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 Med nurse in med-surg., float, HH, and PDN.
In the mid-70's, on a step-down unit which also took overflow from med-surg floor. Can't remember any specific details of pt except there was a need for Lasix pronto. Newish Doc, also new to the hospital, was at the nurses station. I gave him the pertinent info he needed, and he said, "Give her some Lasix."
Me: "How much?"
Him: "80 to start with."
Me: "80 what?"
Him: "Milligrams, you ninny!"
Me: "How do you want it given?"
Him: "How do you think I want it given, for Christsake?!"
I turned my hands up and shrugged in slow exaggeration, and said, "I'm not allowed to guess."
Him: "Oh, mumblegrumblesnort."
Me: "If you can't tell me a complete order, or write the order in the chart and sign it, NOTHING will happen. Now, care to tell me again what, how much, when, where and how?"
He told me the order the way he was supposed to, and he still steamed for a while, but he never gave an incomplete order again!
I work in LTC and we sometimes have transitional/rehab patients too. Had one fellow, double BKA, brittle diabetic, post-op broken hip after his stump got stuck and he fell/twisted. Had been with us for about 6 weeks, had been on PO abx 3 times d/t redness, swelling and pain at his incision site, with spiked temp. One noc shift, I noticed his incision was oozing, red, hard, hot and in 2 hours his temp went from normal to 102F. Cheeks bright red, extremely pale otherwise, diaphoretic, seeing his ancestors coming to get him. I called the on-call doc who's response was "I'm coming in for rounds day after tomorrow anyway. I'll look at it then." In this small town, he was also the on-call ER doc, so I couldn't just send the pt to the hospital--I have to have permission from the on-call to send one of my residents. I was almost speechless, but did manage to throw enough a fit that he allowed me to start cephalexin 500mg BID with some PRN acetaminophen. The pt had an appointment with another doctor in a larger town the next day (before Dr. Idiot's rounds), and that doc was concerned enough that the pt was admitted to the hospital for another week, PICC inserted for IV abx for another couple of weeks.
Same doc who refused to come in to evaluate a pt who fell and was in intense pain because he didn't want to ruin his Sunday afternoon. Turned out she had a broken collar bone. We'd only been able to give her her prn APAP 650mg.
Had another resident with intense abdominal pain, not eating for 2 days, gray, pasty, diaphoretic, HR and BP extremely irregular. Doc was called both days--during his clinic hours! And ordered us to send in a urine sample. Surprise, no UTI! As far as he was concerned, that was the end of the matter. The day shift was in tears unable to get help for this super pleasant fellow. I waited until his on-call hours ended and called the PA on duty who was concerned and wanted him in right away. Had been having "cardiac events" for the last 2 days; admitted to the hospital. Did not survive.
I have more, but these are the stories that pop into my mind first when I think of him.
Specializes in Cardiac, Home Health, Primary Care.
Bipap for pneumonia? Sounds like the patient needed to be intubated
It might have helped for sure. I was on a cardiac step down unit (no vents) and it was night with no hospitalist around sooooo if we had coded him he would have gotten a tube by the ER Doc. BiPap sufficed thankfully!
Specializes in Rural, Midwifery, CCU, Ortho, Telemedicin.
"I started walking down the hallway to the nurse manager's office and he chucked the hard chart at me, which bounced off the back of my head."
I hope you sued, in a civil court, for assault until the moment before the chart hit you, and battery for the impact of the chart; or at least let this assaultive "A**" know that you had the right to greatly shorten his shift the moment that you walked to the phone and dialed 911.
Specializes in psych, addictions, hospice, education.
We had a doc who was known to be a character. One day I was working on the computer and suddenly felt something on my shoulder. It was a ziploc bag containing what looked like a stuffed animal. I kept working. The doc was chuckling behind me. It turns out the stuffed animal was a dead rat...good thing I didn't realize what it was when it first landed.
After that day, however, that doctor never bothered me!
This occurred when I was the patient. I had a tubal ligation after baby #2. Nine years later (nine years of regret in my case) I had reversal surgery. Nine months later became pregnant. Nine months LATER show up at the hospital in labor with what turned out to be a 10# 3 oz baby. (I am 5'1" - you can imagine how I looked) Laying on the bed, barely able to see over my belly, he asks "Any surgical history?" I relate my two c-sections, tubal ligation and reversal. He then says, "So, did it work?"
