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 Cardiac, Home Health, Primary Care.
I am amazed that in this day and age something like that can happen! In my area there would be an RRT team (in my hospital's case the RRT "team" is just one well trained and experienced RN) who can put patients on rescue bi-pap on their own based on protocols and standing orders. I know of other hospitals that have similar standing orders or protocols that are implemented by the respiratory therapists. In any case it should never be up to a physician who is at home and NOT at the bedside to decide weather a patient in respiratory distress gets rescue bi-pap. Those that do not have such a protocol have an in-house physician 24/7 (or several depending on the size of the hospital) who would be expected to come to the bedside in that kind of situation.
I think any facility that doesn't have a policy for something as basic as rescue bi-pap must be hopelessly out dated and unaware of this new thing we have call EBP.
As stupid as that physician acted, your hospital is SERIOUSLY irresponsible for putting you and that patient in that position.
Either they staff an in-house physician who is available to come to the bedside 24/7 OR they have a protocol to allow RRT, RT or something similar to apply rescue bi-pap. Anything else is simply criminally irresponsible.
This was a few years ago and when we call a RR we can do whatever necessary much like a code situation. The ER docs are the only ones there 24/7 (or were. We now have residents and NP's or PA's). By calling the doc we were trying to avoid an official RRT since most of the "team" was there anyway (me as primary nurse, supervisor, RT).
I am in a clinic now so don't know how the hospital runs now but I do know that it's changed a lot. Guess I could add that when this occurred family practice docs still rounded on their patients and it was an on call FP doc who told me to watch the patient. Now we have a pretty big hospitalist team.
Oooooh...he picked the wrong guy to throw a tantrum around!!
I once had a cardiac surgeon throw a telephone that hit me in the head. He wasn't throwing it at me, he was just in a rage from whatever he had just been told on the phone and ripped it off the desk and hurled it. I happened to be walking out of a room and caught the phone on the side of my head. Dropped me like an ox.
I came off the floor pissed off and ready to kick his butt. He saw that and took off running. I called the cops and they went over to the medical center where his office was. I got a phone call from him and he told me the cops were in his office and how sorry he was and what could he do to make it right? Lets just say we came to an understanding and he wasn't arrested and I got taken care of.
I read a dictated h&p on a patient admitted the morning before from my ED. I witnessed the ED doc make the call to the attending that ED doc had admitted his pt 2-ish hours prior. Call went to voicemail and ED doc left as it was the end of his shift.
Fast fwd to all of us returning for another night shift and a colleague showing ED doc what had been dictated during the day.
Attending dedicated an entire paragraph explaining why he didn't answer the ED doc's call..."As I was naked, in the shower with soap in my eyes, I couldn't reach the phone, blah, blah" Uh, and you decided THIS needed to be a permanent record in your patient's chart?
Same doc also wrote, in 2" tall lettering an order in another chart to "GIVE THE F##### TYLENOL" minus the censorship as you might suppose.
Specializes in Emergency/Trauma/Critical Care Nursing.
This order was given to a coworker "Tylenol suppository given PO" Even after confronted, the doc refused to change it. Pt was totally able to swallow normally and was completely oriented.
Who got to inform him that best practice trumps stupidity?
Sounds like a lazy doc who didn't want to be bothered with pain med requests when whatever was ordered wasn't effective.
Our nurse manager put an end to that pretty quickly and it stopped that same day. I personally like to think that his plan totally backfired and his phone got blown up with a zillion text pages all saying "WTH DUDE."
Not my patient, but when I was doing post op phone calls, I had a sheet for a patient that actually ended up admitted, and I only found out because I went to the progress notes section. The surgeon wrote a note on the admitted patient saying I am going on vacation, and if this patient is still unable to be discharged, consult with the hospitalist. I bet he never consulted with the hospitalist before taking off on vacation. The surgeon in question is an ENT surgeon, and he's a dirtbag in general. I will go to his partners before I go to him.
There is another surgeon, an orthopedist, who has figured out how to use nurses' best weapon to his advantage. The write up, or incident report. He is the only doctor I know that actually writes up petty incidents like nurses do. It kind of pisses me off, but at the same time I laugh, because it seems like he's figured out how to play the passive-aggressive game. Surgeons can no longer get away with yelling, screaming, and physical assault against nurses, and he seems to get it. He is a good surgeon, despite this.
anh06005, MSN, APRN, NP
1 Article; 769 Posts
This was a few years ago and when we call a RR we can do whatever necessary much like a code situation. The ER docs are the only ones there 24/7 (or were. We now have residents and NP's or PA's). By calling the doc we were trying to avoid an official RRT since most of the "team" was there anyway (me as primary nurse, supervisor, RT).
I am in a clinic now so don't know how the hospital runs now but I do know that it's changed a lot. Guess I could add that when this occurred family practice docs still rounded on their patients and it was an on call FP doc who told me to watch the patient. Now we have a pretty big hospitalist team.