"What Do You Want Me To Do About It?"

fergus51 · Jun 22, 2006

ok. what if the doctor has a patient that he or she is seeing in their office? i mean you don't expect the doctor to stop what he or she is doing while they have a client in their office do you? the reason im asking just picture yourself being that patient or client thats in the office being seen by that doctor would you want him or her to stop on drop whatever their doing and come take care the one who is worsen? this to me is where they do need a stand by when something like that happens.

If he's on the phone asking me what I want him to do about it, then he isn't seeing anyone in his office at that moment. I work nights and my docs don't see patients in an office so that's not an issue for me anymore, but yes I would expect them to stop what they are doing with an office patient if a hospital patient has an emergency.

Morning-glory · Jun 22, 2006

I do indeed expect a doctor to answer their pager, even if they are in OR. They may wait a minute or 2 before calling me if they have to, but I want him to answer me. I will not call a doc for a colace order at 2 in the morning, so in return, I expect them to respect my judgement and answer the page in a timely manner. If they are in clinic and it is urgent that I speak to the doc I will ask the office staff to interupt.

We are not here to do their jobs. We are the eyes and ears and they need to understand that we also have work to do and that we will not sit around the phone for an hour in a crisis.

I have been known to write up the orders and get the blood work going before the call back. It's all in the approach. I work in a LTC Psych facility now, so if someone is very physically ill I will send them out and then call our on-call DR. I have had no problems with this at all.

leslie :-D · Jun 22, 2006

"Well, I don't know, cuz I didn't go to medical school, but I WILL record in the chart that you were notified about these changes in the patient's condition."
And, if appropriate, "what time you were paged and what time you answered the page".

this is exactly what i do.

i calmly state that i shall note that dr.x was notified as well as note dr's response verbatim.

they do not like this at all.

ooooooh, there are some real twits out there.

leslie

welnet66 · Jun 23, 2006

Thanks everyone! Maybe an effective response to this sarcastic remark will nip it in the bud!

Cheyenne RN,BSHS · Jun 23, 2006

responding to the lowest form of wit is an art i have developed over the years but this one takes the cake: "and what do you want me to do about it?"

i usually answer with "well fix it. that's why you went to school and get paid the big bucks for remember."

they usually aren't sarcastic after that and will give me the orders i need.

weirdRN, RN · Jun 23, 2006

I had a doc hang up on me the other night. He was rude and mean and sarcastic, and before I could tell him what I wanted he told me to send the patient to the ER and hung up on me!

What I wanted was Ativan, 1mg IM x 1 dose. So the resident got sent to the ER for eval for no reason. And I was the one who got reamed by more senior nurses.

caroladybelle, BSN, RN · Jun 23, 2006

ok. what if the doctor has a patient that he or she is seeing in their office? i mean you don't expect the doctor to stop what he or she is doing while they have a client in their office do you? the reason im asking just picture yourself being that patient or client thats in the office being seen by that doctor would you want him or her to stop on drop whatever their doing and come take care the one who is worsen? this to me is where they do need a stand by when something like that happens.

Let's see here:

Patient in office is usually ambulatory, rarely has IVs running or on the vent, and is most likely stable.

Patient in hospital (that I am calling about) is probably not ambulatory, most definitely has an IV - generally several running blood/chemo/dopamine/lyte infusions/multiple antibiotics, may be on the vent and is very definitely NOT stable.

WHO DO YOU THINK RATES THE GREATER CARE?????

-------------------------------------------------------------------------

As a nurse, I am expected to multitask....by caring for several patient's acute needs at the same time...despite them often being acutely ill and not stable. And I am often poorly paid for this, am not given adequate time to sit in a quiet office and get a thorough uninterupted assessment. Do I expect the MD to occasionally get interrupted and have to multitask, when one of his/her patients are going bad?

Why, yes I do.

I am not calling to idly chat, I do not have that kind of time to waste.

If I am expected to handle several patients vomiting/being transferred/admitted/crashing/getting chemo or blood products at the same time, they can to.

If I have two or three call lights/phone calls at once, I have to "handle it".

--------------------------------------------------------------------------

At one facility, I was required to wear a phone. During one 12 hour shift, I received 37 calls. 75% of them: were wastes of my time, unnecessary interruptions, or had no benefits to the patient involved, or could have been answered by the secretary or charge at the desk that forwarded the calls. For each of those calls, due to HIPAA, I had to stop my care of a patient and step out to the hall.

During said shift, I went to bathroom twice, and ended up getting calls while I was "indisposed". I have written orders on toilet paper/paper towels.

And I ticked off one MD by refusing to stop my lunch 30 minutes, to run back to the floor and find out the patient's insurance, something he could have easily asked the secretary.

--------------------------------------------------------------------------

An MD rarely spends more than 10-20 minutes speaking to an office patient. If they would call back within 10-20 minutes, it would be great, but too many wait 45-120 minutes, and then wonder we not sitting at the desk poised to recive their call.

Tweety, BSN, RN · Jun 23, 2006

Oh, yes, I've gotten that a time or two myself.

Answering "I don't know, you're the doctor." isn't a good response in my opinion. I answer the question: "Chest Xray, lasix, abg's...........". Or if there truly is nothing to be done, and often there isn't, we're just informing them of a change or some abnormalities that bears watching, or a fall or med error that they truly can't do anything about, " I am not asking you to do anything, I am informing you of the patients condition, as my license requires. Consider yourself informed and I'll document it.". I've used that one more than once.

Tweety, BSN, RN · Jun 23, 2006

ok. what if the doctor has a patient that he or she is seeing in their office? i mean you don't expect the doctor to stop what he or she is doing while they have a client in their office do you? the reason im asking just picture yourself being that patient or client thats in the office being seen by that doctor would you want him or her to stop on drop whatever their doing and come take care the one who is worsen? this to me is where they do need a stand by when something like that happens.

Carolina gave the best answer. The doc needs to multi-task and take care of all his patients, both in the office and the more sicker ones in the hospital and nursing homes.

During my last physical which was my first one with this doc, so it took some time, he answered two calls. He apologized profusely and I just smiled, saying "absolutely no problem, I do understand". Other people not in the biz get irritated when their doc doesn't give them undivided attention, but if it were their family member crashing in a hospital or nursing home, they would want to doc to drop what she/he's doing stat and talk to the nurse.

I never call a doc unless I have to. I work days and often things can wait until they make rounds and I decided what can wait. So if I'm calling, I expect the doc to do their job and call me back.

Runningnurse · Jun 23, 2006

Our floor generally has a decent number of offservice patients on it, and those are always the docs that act like idiots. Maybe we're just biased, but "our" docs always call back right away, and if we say "Could you come over here?" they come quickly, and if the patient just wants some Sonata, they get some Sonata.

Off-service docs, on the other hand...ugh. There's one particular service in particular that we HATE. They are always in surgery (all night long) without coverage for their pager. Or if we -can- reach them in the OR, their response is typically "They can wait." This to a patient that wants pain medicine. Whatever. We get snappy.