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?
Today I had a doctor (oncologist) ask me what happened to his patient, so I explained how he had PEA in the OR. Then he said, "Yeah, I saw that in the chart. What's a PEA?" Kind of stunned I replied "Pulseless Electrical Activity. He coded." He laughed at himself and said it was time to go back to school. I'm still stunned. And a little scared.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Today I had a doctor (oncologist) ask me what happened to his patient, so I explained how he had PEA in the OR. Then he said, "Yeah, I saw that in the chart. What's a PEA?" Kind of stunned I replied "Pulseless Electrical Activity. He coded." He laughed at himself and said it was time to go back to school. I'm still stunned. And a little scared.
Oncologists rarely actually run codes. That's what oncology nurses are for. Of course, I've worked most of my forty years in teaching hospitals. I might be appalled at what's out there!
I had a patient return from cardiac surgery 40 liters up. When they gave him that much volume in the OR, you know it was a rocky surgery. It was a rocky night, addressing his many issues. His blood pressure would dwindle and the surgeon, who was parked in the room most of the night would order volume and that would improve the blood pressure -- for awhile. Towards morning, when the new residents come in to prepare for rounds with the attending, a brand new (this was July or August) cardiology resident parked herself at the nurse's substation right outside our door to review the chart on another patient down the call. (All the activity in there, I thought I might see something, was her reasoning.). Kevin the surgeon had wandered off to look at another patient when my patient's art line flattened out while the monitor was still reading sinus tach. BP alarms were going off, and I was troubleshooting the art line just in case, when the Cars Resident wandered into the room.
"He's in VT!" She announced. Get the paddles!"
"No," I responded. "He's in SVT. Don't shock that. Besides, I'm more concerned about the PEA." I had already hit the code light, pulled out the ambu bag and taken the bed rails down in preparation for CPR.
"Why would he be in PEA?"
Teaching hospital, I told myself. Let me teach. So I briefly explained cardiac tamponade as it relates to recent cardiac surgery. She seemed to receive this well. Then she asked "What do we do?"
In PEA, you treat the cause. I sent the tech for the warmed saline and Vancomycin from the pharmacy substation on the unit, made sure the chest cart sitting there was the clean one and counted the seconds until Kevin could possibly make it back. And I explained that we'd be opening the chest.
"OK," she said. "Get me some scissors." And she started rolling up the sleeves of her filthy white coat. Fortunately, Kevin got back before I had to restrain her from cutting my patient with scissors. He was pretty senior in the surgery hierarchy and, being tired after being up for 24 hours, cranky because some strange medical resident took it upon herself to try to interfere with his surgical patient and just naturally very blunt and direct. He looked her over for about a second and then said "Who the F*** are YOU?" I could see the poor thing deflate. He delivered a lesson in inter-service protocol while dumping Betadine over the chest and then a lesson in cardiac tamponade and open cardiac massage while he got the chest open.
That cardiology resident decided to be a surgeon after that! I wish I knew how that turned out.
Back when I was working in a SNF, I had a patient on Coumadin. The INR came back at 5-something and there was blood in the foley bag. Called the MD and he said to give the Coumadin and retest in the morning. Um...No. Sorry, not going to do that. Got him to agree to hold and retest in the morning. What the patient really needed was some Vitamin K.
A doc once told me to Vaseline the inside of a straw, place it in the patients ear and suck out a foreign object with my mouth 🤢 ah-no, ill pass! He actually came in the next morning and carried out that procedure himself!! 🤮
A patient was obviously brain dead and ct showed shift in the brain and pt was in 80's with many other diseases and the son asked "what would you do if it was your dad?" The doctor fumbled awkwardly and said she needed to ask her senior. I later told her SO not appropriate.
To many to count or list here. One of the latest, a patient with an obviously infected belly wound. Smelled terrible (to her everlasting embarrassment) oozing frank pus. Doctor would not culture, order antibiotics, nothing because no nurse was going to tell him what to do(we reported to him as home health providers. He never even saw her.) We finally went behind his back and got her PCP to order cultures: Strep A. She ordered abx, finally.
Are you in San Antonio, Texas? We also.had an arrogant paleontologist that fought constantly with nurses! One stood up to him and she became his favorite nurse!
I called a doctor once to let him know that his patient was running a temperature of 101.4 F., was difficult to arouse, and had a heart rate that was above 90. He told me to call him back if his temp went to 101.5. I hung up and then called him right back and said "Guess what? His temp is now 101.5".
We coded a lady in the ICU, and she didn't make it. Her primary care doctor showed up as we were cleaning the post-code debris and prepping her to be viewed by her family. We relayed the events of the code, and time of death to him. He took out his stethoscope and listened to her chest...making sure she was dead? I don't know. Then he straightened up and said, "Let's get a portable chest X-ray."
I once had an elderly woman who had a change in her grip strength on her right side. I had admitted her the day before just before the end of my shift. I was worried she had a brain bleed, so I called the Neurologist to inform him of my findings. He insisted that he had gotten the same morning results that I had just gotten, when he assessed her upon admit.
He finally said "Are you a REAL neurology nurse?"
My response: "Yes I am; are you a REAL Neurologist? I will be documenting the changes in the patient's strength, that you have been notified of these changes and that there are no new orders."
His response: "Just get the damn scan!"
I thanked him prior to hanging up.
My patient did in fact have a brain bleed. No, he never thanked me for saving his rear end; but that's ok. My patient got the best nursing care I could give!!
Specializes in LTC, CPR instructor, First aid instructor..
A doc once told me to Vaseline the inside of a straw, place it in the patients ear and suck out a foreign object with my mouth í ¾í´¢ ah-no, ill pass! He actually came in the next morning and carried out that procedure himself!! í ¾í´®
Garden,RN, ASN, RN
144 Posts
Loved your post.