Things you'd LOVE to tell the doc and get away with it.... - page 9

Since the patient version is so popular, and I had a bad weekend (and no hope for a better one this weekend....) You've been giving this schizophrenic Alzheimer's pt 10 mg Ambien, plus 50mg... Read More

  1. by   beachbutterfly
    Quote from CanuckStudent
    I'm sorry, I suppose we just don't share the same views.

    It's not that I am opposed to you venting, rather I just wanted to address the fact that another poster on here claimed to be rather disrespectful and unprofessional towards an MD (another member of the team). In fact, it was another poster who pointed this out.

    I don't think my point was necessarily offensive. There's a difference between actions and words. I was simply addressing that. Albeit in perhaps not the best way.

    Thank you for your advice, and I do plan on applying to med school (no flaming please). Hence why this is a personal sore spot for me. I'm sick of the hierarchy in healthcare. I hope that I will be part of the new generation of doctors who values the input from nurses.

    I hate seeing the negative comments, as it reinforces the many stereotypes that people have already. Nursing is known for lateral violence. No need to extend that perception. Denying this won't help, but acknowledging it can.

    I'm all for venting, but actions are another story. That was my main issue, and it was directed primarily at one poster. Instead of focusing on my comments, perhaps we should be finding out why the OP handled that call the way she/he did. As suggested earlier, the MD likely was looking for the RNs input.

    P.S. We don't offer 2 year RN programs in Canada anymore, almost all provinces require 4 year degrees for RNs. LPNs now have a 2 year diploma. In my case, it IS true that nurses have a higher level of education than they once did. I was simply pointing that out. Personally, I don't care if you are an LPN (2 years), RPN/Psychiatric Nurse (3 years), or RN (4 years).

    I hope everyone lets this go. Back to venting....
    In the medical school you will enounter many negatives thoughts about nurses,this is a no win-win battle.
  2. by   Keysnurse2008
    Quote from Keysnurse2008
    My favorite thing Id like to tell them....gee...so many to choose from...hmmm
    1. Yes doctor ,..I completly understand why you didnt want to give them anything for that low blood pressure.Umm hmm...yep makes sense to me . Ahh...by the way can you grab that zipper there for me . You know I always DO have such a hard time zipping up these darn body bags.

    2. So...let me get this straight doctor. The patient is still breathing 54 times a minute, they are so lethargic that they will not even open their eyes to voice anymore....and you want to know why I am calling you. Hmmmm.....ok. I tell you what. Ok...I am so very sorry I disturbed you.....tell ya what. Hows about I just give ya a call back in lets say 2 hours when they go apneic. That would be 3 am. Would that time work for you?

    3. I am old , tired and my back hurts. If you arent going to put them on a drip to raise their blood pressure . You need to bring your a** down here bc I am telling you right now I am NOT going to do chest compressions on them.

    4. Can you repeat that in English please? Ok...you dont seem to be understanding me. can you repeat that in English please? Oh...your english skills are not very good? Hmmm...maybe if you just ...did charades Id get the jest of what you are saying. Do you know charades?yeah...that might work. who needs to really know how to speak english....Hey ,maybe we can save the hospital a few bucks ...instead of the communication interpretation phone line I can just start doing my discharge teaching in charades. You can do your consents in charades.You can draw a line across your neck and say you discussed the possibility of death r/t the procedure. I can see your point....yeah...really who needs to know how to Reallllyyy speak english?

    5. really? It doesnt bother you that the patient used to could walk and talk and now they cant? You really dont think that warrants a phone call at 1 am? See doc...thats what I thought too....but the patients son got real upset when grandma got out of bed to go to the bathroom and kept dragging that whole right side around. hell ...its right amusing...granny just keeps going round and round in circles. You are completly right! I shouldnt have called u. I understand your rational completly. I mean....talking is way overrated. I mean ...I understand where you are coming from. If she hasnt said all she needs to say by the ripe old age of 63 then its her own darn fault.
    An example being....I have said all but one of these things to a doc....in the right place...in the right setting to get my point across with dry humor and to KEEP THE BEHAVOIR OF THE MD from reoccurring. I used dry morbid humor....to get that point across....when I have a good rapport with the doc. they do the same with us. But we work together as a team....not as anything else. It works out better for the patients....we work well as a team...and have the mutual respect for each other so we are "OK" to address issues without offending/demeaning one another.It goes both ways though. They use the same dry humor to address issues with the nurses. The other day we were getting ready for a evd ( brain drain placement)...we use nonpreservative saline to prime the line. having an off day one of the nurses stood back ...looked at the set up....and said to the doctor....somethings wrong, what is it that I dont have here? The same doc I did the body bag comment to, picked up a vial of the saline she had used to prime the line and said " ok...after I put this in....will the patient be considered pickled or pruned?".It was the saline filled with preservative. LOL....he used dry humor ...got his point across....now every time she sets up for the EVD placement she will not repeat that same error. That...is an example of how you can use humor to say what needs to be said ....in a non demeaning way. It is our way of keeping each other in check and working in a cohesive team atmosphere. This...team approach is mandated by our attendings and CNO. It works .....it improves pt safety...addresses things that need to be addressed....it works for us.
    Last edit by Keysnurse2008 on Jun 27, '09
  3. by   HelenofOz
    What I would REALLY like to say when the doc has a major tantrum about not getting what they want-equipment that someone else is using, specific OT room, bed for pt when the hospital is full- "Just because you're having a tanty does not mean that I can pull the solution out of my a**e and make the problem go away. I do not keep a secret supply of stores there for just such an occasion as this"

