Please help the MD, don't put him/her to shame!

SharonH, RN · Sep 10, 2007

found this post on sdn...wanted to share it!
http://forums.studentdoctor.net/showthread.php?t=443220
"we just got a new hospitalist at our hospital, and i have to say, he is awesome. he came up to me, introduced himself, by his first name none the less... wanted to know my name, looked me in the eye, held a conversation, and actually listened when i talked to him about the patients.

most of our hospitalists, don't even speak recognizable english, let alone acknowledge the nurses anyways, so the guy is already like my favorite person, and he wasn't bad to look at either , not to mention the extremly good manners and treating me like i had some intelligence.
he had ordered an echo, and the tech told me her ejection fraction was
well our lady started to trend down after the 2nd dose of iv lasix. she was saturating at 100%, but she couldn't "breathe", couldn't even speak barely, and at first i was thinking air hunger, but her bp was trending down, she felt nauseous, and her feet and hands started to feel cold to touch when i assessed her pedal and radial pulses to check her perfusion. she just was giving me a bad feeling all around, and i couldn't even get a radial pulse. she was still able to respond to me, had an apical, was breathing.. etc. but i could tell she just was off. and i decided i needed to page him, this was only 40 minutes after the last one, it just happened really fast.
he asked me what i wanted him to do after i gave him my rundown of what was going on, and i told him i wanted him to come, and he said ok, and literally ran in the nurses station 1 minute and 30 seconds later. we went back there and he decided right away to bolus her with fluids, and he was trying to get a radial, no dice. brachial... nope... femoral... no.. manual bp.. no.
ok .. bolus going wide open, page rt. get a mask on wide open instead of the cannula, and he' sill trying to get a manual bp. nothing. she is responding to him, but he can't get a bp or a extremity pulse.
we trendelenburg her, and he decides he wants dopamine drip, except in our hosp, they can only be run on the cardiac floor or icu. i work on orthopedics. we get medical overflow and ortho, period. no dopamine, at all, ever, he says well let's just start it and transfer her, but we aren't allowed to do that, so the man is resourceful, he is thinking "what is the best way to do what i can to get around the hospital politics bull**** and get what my patient needs, i'll call a code."
so he tells us to call a code. we said call a code? he said yes, call a code... code called.
of course 3/4 of the hosp converged. and wow, apparently when a dr calls a code for a dopamine drip and the patient is not coding, it's ok for icu nurses to be (what i want to say is a 4 letter word that starts with c, because it's the word that best describes it, but i'll use *****) bitches. they ranted, and raved, and complained, and i was so humiliated by the fact that they would act like that......... and to a doctor.

in the elevator he tries again to take her blood pressure and the elevator stops and the icu nurse just snapped i'm going now, and pushed the bed forward, and he was leaning over trying to listen and had his stethoscope connected to try to hear another bp

i've never been so pissed, and he kept it sooo cool, and remained so polite and nice, and never snapped or said anything unkind or snotty, and if i was him, i'd have made some kind of remark about being a nurse and him being a doctor, but he never did. he did his job, we got her down to cvicu, and as i was finishing up my charting and about to leave, he came over to tell me i did a good job, and thanked me.

i really wish i could have ***** slapped those nasty nurses because i don't know who they think they were.
now i am not saying this because i think the dr is 'better' than me as a nurse. i'm not of that mentality. there are some doctors we have that i don't have that much respect for, but i still show them the same amount of respect , and they would never know i don't like them personally. because they are my co-workers, and number one my job is to work with them to take care of the patients.

out of curiosity though, if we have dopamine in our crash cart.. which we do, could a dr not hang it if he wanted it for a patient?

i'm just trying to figure out what we could have done different there."

thanks to all for enjoying my theft from sdn, however i was not the nurse and we do have a rapid response team set up at my hospital. i just love a good tale! all those who love this story are probably excellent nurses or are becoming excellent nurses. that's all, enjoy!

