I'm very curious. I'm sure we've all been there. We've dealt with doctors from all spectrum and mindsets. Most are very good at their jobs and have sound ideas!
But sometimes docs just say and do the craziest things
My example: at my last LTC facility I had one doctor seriously outright refuse/fight giving and prescribing pain meds (for patients who really, really needed it/were on vents/dying) because he honestly believed that these residents who had been stuck in a bed for years were going to get better and go out to buy/smoke crack cocaine.
According to him "prescribing narcotics leads to methadone and crack usage." These poor residents have been here for years taking the same medications and pain meds for years...just WHAT?
Specializes in ER, ICU/CCU, Open Heart OR Recovery, Etc.
During a difficult intubation in the ICU, the doc pulled out the ETT. A long string of blood came from it. Somehow that string ended up in my hair. No I wasn't hovering. The tube went flying.
The dumbest thing a doctor ever said to me, and there have been some whoppers cause I'm a patient plenty of times - about my thyroid which is for all purposes dead from Hashimoto's Disease - he said he never gave T3, isn't going to give me T3, and never will! Not unless the patient is in ICU with something like Myxedema Coma. Gee,wonder why the patient is in myxedema coma! No wonder I often like alternative medicine! That's not dumb, that is negligent. Must be. ICU needs the business.
I used to work in LTC, and we had this quack doctor who would come in every week (which I give him credit for, at least he came in, unlike some) and change every one of his patients' meds to what we used to call, "the medication of the week." If a new drug came out, everyone who could possibly be on it went on it.
I later worked with a Iranian psychiatrist who would start a patient out on one drug, and if the patient had side-effects, or what they thought were side-effect, he would add another drug, and then another one for that side-effect and so on until his patients were getting 8-10 medications. For example, a patient went of prozac, and developed decreased libido. He would order viagra. Then the patient would get stomach ache from the viagra, so he'd put him on prilosec, then the patient would get xerostomia so he'd put him on saliva substitutes, and so on. It was like he'd never heard of titration or alternate medications. Basically he'd order a med, if a possible side-effect was reported he'd look up the counter to that, and so on.
I work on a LTC dementia unit. We frequently take in respite admissions in addition to our long term residents. For several years, I was the main RN to do admissions. Many times family members have a difficult time admitting their loved one, even if it is only for a short respite. They frequently deal with grief and guilt in giving up care of their family to another. It is a fact, and something that I have first-hand knowledge of as I went through it myself with my own mother.
One time we had admitted a respite who originally was to be admitted to the hospice unit for respite. I don't remember the circumstances, but it was decided that he would be admitted to our unit instead. I had heard that the family was not too happy about the switch. The hospice MD asked me to give the family some TLC. I asked him what exactly he meant, and he looked at me like I had 3 heads. Basically, what he wanted was for me to give the family a tour, answer all their questions, and do my best to make them as comfortable with the admission as I could. Which is something that I was in the habit of doing with all family members on admission!
I worked many years in LTC and have experienced this with families. It is also difficult for them to accept that their person has dementia. They still see the person as they were before dementia started. I am experiencing this with a family member. She is young but appears to be getting dementia. It is very had to cope with. One day she is really bright and the next not so much. I also have a good friend to whom this is happening. She has paranoia as well, thinks people are knocking on her door at night, and going into her apt. and stealing trivial items. She had a camera installed. No intruders ever appear on it. No sign of break & enter. Sometimes she finds the missing items. It is so hard to accept this horrible diagnosis.
Resident complained to the chief resident that our manager manhandled him. Chief resident nearly died laughing. "That manager is five foot nothing and weighs 200 pounds -- how the HELL were you not fast enough to get out of her way?"
"She kinda took me by surprise."
"You called a code for a SHAMPOO and your were surprised that the manager got upset? Next time you do something THAT stupid, I'M going to slam you up against the wall and have your gonads for breakfast."
Yes those were the days when nursing managers were nurses and when they stuck up for their nursing staff.
I worked many years in LTC and have experienced this with families. It is also difficult for them to accept that their person has dementia. They still see the person as they were before dementia started. I am experiencing this with a family member. She is young but appears to be getting dementia. It is very had to cope with. One day she is really bright and the next not so much. I also have a good friend to whom this is happening. She has paranoia as well, thinks people are knocking on her door at night, and going into her apt. and stealing trivial items. She had a camera installed. No intruders ever appear on it. No sign of break & enter. Sometimes she finds the missing items. It is so hard to accept this horrible diagnosis.
Big hugs to you. My grandma has Alzheimer's. She's been mildly symptomatic for decades, but it's been tearing it's ugly head full strength for the last few years. The last time I saw her, she had progressed from simply calling me by my mother's name to truly believing I was my mom. It's easy to process when it's your patient and you can just check it at the door. It's utterly devastating when it's your family.
not an RN yet but I heard this one while bringing a patient in to the ER with my ambulance crew. Situation was a 90 yof with abdominal pain. New resident came in:
Doc: On a scale of 1-10, how bad is your pain?
