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Got chewed out by a doc, grrrr

Specializes in Corrections, Cardiac, Hospice. Has 18 years experience.

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

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

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

Has 20 years experience.

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'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.

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

Specializes in Med Surg/Tele/ER. Has 7 years experience.

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

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac. Has 28 years experience.

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

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac. Has 28 years experience.

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.

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.

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

Has 20 years experience.

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!

ShayRN

Specializes in Corrections, Cardiac, Hospice. Has 18 years experience.

This is something she does all the time. It is like walking on eggshells everytime you talk to her and everyone knows it. I have reported her to my director before and will probably do it again today, it gets to be too much. I should clarify a couple things, I didn't even call her specifically for this....I would have if I didn't have a call out to her on another person. But I had to get orders on a new admit and said, oh by the way, I have to ask you something else too. Also, I had already told the nurse to give the Amiodarone, the patient did need that without a question. So really, it could have taken her all of 20 seconds to end the call. Instead, she got herself (and me) all worked up to the point I raised my voice to her and said, JUST GIVE ME AN ANSWER, rofl. I did write the order in the chart as "OK to give Benicar and Lopressor as ordered in spite of b/p 98/58." (there were no parameters ordered) She will probably have something to say about that today, but I am on vacation as of 11:30 tonight and just can't seem to care, LMAO.

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:

As far as this post, Thank you for your concern but I am not in any fear of losing my job.:) I would never get an attorney over something like this unless it got physical. My gosh, if I called an attorney everytime a doctor got mouthy with me, I would be in court all day, every day. Trust me when I say, I am more than capable of standing up for myself when needed or walking away when necessary.:rotfl: I was just venting, lol.:rolleyes:

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

Isn't it ironic that I got chewed out once for exactly the oposite reason? Suggesting that the med be held for a BP around the same??? :angryfire

Supposedly this doc's pt's BP would skyrocket within the next half day if not given the meds.... How the heck was I supposed to know that w/o asking the doc?

Another time, you have parameters for the same meds to be held if SBP

This is what frustrates me about nursing. I've been in a few other professions including being an assistant to a cranky, pampered and spoiled rich CEO and even in that postion one doesn't get bossed around as much as a nurse :angryfire

SmilingBluEyes

Has 20 years experience.

Yep, we all work with "those physicians" who yell at you for asking ANYTHING or act like you are putting them out to get them to do their job. I am glad you are one who can stand up for herself; more power to you. We all need to vent, that is for SURE! Just know we all know how it is.

ShayRN

Specializes in Corrections, Cardiac, Hospice. Has 18 years experience.

She was sweet as pie to me tonight, ROFL. She came onto the unit and I said, Are we in a better mood tonight, she just kind of laughed and was perfectly fine after that. Oh, well, thats life I suppose, lol.

NurseCard, ADN

Specializes in Med/Surge, Psych, LTC, Home Health. Has 13 years experience.

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.

I'm pretty much the same when when it comes to MD's going off. There is one doc in particular who ALWAYS goes off, especially when you call him at 2am, and I usually just let it go in one ear and out the other. I rarely take it personally, because he does it to everyone. He's a big grump and has a very low boiling point, and everyone knows it and no one ever lets it get to them.

There was an incident a couple of weeks ago involving myself and another doctor, who also has a reputation for being rather hard to deal with, to say the least. His delivery is less explosive however, and more sarcastic and just... mean. But anyway... I arrived to work one night and had a patient that had been admitted with weakness. She was being sent home by her primary doctor, but our gastro (the grumpy-butt that I am speaking of) was supposed to see her first, before she was discharged. Well, this patient made practically EVERY indication that the doc had been in to see her, and I really thought he had been in to see her, so I let her go home. Well, turns out that he hadn't seen her yet. :imbar

The whole thing WAS my fault, for the most part. I should have flat out ASKED him had he seen her yet, but I hate approaching the guy to ask him ANYTHING, and I really truly thought he had seen her. She said that he had, and the nurse who preceeded me had said to him "Are you going to see her?" as he walked down the hall towards her room. I just... really thought he had seen her. Anyway, it turned out to not be that huge of a deal... I called her primary doc and told her what happened, and she was like, no problem, I'll just make her an appointment to see him (the gastro) in his office.

But here's the thing... the gastro gave me a nice talking-to about it, and right there at the nurse's station. I guess you could have called it a chewing-

out, but I really didn't take anything that he said personally. He mostly lamented about the fact that no one had bothered to tell him that this lady was waiting to go home until he saw her. He said "if I would have known this, I would have gone to see her first. No one bothered to tell me this". And he did kinda get on to me about not asking him if he'd seen her, but he was obviously more upset that no one had told him she was waiting for him.

Anyway, later on my nurse tech was like "He didn't need to chew you out like that right there at the nurse's station" but I just didn't take it that way. I just kinda took it as venting, on his part. He wasn't even particularly loud or didn't cuss or insult me, or anything. I was however upset that the nurse tech said that, because it made me feel like I'm some sort of doormat. And it's true, I tend to have more trouble than most people, standing up for myself. But when the doctor that I'm calling is being a grump, I just try to cut through the fuzz and just get the order that I'm needing and get it done and get off the phone, and don't worry about it.

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