dr won't call back.. grrrrr ..vent

[ohmeowzer RN]

we have this dr at our hospital that won't call back. we page him several times and he dosen't return calls. what is so horrible about this situation is he is the chief medical officer.. the doc we call when we have a problem w/ the doctors.. one time i had a pt with a h&h of 7.1 and 21. he never called back to get an order for PRBC's. i charted that i attempted to reach him and he saw my charting , and told me not to ever chart like that again , it makes him look bad... what a jerk.. anyway i wrote him up and brought it to the dept manager...and who knows what happened. we know write incident reports for everytime he dosen't call back i am always so grateful when i don't get his patients. he dosen't care about the patients and acts as if the nurses are below him. if you do get in touch with him , he tells you to leave a note on the front of the chart, and he will get to it when he comes to the floor.

anyone else ever work with with a looser doc like this?? and how did you handle the creep?.... i was so mad when he thought he could tell me how to chart... grrrrrrrrrrr:angryfire

[sueleo]

hi,

i feel your frustration. sometimes, we have to deal with such doctors as well. one particular time, we paged the doctor three different times, using the medical society on call pager. no response. we then contacted our administrative officer, who ended up sending the local police to this doctor's home. they woke him up, and surprise he called!!! its a shame, we had to resort to that, but what can u do when its the question of someone's life.

[CaLLaCoDe, BSN, RN]

[MOUSE]

Hi,Kizzy!

Dear physician,

I'm sorry, did I wake you up? I'm with your pt. 8 to 12 hrs. a day. I see the changes in your pt. that you can't possibly see during your 5 min. rounds. I also see the family struggling to get answers to all of your rambling medical terminology and your "touch-me-not" persona. I see other less experienced nurses debating over whether to bother you with your pt.'s quickly declining status because it's 3 a.m. and is it really worth having to listen to your ranting and contempt?

Sorry-- did I wake you up? Did you forget why you went to medical school in the first place? Did you REALLY think that it's all about the money that you'd someday be floating in that seems to be floating away? Have you become disenchanted with the bureaucracy that you must face daily, while trying to do what you worked so hard to learn to do? Well, we nurses fully understand that. Ours hand are tied not only by bureaucracy but by you. While we understand the enormous professional and personal pressures that you face, may I remind you of something? Without us, you would have no practice. You could neither physically nor legally take care of your pts. Hospitals would shut their doors. Both you and your pts. would sorely suffer. We are not your underlings nor handmaids. We are the stuff that attempts to keep it all running smoothly. We are the stuff that does SO MUCH daily in the face of every obstacle. We are the stuff that still cares about your pt's. welfare. We are the stuff that will continue to wake you up.

Perhaps it's high time...

ebear

[/MOUSE]

Bravo! Better than Shakespeare to me!

[santhony44, MSN, RN, NP]

we have this dr at our hospital that won't call back. we page him several times and he dosen't return calls. what is so horrible about this situation is he is the chief medical officer.. the doc we call when we have a problem w/ the doctors.. one time i had a pt with a h&h of 7.1 and 21. he never called back to get an order for PRBC's. i charted that i attempted to reach him and he saw my charting , and told me not to ever chart like that again , it makes him look bad...

Do you notify the house supervisor? In most places, it would then be that person's responsibility to get a response.

If he's not chief of staff for the whole facility, then that would be the person who could be called after a reasonable number of attempts and a reasonable amount of time. If he is the chief of staff, then the administrator on call would be the one to notify. The facility's risk manager would be a good person to report this issue to, also.

Keep detailed records for yourself: problem, times the doc was paged, length of time waited, etc. Copies of those could go to the chief of staff and/or administrator, but keep copies for yourself.

I would also continue to document it on the patient's chart, every darned time. Factually and without commentary, but chart it. No matter what he says. If you don't, and there is a bad outcome, the first thing he'll say is that "the nurse didn't let me know" or "the nurse didn't try hard enough to get me- the first page didn't wake me up and she didn't try again" or some such. I'd bet my next paycheck on that.

"1 AM. Dr. Jerk paged regarding hemoglobin. 1:15 AM: no reply from Dr. Jerk. Paged again. 1:30 AM. No reply from Dr. Jerk; paged again, house supervisor notified." And right on until something is taken care of. This is a big-time CYA issue!

Sooner or later, someone in the facility with the power to do something about the situation will realize that Dr. Jerk is going to get himself and the facility in really big trouble.

[abundantjoy07, RN]

mds act all rude, act mean and curt, don't return pages for the main reason: their license is not on the line...our's is...our living depends sometimes on their giving the right order at the right time.

quick question

why is it always the nurses license? i understand it is because we are the ones administering medications and double checking orders compared with labs and the patient's status at the time... but when are physicians held accountable?

[banditrn]

Had to have the supervisor call the chief of staff one time on a jack azz surgeon that was on call for another surgeons patients. The chief of staff called him at home and told him to get his hiney in there and admit the patient!!

