When assessing my patient this AM I noticed that the patient had a scaly rash on his abdomen. The patient was admitted from the ER last night. I asked him when he developed the rash and he said it was about a week ago. When I came out into the nurse's station his MD was sitting there. I told the MD that I had noticed a rash on his abdomen and no one mentioned it in report so I wanted to make her aware.... She is a very rude doctor anyways and she just looked and me and didn't say anything.
About an hour later I heard her paging me over the intercom system to come to the nurses station. I went and asked her what she needed... (By the way she is pregnant)..... She said in a very snide voice... "You need to go back into that pt's room.... look at that rash... when you've figured out what it is you need to come back and report your findings to me." I said... Well I've already seen it, i'm not sure what it is... She repeated the exact same thing again... I just kind of stood there and looked at her.. she then said... "Well then, take another, more experienced nurse with you, when y'all can figure out what the rash is.. come back and report it to me."
I was very confused at this point but kind of started to get what she meant....... I got another nurse and we looked again.. The experienced nurse told me she was sure it was shingles.. So I went back and said.. "I guess it is shingles." She then said... "I want you to know... that you personally.. put me and my unborn child's life at risk.. You, as a nurse should be able to recognize shingles.. But since you didn't know what the rash was.. My life was put at risk."
I was completely floored..... I just said... "well I am a nurse and I don't diagnose people." And I walked away dumbfounded and angry.... I can't believe she said that to me.. and in front of everyone! Ohhh I was soooo mad and my DON was mad too. If she doesn't want to be put at risk she doesn't need to be a MD in the hospital and if she used standard precautions she's fine. AND she's lucky I even saw the rash.. otherwise I doubt she would of lifted up the pt's gown to look and she'd never of known!!!!!!!!!
Specializes in Alzheimer's, Geriatrics, Chem. Dep..
I was completely floored..... I just said... "well I am a nurse and I don't diagnose people." And I walked away dumbfounded and angry.... I can't believe she said that to me.. and in front of everyone! Ohhh I was soooo mad and my DON was mad too. If she doesn't want to be put at risk she doesn't need to be a MD in the hospital and if she used standard precautions she's fine. AND she's lucky I even saw the rash.. otherwise I doubt she would of lifted up the pt's gown to look and she'd never of known!!!!!!!!!
I have a personal policy for docs like this - I make sure that when they are on call I call them about EVERYTHING - preferrably at 0130, 0145, 0200, 0230, 0235, etc... until the doc gets the message that things come full circle.
Wow, what a moron to be saying those ignorant things. And the fact that she talked to you like that and in front of everyone ..... I would think it'd call for a report/write up. Especially if she normally talks down to nurses like that.
"When assessing my patient this AM I noticed that the patient had a scaly rash on his abdomen. The patient was admitted from the ER last night. I asked him when he developed the rash and he said it was about a week ago."
Good for you,reporting a rash that the ER Doc's and nurses didn't notice! If any lecture should be scheduled, it should be for the ER staff.
"Well then, take another, more experienced nurse with you, when y'all can figure out what the rash is.. come back and report it to me."
Ok, well let me just check and see who the ER Doc and ER nurses that were on last night ,and then we can all go into the room and see if we can figure it out.
So I went back and said.. "I guess it is shingles." She then said... "I want you to know... that you personally.. put me and my unborn child's life at risk.. You, as a nurse should be able to recognize shingles.. But since you didn't know what the rash was.. My life was put at risk."
:no:Say it isn't so! That was a nasty comment! 2 things come to my mind here,,,,,1) This Doc is shocked that a nurse did not know what shingles looked like,,,,which means that she values nursing judgements. What she isn't thinking about is that the Docs and nurses in the ER did not report or see this. YOU DID.
2)She reminds me of a bear with her bear cub, she attacks when there is a threat upon her cub. :scrm:
3) If I were you I would ask the manager to ask the Doc to educate the ER dept via telling about her experience:devil:
It is wierd buy I have always had to tiptoe around docs egos when I knew the diagnoses. Sometimes I know what the patient got and they don't. God forbid that I should say it because that would be a diagnosis and I am not supposed to be diagnosing. Always had to be careful to give them suggestions that let them diagnose. Now all of a sudden you are catching h### because you didn't offer diagnoses. She is a bad physician and I think she should get out of medicine. She going to use that high and mighty attitude on the patients and get herself sued.
She sounds WEIRD!! if she is so worried about stuff like that she shouldnt be working in a hospital. Its not your job to diagnose people, you did the right thing reporting the rash to her. There must be some sort of head of staff you can report her to.
Oh I forgot to mention that the MD went into the pt's room after I told her he had a rash.. After seeing the rash and knowing it was shingles, she confronted me.
Nice. So, essentially she diagnosed the patient and then sent you down there to look at it again to make a point or 'teach you a lesson?'
I would talk to whatever powers in your hospital handle unruly doctors. She has no right to ask you to practice outside of your scope. She also has no right to blame nurses for the possibility of being exposed to an infectious disease while she is pregnant. Perhaps she needs a LOA. She most definitely needs to go home to her mother for a refresher course in basic decency.
No, you did that yourself when you examined a patient without using universal precautions. What I did was save your professional backside by pointing out a potentially serious medical complication that you overlooked by failing to thoroughly examine your immuno-compromised patient. You may now apologize for your bad behavior and thank me for saving your orifice right here in front of the very group of people who watched you try to humiliate me.
Diagnosing medical conditions is not within your scope of practice. Obviously the doc does not know her own scope of practice or she would be aware that she should listen to the nurse that is informing her of a problem with the patient.
Liddle Noodnik
3,789 Posts
Don't blame you there! Wow, what a witch...