That thing would be writing orders without seeing the patient. The doc looks at the CC and perhaps the triage note (although based on some orders, the latter does not seem like it always happens) and then write orders for it before they assess the pt. One case was a 30 something year old male with a CC of upper abd pain. Doctor orders: IV, abdominal labs, urine, cardiac monitor, chest Xray, and troponin. I go in to do my assessment (still before the doc is in there) and it turns out the guy has a hx of GERD and ran out of his PPI.
It has happened in other circumstances too. One time I thought the doc had already been in the room so I carried out the orders including starting an IV (which meant I had to explain why the doc thinks the pt needs an IV even if he hasn't evaluated the pt). While I'm in the middle of lining him, the doc comes in to the room for the first time. I finish up. As I'm leaving, the doc tells him there is nothing we can do for him since he has been seen at our ER multiple times for the same CC (another abd thing). Patient gets upset since he has been stuck for no reason for an IV that was in 5 minutes.
Docs who do this are trying to save time. Since docs are judged on their times (i.e. time it takes them to make a disposition) it makes sense. However, someone has decided to judge nurses based on customer service scores, and putting in IVs for no reason is decidedly bad for PG scores.
Anyone else deal with this?
OK, rant over...for now.