Has anyone here ever put a doctor in their place? - page 5
I keep reading here that nurses are constantly walked on and berated by doctors. That doctors seem to have a God complex and see themselves as better and all omniscient as opposed to the nurses who... Read More
Aug 19, '06My hero of all time in the nursing profession was an LVN that I worked with. I only wish I could think so fast on my feet as she did, when one of the neurologists, who had to have been the Valedictorian in his arrogance class in med school, asked her "What time of day does Mr. *** get his midday dose of Mestinon?" Without even so much as looking up from her med cart, her reply was a very casual, "Midday." I saw the pen he was writing with come to a sudden halt and there was a pregnant pause. His response, "Do you have any more smart aleck answers?" Her very nonchalant answer, "Not unless you have any more stupid questions." There was nothing he could say. I nearly choked on suppressed laughter.
Aug 19, '06I was working in med/surg and had a patient with a long history of CHF. She measured her ankles daily, well her daughter did, anyway. She called me in the room one day and said she was getting more swelled up. I did a quick assessment, lungs, heart, edema, JVD, BP changes, pulses changes, etc. Called the doctor who says "I don't care if her ankles are more swollen, leave me alone and call me when something important comes up". Well, this patient also wasn't getting her lasix, it was somehow overlooked. I mentioned this and he kept saying he didn't think it was important. Very rude voice. I said, "OK, I'll go tell the patient that I called you and you don't want to do anything about it." Ten minutes later he comes stomping in, didn't even talk to me or even LOOK at the patient, wrote a ONE TIME ONLY order of lasix 10 mg PO, and stormed out. He always listened to me since then. If there's anything I can tell a doctor is: Listen to the nurses. If there's anything I can tell nurse is: Listen to the CNA, and IF you need to call a doctor, have all your information available, and I mean everything, I/O, vital signs, recent labs, LOC, lung sounds, everything possible. They may still ask a question you don't know, though.
PS, I told my nurse manager about it, who promply did nothing. I also charted "MD notified, no new orders".
Aug 19, '06Oh, and I should add, I wrote that "MD notified, no new orders" after calling. He then did his storming into the unit and ordered the 10 mg of Lasix and left, WITHOUT charting anything. I wonder how that would look in court if the patient went into full CHF and coded or something? HMM?
Aug 22, '06I do agree in that treat people in the same manner that you would like to be treated... with respect and dignity. Sometimes, there are some exceptions to the rule no matter how hard one tries. When it comes to being a patient advocate, you have to draw the line. When I was on active duty in the Army, I was a LVN on a very busy/multi-specialty ICU. We had Medical, Surgical, Trauma, and Peds all combined at this one Army hospital, and it was also a teaching facility too.
Back to the story... one particular ICU resident was passing through the ICU for the 2nd time around. This person was difficult to work with, constantly changing orders, and was just high strung. Being a resident is stressful.
I tried to be compassionate and helpful, but I would not compromise patient care period. There was this sweet elderly woman who was intubated, on reverse isolation for MRSA, and she required a central line placement for multiple drips. This resident attempted her first initial stick at the internal jugular area, refused to change the needle, and was ready to re-stick this poor patient in the subclavian vein with the same needle. In a calm voice and with a respectful tone, I offered the resident to simply change the needle, in which she refused. She tried to pull rank on me (I was a Sergeant and she was a Captain). But, in this particular situation...I disobeyed her, asked her to stop, in which she began yelling at me. Again, in a calm manner...I pressed the call button which alerted the Charge Nurse station, removed my gown/mask/mask/gloves, explained the situation to the Charge Nurse and the Nurse Manager.
The resident was immediately removed from the patient's room, the Chief Physician of ICU got involved. I was instructed to re-gown, assist the Chief (who was a brilliant sweetheart of a guy), and that central line was placed in less than a minute. For the rest of the ICU rotation, that resident "threw daggers at me every morning" when she looked my way ( I worked mainly day shift). I did'nt skip a beat nor did I lose any sleep. The sun rises every morning, and I knew in my heart that I did the right thing. I gave the resident the opportunity to make things right, but she chose her path.
