New here and venting already

Nurses General Nursing

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hi! i've been reading here for quite some time but was not a member. i've been an rn for almost two years now and today was the first time a doctor upset me enough to bring tears to my eyes. i decided that it was time for some nursing companionship. of course, i can tell my finance, but he doesn't really understand like another nurse would.

so, anyway, to my day, first my one patient takes duonebs at home, but did not have them ordered postop and he was requesting one. i page the md. he calls me back and says this better be important 'cause i'm in a conference right now. what does he think i'm calling him just to talk? trust me he's not that fun to talk to.

then, another patient was on sips of cl after major abdominal surgery with an ng to lcs, hypoactive bs, and no flatus. he's going on and on about wanting to advance his diet. of course i teach him about why that can't happen, but all he says over and over is that he wants to talk to his doctor. so i page the md and transfer him in the room. after they talk the doc askes for me and is all upset because he was paged for a silly reason, like his patient wants to talk to him. then he wanted to talk to the charge nurse. i was upset and mad and i still think that i did the right thing. it brought tears to my eyes which is not something that i do easily. what do you guys think? what would you have done in that situation? and nice to meet you all.

Specializes in Rehab.

I would have called, too. At my job, if someone wants to talk to the MD, it's a reasonable time of day, whether that pt is in distress or not, if he can't be convinced to talk to the MD the next day he/she is in, that MD is paged. Period.

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Specializes in med surg, oncology, outpt and hospice.

I think you absolutely did the right thing. After all your time is as important as his.

:monkeydance:

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Specializes in med-surg.

My experience with MDs is this...they care or they don't. I know MDs that will do anything reasonable (they understand patient needs and concerns, but don't feel the need to explain proper diet at 3AM) and those that will do nothing (sounds like you aren't communicating with the patient. Maybe you should try something else before you disturb my 'sneaky smoke break'). Sorry jerk/jerkess...I gave up my sneaky smoke break to be a good role model to my patients. What the 'bleep' is you problem?

Maybe I need a cigarette...no...no...no...:trout:

Always at war with myself!!!:smiley_ab

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Specializes in school nursing,cardiology,and mental hea.

You did the right thing.Keeping the MDs informed is our job.Continue to do it,document your actions.I just love to put this:MD informed of ____________,no new orders rec'd.Will continue to monitor and report.This has saved my bootie many a times.Be as specific as possible of course.When and if they become ugly,I let it go in one ear and out the other.They chose to go into medicine and taking calls is part of the job.Dont hesitate to call.You did the right thing.We are patient's advocates.

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Specializes in ED, ICU, PSYCH, PP, CEN.

some doctors can be real jerks. I once had a doctor get really mad at me because I called him to tell him that his patients lab results came back with a hemaglobin of 6.1. He said that was not important for him to know and called the house super to report me. I was then told that I could not call him unless I cleared the reason for the call with supervisor first.

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Specializes in Lie detection.
Hehe!

You really have a cattitude here...no cat fight.

Unless the doctor is in the building, you doctor is not going to come to talk to the patient anyway. So...why bother to agitate the doctor while you are not going to satisfy this patient anyway. Always do something that you will get the result...kicking the balls around will not help.

Not about fighting. And really, it's about whether or not to CALL the doc, not even if he's going to come or not, just call. The OP didn't say it was an "off" time so why would you assume the doc wouldn't be in the bldg?

And really, doctors moods are not our problem, patient care is. I don't care if the doc gets "agitated". I think the pt. very well may be satisfied once you DO say, "I have a call in to your Dr.".

I know that has worked for me.

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Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

You did the right thing in both cases.

If you hadn't paged the doctor, the patient would have complained and the doctor would have said "you should have paged me". Or he complains to management and you get dinged for not providing good "customer service". Can't win with these kinds of patients.

It's not worth shedding another tear.

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You did the right thing. Respiratory treatments are important. This patient knows his baseline needs better than either you or his doctor. The doctor was negligent in not ordering them in the first place. No need for the patient to get in resp distress before we get his resp tx ordered. The second patient was not satisfied with your explanation of the need to remain NPO. He would continue to harp on getting food to everyone thinking he would eventually get what he wanted. His doctor is the gatekeeper. Once HE tells the patient NO, problem will be solved. Whats the patient paying dr for anyway? I think the doctors were in a bad mood before you called them. Don't worry about it.

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Specializes in tried almost everything/LTC.

i'm a newbi too, and this is another thread that shows how everyone has a different opinion. that's a good thing 'cause we can learn from others. unfortunately, everyday as nurses we have to make these kinds of judgement calls. usually i feel alone. like someone said if you don't call you get slapped. i hate calling the docs because i have been driven to tears so many times - for calling and not calling!?! (yes, i'm a crybaby.) so, i'll do almost anything to get around it, which isn't good. i too have worked where we had to "clear" calls with the house super. before we "bothered" the docs. that is ridiculous!

our patient's best interest is what's important. if the patient is lying there worried or agitated then they aren't healing!

did anyone see patch adams? i'd love to shadow him for awhile. hope to visit his facility some day.

[color=#00bfff]thankfully, in our ltcf we deal with nps, and hospice a lot - much kinder.

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thank you all for your replies and opinions. i have to say that i am surprised by the number of responses to my first post here. but then i guess that i hit on a issue that is a reoccuring problem everywhere. i still think and it seems like a lot of people agree that i did the right thing. i just want to clarify a few points.

i think that leaving notes for mds is an excellent idea in theory. however, i've left countless notes that never got addressed so i generally don't go that route unless it is at night or something really unimportant (like clarifing a prn medication that is not going to be to used anyway).

in regards to the pt. requesting neb treatments: this was at about 8:00 in the morning. for a lot of doctors, i would have assumed that they would be rounding shortly and waited to just ask when he came in. but this doc is well known for rounding later in the day. by the way, this pt. had a hx. of copd, already needed 4l 02 to maintain 02 sats, and had very diminished lung sounds. so i feel completely justified in making that phone call.

the second pt was a little more complicated. i generally do not page docs just because their pt. wants to talk to them. but this doc had already rounded and would likely not be back until the next day. and the pt. was insistent. it was late morning, not like it was the middle of the night. i still stand by my original decision that it is the pt.'s right to talk to their doctor.

i think the main question is: should doctors only be paged if it is a matter of "life or death" so to speak or should they also be paged for other important but less serious needs? i'm sure that the answer to that question varies between facilities and nurses and even doctors themselves. but i do think that the decision behind whether or not one calls a doctor should never be made based on if he is upset, mean, or anger. that decision should be based on what is in the best interest of the patient.

again, thank you all for your support and opinions.

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Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.
But I do think that the decision behind whether or not one calls a doctor should never be made based on if he is upset, mean, or anger. That decision should be based on what is in the best interest of the patient.

I agree 100% and the nurse decides what will and will be called to the MD, no one else. The MD may say otherwise but we have a standard to adhere to and a state board to answer to. He/she can get upset all they choose too, but they have the information I wanted them to have, based on my assessment of what's in the best interest of the patient.........and I've docuemented it as such.

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You did the right thing. I have told MD's " YOUR patient, family etc.. wanted to speak to YOU, I am in the middle here, I'll tell them whatever YOU want me too." Sometimes human beings need a small reminder of how to act like one.

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