Its pointless to call the doc. Do you have faith in the docs where you work?

[chenoaspirit, ASN, RN]

We truely have a FEW good docs, but about 98% suck.

My day in a nutshell....

One patient with dx "aspiration" is lethargic, will not wake up and has 0 urine output. I called twice, doc came twice, nothing ordered. IVF's KVO. I was hoping he would order some fluids...NOPE. I requested ABG, none ordered.

Next patient is on dialysis and is edematous and weeping, K+ 6.8 with EKG changes. The doc FINALLY sent her for stat dialysis, she came back puking blood. Doc did nothing. Just moniter. This is the same patient who I posted about dobhoff placement... https://allnurses.com/forums/f8/placement-care-dobhoff-315218.html

Next patient with bp of 198/124. Called doc multiple times. NO orders.

I just dont understand.

Docs will tell a patient he will order a med, then doesnt. Family asks ME why, and I cant answer that. One doc will say one thing, another will say the opposite, then I am the one in question. How am I supposed to advocate for these people. And HOW AM I SUPPOSED TO DO MY JOB LIKE THIS?!

I have no faith in the docs where I work and I feel like my job is pointless. I ran around all day today, trying to get things done, behind on my paperwork, stayed late and left there feeling hopeless.

I hate nursing and I wish I had never became a nurse. I hate it. Its ultimately up to the doc, but when you have none worth having, your job is a hard one. I truely hate being a nurse. I hate it. Thanks for reading, I just had to vent. Right now I feel lost.

[oldiebutgoodie, RN]

I have less and less faith in some of the MDs I work with. Especially the surgeons. They seem to feel that if their sutures are holding, they don't have to worry about anything else.

I feel your pain.

Oldiebutgoodie

[leslie :-D]

document, document and document.

but whatever you do, always call the doctor.

(((hugs))), sweetie.

leslie

[Riseupandnurse]

Do you not have hospitalists? It is 100% better since we got them. They are excellent, excellent, doctors, without exception and will come quickly and do what is needed. I feel sorry for them because some of the "regular" doctors use and abuse them when they themselves should be in taking care of their patients, but the patient is better off with the hospitalist in many cases. It's made a world of difference.

[2shihtzus]

I know the feeling. I have faith in VERY few of the MD's I work with. Document everything and CYA. Hang in there.

[mpccrn, BSN, RN]

sometimes i find myself forcing orders from clueless docs.....mr. smith's heart rate is 140, sinus, he's behind in fluids according to his I&0 by about a liter.....do you want to challenge him now?....yes/no (from MD)....fine, i'll chart that you were made aware...thanks, i'll keep you posted.

[Jolie, BSN]

Have you tried implementing the chain of command? Go to your nursing supervisor and ask her to get the department head involved, or even the chief of medicine, if need be.

Of course, this is not the plan of choice for a minor oversight, but for patients whose ciritical needs are not being addressed, I don't think you have a choice.

Nothing like getting the Chief of Staff involved to prompt a physician to take necessary and appropriate action.

[chenoaspirit, ASN, RN]

sometimes i find myself forcing orders from clueless docs.....mr. smith's heart rate is 140, sinus, he's behind in fluids according to his I&0 by about a liter.....do you want to challenge him now?....yes/no (from MD)....fine, i'll chart that you were made aware...thanks, i'll keep you posted.

Great idea! The sad thing is I was so behind, I didnt do a very good job of charting.

We do have hospitalists, but they are only on during the nightshift. When I worked nights, they were awesome to come whenever needed. And last night I called to check on my patient and the hospitalist indeed ordered a scope of the woman vomiting blood...THANK GOD. I still hate nursing though.

[texas2007, BSN, RN]

It really depends who is on call at my unit. Since I work nights, it's usually a resident/fellow who you call for most things but about half of them don't even know what they are doing in the first place. Usually have to bring up a suggestion of what to do next and they follow it. Unfortunately since I'm just off orientation, I haven't experienced everything yet so I'm scared when the time comes that I don't have a clue and neither does the MD. Thank god the attending is usually a real doctor but not always; sometimes they have fellows as the acting attending. SCARY!!!

[shellsgogreen]

i find if the md is laid back about care for the pt - then i go to someone who does care, and i get the orders i need; and then i make a point of telling them what transpired during their neglect.

[elizabells, BSN, RN]

I have to say, as much as I hate SBAR because it sounds so fake when you do it right, it does make it easier to tell the doclings (I'm in a teaching hosp) what they need to do.

That doesn't cover the ones who just don't give a hoot, but the ones who have no clue get there eventually.

[MrsMommaRN]

the docs we work with are great. sure they have their days, but they are very supportive to the nurses and know they depend on our view to plan patient care.