things you wish you could tell the doctor

[celery]

I enjoyed reading the things you wish you could tell the patient, here is something I wish I could have told the doctor:

We are standing at the foot of the patients bed...

Doc: Has her foley been d/c ed?

I'm not even going to say what I was thinking, lol, use your imagination folks

Here's another

Doc: Why didn't you tell me about her K level?

This was about an hour after he got mad at me for calling him on Sunday and he hung up on me. Before, of course, I could tell him about the K level. Again, use your imagination.

[ebear, BSN, RN]

Think this is a resident doc?

[al7139, ASN, RN]

I love when I call a doc and tell them what's going on, and they say "What do you want me to do?" "Gee Doc, I don't know...Could you give me an order to treat this problem, since I can't diagnose or prescribe, and I wouldn't be calling you at 0300 for just anything?"

Or, when an MD complains to me that he would be there faster if the nurses would stop paging him. Correct me if I am wrong, but isn't it my job to call you with a problem, and your job to give the orders I need to correct the problem? I wouldn't be calling you at 0300 just because I felt like it. I do my job, you are there to do yours. Accept the fact that the nights you are on call, you won't sleep.

[UM Review RN, ASN, RN]

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[GrumpyRN63, ADN, RN]

Think this is a resident doc?

ebear, I agree with you, student more likely IMHO

[TiredMD]

ebear, I agree with you, student more likely IMHO

I will occassionally ask a nurse what she would like me to do about a problem she has called me on.

The reason I ask is because it is more respectful than saying, "I don't really think this is a problem, and unless you have something specific in mind, I am going to do nothing." This is usually things like calls at 10pm for no bowel movement x 48hrs or 'patient had reflux after dinner but it's gone now' kind of calls.

There are times when patients have an issue that I don't feel need immediate intervention, but the nurse does. In those cases, if the RN would like an order for something and it is reasonable, I will defer to him/her. However, if they don't want to suggest anything, I will end the conversation with, "Thanks for letting me know, I'll keep an eye on the patient."

I just don't want anyone getting saucy with me for not taking their concerns seriously, so I ask if they have something in mind.

BTW - in case anyone was wondering, no, I didn't report any of the posts in this thread as offensive to the admin here, I thought a lot of them were pretty funny

[Diary/Dairy, RN]

I will occassionally ask a nurse what she would like me to do about a problem she has called me on.

The reason I ask is because it is more respectful than saying, "I don't really think this is a problem, and unless you have something specific in mind, I am going to do nothing." This is usually things like calls at 10pm for no bowel movement x 48hrs or 'patient had reflux after dinner but it's gone now' kind of calls.

There are times when patients have an issue that I don't feel need immediate intervention, but the nurse does. In those cases, if the RN would like an order for something and it is reasonable, I will defer to him/her. However, if they don't want to suggest anything, I will end the conversation with, "Thanks for letting me know, I'll keep an eye on the patient."

I just don't want anyone getting saucy with me for not taking their concerns seriously, so I ask if they have something in mind.

BTW - in case anyone was wondering, no, I didn't report any of the posts in this thread as offensive to the admin here, I thought a lot of them were pretty funny

If it;s something silly (ie UOP not up to par) I just say - I just wanted to let you know....

If not - I TRY not to call in the night, unless I actually need something.

[ebear, BSN, RN]

TiredMD, thanks for your response and input.

I do also expect nurses to have common sense when calling a doc about something. If it can wait and is not urgent, leave him/her a note on the chart. If he/she left specific orders to be notified--notify. If the pt. is in trouble--notify. If the doc has poor handwriting and NO ONE can read it, maybe he/she will learn how to write more legibly in the future if woken up; better still, discuss new orders with the pt's. nurse before leaving the unit. That gesture alone would solve a lot of everyone's problems. I know that docs get many "dumb" phone calls but sometimes it's their own fault.

ebear

[leslie :-D]

this is why i do not call the docs, when my instincts are telling me my pt is circling the drain.

what is it i expect the doctor to do?

hmmmm.

vss, all assessments wnl, mentation alert, but still....

and yes, my instincts are usually spot on.

they crash and die.

i guess i don't understand why some nurses get offended when md's don't listen to them about their gut instincts.

what are they supposed to do?

i honestly can't justify ordering a boatload of tests, based on my gut.

leslie

[TiredMD]

I know that docs get many "dumb" phone calls but sometimes it's their own fault.

Truer words have never been spoken. But honestly, you probably could have said "frequently" instead of "sometimes".

If the doc has poor handwriting and NO ONE can read it, maybe he/she will learn how to write more legibly in the future if woken up;

Thank God for the EMR!

[ebear, BSN, RN]

Well, honestly, is it "sometimes" their own fault or "frequently" their own fault? Not everybody has EMR, BTW.

ebear

[TiredMD]

Well, honestly, is it "sometimes" their own fault or "frequently" their own fault?

It took me a month into my internship to learn a couple things:

1) If you don't care about a BP of 170/85, don't write "Call HO for SBP >160 or DBP >80."

2) If you know the patient will have a fever postop, write for 24hrs of scheduled Tylenol.

3) If you know someone will have pain, give them a PCA.

There are a million other little things you can do to reduce the number of pages you will get. I am continually amazed at my colleagues who continue to write stupid orders that essentially force the RNs to call them in the middle of the night, then continue to do the exact same thing call night after call night.

So long story short, for me it is "sometimes", for many others it is "frequently". :) Sorry for the thread hijack.

[EmmaG, RN]

There are a million other little things you can do to reduce the number of pages you will get. I am continually amazed at my colleagues who continue to write stupid orders that essentially force the RNs to call them in the middle of the night, then continue to do the exact same thing call night after call night.

It would save a lot of hassles for all involved if they would simply write prn orders (barring any contraindications) for something for sleep, nausea, constipation, and pain.