11-7 shift here. So I called a doctor at 3am and left message for call back because a pt had hematuria (bladder ca and history of hematuria) Anyway, he only accepts calls after 7 am so he called back as I was on my way out the door. I told him a brief summary of the night, he asked if he was on blood thinners and I said yes and told him which ones. Well, he said hold the ASA, get a pro time and that's where I stop the story. When he said pro time, I could have sworn up and down he said fro teen (I didn't put 2 and 2 together after he asked about blood thinners AND I have only had doctors say PT INR to me so yeah it's my newbie error)... ANYWAY...I asked if he could repeat himself and he did- this time it sounded like 'protein'. To avoid confusion I asked him to spell it out and he went off. Told me anyone who doesn't know what a pro time is should not be a nurse, the pt needs a proper assessment because he doubts I could do it and since he's medical director of the place, he is telling the DON. I simply said "okay" then he asked to speak to someone who knows what a pro time is so I passed him over to my relief.So now I'm the joke of the day and to top it off, I've been hating my job the past 3 months so this didn't help much. *sigh* I can't stand those who forget what it's like to be new...
Tait, MSN, RN 6 Articles; 2,140 Posts Specializes in Acute Care Cardiac, Education, Prof Practice. Has 16 years experience. Dec 31, 2007 Shrug it off.It happens :) I have had a lot of docs with accents, bad phones and groggy voices, in the end what matters is that the order is clear.:icon_hug:Tait
EmmaG, RN 2,999 Posts Dec 31, 2007 Exactly. I'm really bad at understanding someone with a thick accent, and have no problem at all asking them to spell out words when I don't understand or what I think I hear doesn't make sense. What I find truly alarming about your post is that this a doc (presumably) on call for the night and yet refuses to take a call before 7am. What the hell?
GrumpyRN63, ADN, RN 833 Posts Specializes in Gyn Onc, OB, L&D, HH/Hospice/Palliative. Dec 31, 2007 I wouldn't get that worked up over it, so he tells the DON. If she asks you, simple explain that you could not understand exactly what he was saying and you asked for clarification.. Your first priority is pt safety, which it is your responsibility to ensure by asking him AS MANY TIMES AS NEEDED in order to confirm/clarify/verify the order. There are many instances I have had to ask doc , nurse ,whoever ,to repeat something in order to ensure I heard them correctly. Sometimes if they say it a different way, instead of repeating the SAME DIFFICULT TO UNDERSTAND GARBLED MESS, it would make life easier ! It's not your fault you couldn't understand him, better to clarify than to ASSUME. I'm sure he'll get over it, he was just projecting his annoyance (of himself being intelligable), onto you, I'm NOT defending him, I'm just sayin', that's how some people react. I wouldn't worry about it.
Virgo_RN, BSN, RN 3,543 Posts Specializes in Cardiac Telemetry, ED. Dec 31, 2007 Oh brother. You did right. I hope it all works out.
jjjoy, LPN 2,801 Posts Jan 1, 2008 You did the right thing. You didn't understand and you asked for clarification. What more could you do? You could've guessed that this word he was saying was probably something related to blood thinning... but it's not your job to guess, it's your job to CLARIFY if you don't understand and that's what you did, absolutely nothing wrong there. And you DID know the issues involved. If you truly had no knowledge of such blood tests, there would be a problem, but that's not the case here. The MD just assumed that because you didn't pick up on the phrase "pro time" that you don't know anything about anything... clearly there's no real basis for such a conclusion. And regardless, even if you said something that made the MD doubt your clinical abilities, he had no good reason to "go off" on you. He could simply ask to speak with someone else and calmly relate his concerns about your understanding. If the MD wants to raise his blood pressure by getting upset over something that could've been more easily taken care of, there's only so much you can do. But you needn't let YOUR blood pressure soar because you did right and good. You can't know everything every time, and it's best to ask in those cases.