He was SO ticked off when he walked in the door that I wanted to snicker at him - but I figured it wasn't a good idea at the time! I couldn't WAIT until the next day to tell the other surgeon how he had acted about the whole thing - he was a friend, and he wasn't pleased!

[RNview]

We have some hospitalist who does that. What we do is we page the house supervisor and she works a miracle! This same hospitalist doesn't even want to hear any suggestions from the nurses. We also have an on-call oncologist. He usually works in a different hospital but from time to time he works on-call for our oncologists on the weekends. We have to page him a hundred times before he calls back. But when he calls back, he'll pass the buck to the other MD. He'd tell us to call Dr. So and So to get an order. For goodness sake! I just need an anti-hypertensive drug order for one of my patient. :angryfireIt happened that the patient doesn't have any other MD. So I paged the house supervisor and she chewed him up. Then the following day (Mon) I told the oncologist he was on-call for, that it took him 4 hours to finally order a BP meds for his patient with an SBP >200. That was the last day I saw him in our hospital

[ebear, BSN, RN]

sueleo,

That is SO FUNNY! Ha! I'll bet that doc browned his shorts! HaHaHa!

ebear

[ebear, BSN, RN]

santhony44,

AMEN!

ebear

[november17, ASN, RN]

There is this one particular doctor that will actually call back. But god forbid you leave him on hold. A few days ago the offgoing nurse had paged this particular doctor at 6:30pm over something semi-important. I came on at 7pm, and she reported off to me. She told me she had paged him, but he hadn't called back yet. I went off to do my assessments, get organized, etc. He finally called back at 7:30pm. The unit secretary grabbed me and told me I had a phonecall (I was in a patient's room right in the middle of a Code Brown). I finally got to the phone and realized it was the Doctor the previous nurse had paged over an hour ago. I told him I needed a second to go grab the chart. He said, "I'VE BEEN ON HOLD FOR A LONG TIME!! YOU BETTER HURRY UP!!!" I set the phone down, walked 5 feet over to the other desk, picked up the chart, and when I picked the phone back up I said, "Doct-..." *CLICK* he hung up right in my ear on purpose.

I swear to god when I finally meet him (I work nights, so I haven't met this physician yet), I'm going to ask him if he remembers the incident and tell him to never do that to me again. Jerk.

The hospitalists where I work are really cool. I love them. They're mostly younger physicians and they're really on point. I'm always grateful when I get a patient with a hospitalist consult!

[ebear, BSN, RN]

November551,

And they wonder why there's a nursing shortage. ebear:angryfire

[rn undisclosed name]

Where I am at there is this one particular doc who is notorious for not returning calls. It is so aggravating when this happens. I always make sure I chart the exact time I call him. My charting usually looks like Paged Dr. so and so to notify of ???. Awaiting return call. Paged Dr. so and so x2. Awaiting return call. Paged Dr. so and so x3. Awaiting return call. When I do call his service they say if I haven't heard anything within 30 minutes to call them back. I tell them oh I'm pretty sure you will be hearing back from me and they laugh. If he does call back I tell him I have to cover x amount of things with him so that he won't hang up on me. I also have to tell him at the beginning of the conversation if another nurse needs to speak with him so that he won't just hang up. He is so bad that other docs have yelled at him for not returning pages from the nurses.

Then he likes to complain about the nurses. One of these days I will have to say something to him. This is what he thinks about the nurses:

(1) all they do is sit around the nurses station and chit chat all day long

(2) they play doctor

(3) we're a bunch of incompetents

This particular doc got mad at me one day because my pt did not have a patent IV site and so I couldn't carry out his orders. Pt was NPO for sx and he wanted D5 0.45 started and to have me give 1/2 his dose of 70/30. Well I couldn't get an IV on him and neither could the IV team. I tried to get someone from sx but the anesthesiologists were really busy and said they would just get him when he went down. I called doc to notify him of this. He started ranting and raving about how incompetent I was and how great it was that we'd be calling him back when his blood sugars shot up and we couldn't control them. So I did the professional thing and hung up on him. I know I shouldn't have done it but it felt so good since he has hung up on me numerous times. Yeah I know I could have gotten in trouble for it but I didn't.

I would love to take a copy of that letter ebear wrote out and nonchalantly put it on his clipboard. Wonder if I would get in trouble for that one.

Kelly

[banditrn]

At the hospital where I worked for many years, we had a VP that was in charge of disiplining the doctors. That wasn't his title, but that was his function - to take care of out of control doctors - we had had a huge problem there for a long time.

If any particular doc got enough complaints, he had to go see this guy. I remember one doc had to take anger management classes or lose his privleges - another had to go apologize to a nurse - in front of her co-workers, because he'd been an azzhat. It calmed a lot of them down - didn't completely take care of ALL the problems, but it did take care of some major ones!