Butting Heads with Doctors

[RN4it]

I work in a behavioral health facility caring for adolescent patients. Many times we will get patients on the unit whose parents are not in favor of medication and this has never been such a pressing issue. The psychiatrists will usually talk to the parents and come up with a reasonable treatment plan where all parties are satisfied, but today I had a psychiatrist push the issue of hot-lining a parent to Children's Division for refusing to allow us to start medication on a 13 year old patient. I did not feel that the matter was neglect on the parent's end because the doctor never spoke to the parent about the medications that were to be started. Only myself and a case manager had spoke with the parent. The psychiatrist asked the case manager to hotline the matter and she agreed to hot-line the situation. I feel that something is wrong with this not only because the psychiatrist never reached out to educate the parent for his rational, but because I feel like he is trying to bully the parent into starting medications. The psychiatrist even hung up on me when I asked him if he spoke to the parent. He told me that that was irrelevant. My supervisor is aware of the situation. What more can I do? Any advice would be appreciated. Thanks in advance.

[NurseCard, ADN]

Probably nothing. Seriously.

Does the kid have something going on that generally REQUIRES medication

to control? If so, then you could try talking to the parents yourself maybe

one more time, saying you know, I know you are upset with the doctor, but

give the medication a chance...

If not... the doctor refuses to prescribe therapy in lieu of meds... parents

are unhappy... not much you can do. Parents need to come and get their

kid and take him/her somewhere else.

[Have Nurse, ADN, RN]

Take this to the Medical Director and/or the Patient Rep. And do it soon.

[Have Nurse, ADN, RN]

I must respectfully disagree with this idea. She is not in a good position to over-step the Physician and speaking with the parents. I do however think though, that since nurses are patient advocates, that she would be well within her practice to take this to the Medical Director and to the Patient Representative. They could reach out to the parents and deal with the doc.

Unless this child is Imancipated, not needing parental consent for meds, the parents should have been brought into the discussion by the Doctor. Not doing so did not allow them to have their questions and concerns addressed. This is irresponsible and rude.

It's up to that nurse how she is going to handle this, but it needs to be done immediately if she's going to move forward with this.