Made to look like an idiot. (rant)

redshiloh · Dec 23, 2003

If the patient's pain was 10/10 and it sounds like it was acute, I would THINK the MD should come and look at him. The MDs charting was WAY out of line and VERY unprofessional. I think I would have done the same...too bad there is not someone to stand up with you there....but NH's usually kowtow to MDs.

BarbPick · Dec 23, 2003

when in doubt, call the doctor. I keep tell you all Medical School is really a front for a Terrorist Training Camp. You were correct, Darvocet N is not a drug for abdominal pain. Usually anti colanergics (spelling, sorry) is a drug of choice, maybe even maalox would have been a better choice then Darvocen N.

Don't take what he did to heart. You did the right thing, as Jiminey Cricket said, always let your conscience be your guide.

cannoli · Dec 23, 2003

Unfortunately, things like that (the doctor's remarks) are not uncommon.

You are not the first one something like that has happened to and you won't be the last.

You could have put something in your own notes (maybe you did) about not wanting to give analgesic due to extensive GI history and not wanting to mask abd pain and MD called because of that.

Just try not to let it bother you and keep on truckin'!

weezieRN · Dec 23, 2003

you are certainly not the idiot here, Does the doctor not care about the pt with hx of obs in acute pain, were their any tests ordered any type of assessment etc, pt could have something major goin on in there. was abdomen distended, any bowel sounds nausea vomitting last BM etc. Hope patient gets better. Take the comments with a grain of salt you did what you thought was best and that is all that matters.

Tweety, BSN, RN · Dec 23, 2003

I echo what the others have said. The Darvocette was for back pain. This was a new onset of acute abdomen and should have been called to the doctor. Had you not called the MD would have written a note like "patient reported severe adominal pain, nurse did not call MD only used Darvocette".

While not unheard of to give narcs for abdominal pain, I always let the MD decide. I've seen a few bowel ruptures and other bad outcomes from acute abdomen.

Rest assured you did what was best for the patient. Kudos.

unknown99, BSN, RN · Dec 23, 2003

:eek:

What a nasty doctor!!! There must be one everywhere!!!

Here's what I would have done. I would have asked the patient, in a very convincing manner, if he wanted to go to the E.R. Of course, he most likely will want to with pain of 10/10. Then I would have called the squad. As soon as I hung up from calling the squad, I would have called the doctor and told hm that the patient requested to go to the E.R. and that the squad was on the way. That way you are covered, and the patient will be getting the medical attention he needs. The doctor may try to raise the roof, but will quickly get over it, especially if the hospital decides to admit the patient!!!

The next timer the doctor gives you a hard time, write it up on an incident report. The last time our nasty doctor gave me a hard time, I did that, and he has calmed down , at least for a while.

P_RN, ADN, RN · Dec 23, 2003

YOU are NOT an idiot. You are a sympathetic, observant nurse. You did what needed to be done. The doctor needs a bit of human kindness in his stocking Christmas day, because he seems to be sadly lacking.

PMHNP10 · Dec 23, 2003

Far be it from me to know the laws MDs live by in their practice, but since his attitude is scribed on an official sheet of paper, I wonder if anyone (eg. whoever is in charge at your facility, AMA) would appreciate his words? It certainly sounds like bad medicine to me.

BarbPick · Dec 23, 2003

Originally posted by psychrn03
Far be it from me to know the laws MDs live by in their practice, but since his attitude is scribed on an official sheet of paper, I wonder if anyone (eg. whoever is in charge at your facility, AMA) would appreciate his words? It certainly sounds like bad medicine to me.

A nurse with 4 months expereince needs to lay low on pointing fingers. To be able to work agency you need one full year of nursing expereince. Better he bring it here than make a federal case of it.

PMHNP10 · Dec 24, 2003

Originally posted by BarbPick
A nurse with 4 months expereince needs to lay low on pointing fingers. To be able to work agency you need one full year of nursing expereince. Better he bring it here than make a federal case of it.

I respectfully disagree. Perhaps I did not make my line of thinking clear, but the main reason I am suggesting the OP show the MD's charting to a supervisor or higher power is not about the pain medicine being given for ab pain, but rather the MDs attitude. Actions such as these are meant for nothing more than intimidation. I see nothing wrong with the OP at least taking this to their supervisor. IMHO, better to stand up for oneself early on than allow an MD to belittle, criticize, demean over an extended period of time. Chalk up one more example nurses site for not working at the bedside, and therefore, there being a bedside nursing shortage. The MD's behavior is unacceptable, and really should be made privy to this by someone.

As for the agency comment...I apologize, but I did not read anything about agency--what does agency have to do with this situation? Did I miss something completely on the original post?

BarbPick · Dec 24, 2003

Real simple. New nurses are locked in to get a full year of med surg experience. After that, they can work where they please, even Agency.

I am sure a charge nurse saw the doctor's note. LTC facilities usually have a hand full of Doctors.

They tend to control the census. You are allowed your opinion, I, mine.