Nurse/Physician Conflicts

bosnanurse · Feb 17, 2010

Well, you will certainly get a lot of stories in this tread. So , here is one of God only knows how many :))

Young resident , knows everything , sure in her skills. Young patient , little bit " slow " and mentally on level of 7 years old child, ESL with basic English language trying to please everyone . blood pressure through the roof. Me asking for meds or transfer from MS floor. Resident gives meds , but patient's situation gets worse and worse. I am calling and saying that I need something else. She gives different meds IV push x3 doses. No results . Calling again. She said to stop calling her because I am making it up . I tell her to come to floor and see herself. She comes and asks patient how pt feels. This " kid" says OK even though she breathes with her all muscles that she has and gasping for the breath . I take resident outside and explain that this is not a regular person but someone who is trying to please everyone . She dismisses me and walk out. Blood pressure almost 200/ 150 . Call again , said that I will call rapid response if there is no response from BP. She yells on me and asks me if I "threaten her with RR" I said NOPE I am just informing her what I will do in next 15 minutes. So I call it . RR comes , assess patient who already was in respiratory failure, kidney failure and total mess. Intubated in next 15 minutes, transferred to CCU , called family and tried to find excuse for myself and for everything around me that night.

What should I do different.. I would call RR much , much , much sooner. I would have save this " kid " from intubation and multiple organ failure. Feeling guilty - yes, but hey we learn our lessons every day. I hope this helps:))):redbeathe

Pixienurse123 · Feb 17, 2010

I was doing home care hospice a few years back-admitted a man who had lung cancer with spinal mets-had been on IV Morphine in hospital (fairly sizable doses if memory serves) but sent home on Lortab. By the time i drove out to the home and did the admission he was rating his pain at a "10". I drove straight to his MD's office and informed him of the situation. He told me that he didn't believe he was actually taking much pain meds in the hospital (even though I had copies of the MAR) and that hospice nurses exaggerated patients reports of pain. He then said that since the patient was a small man he wouldn't have as much pain a larger man and Lortab would be fine. WHAT??? the man had SPINAL METS!!! All I could think of to do was just stand there in the doorway of his office blocking his way out of the room and stare at him. I was determined to get what my patient needed. After quite the standoff (literally) I left his office with scripts for Duragesic and Roxanol. Small people have less pain??... Dude, get a clue!!

ivorybunny · Feb 17, 2010

Was asking an infectious disease doctor about a patient's IV antibiotics. She has been getting IV Flagyl Q8 for about 10 days. I was asking him at what point would she be switched to PO pills? And he told me that if I got him a cup of coffee he would consider changing her to PO. Well, I didn't get him coffee and I told him that maybe he should just do his job and change it anyways.

I know there's a better one in my six years- but for the life of me can't think of any...

MissRNstudent10 · Feb 17, 2010

Thank you! There are all great!

PJC10181 · Feb 17, 2010

I cant think of a specific example, but I work in a military/teaching facility. When we have issues, we have a specific chain of command. Usually the problem gets fixed when you call the next senior person.

Argo · Feb 18, 2010

Surgeon had some problem, he is a known hothead, and came to me to yell at me for something that someone else did. It seemed funny to me that he was about chest high to me and acting totally inappropriate and threatening... I smiled at him and walked off. He came after me but about that time my new VP had heard the tyrate and jumped between us and told him to go sit in the lounge and chill out or he would call security and have him removed. lol..... The chief of surgery was around the corner and hear the whole thing also, he made the guy go to anger management....... The surgeon has loved me ever since...... I am the one person that can cheer him up on a bad day, strange.

Another one. One of the staff anesthesiologist who was owner of the primary group was in contract negotiations with the administration of my place. He didnt want to cover a case and thought that was his "muscle" to flex to no cover surgeries. I called another group and got coverage for the cases, that is my job after all. He was livid, I called up my chain of command and made them aware of the situation and he got chewed out up and down and was even more ticked off. About 10 minutes after one of his calls he was walking by me in the hall and decides to cuss me out. I am a large guy, 6' 290 with plenty of solid attributes...... He walked off pretty quick and I just laughed.... I caught him in a room that was private as I do not air problems publicly especially when I plan on yelling. This dude starts trying to be a biter but only could bark, he threatened me and tried to get in my face, I told him if he didnt like me doing my job he can get out of my OR. He didnt like that and threatened me some more so I offered to clock out and let him test his bravado on me, he declined and left. His partner was in the room and found his actions totally inappropriate and let admin know what happened, as I did. About a week later with plenty of more irate behavior he fell off the deep end cause he could not pull his "muscle" and when he did I was there to fill in the spots, he resigned and the contract was changed to some other company. Fortunately my upper admin knows that I am there looking out for their and our best interests and trust my opinions and back me up with things like these.......

There are plenty more, these are just the few that stand out..... I have chased an old cranky internal medicine Dr off of the OR floor for coming up and publicly yelling at one of my staff..... He doesnt say a cross word to any of my people any more. I will not stand for mistreatment of my people. They can come talk to me and I will address the problem privately.