First Negative Experience w/a Dr...

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I have had a lot of neutral experiences with Drs., and a few really stellar Drs work on our floor. They take time with the patient, have asked me my opinion (to which I murmur "we haven't covered that just yet...), and listen when I say something (like when the patient told me he was trying to kill himself when he drove into the center divider...at speeds over 100 mph...).

Today, though, I had my first negative experience.

Dr. in the room, asking questions. I had been assessing breath sounds, and stopped to let her do her thing. No big deal, because I had ONE patient today, and he was being discharged. LOL. MAR and chart both state No Known Drug Allergies. Anyway, Dr. asked a question about his tolerance to meds, patient said that he vomited every time he took that drug, and my ears perked up. I asked "what antibiotic was it?" to the both of them...

She replied: "Oh, it's all right. I know what it is."

I said: "Erm, it's not all right; I don't know what it is."

She said: "Why do you need to know what drug it is?? For Pete's sake!"

I said: "I give him meds. His chart says NKDA. This might be important, don't you think?"

She said: "No, I don't think. Student nurses don't know anything, and they shouldn't THINK about that anyway..."

I told the patient I'd be back in a while to change his linen.

When I returned, he told me the drug name. I charted it. :chuckle

Blergh. Last day of clinicals for this semester...I almost made it without a problem with Drs. Sooooooo close....and blammo...

Bahfooey.

Just thought I'd share that little experience.

Best-

Lovin' Learning

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Gotta love Dr.s, some of them just love to be annoyed at everyone...esp if you stand up to them...egad!:lol2: You did fine it sounds like, and believe me it won't be the last time! Don't ever let a Dr make you think you are being stupid or wasting their time or yours. If you know you are right, do just what you did today and pursue it! I have seen Drs get chewed out by the Nursing Supervisor for that kind of attitude, as well they should be. We are all supposed to be working together for the patient...right? I agree with you; phooey on them!:p

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Specializes in med/surg, telemetry, IV therapy, mgmt.

Never butt in on a doctor's conversation with a patient--ever--unless you are asked for input. And saying, "I give him meds. His chart says NKDA. This might be important, don't you think?" is rude, arrogant and presumptuous. That doctor has a relationship with his patient and it is not any nurses place to interfere with it so untactfully in front of the patient. A comment like that challenges the doctor's medical decision and plan and does it in front of the patient! The more tactful way to have handled this was to say something to the doctor privately and out of the earshot of the patient later. As it was, the situation became tense and the doctor retaliated.

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Never butt in on a doctor's conversation with a patient--ever--unless you are asked for input. And saying, "I give him meds. His chart says NKDA. This might be important, don't you think?" is rude, arrogant and presumptuous. That doctor has a relationship with his patient and it is not any nurses place to interfere with it so untactfully in front of the patient. A comment like that challenges the doctor's medical decision and plan and does it in front of the patient! The more tactful way to have handled this was to say something to the doctor privately and out of the earshot of the patient later. As it was, the situation became tense and the doctor retaliated.

I hear you, and yes, I could've dealt with it differently/better. But something always gets lost between the occurrance and the written word; my tone was not rude nor disrespectful, although that can't really be conveyed with writing. Should I have done it out of earshot, yes. But the way I said it was neither with disrespect nor rudely...

The doctor is a student as well, and her tone was really rude. She did not have a 'relationship' with this patient (this was her second time with him, and he didn't know who she was...and not because he was confused...he was AOX4), her accent was heavy, and he was a spanish speaking gentleman with a thick accent as well (not the same accent). This is the Dr. that had, to a previous patient, wrote an order for 2 g morphine (which another student nurse caught before anything happened) while removing a chest tube from another patient. Further, she already knew that he has a reaction to an ab, and it's not in the chart.

Again, though, I hear you. I'm always looking to improve, and your comments have given me something to consider when it happens again.

Best-

Lovin' Learning

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Ok..I have to be honest. You did say something wrong to the physician, and my jaw dropped when I read what you said.

When you asked the patient which antibiotic was it...and the doctor said, "It's alright, I know what it is."....THEN you said,

"Um, It's not alright...."....anything you had to say after that, I can tell you, she wasn't listening. Then it appeared that you said this in front of the patient...which I sure hope didn't happen, b/c if it did, it was very inappropriate.

If you needed to know to charting, then you should have said, "I just need to know which drug it is so I can chart it."

I think the outcome of the conversation would have been quite different. Daytonite is 100% correct. You want to work WITH doctors, not stay in a battle with them.