After that incident, the resident was over shadowed by another resident/physician that was senior to her. I don't think she was too happy, but then again we are there for the patient's, and not for her happiness.
The other nurses did not trust her either. And, we were all so glad when she finally left the ICU. In all honesty, I think this individual washed out of the program in the end.
Sep 3, '06Quote from RNTOBSNGUY
PS, I told my nurse manager about it, who promply did nothing. ".
i have seen this way to often - i have reported several rude and nasty docs that have residents at our NH and i was told by the DON that is "just how they are" and when i went above her to the administrator i was basically told we had to suck it up because without doctor so and so we wouldn't have the residents blah blah - sickened me to no end and am currently looking for another job because of it.
Sep 4, '06I agree with most of the posts in that you receive back what you give. I think that sometimes the doc's are as fustrated as we are at times during our day. I have told several physicians that the way they are speaking to me or about the staff in general is not appropriate over the years. I always make sure that it is not in front of the patients or other staff if possible. Believe me when you walk out of the room or away from the desk because they are throwing a fit, they will normally follow you to make sure you get the message they are trying to say. But it takes to people to have an argument. They will usually continue to berate you until they get it off their chest. Once they are done, I calmly tell them what I see can be done to resolve the issue and ask if they think it will help. After they realize that I am not against them they seem to calm down and are receptive to my view of their behaviour being a problem. I let them know how their remarks and actions not only make me feel belittled but that it affects the relationship that we all work so hard at to make sure our patients trust us and our skills. I always tell them that unacceptable behaviour is unacceptable behaviour. It should not be present in how patients receive the care he wants or in how we treat members of our team.
I have worked the night shift for 15 years and when they are woke up for the 20th time during the night a doctor can be extremely rude. I always start with an apology that I have had to wake them and have concise and significant information about the condition of the patient available. I also tell them all the interventions that we have taken to resolve the situation and the outcomes. When I give them a chance to readjust their attitude they usually do. If they don't, I remind them that our scope of care requires us to notify of a change in our patient status and that the negative outcome of not doing so would result in patient harm. When they come in for morning rounds they are usually apologetic for being rude and thank us for calling so futher complications haven't occured.
There is a system to make formal complaints if my attempts are unsuccessful but so far I haven't had to write any up. I always make sure the nursing supervisor is aware of any problems and how I have attempted to resolve them so they are not blind sided if the doctor decides to complain. Also if I am reporting something that they refuse to address, I write a specific order of what was reported and that no new orders where received. If it is a life threatening situation, I have gone to the medical director after speaking with my supervisor in the past. Believe me, you usually get results for the patient and the doctor's behaviour if you are waking the director during the night.
Most doctor's are aware that the nurse's at the bedside are an intricate part of the team and treat us with the respect and professional courtesy that we deserve. For those that don't I say "There but by the Grace of God go I." One day I may be the one who let's my bad day become everyone elses. I hope that if I ever forget that I came into this field because I care and want to make a difference, someone will be kind enough to tell me my attitude is not acceptable. It may be all that is needed for me to turn it around.
Sep 5, '06i was a student nurse and i had to do a skin test on my patient. intra-dermal, meaning on the skin right? this student-doctor tells me in front of the patient that im doing it wrong bec i should be inserting the needle deeper. hello?!!! insulting me in front of a patient. even worse, she was giving me wrong instructions. of course i didnt listen to her, so she repeated her instruction. and i still ignored her.
as i didnt want to stoop to her level i talked to her after the procedure, so that the patient wouldnt hear us. i had to tell her flat out that she is only a student, as i, and only my instructor can tell me what to do. i told her that she better check her books again bec she was wrong. and finally i told her that she should never intentionally criticize me or any other person in front of a patient.
btw, i have a bad-ass teacher that once shouted at a doctor. this doctor continuously perstered her for cottonballs despite obvious up-in-arms workload. she told him that she was a nurse and not a slave and that the cotton balls were accessible if he needed them. go nurse power!!