully and completely from this point out socument EAcH AND EVERY phone call, and conversation when you are trying to get him into see a pt.

I would also probably have the need to phone or page him very frequently to update or adivse him about changes with all his pts. "MMM Dr Jerk, your pts BS was 204, now it is 207....." "Dr Pinhead, the pts Temp is 100.9, it was only 100.5 earlier just figured you would want to know." ( this last part might be j/k)

TypicalFish · Feb 27, 2006

I am working on filing a complaint to the powers that be regarding the situation and was wanting to know, would it be appropriate or not to state how insulted I was by the comment that he made in the complaint or should I just stick to the facts!! This doctor, who btw, is a hospitalist has many times degraded the nursing staff and the hospital itself with comments such as these.

Any advice appreciated!!

If I were you, I would leave any emotions out of it-I would, instead, focus on the idea that the comments made by the doc made the spouse question basically if the pt was safe under your care-that the comment made bythe doctor made the spouse wonder if the pt was safe in the hospital itself-the hospital is represented by the careproviders, so if you can't feel safe with the nurse, that would suggest that the hospital itself is not safe; you could also mention that if, God forbid, there was a negative outcome for the pt-or even a perceived negative outcome-that this comment could come back to haunt the hospital. You should also make it clear that the spouse was anxious, upset, worried in GENERAL after that comment ( just so they can't say "well, just don't assign nurse X to that pt; that'll fix it)-Do not get emotional. Just state that this comment undermined the trust of the spouse, may influence her decision making process r/t to pt's care, increased her anxiety, and made her doubt the care being provided. Go at it from a "looking out for the patient and spouse's best interest, and looking out to protect the hospital's integrity"

But-I would also say only file a complaint if you really feel it necessary and pertinent; and be prepared, if you do, for any backlash. Good luck and let us know what happened.

jmgrn65, RN · Feb 27, 2006

just stick to facts mam, :) and i would also make sure your nurse manager is aware of the situation she (or he) should be talking to that phscian and find out why he is saying something like to the patient. The patient family is right how are they suppose to trust the nurses if the doctor doesn't. He is really a JERK!!!

allnurses Guide · Feb 27, 2006

I would talk to the doc first. In a non-confrontational way. Just offer the facts.

And our docs always do their own assessment after the nurses do theirs. That is part of their job. He should have just told the family the truth.

Off topic - I always find it interesting the things patients say different to the doc than they said to the nurse. Sometimes they leave things out but more often than not the story changes or elements are added. I especially like when they tell the nurse "no, I'm not allergic to anything" and then tell the doc "I'm allergic to sulfa drugs".

As professionals, I think it is always the right thing to do to go peer to peer and then if you have no resolution, higher up.

steph

rn/writer, RN · Feb 27, 2006

If you file a complaint, include only objective information. Saying that you felt insulted makes the situation about you--maybe you're too sensitive, maybe you don't get along with this doc, maybe you misinterpreted, etc. Don't allow that to happen.

Actually, before making an official complaint, I suggest you talk with your nurse manager. She might be able to make it clear to this doc that she doesn't take kindly to his derogatory remarks about her staff. She can then mention the possibility of an official complaint being filed if such a thing should ever happen again.

Again, even with the NM, keep the information factual and focus on the distress the doc's comment caused the patient and family, not the effect it had on you.

I wish you well.

allnurses Guide · Feb 27, 2006

I just thought of something - nurses are not perfect and I have seen nurses miss things or misinterpret things and then the docs are not impressed. Recently happened with a patient that the nurse felt was fluid overloaded but in fact was dehydrated and third spacing - the nurse gave a report w/o adequate info to the surgical doc and got an order for Lasix instead of calling the primary doc, who was livid when he found out and asked why the nurses didn't know about third-spacing . . .he gave a little inservice at the nurse's station. It was embarrassing as the nurse who misinterpreted and withheld info was already gone.

Maybe, just maybe the docs have been disappointed in the nurses . . . . just as we seem to bash the docs for being idiots, nurses are not above making mistakes.

