Today I was screamed at by a patient for mentioning one of his admitting dx; syncope, GI bleed, acute renal failure. No one had mentioned the ARF, he assumed I had the wrong patient info. I didn't. Proceeded to explain that ARF is a common result of dehydration, a byproduct of his GI bleed. Said I would review chart for plan of care and clarify ARF dx. Patient (hysterically) not receptive to communication so I offered to contact MD to clarify. Exit.
Paged admitting doc x2 in a half hour - no call back in an hour. Got house MD who graciously came to talk with patient. He claimed patient requested nurses to come in and say "hi" and leave the "medicine speak" to the MD... Prior to the house MD being involved I paged the nursing sup to talk with upset patient, as I couldn't get an MD to call back (I've learned the hard way crap can be kicked up too). After doing so, her sage advice: page the doctor....
This is where it's gets good. Attending shows up late morning and wants to know why the patient, and 5 of his family members at the bedside, are under the impression that the patient has a diagnosis of ARF. Explain exchange with patient, show MD ER note enumerating ARF as part of DX and recite supporting lab values. (BTW he did return the page, as confirmed with his iphone, one hour later. No clerk to answer his call. I was blamed for that too.)
His response: "YOU need to fix THIS"!!!
REALLY? (THIS being the component of DX on record reflecting ARF.)
When will it end? Now the nurse is responsible for the diagnosis too (FWIW admitting lab values did support ARF)? No, No, No!
Never been one to doctor bash as I have the utmost respect for anyone who puts themselves through that process, regardless of the motivation. Now I'm changing my tune.
NO - can't change a diagnosis.
NO- won't support the fact that you, MD, didn't explain adequately to your A&Ox3 patient what was happening to him physiologically.
NO - don't subscribe to the harassment mentality predicated on nurses today.
Learned my lesson. Keep a smile on my face, speak when spoken to, it's a task oriented job, play dumb.
