did the Dr. have a right to scold this nurse?

[Lurker011]

first let me say that i have no nursing experience..i do computer work for the huge local teaching hospital. 2 days ago i was told that i could become a "code" recorder. a "code" was announced yesturday for the Cardiac ICU and i had to be there to record the events. when the whole team showed up,the patient was awake,alert and breathing fine. it ended up being a false alarm. what happened was the new nurse just started her shift and she noticed on the monitor that this pt. had a severe bradycardic heart rate of 20 BPM. nurse said that she shaked the pts. shoulder and got no response,so she panicked and pushed the code button. as it turned out,this pt. is a very heavy sleeper and her baseline HR is very very low during sleep. after this false alarm was over,i noticed the team leader dr. talking with the nurse face to face and the nurse was wiping a tear from her eye. i'm guessing that the dr. was scolding her. i am a sensitive person and i felt very sorry for the nurse..i would have hated being scolded. would any of you call a "code" for a pt. with a HR of 20? and was the Dr. right in scolding this nurse??

[OCNRN63, RN]

Children are scolded, not nurses.

[OCNRN63, RN]

As for a computer tech recording a code, you really don't want to know what I have to say about that.

[NurseLoveJoy88, ASN, RN]

A doctor or anyone else NEVER has a right to scold a nurse:nono: .

The new nurse did what she thought was best at the time. Should a code been called, no. Should the doc scolded her, maybe/ maybe not.

I have seen this exact thing happen. Code called even though pt. was awake and had a pulse. Mistakes happen, not the end of the world.

[MunoRN, RN]

Unresponsive (or at least apparently unresponsive) with a HR in 20's is appropriate for a Code. Code's are for both unresponsive/pulseless, and clearly unstable patients. That being said, many MD's will disagree. Our Codes are responded to by ER MD's and a few of them will turn around and leave if the patient is only 'sort-of' dead. We had one that we actually pressed charges against after he left the room of a patient who was in persistent VT and was intermittently regaining consciousness. The ED Doc left saying "call me when he stays unconscious", I never heard what happened with the charges, but he still works there.

[anotherone, BSN, RN]

A computer tech records the codes? Wow.... You don't know what the doctor said! Right? Maybe the doctor was saying, " don't worry about it." not necessarily, " HOW DARE YOU CALL A CODE YOU IDIOT NURSE!"

[Anna Flaxis, BSN, RN]

How do you know the doctor was "scolding" the nurse? Perhaps the nurse felt badly about having called a false alarm, and the doctor was offering support. Maybe the nurse felt like an idiot for calling what turned out to be a false alarm, and the doctor was saying "I would have done the same thing; don't be too hard on yourself!", or perhaps the doctor was simply telling the nurse in a respectful way what she should do next time (like a sternal rub, perhaps...), and she was just crying because she already felt badly. Unless you overheard the conversation, you don't really know what was going on.

Doctors are not the authoritarian figures they may have once been. Where I work, in the ED, doctors, nurses, and techs are co-workers. If I mess up, it is not the doctor's place to "scold" me. It is my supervisor's job to correct me, and the doctor is not my supervisor. My charge nurse is my supervisor.

If the doctor wants to talk to me about something I messed up, they are obligated to do so in a respectful, collegial way. Public humiliation, shouting, "scolding", or any other forms of disrespect are not tolerated in my workplace, and if something like that were to occur, I would be well within my rights to write an incident report.

[Horseshoe, BSN, RN]

fi after this false alarm was over,i noticed the team leader dr. talking with the nurse face to face and the nurse was wiping a tear from her eye. i'm guessing that the dr. was scolding her. i am a sensitive person and i felt very sorry for the nurse..i would have hated being scolded. would any of you call a "code" for a pt. with a HR of 20? and was the Dr. right in scolding this nurse??

Ok, so you have no idea what the doctor was saying, right? For all you know, the nurse was tearful and apologetic because she was feeling bad that she called a code and got so many people involved in a "false alarm" and the doctor was saying something along the lines of "hey it happens," "better safe than sorry," or something to that effect. You haven't described any behavior on the part of the doctor which would make it a certainty that he was scolding her.

I, too, am AMAZED that a non medical person would EVER be designated as a code recorder!!!

[OCNRN63, RN]

Maybe they're confusing computer "code" with the type of codes medical personnel deal with. "You can write code? You're hired!"

[merlee]

I have called codes twice when pt's were still AAO - the first was starting to gurgle from acute fluid overload, and the doc tried to tell me I over reacted. Then the pt became unresponsive and gray.....Thank heavens the code team had already arrived. Everyone except the initial doc commented on my 'lucky' call. Lucky, my foot. Excellent nursing judgement, I say.

The second was a first-time dialysis patient who started to cough immediately as we started the treatment. I knew he was about to go into anaphylaxis, stopped the treatment, got the doc who was available. She didn't want me to call the code. We called anesthesia 'just in case'. Then the pt went into full-blown anaphylaxis, and we called the code. Again, everyone except the nephrologist was impressed with my nursing judgement.

Both patients survived because a nurse made a call.

Keep making those calls. The life you save may be the doc's.

[netglow, ASN, RN]

20 BPM is cause for alarm.

Calling a code? It's hard to calm oneself in order to look quickly for trend and meds. If patient is a full resus, 20 is just as easy into asystole with pathology. The "wiser MD" or previous nurses with knowledge that this for this particular patient is deemed "no worries" had better highlight that very brightly somewhere in report and EMR.

[MrChicagoRN, RN]

On our surgical unit, the staff assist light was pulled frequently, which alarms across the unit. Its treated by the unit like a code, just not announced system wide. If it is a true code, we then call.

Everyone comes running, someone grabs the crash cart, and its usually a false alarm; but nobody gets criticized for over reacting.