My favorite are the clueless ER residents that show up to codes or rrt's and have no clue how to run through ACLS. Ex. Pt is in vtach (awake and alert), we've already hung amio bolus and started a gtt. Resident walks in... "how about we start a cardizem gtt?" Me: "Or how about that amio gtt that's already hanging?"
I'm a new grad, and my experience with docs has been nothing but positive throughout clinicals in nursing school (especially in the psychiatric setting), EXCEPT one incident that occurred before I even started nursing school. This guy was a resident at the time, I was thinking about nursing school and he said to me, "Nurses don't ask 'Why' questions, they just do as they're told. If a nurse is told to fill half a cup with water, she does exactly that without asking questions". I was literally speechless. I wonder if he's changed his tune since then ....
Specializes in Cardiac, Home Health, Primary Care.
JUST THOUGHT OF ANOTHER. I was a student nurse tech and it must have been a student MD and I HOPE I somehow dreamed this story:
I was sitting at the station charting or watching tele monitors. This likely MD student came up holding her beeper and looking at it with a puzzled look - came up to me and asked "What's a code blue?"
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Patient has been receiving IV Vancomycin for a couple of days when the culture & sensitivity report is finally prepared. It indicates the patient's microorganism is resistant to Vancomycin. I inform the physician who prescribed it during rounds.
Dr. responds, "Well, let's still try the Vancomycin. It might work."
One week after the course of IV Vancomycin has been completed, a follow up urine culture indicated the patient still has the same raging UTI.
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
Craziest thing a doctor has ever said to me? There are so many examples.
"Yes I DO want q 1 hour ABGs on this patient, even though she has no art line and you have to stick her and even though she's a DNR and we aren't going to treat the results anyway." And yes, he wrote that as an order -- word for word -- taking a whole sheet in the order book.
"Flower care q 24 hours."
"If the nurse is at lunch and you're watching her and you won't give her a shampoo right now, I'm just gonna call a code on her." And he did. (Our manager grabbed him by the lapels, swung him around and slammed him up against the wall. Her tirade started out with "Buck up, Buster" and ended with "and if you ever do such a thing again, I will have your gonads for breakfast." I don't remember the middle parts, probably because I was laughing so hard I nearly peed my pants.)
To me, from my (former) PCP: "Don't you worry your pretty head about your blood pressure. You let me worry about the big numbers." (Yes, he actually said this. I was 20 at the time. I was pretty when I was 20 -- everyone who is 20 is pretty. Even the boys.)
R.E. q 1 ABGs - I received a similar order on a similar type patient one time. I knew perfectly well the order was ALL about the physician showing the nurses who was boss and NOT about caring for the patient. Like in your case we were not going to treat results. We hadn't treated any of the ABGs we already had (several had been obtained by respiratory therapy before ICU admission. The RTs apparently just following orders. I was disappointed with them).
I just accepted the order and for the rest of the night charted "attempted ABG stick, unsuccessful".
In the morning I showed the resident's order to the attending, a physician I have worked with in several different hospitals and known for 15 years, oh and we are fishing buddies. Never saw that resident again. When another nurse asked about him the only answer we got "officially" was "you won't be seeing him here again".
No Stars In My Eyes
5,621 Posts
In the mid-70's, on a step-down unit which also took overflow from med-surg floor. Can't remember any specific details of pt except there was a need for Lasix pronto. Newish Doc, also new to the hospital, was at the nurses station. I gave him the pertinent info he needed, and he said, "Give her some Lasix."
Me: "How much?"
Him: "80 to start with."
Me: "80 what?"
Him: "Milligrams, you ninny!"
Me: "How do you want it given?"
Him: "How do you think I want it given, for Christsake?!"
I turned my hands up and shrugged in slow exaggeration, and said, "I'm not allowed to guess."
Him: "Oh, mumblegrumblesnort."
Me: "If you can't tell me a complete order, or write the order in the chart and sign it, NOTHING will happen. Now, care to tell me again what, how much, when, where and how?"
He told me the order the way he was supposed to, and he still steamed for a while, but he never gave an incomplete order again!