Not a doctor but is asking to be called "Dr" while on the unit.

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The patient (who used to be a doctor) asks in a nice manner that she be called Dr. so and so while in the unit. But apparently, she lost her license recently, and with the way she acts, she thinks that the staff on the floor doesn’t know about her license being revoked recently. How would you handle the situation? What will you tell her?

Specializes in Endoscopy, PACU, Medicare skilled units.

A man at my nursing school used to be a "pain management dr.'

He had his license revoked for knowingly prescribing too many narcotics, resulting in the death of 6 of his patients.

To me at least this man has lost the privilege to be called "Dr."

I'm ex-military so I equate titles with certain responsibilities. Just as a Sargeant, Petty Officer, or Captain could do something that results in the loss of his title, in my mind so can a doctor. Now this guy is just a murderer that happens to hold a doctorate in medicine.

Too harsh? Maybe.

However everything changes when that person is placed in your care. If he were my patient I wouldn't have anymore respect for him than I do now, but I'd show him respect. And sometimes all that matters is the patient's perception and their needs.

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Specializes in Clinicals in Med-Surg., OB, CCU, ICU.

In nursing school, one was taught to always refer to the patient as the patient would prefer. Mr. and Mrs. maybe, Dr. (insert) Last Name. or by first name if the patient doesn't mind. But, never *******!

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just let me suggest to be alerted to any potentially manipulative behaviors.

i'm thinking she is not in there voluntarily, so it's not as if she's genuinely seeking rehab.

i'm also wondering if her request to be addressed as "dr", may be a double-edged sword.

i'd proceed cautiously.

leslie:)

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
the patient (who used to be a doctor) asks in a nice manner that she be called dr. so and so while in the unit. but apparently, she lost her license recently, and with the way she acts, she thinks that the staff on the floor doesn't know about her license being revoked recently. how would you handle the situation? what will you tell her?

if she's nice about it, i'd call her whatever she wants, including "your majesty." so few patients are nice about things these days! but if she came in to see patients rather than as one, that would be different.

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Ask the person straight up, r u still a dr? No wait better not do that

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I think that as an RN I also have the responsibility to keep my patients safe and correctly informed. If I call her Doctor and other patients on my unit hear it, they could seek medical advice from her (it's not unusual in the place that I work at that patients ask other patients about their meds/compare meds) it could lead to confusion-----they might think that she is the real doctor on the unit. Along with titles come the responsibilities. If her license was revoked because she knowingly wrote for higher than the normal dosages of certain meds, I cannot just allow her to give medical advice in the unit or dictate to any staff member what dosage she needs to get. She can speak her mind out and participate in her treatment plan but she cannot be out of line.

i guess i look at it as you are her advocate , your job is to provide non-judgmental care to her. She has the right to automony and to question or make request for meds. she is educated in medicine and she is fully entitled to share her opinions and her desires in her care. kwim? im not sure how that is uncomfortable.... just because she has an addiction and has had her license yanked doesn't mean she shouldn't have an active voice or deserve to be treated with respect. how would their be any implications by referring to her as dr? i just don't get it. and depending on the medical board the other people on the floor may not have a good handle on what the situation with her license really is. a dr that i went to church with growing up was addcited to ritilian and there was a big public scandal on it two or 3 times throughout his career. he had to jump through a lot of hoops but he did get get his license back every time after meeting the treatment stipulations and paying the fines ect.... I stand by treat her as a patient, refer to her how she would like to be referred and don't worry about the current state of her license....its not relevant .
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Well, you are right. That was what I was thinking. She was using the "I know what I'm talking about I'm a doctor" line so that she could try to dictate to me and the rest of the staff the dosage of the meds she should be on. That's when the license revocation becomes relevant in this situation-----if she knowingly prescribed higher than the normal dosages of certain meds before and is still seeking more meds for herself, I wouldn't be comfortable calling her doctor because the other patients might think she is the doctor in the unit and then may ask for medical advice from her as well.

just let me suggest to be alerted to any potentially manipulative behaviors.

i'm thinking she is not in there voluntarily, so it's not as if she's genuinely seeking rehab.

i'm also wondering if her request to be addressed as "dr", may be a double-edged sword.

i'd proceed cautiously.

leslie:)

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I will call a patient anything they darn want (up to a point) :cool:

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Specializes in ER.

