What doctors do that bugs you... - page 6

1. in our nursery, the charge nurse assists the pedi while rounding. there's this one pedi who will ask questions about a baby (was mom's gbs neg., etc.) as she is looking through his/her chart. ... Read More

  1. by   twotrees2
    Quote from IslandtrainedRN
    This isn't really an OB thing, but it DOES drive me nuts.

    When I have a patient on the medical unit who is a mouth-breather and is "comfort cares only", one or two doctors write irritating orders, like an order for "good mouth care" or "mouth care QID". It drives me crazy because that is NURSING CARE!!! Do they think we don't know when our patients need mouth care??

    I was very tempted to write a note to the doc who ordered mouthcare QID and let him know that we're actually doing mouth care q1hr, but thanks for the suggestion. He may as well have written an order for nursing care PRN.
    unfortuantley some of us have had to ask for orders like this as no matter how much we talk to cnas, nurses to watch cnas and directors who dont even approach it cause thats a minor issue to them - sad but true.

    oh heres another i just had the other day - the discharge stated skin intact - but upon assessmnet the resident had a 2 in incisoin draing from a cyst they had lanced - no orders for wound care and doc got mad we asked for some and said "just put a 4x4 on it for heavens sake" - yeah well ok but we still need an order for something like this and it should have been reported he had t to begin with!! - sheesh.
  2. by   augigi
    Do you need orders for wound care? Isn't it nurse initiated there?
  3. by   twotrees2
    Quote from augigi
    Do you need orders for wound care? Isn't it nurse initiated there?
    with this type of incision some want packing to keep it open to keep draining and some dont - cant just make up a dresing in my opinion with an incision- for scrapes, skin tears , mild ulcerations we have protocol which addresses this and we choose the right one but when an incision comes in i belive anyhow it shoud be asked for. matter of fact the last lanced area i had the doc wanted packing to keep it open and heal from insideout - another doc with same type of incision just wants a 4x4 - big difference and out of my scope of practice to preescribe which dressing they want. and i think i wsa most annoyed that the discharge said skin intct and i go to do my skin assessment find a dressing on an area take it off and find an incision - thats not intact by any means.
  4. by   HMtravelRN
    Hmmm... What do doctors do that bugs me...

    BREATHE !!! [EVIL][/EVIL]

  5. by   wooh
    Quote from flytern
    2. If MD calls to send in induction, but there's no room at the end, magically this patient has all kinds of problems (PIH w/ a blood pressure of 100/60)
    or macrosomia (would 1 more day in utero be that much of a weight gain?).
    When I was doing adult med/surg, we had a patient throwing a fit about getting a private room. We were full to the max, to do that required lots of shuffling, and actually moving someone from a private to semi-private. When we said we couldn't do it, he ordered a stool for c-diff, which automatically put her on contact precautions and got her a private room. I enjoyed repeatedly charting no stool sample r/t no bowel movement at this time, pt reports last BM x hours ago. Finally 18 hours after the order was written, I got to chart, "Moderate sized hard formed stool sample sent to lab." When the stool goes "clunk" into the cup, it doesn't take the lab to tell you it's not c-diff!:chuckle
  6. by   LDRNMOMMY
    We had a doc the other day induce a pt with Pit who was 38 3/7, primip who was orginally admitted for obs after an MVA. After her period of obs was over she wrote orders for breakfast then NPO for Pit once a room became available. We were in a jam for beds, holding postpartum patients no room at the inn. The charge nurse called her to question the order and the MD's response was "She is term with no evidence of abruption, I am not going to send her home so something can happen" Like what?? Go into spontaneous labor when the baby is ready! Oh yeah her cervix on admission was 0-1/thick/and high. Her stip looked beautiful the whole time she was obs. There was no medical reason to induce her!
    Last edit by LDRNMOMMY on Nov 22, '06 : Reason: spelling
  7. by   NurseNora
    I called the physician in the middle of the night with this report: "Your patient Susi Smith is here; she's a multip, 8cm, 100% effaced, +1 station. I need you to come in now."

    He took longer than usual to come in and missed the delivery--because I sounded calm and didn't tell him he had to hurry!
  8. by   mhull
    Quote from Marie_LPN
    Our docs started writing that as a part of their orders, since when we would get some of them for surgery, it was quite obvious it wasn't getting done sometimes. A few of out pts. had to have mouthcare before they could even start with induction, because of the solid gunk and slime in the mouth that an ET tube couldn't even pass though.

    I am an ER nurse just lurking on the OB tread, but I took orders from an Ortho doc the other night and he wrote for "complete bath with strict pericare daily". I asked why and he said it wasn't being done like he wanted. He then said he wanted all of his pts cared for like they where his mother. I began to really like him then.
  9. by   twotrees2
    Quote from mhull
    I am an ER nurse just lurking on the OB tread, but I took orders from an Ortho doc the other night and he wrote for "complete bath with strict pericare daily". I asked why and he said it wasn't being done like he wanted. He then said he wanted all of his pts cared for like they where his mother. I began to really like him then.
    i have on occassion had to get ridulous orders like these- you wouldl think its common sense but there is a lot of that missing in our field sometimes. sad when we do have to get it.
  10. by   traumamomtx
    doc's that have 20 patients on the floor so they pull every chart stick it on a rolling rack and when the nurse tries to take it for a moment to write something they yell "don't take my charts"....ok, you can't be charting on 20 pts at the same time. "I'll put the stupid chart back in a second"!
  11. by   traumamomtx
    doc's who come to you about family complaints that are ridiculous. Ok, first the doc knows the family is a PITA because they have been trying to get them discharged since day one. Ok, so don't come to me and say "did you know Mr. Jones was wet last night and had to wait 10 minutes to be changed?" No, I'm on the day shift and that sounds like a staffing issue. Don't ask me how Mr. Jones slept last night because I don't know I wasn't there.
  12. by   SierraN
    Quote from Marie_LPN
    Docs that breathe and speak.

    (No it wasn't a good day at C-section Land today lol)
    LOL - How funny!

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