Has any dr tried to get you to do something outside of your scope?

[NurseyPoo7]

Had a doctor call me out of another pts room when I'm attempting to give meds and do my assessment this morning - I come out and he tells me another pt of mine is going to need blood and I have to call the POA and get consent... Uh. I know we cant get surgical consent and all that but I wasnt sure about blood, but I was pretty sure the answer was no way.

I ask our RN care coordinator and she says no way - call our charge nurse and she wasn't sure. I called another nurse experienced on our unit (btw, I have to call these people b/c our unit is ridiculously large) and she said "If the dr was up here, he needs to get off his lazy butt and do it himself!"

I looked up our policy on blood admin and it only said to ensure consent was signed. Finally called the supervisor and she said No and told me to tell the MD if he had a problem with it, to call her!

I really think this Dr tried to pull a fast one on me from his laziness or maybe he honestly didn't know.

Has any dr tried to get you to do something outside of your scope?

[jlmb214rn, BSN, RN]

My thoughts exactly!!! And I had never seen a CVL in the carotid artery before, thank goodness, but You could see the TPN and Lipids both just pulsating back and forth in the tubing!! And the way the doc sounded on the phone when I called him with the results. And yeah, like a bandaid would fix something like that?!!

Anne, RNC

I've never seen one in a Carotid either... Makes you wonder if he even looked at the fluids as he hooked em up. And how could he not know that it was in the artery??? It had to spurt blood! I hate assisting with those things cause sometimes I just wanna reach in and do it myself!

[jlmb214rn, BSN, RN]

I had a pt with a abdm surgery, heart that bounced between afib and a flutter all the time, 7 days post removal of half his large intestine, still on a rectal tube over a period of 3 days. The incision looks like it's going to dehisce to me -- staples down the midline and the skin is making "figure 8's" around the staples which "breathe" as he breathes. I call Dr. Wonderful at least 3 times during my 2nd shift with the patient, asking him he's come see the pt, who is now febrile, has had a LOC change and just looking like he's going septic to me.

Dr Wonderful comes in all PO'd because I've got my NM into the room, showed her what's up, and she's called the doc after he hasn't returned my call for 8 hours. He looks at the pt, never touches him, never palpates the abdm, and says, "oh, just take all the staples out" and leaves the room! I follow him out into the hallway, and I told him NO SIR, I'm worried the pt will dehisce and eviscerate (at this point, you could see tissue trying to herniate thru the spaces between the staples). I would get the supplies for him to do it, but I wasn't about to. He starts yelling and cursing at me, and I told him I didn't care how loud he screamed, I was not going to do it, and would document his request. He storms off, screaming he's going to get me fired. My NM is curiously unavailable (read: hiding).

Well, next shift, he calls in and tells the charge nurse he wants HER to pull the staples -- not the pt's nurse, his buddy that he cheats on his wife with. She does, and surprise! the pt dehisces, and then eviscerates about a 2 foot section of small intestine. He made sure nothing happened to her for doing it, but I know I would have been thrown under the bus if I'd done it.

BTW, the hospital severed his contract because he's got 4 outstanding lawsuits involving pt deaths. All we could think of was, "only 4?"

Wow. I take care of a lot of abdominal surgeries and this sounds awful. You can remove staples as a nurse, but you best believe on something like that, I would have done the same thing! Don't you love these "Godly" physicians and thier attitude problems!?! Must've felt good to know that when he got the call that his pt dehisced, he thought "she was right" somewhere in his subconcious??

[Zookeeper3]

my favorite is Iv diprovan drip in the non intubated.

[emnicams]

We get orders to titrate cardiac drips such as Cardizem on new admits all the time, which titration can only be done in ICU at my hospital. You would really think the MD's would figure this out. The funny thing is that when we call them to tell them we can't do it, they just change the order to a set rate. Funny how they "needed" titration a minute ago, until you found out you'd have to move your patient...

[MAISY, RN-ER, BSN, RN]

I work in the ER so it's a little different. We can push alot of medications, but there are tons of things we shouldn't do.

Consents I will witness, but will not follow through if the patient states they don't understand....after a few years here, the docs that pull that crap know they'd better explain their procedures to patient very well, otherwise, they will be getting the call. Also will not get consent.

During conscious sedation, we can administer subsequent iv push and infusion, but the PHYSICIAN must push the first dose...when I was being precepted, my preceptor pushed the first dose....as I related by day to the nurse educator she freaked out and told me never to do it! I never have, despite MD saying "its ok".

Adenosine iv push-stops the heart for a millisecond-MD must push ...I have had docs say "you don't need me, its okay" How about "NO".

The best one is doctors that diagnose from nursing notes, while we have standing orders for cp, cva and abd pain(gallbladder, uti, flank, whatever) and will initiate, I will not follow orders for patients not seen by certain doctors that do not follow these standing orders....SAME GOES FOR VERBAL ORDERS from these same doctors....always change their minds or say "did I say that?"

Maisy

[neneRN, BSN, RN]

Adenosine iv push-stops the heart for a millisecond-MD must push ...I have had docs say "you don't need me, its okay" How about "NO".

Really? The RN always pushes it where I'm at...the docs at bedside, but they don't push it.

[MAISY, RN-ER, BSN, RN]

Adenosine iv push-stops the heart for a millisecond-MD must push ...I have had docs say "you don't need me, its okay" How about "NO".

Really? The RN always pushes it where I'm at...the docs at bedside, but they don't push it.

Really...the thought is, the doc pushes, we chase with the normal saline 10cc flush. If patient codes doc on site and made the decision. Maybe its because NE is so sue happy.

Maisy

[neneRN, BSN, RN]

Our docs occasionally ask the nurses to put in EJs...they don't have to use angiocaths very often (because the docs just typically go right to a central line if they have to put one in), so a lot don't feel comfortable handling them...I know that some facilities allow this, but ours doesn't.

They're also famous for wanting us to push Diprivan...

[leslie :-D]

we had one doc who ordered us (nurses) to administer lethal doses of sedatives and narcotics to our dying pts.

of course we refused.

and, was fired, reported and lost all his privileges...in this state anyway.

leslie

[neneRN, BSN, RN]

Oh yeah, and had one ER doc, who's a jerk anyway, tell me to pull back a chest tube he had just inserted and resuture it...um, are you crazy?

[MAISY, RN-ER, BSN, RN]

we had one doc who ordered us (nurses) to administer lethal doses of sedatives and narcotics to our dying pts.

of course we refused.

and, was fired, reported and lost all his privileges...in this state anyway.

leslie

Yikes!

[leslie :-D]

Yikes!

hmmmph.

he lasted 2 days at our facility.

when i received an order from him, i scurried to my boss and reported it/him.

evidentally, other nurses did the same as they received orders from him...

on his 2nd day there, the med'l director came in and escorted him out, with security present.

it was that day, i found out what he had been doing w/other nurses as well.

yes...

very, VERY scary.

leslie