What drives you crazy or hampers your work when it comes to doctors' behaviors? This certainly is not an urgent issue or one to dwell on, but I just thought it would be fun to hear your stories and vent a bit. Now, having said that, there actually can be things we run into on this topic that could be a serious issue not to be taken lightly. I'm just curious as to what your experiences are and how you deal with them. Here is one of mine:
Usually a surgeon...You walk into your patient's room to find their dressing taken down, wound exposed, a mess left on the bed or bedside table. The patient tells you, "oh yes, doctor so and so was just here. He said you'd take care of this.". No communication from Dr. So and so. No attempt to find you and let you know he is planning to check the wound so that you can be there and assist, Ask your questions on the care from there, if you have any, etc....No clear order on how he/she wants the wound dressed, etc...
Now before you all tell me what you would do, such as..."Well, call the doctor and ask him.". Duh....
Not the point. We all know what to do, just wanting to hear your situations. And if, they are serious concerns, as opposed to just annoyances, All the better.
We have one surgeon who keeps the chart when he puts in the post-op orders & dictates. Not a big deal right? We just have to step out of PACU & grab it when he's done; takes 5 seconds. Except when you go to get it in the dictaton booth & it isn't there...because he went straight into the next case & took it with him...or left it behind the surgical desk...or behind the printer...or in the surgeons' lounge...
Irritating and time consuming for you. One of those things that come up that take your time not covered in the acuity rating system!
To be perfectly honest, I don't have any pet peeves regarding the "generic" physician. I have had problems with individual coworkers (physicians, nurses, CNAs, physiotherapists, dietary staff etc.) but I tend to view them as exactly that, having differences of opinion on how we should treat each other or how things should be done with a specific individual.
When I worked in med-surg there was one surgeon who was infamous for doing this. He never even tried to locate the nurse responsible for the patient he was rounding and the patient's room usually looked like a 10 kiloton bomb had gone off in there Drove me slightly nuts to go into the room finding a patient idly scratching their surgical site with their none too clean fingers.
"Oh nurse I know I probably shouldn't, but it itches".
The funny thing was that despite the patient's room looking like a complete disaster area after the surgeon had rounded, he was known to be a perfectionist and a very gifted surgeon. I was a recent graduate and this was my first nursing job. I decided to ask him if I could attend one of his surgeries (a rather unsual operation scheduled for the next day) and he said I was welcome to. Turns out the guy loved to teach and I actually chose to come in early before evening shifts to watch another couple of his surgeries in the coming months.
Anyway, I told him about what I'd witnessed with his patients after he was done rounding and asked him if he didn't think it would be better if he'd let me know ahead of time so that I could round with him. That would also save me from having to chase him in the OR (which I noticed really annoyed him/broke his stride when I watched the surgeries) to get orders that he could have given me bedside at rounds. That was actually all it took, worked like magic :)
Emboldened by my recent success I decided to take it one step further When rounding with him (and yes, he came and fetched me beforehand) I used one of my feet to discreetly (ahem..) push a trashcan on wheels closer to him... and said with a wink that the trash will be going there eventually anyway... So why not... The guy actually had a sense of humor and lo and behold! he managed to deposit the old surgical dressings directly into the trashcan instead of as previously flinging them all around the room. Victory :)
I can understand why surgeons do this. At least on the floor that I worked they had a very short time to round multiple patients in the morning before starting the first surgery of the day. Most of them went through the floor like a whirlwind on amphetamine. I understand the stress. I think that talking to people will solve most problems though, and in this case I think that it was a win-win for us both.
Excellent! This is what I was hoping for...what happens and then how to solve it.
To your point regarding the time pressures they are under...If they took the extra few minutes to find the nurse, hopefully, they wouldn't be interrupted in the OR later...just a thought.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
oh...good one!
Just wondering, how do they respond when you let them know the computers are in short supply for the nurses?