I initally agreed with the other posters- even if someone has lost their medical license they still have a doctorate. Upon reading further and realizing she is in a psych/detox unit I have a whole different opinion.

I can see your point of view. Even if she's technically receiving voluntary treatment I'm sure at heart it's involuntary. Were she to have sought treatment before being caught, then it'd be a different matter but the information implies otherwise. Once caught, it goes beyond the simple process of trying to get her license back. She is probably required to have treatment to prevent possible legal repercussions as well.

Psych is all about control and setting limits. Many pts in inpatient psych have lost control somehow. I hazaard to guess all pts in detox have definately lost control. A medical doctor wanting to be refered to as Dr. so-and-so on a detox unit poses all kinds of problems, IMO. I cannot see where someone who was thinking rationally would want to be referred to a Dr in such a situation. Considering the general pt population, it's asking for trouble. I'm sure quite a few of the pts already have her name memorized so that they can look her up if she eventually is able to practice again. Having her referred to as Dr in this setting gives the implication of status and control, and she's in a great position to undermine other pts treatment by giving medical advice that goes against their treatment plan. Having to discuss at length with her her medications and the dosage oversteps her basic right to participate in her treatment and goes into the realm of passive-agressive control tatics and her trying to feed the addiction. It's not healthy thing, IMO. After all, you wouldn't have similiar conversation with an alcoholic over how much beer s/he is allowed to drink a day, right?

I agree with another poster that all the staff need to be on board in deciding how best to handle the situation. I think it would be a good issue to bring up in group therapy as well- which would allow you to not only adress the issue but make sure that it clear to the other pts that even though she may be a doctor, she is still a pt w/ the same problems they have and is no longer allowed to practice medicine. I have a feeling if it's addressed in this manner, she'll quit making such an issue about it, as it will be apparent to everyone that she cannot practice.

Also, if the staff collectively come up with a game plan on how to best address the situation, it will make her treatment more consistant. It will prevent her from being able to have a 'favorite doctor/nurse/therapist' based how they may address her. Once you have a gameplan and then discuss it with her, whenever she tries to overstep her bounds, it will be easier to say "You're correct, you are a doctor, but you've lost the privilage to practice because of your addiction. Your addiction is why you are here to receive treatment. Right now, you're a pt, and we need to treat you as a pt in order to give you the best care and most beneficial treatment." You can also set boundaries with her to make sure that she isn't 'treating' the other pts. Make it one of her goals- "You continue to attempt to practice medicine by giving other pts medical advice. However, you have lost your license and it is not appropriate for you to do this. Until you can handle this situation appropriately, your healing cannot progress and we will not be able to say that you have successfully completed your therapy."

Be polite of course. Do these things not to simply win a power struggle. It's apparently an issue with her, and the reality is that she may have a good chance of regaining her license to practice. In order to be able to function without addiction, and certainly in order to be able to practice medicine again, she needs to accept fully the consquences of her actions. Just my opinion, but I think she needs to earn back the privilage of being called Dr.

My :twocents:

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Specializes in ortho, hospice volunteer, psych,.

i missed the detox unit part when i first read the original post. she is manipulating the system -- or trying to manipulate and control. limits must be set and all staff should follow the same program.

kathy

shar pei mom:paw::paw:

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Specializes in ICU, Med-Surg, Post-op, Same-Day Surgery.

I think that as long as you are not buying into a patient's delusion or hallucinations, call them what makes them feel comfortable. Even if she isn't a doctor, how would you prove such? Just another patient. As long as she isn't out at the desk trying to write orders...

I had a patient once with a significant other that preferred to be called "baby daddy". He was so proud of his newly-found status as a father that he wanted to be called that. I drew the line at calling the mom of the baby "baby momma" though...:D

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Here's my take. She might have lost her license, but her degree cannot ever be revoked from her. I assume the patient has attained an MD degree, so she is still a doctor by virtue of possessing a doctorate degree (just not licensed to practice medicine).

Dr. Robert Jarvik, the inventor of the artificial heart and a spokesman for Lipitor, earned his MD degree in 1976. However, he has never been licensed to practice medicine in any state or country. He has spent the past 30+ years working in research, so he has never really needed the license. However, he can still use the title of 'doctor' since he has attained a doctoral degree.

Your patient is a doctor and may use the title as long as she's got her degree to back it up, but she cannot legally practice medicine without being licensed. If calling her 'doctor' nurtures her spirit, then so be it.

Well said :yeah:

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