So I got in report this morning that a patient had been retaining CO2, and that the nurse had put him on a NRB because his sats weren't so great. First thing I did was put him on a nasal cannula. to keep his sats around 90 or so.
Around mid morning our weekend hospitalist Dr "Napoleanic Complex" came in and we were discussing the patient and he mentioned the patient having been on the venti-mask. I said "No, he actually was on a NRB when I came on, but I put him back on the NC". He started arguing and told me that he had instructed ER to use the venti mask, that he had ordered the venti mask because he was starting to retain CO2. So I brought him in the room to show him the NRB. He proceed to have one of his little tantrums in the room in front of the A&O patient.
So, we went out of the room. I definately didn't want to discuss this in front of the patient. Then, my nurse manager who was filling in as house Super came around and we proceed to discuss the problem of ER blasting the CO2 retainers with O2 and also nurses not being tuned into the problem. After Dr Napolean left, I told my manager that he had had a tantrum in front of the patient, and she affirmed that it was inappropriate.
So, I went into the patient's room to take his VS. He had a grin on his face, and immediately said "That Doctor sure is a horse's orifice!!!" I tried to play down his remark. Then he said "People have a right to chew someone out, but they should never do it in front of someone else". I explained to him that he wasn't exactly chewing me out, but was angry about something, then I left the room.
My nurse manager was still there, so I told her that the pt said that Dr Napolean was a horse's orifice. I told her I was going to talk to him anyways about that. So he walked up and I proceeded to tell him that, although he had a very valid concern, that he shouldn't air that in front the the patient, that it was bad PR. I told him that we shouldn't work out our dirty laundry in front of the patients. He argued saying that the patients have a right to know everything about their care. I told him that the patient had told me, uncolicited, that he was a horse's orifice.
Later the doctor tried to explain the whole thing to the patient. So I went in and asked the patient "Soooo, how did your conversation with Dr Napolean go???" The patient told me that he told off the doctor telling him that he should never chew out people in front of others. The patient was pretty pleased with himself.
rnmomtobe2010
1,051 Posts
Yeehaw For This Patient.