Have you or someone you know been written up by a doctor?

Marie_LPN, RN, LPN, RN · Apr 17, 2005

If I want to be barked at, I'll get a dog.

I need to remember that one.

dazzle256 · Apr 17, 2005

I haven't myself but I was wondering what the reasoning was for the write-ups.

I had a Dr start an internal investigation on me because his patient went into renal failure. Long story short... I was working on a Sunday and the nephrologist was covering for someone else. A patients Gent level came back high so the Dr lowered the dose. OK... I was at a code when the lab values came in so the Dr actually told me about this and he had lowered his dose of Gent. Pharmacy calls me and says dose isn't low enough for his lab values... I call the Dr (thank goodness charted it)......he didn't want to change it... later I called him again....are you sure?? Yes he says I'm not changing it... Pharmacy calls him tells him they don't agree with his dosage... Dr doesn't care he doesn't want it changed. Pharmacy calls me and says go ahead give the dose after talking to Dr.

Next morning the Dr comes in that has this patient and immediately has my supervisor call me at home (she is in tears) telling me Dr so and so wants me fired for not informing his partner of the lab work.....the paperwork has already been started for the internal investigation. Well needless to say nobody bothered to look at the chart to see he was notified.....in fact the other Dr had it in his own hand writing in the progress notes about the lab work and what he did about it. Well......the doctor got his partner into a lot of trouble. This was my first couple months of working ICU. My mistake was thinking....Well he's a Nephrologist he must know what he's doing.

You know it was automatically the nurses fault. Don't even look at the chart Drs can do no wrong.

PicklesRN, RN · Apr 17, 2005

THis has got to be one of the funniest posts I have ever read! :rotfl: :rotfl:
I have just finished two books by Echo Heron and I'm sure she would be proud!
I want to be just like you! :chuckle

I ended up leaving the hospital without visiting my friend. I quickly realized I wouldn't be doing her any favors letting him know who my friends were in that hospital. Guilt by association and all that stuff.

You know, it's too bad that it takes over 20 years of nursing in order to have just a couple of those. I'm not talking about all aspects of nursing, I'm talking about really getting a smarmy creepy little doc and putting him in his place in that manner.

When I have had patients that had docs with attitudes similar to the above doc and they ask me if the doc is any good, I've learned to be creative in my responses. Something such as... You know, someday he is really going to be good, someday I am quite sure he'll be (uncomfortable pause) really ... good!

Or if they ask me if I would ever consider going to Dr. Smarmy I try to fake stuttering and lots of umms, well... hmmm, uh, okay, (nurse looks verrrry uncomfortable, shifting weight from one leg to another, looking to outer space trying to think of an answer...) hey, would you like some fresh water, Mrs. Jones?

Best trick in the whole world to change an uncomfortable topic (for me, anyway) is to put my hand on their arm and start talking about something else. Just the touch and feeling of concern makes it a piece of cake to change the topic.

PicklesRN, RN · Apr 17, 2005

I need to remember that one.

Ditto.

kitty=^..^=cat · Apr 17, 2005

Wouldn't that be similar to charting that an incident report is written, though?

If the incident report is mentioned anywhere in the medical record, it becomes discoverable in court and is no longer a "protected document". By documenting a reference to it in the record, the incident report, in effect, becomes part of the record.

DutchgirlRN, ASN, RN · Apr 17, 2005

I got written up and an SOE filled out because I threatened to call administration on a cardiologist ("the" big cheese @ the hosp). I was in charge, the patient had a heart rate of 220 and a BP of 70/50 and was hyperventilating.

The nurse who had her called him and he orderer Lopressor 5mg IV x 2. Her heart rate went up to 240 something and her BP went down a little more and the doctor would not return the page. I called him on his cell phone (which is only for an emergency which I considered it to be) and he said

let's give it an hour or so and see how she is. I said ah no I think she needs to go to the unit. He said you're not the doctor, I said yes but I'm responsible for this patient just the same. He said no again and he said "If it makes "you" feel better, call a code"! I said let me look up and see whose on call for administration this afternoon (6:00pm) and see what they have to say. He was up on the floor in 3 minutes flat and yelling at me, next he looked at the monitor, called the unit and asked them to come get the patient and then called anesthesia to come in stat for a cardioversion.

Afterwards he was back on the floor calling adminstration in my presence and filled out an SOE in my presence. The jist of his conversation was that I was threatening him with administration and that I had no right to question his orders and that under no circumstances was I to ever take care of or have anything to do with any of the cardiology patients. THIS WAS MY FIRST TIME EVER DOING CHARGE and we had no supervisor.

