Got chewed out by a doc, grrrr

NurCrystal22 · Aug 16, 2005

One of my nurses asked me to talk to a doc about her patient. B/P was 98/58 and pt was on Lopressor 25mg, Amiodarone 200mg and Benicar 20mg. She asked me if I would ask doc if she should hold the pills for a bp that low. OMG, you would have thought I asked if we should give water to a thirsty man. SHE WENT OFF ON ME. She said, You nurses, where is the critical thinking skills here? Everyone just wants their paycheck, nobody wants to do any work. Ok, Huh? Where did that come from? We have 3 isolation patients on my floor and one patient that is over 495 pounds, yet we are being lazy? I told the doc, listen, these nurses have been working their butts off around here, so don't even say that to me. I don't care what you want to do, just give me an answer....Where do these people get off acting this way?:angryfire

Well, did the doctor have um... orders that if b/p is that low to hold the meds. IF NOT, then this doc is taking it too far. I mean what's wrong with asking a QUESTION anyway? Well, don't take it too personal, maybe the doc was having a bad day. That's no excuse to take it out on you but I wouldn't worry about it.

~Crystal

pebbles1977 · Aug 16, 2005

One of my nurses asked me to talk to a doc about her patient. B/P was 98/58 and pt was on Lopressor 25mg, Amiodarone 200mg and Benicar 20mg. She asked me if I would ask doc if she should hold the pills for a bp that low. OMG, you would have thought I asked if we should give water to a thirsty man. SHE WENT OFF ON ME. She said, You nurses, where is the critical thinking skills here? Everyone just wants their paycheck, nobody wants to do any work. Ok, Huh? Where did that come from? We have 3 isolation patients on my floor and one patient that is over 495 pounds, yet we are being lazy? I told the doc, listen, these nurses have been working their butts off around here, so don't even say that to me. I don't care what you want to do, just give me an answer....Where do these people get off acting this way?:angryfire

Does sound like the MD might have been having a bad day. Well who knows? But I know that I ask questions and always double check call orders that are close (and this one, depending on your unit, could have been close). We don't help each other by demeaning. And to say "you nurses..." that right there is derogatory. Maybe you could have said, well Dr, it's not just "us nurses" but this pt that needs direction from you, since you are the all knowing one here!

J/k, but wouldn't you like to say that? Then again, isn't it funny that we don't feel ok to say these things bc we're trying to be professional, and others can just say whatever without consequence??

Btw I'd also like to know if there were call orders and if the bps were just outside the range or what. Just out of curiosity.

SmilingBluEyes · Aug 16, 2005

I would have had a few choice words for that physician in private, later, after I cooled my jets. That much I promise you.

Maynmom · Aug 16, 2005

I'm sorry that happened to you. What a drag. Next time you have to call about something that you are unsure about try asking for perameters. That way you'll have a better idea when to give the med and when to hold it. That doesn't take away from your critical thinking skills it just helps to keep your patient and you safe.

Demonsthenes · Aug 16, 2005

Under the Texas Nurse Practice Act and, probably, the nurse practice act of the state in which you work, it is unlawful for an employeer to discharge an nurse for reporting to an MD something to the MD which he or she is required to do under the act. Clearly, as per your original post, you were required to notify the MD of these significant findings.

If you are discharged, as per the above, the same is illegal and is reportable, at least under the Texas State Nurse Practice Act, to the board of nursing.

As a result, I would send a letter or fax both to your employeer and the MD in question, as per the above.

Best of luck and congratualtions for following standard nursing and ethical guidelines!

I am an RN and a Certified Legal Assistant. I am not an attorney.

I suggest that you consult an attorney with regard to this matter. :coollook:

One of my nurses asked me to talk to a doc about her patient. B/P was 98/58 and pt was on Lopressor 25mg, Amiodarone 200mg and Benicar 20mg. She asked me if I would ask doc if she should hold the pills for a bp that low. OMG, you would have thought I asked if we should give water to a thirsty man. SHE WENT OFF ON ME. She said, You nurses, where is the critical thinking skills here? Everyone just wants their paycheck, nobody wants to do any work. Ok, Huh? Where did that come from? We have 3 isolation patients on my floor and one patient that is over 495 pounds, yet we are being lazy? I told the doc, listen, these nurses have been working their butts off around here, so don't even say that to me. I don't care what you want to do, just give me an answer....Where do these people get off acting this way?:angryfire

crb613, BSN, RN · Aug 16, 2005

I would have had a few choice words for that physician in private, later, after I cooled my jets. That much I promise you.