    and also "If you want to be friendly that's great, if you want to be professional and distant, that's great, but do not change from one to the other. Be consistent"

    With reference to respect etc etc. I'm sure we all treat the docs with respect and professionalism, but if that isn't reciprocated it's a very difficult thing to keep going. And have you noticed that the nice doc's have less problems with their patients than the snarly ones? I loved the plastic surgeon who always ended his phone calls with-'thankyou for letting me know' after I called re the pt's temp of 37.5, (cos that was part of his protocol-contact if temp 37.5 or more!) He was such a control freak that he was easy to work with, everyone knew exactly what was expected, and he was always a gentleman, and did beautiful work-just a shame he retired as we all got old enough to need his services!
  4. by   nerdtonurse?
    To the idiot doc who asked me what medical school I went to because I started a sentence "Doctor X, I'm very concerned about Mr. X's latest troponin--"

    I don't have to be a meterologist to know that it's raining, and I don't have to be a cardiologist to know that a pt with a hx of prior MI, with a troponin of 4.9, SOB, diaphoretic, C/O "elephant on my chest" and a BP of 210/180 needs to be in ICU -- forget that, needs to been in freakin' helicopter on his way to the flagship hospital in the capital. And as soon as I can control the urge to kick your sorry, lazy, stupid self satisfied gluteus maximus from here to the Pacific, I'm calling the admin rep to see if we can save the pt.

    BTW. Pt died.
  5. by   pawsomepooch47
    i have found that if being snapped at , yelled at, sneered at is met with a similar response, it is not likely to happen again!:smiley_ab
  6. by   cherrybreeze
    Quote from CanuckStudent
    I'm sorry, I suppose we just don't share the same views.

    It's not that I am opposed to you venting, rather I just wanted to address the fact that another poster on here claimed to be rather disrespectful and unprofessional towards an MD (another member of the team). In fact, it was another poster who pointed this out.

    I don't think my point was necessarily offensive. There's a difference between actions and words. I was simply addressing that. Albeit in perhaps not the best way.

    Thank you for your advice, and I do plan on applying to med school (no flaming please). Hence why this is a personal sore spot for me. I'm sick of the hierarchy in healthcare. I hope that I will be part of the new generation of doctors who values the input from nurses.

    I hate seeing the negative comments, as it reinforces the many stereotypes that people have already. Nursing is known for lateral violence. No need to extend that perception. Denying this won't help, but acknowledging it can.

    I'm all for venting, but actions are another story. That was my main issue, and it was directed primarily at one poster. Instead of focusing on my comments, perhaps we should be finding out why the OP handled that call the way she/he did. As suggested earlier, the MD likely was looking for the RNs input.

    P.S. We don't offer 2 year RN programs in Canada anymore, almost all provinces require 4 year degrees for RNs. LPNs now have a 2 year diploma. In my case, it IS true that nurses have a higher level of education than they once did. I was simply pointing that out. Personally, I don't care if you are an LPN (2 years), RPN/Psychiatric Nurse (3 years), or RN (4 years).

    I hope everyone lets this go. Back to venting....

    The MD was not looking for the RN's input when his answer was "ok." I've had physicians agree to a particular med that I ask for, and they say, "I'm not very familiar with that, how is it usually dosed?" They will either go with what I suggest, or have me write for pharmacy to dose (not that they don't trust me, but I'm not a physician, so I don't take offense either way). THAT is "looking for the nurse's input."

    The crack about "why don't you just go to medical school?" or whatever, is uncalled for. Nursing is a different profession, most nurses don't WANT to be doctors. Do you REALLY, honestly think that docs don't complain (vent) about nurses??? PLEASE. We're getting our vents out in a safe environment, to people who understand our frustrations....that is not "lateral violence."