The next day I heard there was a big meeting in administration and my nurse manager went. I was not invited to the meeting. My nurse manager and the CNO came to me afterwards and told me that he was wrong, I had been right and they would back me 100% and that he was told that if he thought I would not be taking anymore cardiology patients that he was mistaken and that his SOE would not stand up but that mine would. He didn't know I filled one out on him too for abandonment and uncaring manner. I was sooooo relieved that they were behind me because I wasn't going to let them fire me without a legal fight. As a result our supervisor now comes in at 5:30 pm on weekdays rather than 7:00 pm. The patient was in the unit for 5 days. Her original admitting dx was abdominal pain and she was 2 days post-op lap choly.

I found out later that the patient and her family reported the cardiologist to administration and commended me for taking charge and doing what was best for the patient. I feel very blessed to know that administration will back us when were right even though the doctor is the major money producer for the hospital. He was the one who brought CTA to the hospital and at the time we were one of only 3 hospitals in the country to have it and we have been rated in the top 100 hospitals in the country for 5 years straight. Not even Vanderbilt or St.Thomas made the list.

mattsmom81 · Apr 17, 2005

Wouldn't that be similar to charting that an incident report is written, though?

Yup. A few continue to do this despite instructions from risk management. These are the finger pointing docs...we all know the type. :uhoh3:

Oh and Dutchgirl...you done good. You are fortunate to work in a good place with with good administrators...stick with them. I know many nurses with similar stories (including myself) who have been reprimanded in a similar situation,(even tho we did the right thing) because administrators cave to the egos of the docs. I want to work at your hospital...we need more like them. :)

kitty=^..^=cat · Apr 17, 2005

we were one of only 3 hospitals in the country to have it and we have been rated in the top 100 hospitals in the country for 5 years straight. Not even Vanderbilt or St.Thomas made the list.

An HCA facility, right?

If you're where I think you are, you're truly working in a patient-centered, quality-based atmosphere. Yes, it's for-profit, but having worked for a not-for-profit organization and a private for-profit (physician-owned) hospital since leaving HCA, I see that the structure and discipline of the corporate "presence" creates decreased risk to the patient (and the staff as well) than other organizations.

Keep up the good work!

Tweety, BSN, RN · Apr 18, 2005

I wasn't written up, but I did have a doc chew me out on the phone (I didn't get to the phone fast enough). When he got to the unit he started trying to chat me up and be nice. I stopped him and said, "Don't you ever talk to me like that again. If I want to be barked at, I'll get a dog."
Shocked the heck out of him.

:rotfl:

DutchgirlRN, ASN, RN · Apr 18, 2005

An HCA facility, right?
If you're where I think you are, you're truly working in a patient-centered, quality-based atmosphere. Yes, it's for-profit, but having worked for a not-for-profit organization and a private for-profit (physician-owned) hospital since leaving HCA, I see that the structure and discipline of the corporate "presence" creates decreased risk to the patient (and the staff as well) than other organizations.
Keep up the good work!

Kitty Kat, Yep you're right, I work for HCA. All hospitals have their problems and issues and the work is very very hard on med/surg, but I feel very fortunate to know that administration stands by their nurses over the big ego doctors that bring in the majority of the money and yes we are definately patient-centered. I count myself lucky to be working there! P.S. I still do charge. The was the first time in 29 years as a nurse that I have cried at work and I was hysterical, mostly because I was sooo mad at the "butt" !

Hellllllo Nurse, BSN, RN · Apr 18, 2005

An HCA facility, right?
If you're where I think you are, you're truly working in a patient-centered, quality-based atmosphere. Yes, it's for-profit, but having worked for a not-for-profit organization and a private for-profit (physician-owned) hospital since leaving HCA, I see that the structure and discipline of the corporate "presence" creates decreased risk to the patient (and the staff as well) than other organizations.
Keep up the good work!

Well, HCA hospitals must not all be the same. I worked at an HCA hospital in 2001, med-surg. 10-13 pts per nurse, no CNA, no unit clerk. A very dangerous and poorly run place. We had to hang IVs on the over-bed light fixtures, because we had very few IV poles in the whole hospital. Morale was the lowest I'd ever seen in my life. The place was an unsafe hell-hole.

They are so unorganized, they continued to send me employee emails and snail mail for over two years after I left. They even mailed me check stubs with "0" gross and net pay on them.

And I repeat, it is an HCA hospital.

DutchgirlRN, ASN, RN · Apr 19, 2005

The place was an unsafe hell-hole.
They are so unorganized, they continued to send me employee emails and snail mail for over two years after I left. They even mailed me check stubs with "0" gross and net pay on them.
And I repeat, it is an HCA hospital.

Whoa, that's is beyond awful, so glad to hear you're out of there!!