And I'm not saying the OP is making any mistakes . . . .not at all.

steph

rn/writer, RN · Feb 27, 2006

I just thought of something - nurses are not perfect and I have seen nurses miss things or misinterpret things and then the docs are not impressed. Recently happened with a patient that the nurse felt was fluid overloaded but in fact was dehydrated and third spacing - the nurse gave a report w/o adequate info to the surgical doc and got an order for Lasix instead of calling the primary doc, who was livid when he found out and asked why the nurses didn't know about third-spacing . . .he gave a little inservice at the nurse's station. It was embarrassing as the nurse who misinterpreted and withheld info was already gone.
Maybe, just maybe the docs have been disappointed in the nurses . . . . just as we seem to bash the docs for being idiots, nurses are not above making mistakes.
And I'm not saying the OP is making any mistakes . . . .not at all.
steph

Good point. I have seen this, too, where a doc felt he'd been set up to fail his patient when he received inadequate/incorrect info.

Still, it would be nice if docs could address these concerns without scaring the patients. That just seems divisive and unethical, especially if the remark is made casually over something as basic as him performing his own assessment.

imenid37 · Feb 27, 2006

If the doc has issues w/ not trusting the nurse or certain nurses, he needs to go to the manager and spout off at them. Not the patient. What an unfair situation this is for him to put a patient and family in. I guess he doesn't learn much in his time at church. You know like consideration for others, namely his patients. I hear lots of c/o's fom patients about their docs all the time. I do agree w/ Stevie, pt's often save things to tell their doctor about that they fail to share w/ the nursing staff. I am not sur why. I am a bit too much of a smarta$$ for this doc, I may have had to ask him why he doesn't just camp out at the bedside if he doesn't trust the nurses and provide round the clock care for the patient himself.

allnurses Guide · Feb 27, 2006

Good point. I have seen this, too, where a doc felt he'd been set up to fail his patient when he received inadequate/incorrect info.
Still, it would be nice if docs could address these concerns without scaring the patients. That just seems divisive and unethical, especially if the remark is made casually over something as basic as him performing his own assessment.

I completely agree that the doc was WRONG to talk about this in front of the patient and family.

That is why I would go to the doc, face to face, in a non-confrontational way and discuss it. If I got no satisfaction, then higher up.

I start my shift at 2:45 a.m. and when the doc comes in the morning to round, I usually go into the room with him when he does his assessment so I can make sure the patient tells him the same concerns he/she told me . . . . I've found that patients will share many things with me that they don't share with the doc.

steph

beepeadoo · Feb 27, 2006

Is it possible he's not a jerk, but just lacks decent communication skills? hmmmm I know that would be a rarity, but I'm of a mind that doctors, although excellent at practicing medicine, run the gamut as far as social and communication skills. And do tend to lean towards "awkward at best" in the "How to Talk To Patient Families" department.

That said, when he opened his mouth to explain to the woman why he was asking them again, he said, "I can't trust the nurse's assessment."

But maybe that's not what he meant. Maybe what he meant was,

"I can only trust MY assessment, because that's standard procedure, and I may think to ask something that would shed a different light on the situation. I would ask you the same questions if it was a nurse, another doctor, the chief of surgery, or Everett C. Koop himself who had asked you before."

Now that said, only you can tell me if he meant it maliciously ie, THAT nurse. or meant it generally ie, ANY nurse, doctor, etc.

I would suggest a gentle conversation, and ask him what he meant. You don't have to leave emotion out of it at that point. You were there. You were disturbed to hear him say that. You would like to be a better professional. Does he have issues with your performance? Or did he mean it in a more general sense. In which case you might coach him towards some better language so that in the future he doesn't stick his foot in his funny little doctor mouth.

If that does not produce anything, then I'd say chain of command is in order, and right on up it. But before you escalate to that, I'd say give it a chance for some one on one communication with him in the most positive, but non-confrontational, way you can muster.