UM Review RN, ASN, RN 7 Articles; 5,163 Posts Specializes in Utilization Management. Jan 2, 2008 11-7 shift here. So I called a doctor at 3am and left message for call back because a pt had hematuria (bladder ca and history of hematuria) Anyway, he only accepts calls after 7 am so he called back as I was on my way out the door. I told him a brief summary of the night, he asked if he was on blood thinners and I said yes and told him which ones. Well, he said hold the ASA, get a pro time and that's where I stop the story. When he said pro time, I could have sworn up and down he said fro teen (I didn't put 2 and 2 together after he asked about blood thinners AND I have only had doctors say PT INR to me so yeah it's my newbie error)... ANYWAY...I asked if he could repeat himself and he did- this time it sounded like 'protein'. To avoid confusion I asked him to spell it out and he went off. Told me anyone who doesn't know what a pro time is should not be a nurse, the pt needs a proper assessment because he doubts I could do it and since he's medical director of the place, he is telling the DON. I simply said "okay" then he asked to speak to someone who knows what a pro time is so I passed him over to my relief.So now I'm the joke of the day and to top it off, I've been hating my job the past 3 months so this didn't help much. *sigh* I can't stand those who forget what it's like to be new...I once had a (grumpy old) doc go off on me because I didn't get what a "hemogram" was, so I finished up the conversation by asking him if he was sure he didn't want an H&H with that.I survived to laugh about it today. You will too.
ebear, BSN, RN 934 Posts Specializes in Med-Surg/Peds/O.R./Legal/cardiology. Has 37 years experience. Jan 2, 2008 I don't mean to laugh but....:rotfl::rotfl::rotfl: I can just see in my mind how that went! Eh, you'll laugh about it too one day!I once couldn't understand a thickly accented doc saying "diluent". Finally, I asked him to spell it and he screamed "DO YOU KNOW WHAT A DILUENT IS??" Me: "Uh...yes, sir..." "WELL, THEN MIX IT LIKE I'M TELLING YOU!" Me: "OK, bye..." It hurt my feelings at the time (I was new) and I told another nurse. She just looked at me and tried to hide a laugh, then we both about peed our pants laughing! It still gives me a chuckle!Oh, well... I wish that were the worst thing that ever happened.
catlynLPN 301 Posts Jan 2, 2008 He's just being a jerk. It's not your fault he talks like he has mush in his mouth. Just like their handwriting...who can read it??? some of them....not all, but a good portion of them.
RNcDreams 202 Posts Specializes in Tele, ED/Pediatrics, CCU/MICU. Has 4 years experience. Jan 4, 2008 Hahah i had that happen to me today! (Im new as well...) Doc asked me for an Alcohol Detox protocol sheet... and it was loud and he has an accent... and I had to go "What?" three times, because all i heart was "I'll need an aloe eeet" Siiiiggghh..someday we will be reminiscing about this :)
paxpax 21 Posts Specializes in med-tele. Jan 5, 2008 OH MYHappened to me tonight too. I work on a busy telemetry floor which has a lot of geriatric patients. I have a patient I've never had before - Patient and Patient's family (on behalf of the patient) c/o SEVERE pruritis. I check pt's meds, pt gets topical benadryl.. tell them DID YOU TRY THE TOPICAL BENADRYL (it was at the bedside). Oh yes, doesn't do a thing blah blah blah. So I call the doc. Doc calls back at the same time that this thing they drive around the hospital halls to clean the floors - like a frickin' ZAMBONI is drivin' by the nursing station. Doc has an accent and we don't have a good connection. I can hear the Doc literally yelling, DON'T YOU HAVE AN ORDER FOR ATARAX? By now I am intimidated and am frantically flipping through the MAR and don't see it. I say, "I'm sorry Doc, can I take a T.O. Order", which she gives...... Then she adds "Triamcinolone cream" which I can't hear because the ZAMBONI is driving by again. First I say WHAT!!??! I can't hear you. I hear the disgusted sigh and she repeats it and I still can't hear it. Then I say, can you SPELL it. Then I get the you-are-an-idiot huff and, I don't remember exactly what she said, but it was about the fact that if she had to spell it, maybe I shouldn't be taking orders. I explained the noise factor and OVER-APOLOGIZED. I wish I could remember to say she was being a bully before I hang up the phone, but being new, I just always assume it is because I don't know and I am new. AND - How often does one take orders for Triamcinolone cream on a tele floor? this was the first time for me anyway. The cherry on the cake is AFTER I hang up, I DO see ATARAX already on my MAR. This is all on the first hour of my shift. Rest of the night was better.
al7139, ASN, RN 1 Article; 618 Posts Specializes in Emergency. Has 5 years experience. Jan 5, 2008 Hee Hee!!!I Love this post! I work on a very busy tele unit and some of the regular docs that we work with are foreign and have very thick accents. My favorite is a Doc who is Chinese, and is a really good doctor, but his accent is almost impossible to decipher. I frequently go into a pts room after he has visited, and the pt is asking me what the heck he just said to them! I have to laugh at this point, because I feel like saying "try calling him at 0300 for an issue and translate his orders over the phone without the advantage of lip reading!" The sad thing is that he is a great doctor, and is always nice to us and understands that we have a hard time understanding him sometimes.Amy