this post is really kind of sad. apparently, the work atmosphere is so poisonous where she works that a polite physician is deserving of some kind of hero worship. it really is a shame that she thinks this guy is so great because (1) he introduced himself (2) didn't tear her head off after she called him 3 times (gasp!) when his patient was circling the drain-which is what she was supposed to do anyway and (3)he's cute to boot(giggles!). from the description she gave, the physician performed well, but was he really that extraordinary? he took care of his patient and he was polite which is what he was supposed to do. do we really have such low expectations of physicians that we have to be shocked and awed when they take care of their patients and they are nice too? yes, i know, i know, i worked in hospitals for years........but it's sad!

also, the poster stated that "now i am not saying this because i think the dr is 'better' than me as a nurse. i'm not of that mentality" but i think that is exactly the mentality that this person has. she bristled at the nurses stepping out of their place(who did they think they are, he's the doctor and they are the nurses) how dare they act like that and to a doctor ooooohhh.

what could have they done differently? well this lady was on ortho, she should have already been in a monitored bed to begin with...at the least. he knew she was in bad shape with an ef of

other than that, there really was nothing they could do and calling a code was appropriate. however, they need a rapid response team who could act in this situation and who could have started the drip and monitored the patient in the interim pending transfer. if not a rrt, perhaps a policy change which allows an icu nurse to come to the floor, start the drip and monitor the patient, again pending transfer. that is the way we used to do it before rrts.

leslie :-D · Sep 10, 2007

personally sharon, i think it's refreshing to deal with an even-tempered and respectful md.

it doesn't happen often enough.

should md's always be respectful?

absolutely.

but they're not.

i didn't get the impression this nurse was awe-struck by physicians.

and it's nice to read about a nurse who felt vindicated.

i think it was a story worthy of sharing.

leslie

SharonH, RN · Sep 10, 2007

personally sharon, i think it's refreshing to deal with an even-tempered and respectful md.
it doesn't happen often enough.
i think it was a story worthy of sharing.
leslie

That's my point. It's sad that it happens so rarely that when we meet a physician who is essentially acting the way he should, we have to get so excited that we run to post about it on the internet. There's really something very sad about that and I think it speaks to something which is very wrong with the hospital culture.

But I disagree that she was not awe-struck. As a matter of fact, "shocked and awed" were the words she used. She was practically drooling at the handsome doctor who spoke "recognizable" English and who actually asked her name. Remember, although she did give lip service to the fact that she was upset that those nurses acted like that in front of the patient, what really infuriated her was that they acted like that to the physician, who was so polite and soooo nice. That was really the crime here.

FireStarterRN, BSN, RN · Sep 10, 2007

"she" is a he, actually. telerner is a man, in case you wanted the straight scoop.

FireStarterRN, BSN, RN · Sep 10, 2007

(Also, he mentioned in another thread that he's married to a woman, so I don't think he drools over handsome male doctors)

SharonH, RN · Sep 10, 2007

(Also, he mentioned in another thread that he's married to a woman, so I don't think he drools over handsome male doctors)

I thought that TeleRNer only brought the post over from SDN, he didn't write it himself.

FireStarterRN, BSN, RN · Sep 10, 2007

I thought that TeleRNer only brought the post over from SDN, he didn't write it himself.

I stand corrected, my mistake.

CaLLaCoDe, BSN, RN · Sep 10, 2007

I thought that TeleRNer only brought the post over from SDN, he didn't write it himself.

You win! That is the truth! Oh well, no one is as perfect as this RN whose tale I usurped from SDN!

leslie :-D · Sep 10, 2007

That's my point. It's sad that it happens so rarely that when we meet a physician who is essentially acting the way he should, we have to get so excited that we run to post about it on the internet. There's really something very sad about that and I think it speaks to something which is very wrong with the hospital culture.
But I disagree that she was not awe-struck. As a matter of fact, "shocked and awed" were the words she used. She was practically drooling at the handsome doctor who spoke "recognizable" English and who actually asked her name. Remember, although she did give lip service to the fact that she was upset that those nurses acted like that in front of the patient, what really infuriated her was that they acted like that to the physician, who was so polite and soooo nice. That was really the crime here.

ah, i see what you're saying.

and yes, it is sad that we have to marvel at one's good manners.

now that i think about it from your perspective, perhaps she had a little crush, yes?:)

leslie

indigo girl · Sep 10, 2007

It is still a good story. Thanks for borrowing it from SDN, TeleRNer!