PT: 7
Doc: When was your last period and was it regular?
PT:...well nixon was the president at the time.
The rn in the room just started laughing and left the room.
Yeah probably if it was a laptop. How these unstable docs get through med school, secure jobs and get away with this?
Think about it - when we are in our 20s, making normal life milestones, being grown ups with jobs and kids, they are still in school and residency with little time to be in the real world. Many of them get their first job ever after residency, which would be at no younger than 28. That has to affect normal development of EQ, social awareness and maybe typical coping mechanism/conflict resolution skills.
My own providers (two of them), me as a patient. I had had a recent medication change (a massive increase in a Med that drops the seizure threshold).
Symptoms - repeatedly having holes in my memory that had lasted for days nonstop, in a very specific pattern of every 5-10 minutes, lasting predictably for at least 30 seconds at a time.
The prescriber who wrote the script said I had too much stress in my life, was having anxiety, I needed to calm down and stop reading so much (I was in school at the time). I insisted it wasn't anxiety. He insisted it was.
I went to the ED when I had a loss of memory lasting nearly ten minutes. That one scared the crap out of me. ED MD called that provider who prescribed the increased med, came back to me and said its anxiety. I busted out the mom voice and told him I'd already been blown off by someone else with that crap, I was in the ED to get HIS assessment. Got labs, all normal, he came back and said absence seizures.
Went to my PCP the next day, told her this whole story, she said its not seizures. It's anxiety. Mom voice came out again. I insisted it wasn't anxiety. She insisted it was. Gave me a script for an SSRI to help with anxiety and sleep.
Got a neuro referral. Left temporal lobe seizures and serotonin syndrome. MDs, NPs, and PAs are never quite as dumb as they are when they COMPLETELY ignore their patients. I am a very lucky girl that the seizures didn't get worse than they did, and that the serotonin syndrome didn't cause huge problems.
As a nurse, a chest pain/rule out MI was admitted during night shift. Cardiac biomarkers were negative, EKG NSR. Hospitalist ordered a diet, patient got breakfast at the very beginning of day shift, at which point I was his nurse. The unofficial policy on chest pains with all negative testing is they get a diet. But, the cardiologist doing consults that day was Dr. McCrabbypants, the only MD at my hospital who doesn't mind ripping nurses a new one whenever he felt like it.
So, he comes around first thing in the morning. Early enough that I was still looking through orders for the day, but not realizing yet that breakfast had arrived. So he comes stomping my direction demanding to know why I let the patient eat. I told him I didn't know breakfast was on the floor yet (honestly, it was way earlier than normal), that he was ordered a diet at admission and the night nurse didn't change it to NPO. I also reminded him that typically negative testing did not get ordered NPO.
This man threw a toddler-sized temper tantrum, making sure I knew exactly how stupid I was because ALL chest pains are required to be NPO. He is the ONLY cardiologist to expect this at my hospital. He had wanted to order a stress test, which requires being NPO x 4 hours. The guy wasn't going to go down for that until at least 4 hours later anyway.
Got another CP/rule out MI recently. Lady's pain was abdominal, not chest, and by the description, was intestinal, kidney, or liver/gall bladder. It was so completely a GI pain, not chest. But, she was admitted for rule out MI, which cardiology immediately ruled out, and put in his note - probably gall bladder, need GI consult.
When the patient started vomiting what looked like diarrhea, I called the Hospitalist, who blew me off, literally laughed at me when I suggested GI. Vomiting made her feel better, she got no GI consult, but did get an ultrasound of liver and bladder, which were negative. No other abdominal imaging ordered/obtained yet since she had arrived to the ED that morning.
At shift change, pain became severe and vomiting began again. Nighttime Hospitalist got this dumped on him, but unlike the daytime one, he knows it's good to listen to nurses' intuition. Got a stat CT, complete obstruction. Got an NG tube, GI and general surgery on board, and she lived happily ever after.
Back in the days of paper charts, an order was written periodically "Add progress notes to chart". The same doc was known to also write at the very bottom of the order sheet "Add order page to chart". All he had to do was ask!
Big hugs to you. My grandma has Alzheimer's. She's been mildly symptomatic for decades, but it's been tearing it's ugly head full strength for the last few years. The last time I saw her, she had progressed from simply calling me by my mother's name to truly believing I was my mom. It's easy to process when it's your patient and you can just check it at the door. It's utterly devastating when it's your family.
Yes exactly. Because we knew the pre-dementia person and it is as if that person has died but there is no closure because another person has taken over them. When I read about people being possessed by evil spirits, it is what I think dementia is. The person is taken over by this horrible disease process and they don't know what is happening to them.
SororAKS, ADN, RN
720 Posts
During a difficult intubation in the ICU, the doc pulled out the ETT. A long string of blood came from it. Somehow that string ended up in my hair. No I wasn't hovering. The tube went flying.