I am still in school (3rd semester ADN) & I would like to know is this the way to handle physicians that go off on you?? I am really going to have to work on this kind of stuff I know...I am not a hothead but my blood does boil kinda quick sometimes. I can take any kind of criticism as long as its done as an adult to an adult but my fangs come out if I am attacked & treated like I am beneath someone. I am easy to get along with but I can be really plain spoken/pdq. I don't want to be thought of as unprofessional & your advice would be appreciated.

Tweety, BSN, RN · Aug 16, 2005

Good for you for standing up for your nurses. I would have said something like "since you did not leave appropriate paramenters, and I have no license to practice medicine, I'm not going to do your job". sheesh she should have been greatful your nurses are so on the ball.

Tweety, BSN, RN · Aug 16, 2005

I am still in school (3rd semester ADN) & I would like to know is this the way to handle physicians that go off on you?? I am really going to have to work on this kind of stuff I know...I am not a hothead but my blood does boil kinda quick sometimes. I can take any kind of criticism as long as its done as an adult to an adult but my fangs come out if I am attacked & treated like I am beneath someone. I am easy to get along with but I can be really plain spoken/pdq. I don't want to be thought of as unprofessional & your advice would be appreciated.

Not many MD's "go off", but many times they are angry about something, and I just allow them to vent. Sometimes, while the method of delivery could use some polishing, I try to listen, validate their concerns, and see if there's something I can do about. I concentrate on why they are angry, which is usually something trivial like "where is my daily wt. why can't I ever get a daily weight done around year". They aren't "going off" per se, and I just either ignore it, or go find the dang weight, or weight the patient. It's not worth my time otherwise.

Walking away, hanging up, or otherwise ending the conversation is appropriate. One time in 13 years did I have to do this when a doc was blathering about a patient refusing a bowel prep and me not calling him earlier. Finally the charge nurse walked by and I said "I'm ending this call and you can talk to my immediate supervisor about this."

In the heat of anger it's easy to loose site of "therapuetic communication". Fortunately, my blood has a high boiling point and I don't stoop to their level.

Katnip, RN · Aug 16, 2005

Posts like this make me very glad I work with the docs, PAs and NPs we have. They're an emergency group, and they are never offended when we question an order, and they always explain their rationale if their order seems a little quirky. They love to teach, and for the most part work well together.

Granted, they can have bad days just like us but they don't tend to get nasty about it.

Most of the attendings are respectful too, though there are one or two we don't like a whole lot. Thankfully, we don't deal with attendings too often.

Shay, it's good to know you stand up for your nurses. Too few in charge do.

mandrews · Aug 16, 2005

I woud document called doc and reported b/p 98/58, etc. no new orders at this time. This is what we do with a doc at our hospital and we all swear one day his crack will be in a sling. If there is a real emergency and he doesn't call us back (often) we call er doc or his partner at home.
495lb patients are a lot of work. It takes 2-3 people to keep them turned, and cleaned. Lazy remark is always uncalled for. Doc's come in and make quick rounds for the most part and they do not know or have forgotten what backbreaking work nursing or cnas do all day long.

SmilingBluEyes · Aug 16, 2005

I am still in school (3rd semester ADN) & I would like to know is this the way to handle physicians that go off on you?? I am really going to have to work on this kind of stuff I know...I am not a hothead but my blood does boil kinda quick sometimes. I can take any kind of criticism as long as its done as an adult to an adult but my fangs come out if I am attacked & treated like I am beneath someone. I am easy to get along with but I can be really plain spoken/pdq. I don't want to be thought of as unprofessional & your advice would be appreciated.

Yes IF I had all my info straight and the person left me NO parameters to work with--- you bet I would speak to them in private about treating me this way. I have done JUST that in the past, believe me. It's not always well-received, but it did effect change in how I was treated later on, in nearly EVERY case.

You have to "know your stuff" however, if you plan to take someone to task, or else you have a weaker "case" for standing up to them. But you make no mistake, the physician's remarks were OUT OF LINE in this case!