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?
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.....
nerdtonurse?, BSN, RN
1 Article; 2,043 Posts
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.....