One time when the physicians were hogging all of the computers at the bedside, I just went into their office and used theirs. When one of them objected, I pointed out that they had this big office with eight computers and no one using them while we had a nurse's station with six computers all in use by physicians. "Since I have to chart somewhere, or you won't have any vital signs to look at when you log in, I'm going to chart HERE until someone frees up the computers at the nurse's station." It didn't make it any eaiser to get into the nurse's station computers, but I didn't get any more flack for being in their office. Of course you can't see the monitors from there . . . .
Usually, if a provider sets up shop at the nurse's station computers, I sit down next to him, uncomfortably close and stare at the patient room directly across from the computer. When I get his attention I say "I was using that computer. You can sit there, but if you do then you're responsible for watching Mr. Houdini over there to make sure he doesn't pull out ANOTHER art line or fall out of bed AGAIN." Usually, they can't vacate the computer fast enough!
One time when the physicians were hogging all of the computers at the bedside, I just went into their office and used theirs. When one of them objected, I pointed out that they had this big office with eight computers and no one using them while we had a nurse's station with six computers all in use by physicians. "Since I have to chart somewhere, or you won't have any vital signs to look at when you log in, I'm going to chart HERE until someone frees up the computers at the nurse's station." It didn't make it any eaiser to get into the nurse's station computers, but I didn't get any more flack for being in their office. Of course you can't see the monitors from there . . . .
Usually, if a provider sets up shop at the nurse's station computers, I sit down next to him, uncomfortably close and stare at the patient room directly across from the computer. When I get his attention I say "I was using that computer. You can sit there, but if you do then you're responsible for watching Mr. Houdini over there to make sure he doesn't pull out ANOTHER art line or fall out of bed AGAIN." Usually, they can't vacate the computer fast enough!
What drives you crazy or hampers your work when it comes to doctors' behaviors? This certainly is not an urgent issue or one to dwell on, but I just thought it would be fun to hear your stories and vent a bit. Now, having said that, there actually can be things we run into on this topic that could be a serious issue not to be taken lightly. I'm just curious as to what your experiences are and how you deal with them. Here is one of mine:
Usually a surgeon...You walk into your patient's room to find their dressing taken down, wound exposed, a mess left on the bed or bedside table. The patient tells you, "oh yes, doctor so and so was just here. He said you'd take care of this.". No communication from Dr. So and so. No attempt to find you and let you know he is planning to check the wound so that you can be there and assist, Ask your questions on the care from there, if you have any, etc....No clear order on how he/she wants the wound dressed, etc...
Now before you all tell me what you would do, such as..."Well, call the doctor and ask him.". Duh....
Not the point. We all know what to do, just wanting to hear your situations. And if, they are serious concerns, as opposed to just annoyances, All the better.
Just thought about this and want to add.....Many problems we have working together are caused by logistical issues that are hard to get around and it becomes a challenge to improve the situation. Some issues are entirely fixable and I would like to hear suggestions for improvements as well as the problem.
One poster in a different thread was concerned that this topic may be construed as "divisive" - Not my intent.
1. Incorrect postings. Just in general it bugs me when because the posting was wrong it's generally on the staff to scramble and correct it.
2. Residents who feel the need to tell you a "plan" that makes perfect sense to them but is *not* how any of the attendings approach anything (instead of listening when you explain reality). Then, when the attendings ask why everything is wrong, residents try to throw the OR staff under the bus. It's okay though, the attendings know what the staff know and generally believe the staff over the residents.
3."Emergencies" that are actually in no way emergent other than called emergent so the case has to be started. Invariably, this occurs at shift change, holding staff hostage. *Not* a way to make friends. There are legitimately emergencies and while nobody loves getting held hostage to cover those people don't complain as much.
4. A lack of phone etiquette. It bothers me from all kinds of coworkers not just physicians. It's less annoying now, we have caller ID. I still call them out on it (and have trained the surgeons I work with).
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
At some facilities where I've worked, physicians expected nurses to give up their seats at the nurses station so they could chart when they already had a nicely appointed dictation room (filled with snacks and bottled water) to do their charting.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
At some facilities where I've worked, physicians expected nurses to give up their seats at the nurses station so they could chart when they already had a nicely appointed dictation room (filled with snacks and bottled water) to do their charting.