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Gotta love Dr.s, some of them just love to be annoyed at everyone...esp if you stand up to them...egad!:lol2: You did fine it sounds like, and believe me it won't be the last time! Don't ever let a Dr make you think you are being stupid or wasting their time or yours. If you know you are right, do just what you did today and pursue it! I have seen Drs get chewed out by the Nursing Supervisor for that kind of attitude, as well they should be. We are all supposed to be working together for the patient...right? I agree with you; phooey on them!:p

The whole floor was contentious yesterday...a Dr. was yelling at the Nursing Supervisor in front of all the students and teaching nurses; another Dr. chewed out the unit secretary; nurses were frazzled...computers were locking down, televisions were unable to be shut off, supplies were short. It was a circus yesterday. Every student, Drs and SNs, are in finals, and tempers are short, eyes were rolling, and the only time there was any quiet was when I went into the nutrition room for something. LOL.

It was just one of those days...I almost made it through the semester without a negative experience...but it was not to be.

Oh well, there are three more semesters to do it in...

Best-

Lovin' Learning

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Justme, I love learning...and it seems, between your post and Daytonites, that I sure could've dealt with it better.

Please know this.

I will take your (and Daytonites) advice, and next time it happens, I will handle it in a far better manner. But I won't stop advocating for my patient, you know? (And I know you're not suggesting that).

Honesty is just fine with me. I learn from my mistakes, and try to always be open and hear when I've erred...so that next time I can be better. I'm hearing it, and like I said, I will take from this a better way to deal with the situation should it occur in the future.

Best-

Lovin' Learning

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Specializes in OR-ortho, neuro, trauma.

There are some nasty doctors out there but I think your approach was wrong. Put yourself in the shoes of the MD and you are speaking to a pt and a nurse (or anyone) interrupts your conversation (people interrupting me is my biggest pet peeve) to ask a question that can wait until the MD's assessment is done. It's very rude like daytonites post already stated.

We all know you had the patients best interest at heart and it's all about learning. Over the years I've learned to kill them with kindness and have even had doctors that were rude in a situation later apologize and commend me on my professionalism.

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After reading through this thread I just want to say that I'm glad this forum exists. I learn a lot everyday and it has me thinking how I can apply the information I find here.

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Specializes in med/surg, telemetry, IV therapy, mgmt.

but the way i said it was neither with disrespect nor rudely

well, i disagree. it was very rude and disrespectful. we have to be aware that we are always viewed as role models. bad behavior is never forgotten. your comment was catty and unprofessional. had the tables been turned i guarantee you wouldn't have liked it at all and would be complaining about getting no respect as a nurse.

the doctor is a student as well, and her tone was really rude. she did not have a 'relationship' with this patient (this was her second time with him, and he didn't know who she was

so being a medical student gives a nursing student carte blanche to be rude back? how childish is that? and, the doctor had no relationship with the patient? how do you know? how do you know what prep work the medical student did before seeing the patient? don't you get a report and look through the chart before you see the patient? how do you know what was told to this medical student in report by other the resident physicians? they work as a team in teaching hospitals.

the whole floor was contentious yesterday...a dr. was yelling at the nursing supervisor in front of all the students and teaching nurses; another dr. chewed out the unit secretary; nurses were frazzled...it was a circus yesterday. . .tempers are short, eyes were rolling. . .oh well. . .

this is not a valid justification for anyone else to roll up their sleeves and join in getting involved in a confrontation. if anything, it should make everyone extra careful of what they say and do when interacting with others knowing that tempers are already hightened.

next time it happens, i will handle it in a far better manner. but i won't stop advocating for my patient, you know? i will take from this a better way to deal with the situation should it occur in the future.

there are acceptable ways to advocate. there is no reason to be confrontational. that is what sets people off to go postal, start fights and shoot others. it is also not our job to supervise doctors. that belongs to the chiefs of their respective services. if i don't like the way a doc treats me, i write it up for his chief of staff and give it to the medical staff service clerks. the doctor has his/her job to do which we need to respect and we nurses have our job to do which we need to do with dignity. both of us have to work together and with respect for each other
even if we disagree with the way the other practices
. we don't work
against
each other.

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Specializes in Telemetry.

Well said Daytonite. I like the way you express yourself. We have to be tactful at all times.

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Happy Holidays, everyone!

As your name says, LovingLearning, you're learning.

:)

Maybe you could have handled it better. But the doc is still a jerk.

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