Don't touch that!

You can fix this problem by communication,by communication i mean, nurses should communicate their concerns to the nurse manager, who will inturn communicate your concerns to the Md in charge because this is pt safety issues and should be addressed immediately.

Do any of you have problems with doctors coming into rooms and changing things without telling you and then leaving the room? If so, how do you deal with this?

I've often come into my pts room and found them on sedation vacation because the Dr decided to turn the pumps off without telling me.

I say, "Did you turn off my pumps? And could you show me where you charted the sedation vacation? Also, did you flush the lines after you turned the pump off or are all my lines clotted now? And are you charting it on the I&O that the pump is off, and also on my medication section that it's off?"

Then I give them a little talk about sedation vacation and how unsafe it is for their pt if I'm not monitoring them, or if they aren't in restraints while they come to. Then they get to sign the restrain order form (lengthy).

It's all a pain.

Usually they laugh, and then I tell them that unless they follow through and then chart what they've done then they can't do my duties. I am only a room away at most and they can either wait for me to do it, or they can come find me.

Now, if they turned off the pacer and walked out, resulting in a code, then I'd be even more direct. And if direct communication, right there, with the Dr isnt' working, then like the PP said, I'd go up the chain.

I would file an incident report. I don't care who they are what they are doing can and will result in the harm of a patient.

I think you've handled yourself very well. A simple, "next time you adjust my patients care without speaking to me so I can monitor him appropriately, I'll be sure to chart specifically what you've done, in an untold amount of time where I found it, can you spell your last name for me?'

I swear, this will fix the issue, be sure to have that pleasant smile and kind tone of voice, lol. It works quick. And they talk to each other so word will spread.

do any of you have problems with doctors coming into rooms and changing things without telling you and then leaving the room? if so, how do you deal with this?

we have been having increasing problems with this-docs come and and change ivs, remove tubes (foleys, ngts), or (our unit's favorites) disconnect the patient from a pacemaker! whenever we see it we call them on it, but it doesn't seem to be helping.

we finally had an issue really yesterday. i had a patient that was pod #6 from an avr/cabg x1 who had been on amio gtt for afib (had her during nights and the issue came up on days). she finally converted to sr at approx 0830, but then went into 3rd degree block (which she was in when she came out of surgery) around 0930. so the day nurse hooked up her av wires (still in from surg) and set her at a rate of 50 for which she was 100% paced. the surgeon came in and was told the patient was placed back on the pacer and why. the nurse got called away while the doc was in seeing the patient, and a few minutes later the daughter of the patient comes out calling for help because the patient went nonresponsive (and asystolic)! turns out the surgeon had just turned off her pacemaker and walked out. (luckily he was still on the floor when the code was called and was able to see what he did!)

i'm just getting frustrated with doc's doing this sort of thing, and leaving it up to us to "figure it out" or fix whatever they've done. i just want to smack their hands and tell them "don't touch that!", but i know i can't! :) what do you do when things like this come up?

hi

never let the mongrels near a patient with out you seems to be the only way round this world wide problem. not always practical i know.

vamparee

Our docs wouldn't know how to work an IV pump if you hit them in the head with it.

They do monkey with the vents, though, which drives me up the WALL. Reporting off an incorrect vent setting or, most especially, an incorrect FiO2 is the most mortal of sins on my unit. What's funny is that the doc who is the most psychotic about the nurse being on top of the vent is the worst offender when it comes to wandering in, changing something, and wandering out again without saying anything to anyone.

Our docs wouldn't know how to work an IV pump if you hit them in the head with it.

They do monkey with the vents, though, which drives me up the WALL. Reporting off an incorrect vent setting or, most especially, an incorrect FiO2 is the most mortal of sins on my unit. What's funny is that the doc who is the most psychotic about the nurse being on top of the vent is the worst offender when it comes to wandering in, changing something, and wandering out again without saying anything to anyone.

Usually I just yell at them....

Write Up Whoever That Md So Everyone Knows And Be Alarmed Of What He Is Capable Of.that Is So Dangerous!!

We also have the same problem with the IV pumps what we do in our unit is we never leave the Dr with the patient alone one of the nurses should always be with him in a round so as to e able to see what he does

OMG Liz...you hit the nail right on the head!

Our Docs are the same...would NEVER mess with the IV pumps, for the same reason you stated!:chuckle

But the Ventilator thing>>>GGGRRRRR!!!!! Yep....same in our NICU...we have the Docs who are "fiddlers!" adjust settings while you turn your back and dont tell you! Thats my pet peeve too!

Our docs wouldn't know how to work an IV pump if you hit them in the head with it.

They do monkey with the vents, though, which drives me up the WALL. Reporting off an incorrect vent setting or, most especially, an incorrect FiO2 is the most mortal of sins on my unit. What's funny is that the doc who is the most psychotic about the nurse being on top of the vent is the worst offender when it comes to wandering in, changing something, and wandering out again without saying anything to anyone.

I'm an RRT at BWH in Boston and residents will occasionally perform mechanics and/or compl/Raw/Ppl on the vents without us being there. Infact its illegal for them to even touch a setting on the vent. Last week I walked in on a Frozen waveform with a Fellow standing infront of my vent.

I said, "So we wanted mechanics?, I see that it's already been done!" He says, "Oh, are we not suppose to do that?" "AH, NO." I say. (He also did the mechanics with all the wrong settings for a true number, to boot)

Sometimes they act unknowing to this when as a fellow, I hope he knows what he can and can't touch. Just another "I'm a doctor and your not" thing.

I had a "fiddler" that kept messing with settings...you'd have someone on a cardizem drip at 5cc/hr, then after the doc would come in, "fiddle" and you're trying to explain to next shift why the 5cc/hr is now double, etc. I mean, we all know who it is, but that ain't gonna cut it if someone died, right?

So, I got some of those little post-it stickies, punched the "lock" button, and taped a sticky over it that said, "Dr. XXX, pls don't adjust without telling the nurse."

Sure enough, I hear all this racket out of a room, and meet Dr. XXX coming out, telling me the pump's "broken." I lead him back in the room, peel off the sticky, and just show it to him. Didn't say a word.

He ignored me for a week, but he left my pt's alone...or he couldn't figure out how to disable the lock function, one.....