We have a new ICU with hot and cold running computers, computer stations and COWs. Back in the day, when we only had one computer for the secretary and one computer at each bedside, it used to but the living day lights out of me when one of our attendings would walk into the room, take over the computer (and the chair) and then sit and fire questions at you like "What was his K+ at midnight? And you gave him how much potassium? What did the Neuro attending write in his note? Did someone order . . . ?" Well if you want to let me into the computer, I'd be happy to tell you, otherwise look it up yourself. It particularly irritated me if I was logged on and in the middle of something when he'd swoop in behind me, snag the chair and then roll himself right up to the screen and start opening other patients' charts. It got so I'd just reach over and log myself out when he started; then he'd want me to log him back in because "I can't remember my password." The first time I told him I'd be happy to call IT for him so they could help him change his password, he reported me for insubordination. Once my manager set him straight (she's not insubordinate because she's not in your chain of command, and you should know better than to expect anyone to log in for. You. Besides, we just bought you your own special COW, so you have no reason to take over the bedside computer, so grow up already) he stopped asking for us to log him in, but he'd still snag our computers and surf under our passwords whenever he could. It's irritating to have a computer at the bedside and get up to empty a Foley bag and chart the amount and have this guy in your seat and on your computer when you back away from the bed to chart.
Even with the plethora of computers, it never fails that some consultant will come on the unit, ignore all of the computers that are obviously available and plop down in front of the one computer where you have your pens, your water in the approved container, and all of your stuff arranged and log you out in the middle of your note (which you won't be able to get back now that he's erased it) to do something he could easily have done from another computer, from his office, from the MD office, from the NP office, from the break room, from the substations between the rooms, from the bedside . . . .
YES!! I work in a teaching hospital, so we have medical students, interns, residents and attendings, so as few as 4 or as many as 7 or 8 people sitting at the nurses station with 5 computers. They are like a flock of birds when a person throws down bird seed at the park, then precede to sit at all the computers and use all the chairs talking about what-the-heck-ever topics while we (the nurses) have to go into an empty room or pt rooms to chart. And Heaven-forbid they put charts back after they are finished rounding or throw away old coffee cups...guess common courtesy isn't so common anymore.
Specializes in Palliative, Onc, Med-Surg, Home Hospice.
When they ask me what I think they should order for the patient but then decide I don't know what I am talking about. (Like when I asked for Motrin instead of Norco for my patient, because she refuses to take narcotics for migraines!)
Or when I explain that the patient needs to have a lactic acid and cultures drawn BEFORE the antibiotics per code sepsis protocol, and they tell me "start on cefepime, blah blah blah. I have to ask my attending about the labs." Oookay.
For the most part, I work with really good docs, so it is actually individual docs who drive me nuts. Like the one who calls the nurses station to have the nurse come in to turn off the TV. We just go shut it off when we see him on the floor now. Nothing like being pro-active.
We have a chart that stays up and running in the room. At the end of shift you "lock" it for the next person to sign in, but all the while all the patients vitals and data are slaving over to the chart. There's a button you can click to see the patients I&Os. Doctors (we're a teaching hospital, new docs all the time) really like that info and like that button. Except they don't always know what button it is and just starting clicking stuff in my chart. Drives me crazy.
Drove me slightly nuts to go into the room finding a patient idly scratching their surgical site with their none too clean fingers. 
When rounding with him (and yes, he came and fetched me beforehand) I used one of my feet to discreetly (ahem..) push a trashcan on wheels closer to him... and said with a wink that the trash will be going there eventually anyway... So why not... The guy actually had a sense of humor and lo and behold! he managed to deposit the old surgical dressings directly into the trashcan instead of as previously flinging them all around the room. Victory :)
BeenThere2012, ASN, RN
863 Posts
Irritating and time consuming for you. One of those things that come up that take your time not covered in the acuity rating system!