New Doc is crazy

[jessiern, BSN, RN]

About 6 months ago our small hospital was blessed with a intelligent, compassionate, freindly doctor. She was great to the nurses, always willing to listen. Spends a long time with her patients. We were all really excited about her, thought she was going to do great things.

Well, she started new hours. Her office is open 8am-9pm Mon-Fri, and 9am-6pm on Sat. She doesn't report off her patients to the oncall docs, so she is ALWAYS on call for her patients. Who knows when she sleeps. She rounds on patients at 2am (80 year old patients seem to not like that). Her nurses at the office are terrified of her, becuase she is "the devil" I am told. When we call to her office, she requires the nurses to write a note for her, and leave it in her box and she'll read it. Problem is, she never does, so we never get answers. A pt went 16 hrs without urinating a week ago. Her bladder was distended, and her nurse started at lunch calling her office. Pt was in severe pain. At 6pm, she still had not called back after us calling 5 times. So, we put the foley in (are hospital requires an MD order for a foley). Nightshift said she was mad as you know what when she rounded at 11pm. That is typical of her, and unless it is an emergent situation I don't even bother calling, because I know it is pointless. And if patients ask why their problem was addressed, she tells them the nurses never called her. She we get surveys back all the time with comments about the lying nurses.

She is way too busy already, but yet she is always trying to find more patients. I have been told if I come to her office, she'll give me a Rx for a diet pill (I'm maybe 20 pounds heavy). She has gotten on the other docs bad side for trying to steal their patients while they are in ER.

I am ready for this woman to go. Now

[Jolie, BSN]

I don't know if your new doc is over-worked, sleep-deprrived, mentally-ill, or anything else. I do know that those factors are out of your control.

What you can control is your response to her lack of communication. No patient should suffer from a distended bladder for 16 hours without relief. If the doc failed to return calls, the chain of command should have been implemented. Getting the nursing supervisor and chief medical officer involved would have resulted in appropriate orders for the patient in need and forced the offending physician to account for her lack of communication.

[elkpark]

Have you and the other nurses documented your concerns (her problem behaviors, esp. those that put clients at risk, not just being unpleasant to the nurses) and taken them to the chief of medical staff? The hospital must have one, and there must be (CMS requirements) medical staff rules that spell out what is and isn't acceptable behavior for the docs, and what investigation & discipline process is to be followed if a doc is significantly out of line.

[jessiern, BSN, RN]

I don't know if your new doc is over-worked, sleep-deprrived, mentally-ill, or anything else. I do know that those factors are out of your control.

What you can control is your response to her lack of communication. No patient should suffer from a distended bladder for 16 hours without relief. If the doc failed to return calls, the chain of command should have been implemented. Getting the nursing supervisor and chief medical officer involved would have resulted in appropriate orders for the patient in need and forced the offending physician to account for her lack of communication.

The foley was inserted by our DON, who had called herself. The problem was brought before our admin. as well. And she had went 16 hours without urninating, her bladder was not distended that whole time. Her nurse started calling before her bladder was distended to try and prevent that. Situations like this have come up many many times with her. She has been talked to about it by admin and the other doctors many times, but she refuses to learn from the past.

[jessiern, BSN, RN]

Have you and the other nurses documented your concerns (her problem behaviors, esp. those that put clients at risk, not just being unpleasant to the nurses) and taken them to the chief of medical staff? The hospital must have one, and there must be (CMS requirements) medical staff rules that spell out what is and isn't acceptable behavior for the docs, and what investigation & discipline process is to be followed if a doc is significantly out of line.

Yes we have. Anytime we have a problem like that, we document when we have called, who we spoke to, and what was said. If we don't get a response, we make a copy of our notes for our DON. CMS has spoke to her many times. He has also given order in her place many times when we were unable to reach her.

[SDS_RN, RN]

I would be documenting in my NN everytime I tried to contact her and I would have other nurses do the same. 1830 called Dr. so&so, 1930 No response called Dr. so&so ect... This issue I would say needs to be addressed. She is letting the nurses take the fall for her shortcomings w/ the pts and that's not right by any means.

I hope it gets better for you w/ this doc.

[leslie :-D]

since admin is aware, i would think eventually she will lose her admitting privileges.

until then, keep everyone in the loop, and may your/her pts stay safe.

leslie

[elkpark]

I would be documenting in my NN everytime I tried to contact her and I would have other nurses do the same. 1830 called Dr. so&so, 1930 No response called Dr. so&so ect...

Ditto!

Also, you have the option of making a complaint to JCAHO, your state agency that licenses/regulates hospitals, and the state medical licensing board. You have a state agency that licenses and regulates hospitals (I worked for several years as a surveyor for the agency in my state) -- they are called something different in every state, but it is usually a division of your state Dept. of Health and Human Services (or whatever that's called in your state :)). Your state DHHS website would be a good place to start looking for info on who to contact. My agency accepted anonymous complaints, and I imagine most other states do, too.