    Maybe there aren't 2 year RN degrees in Canada any more, but there still are in the US. So I take offense to your continued comparisons to time spent = degree. At the end of the day, my license is the same as yours. And I'm a damn good RN.
  7. by   pawsomepooch47
    i had the distinct pleasure of firing a pompous ass general surgeon who we had to take for my 13 yo sons ruptured appendix because he was on call that night. wow was he surprised! after a week in the hospital with a wbc that wouldn't go down and a fever and unable to eat or drink with his closed incision draining green drainage and mr. surgeon refusal to do a repeat abd ct or change antibiotics-- (i was told every day "maybe just another day and things will improve") i fired him, got a better surgeon who did a repeat ct which showed multiple pockets of fluid in his abdomen and took him back to surgery that afternoon and changed his antibiotics. after that he finally got better but not without an ng tube, tpn and a central line. he lost 16 pounds in 16 days in the hospital. pompous ass has now retired--about 2 years too late.
  8. by   Spiker
    its almost like a bully situation with some docs. they will push you around and abuse you until you stand up for yourself. once you do, they tend to behave. so sad to see this childlike behaviour in supposedly mature adults who are pervasively looked up to as leaders and professionals.[/quote]

    you hit the nail on the head: i've been an rn for over 30 yrs. now, & the majority of the docs are now younger than i am. the ones that i've stood up to are now the ones who treat me with the most respect,. of course, they all have their moments, as do we, but i think if you show some respect while proving you have a brain & a spine, things are much better between you. hang in there, remember to be an advocate for your jpatient, no matter what!
  9. by   lamazeteacher
    Have any of you who work with "hospitalists" found them more congruent with nursing staff members? The private physicians seem to mess up every good care plan, contradicting anyone who doesn't agree with them........
  10. by   mama_d
    Actually, the one doc that I have consistent problems with (and posted about, apparently causing controversy, for which I apologize) is a hospitalist.

    Putting on my big girl panties here...for anyone who I offended by my prior posts, I apologize. Perhaps it was in poor taste for me to post what I did, but I would like to point out that it is ONE doc that I have this problem with, as do ALL of the nurses I work with. Not one nurse has a good relationship with this doc, and many have said much worse than I did to him. However, those of you who pointed out that this thread was for what you would like to say as opposed to what was actually said are correct, and I will try to pay closer attention in the future.

    Even though it's not as much fun, here's a couple more from me

    Dr. X, thank you so much for your needed acknowledgment of the absolute crazy that the patient's daughter embodies, and laughing about the fact that I had to call you at 0200 with her insane demands. If all the docs engendered the same camaraderie as you do, work would be a much better place.

    Dr. Y, thank you for remembering my name and asking about my baby, even though you haven't seen me since before I went on maternity leave and the baby's almost three now. One of the reasons why we all love you is b/c of the simple fact that you know all of our names, and actually use the word "please" when you want something. To all the other docs: this is why we'll bend over backward for this doc...emulate his example, and we'll do the same for you.
  11. by   nursechris1
    To a doctor who wanted to cut the hospice patient's pain medicine in half, just to see if she was really in pain. "How about if I kick you in the family jewels, to see if it really hurts?"

    I told a different physician "I informed the patient's family that you did not want to treat their dying mom's pain. They family has decided to fire you and obtain another physician, and yes, our medical director would be happy to care for this patient."

    Just because you are the patient's primary physician, does not mean that no other physician can treat your patient without asking you. You are an internal med doctor. You are not an Oncologist or Cardiologist. If you wanted to be either of those specialties, you should have gone to school for that. The patient is not "yours". You work for the patient, you do not own them.
  12. by   pawsomepooch47
    Quote from CanuckStudent
    Thank you for all of your posts. They were a logical level-headed breath of fresh air. I know this thread is supposed to be funny (and I can appreciate humor) but trashing healthcare team members is unfair. Some of this is too far. Both sides need to work together. The anger and bitterness that is evident in nursing obviously has complex causes that can't be addressed overnight. But I do think that everyone should at least do their best to be professional and polite, to everyone.

    If you are truly unhappy with nursing, consider another career. There are lots of other options in healthcare. Instead of complaining, if you think that you can do better, why not go back to school and apply to med school and become an MD yourself? Actions are what is needed to make a difference.
    Another student who thinks you can snap your fingers and go back to school--just change careers.....
  13. by   Scrubby
    Quote from pawsomepooch47
    Another student who thinks you can snap your fingers and go back to school--just change careers.....
    I actually agree that if a person truly HATES their job and it affects their life to the point where it's impacting on them physically and emotionally it may be necessary to look at other options. I don't believe that once your a nurse your incapable of doing anything else.

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