"You put me and my unborn child's life at risk"

Nurses General Nursing

Published

This is what a Dr. told me today..

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!!!!!!!!!

Angry

Tiger

Specializes in FNP, Peds, Epilepsy, Mgt., Occ. Ed.

Since she is a physician,she should have known to check her own titer before becoming pregnant- and if she lacked immunity, to have had the immunizations. You work in health care, you run the risk of coming into contact with communicable disease. DUH.

As others have said, she should use proper precautions. Some illnesses, including chicken pox, are contagious before there are obvious symptoms. And, too, you never know what someone has under their clothes that they haven't mentioned to you.

Congenital problems from chicken pox can happen, of course, but it's pretty rare. I've been a nurse a long time, done a lot of peds, and worked in a teaching hospital, and I've never seen it, personally.

She was rude and inappropriate. You were in a "damned if you do, damned if you don't" situation here. If you'd come and told her that you thought the patient had shingles, she would've ripped you for diagnosing.

You didn't do anything wrong. You did not put anyone at risk!!!!

Specializes in NICU.
I wondered about that myself! There were enough ppl there to see it. Mind you, it could backfire horribly.

I definitely think that should be written up, there is absolutely NO reason whatsoever for her to speak to anyone like that.

Since she is a physician,she should have known to check her own titer before becoming pregnant- and if she lacked immunity, to have had the immunizations. You work in health care, you run the risk of coming into contact with communicable disease. DUH.

As others have said, she should use proper precautions. Some illnesses, including chicken pox, are contagious before there are obvious symptoms. And, too, you never know what someone has under their clothes that they haven't mentioned to you.

Congenital problems from chicken pox can happen, of course, but it's pretty rare. I've been a nurse a long time, done a lot of peds, and worked in a teaching hospital, and I've never seen it, personally.

She was rude and inappropriate. You were in a "damned if you do, damned if you don't" situation here. If you'd come and told her that you thought the patient had shingles, she would've ripped you for diagnosing.

You didn't do anything wrong. You did not put anyone at risk!!!!

I actually did see a baby who was born deformed because his mother had chicken pox when she was pregnant. He was a boarder in the peds ward because his parents abandon him when he was born.

That being said, if she was so concerned about putting her baby at risk, she should have taken a job in research, or something away from infectious patients while she was pregnant. She also never took into consideration that she could catch communicable diseases out in the community while shopping at a mall, or grocery store. You never know what someone has, therefore always use universal precautions, and watch when you are out and about in the community.

Lindarn, RN, BSN, CCRN

Spokane, Washington

From what I have read, she needs to go back to medical school.

Specializes in Rehab, Med Surg, Home Care.

If she is assessing pts in that setting, she should know that it's a given that she will be exposed to all sorts of risks all every day. It's up to her to decide the level of potential risk she is willing to take and if she should continue to practice in her current setting.. Something is wrong if she thinks this is your responsibility.

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.

:yeahthat:

End of story.

Specializes in NICU.

Thanks to everyone for the support. I'm glad I wasn't the only one who thought this was out of line.

Report the incident....Doctors need to be held accountable for misbehavior just like anyone else.....

Specializes in RN, BSN, CHDN.
Thanks to everyone for the support. I'm glad I wasn't the only one who thought this was out of line.

You are in no way wrong, it is amazing how some Doctors think they can say what they like to us Nurses.

You should be proud of yourself you handled the situation perfectly

:clphnds:

anyone who has not had vacination or previously had chicken pox can develop chicken pox from the exposure to shingles

dd had chicken pox at two yrs of age when exposed to shingles, she had another bout [much milder] when pregnant, her doctor told her that the worse time for baby was during first trimester, dgs had no problems except for being hyper but that runs in the males of the family

Specializes in Hemodialysis, Home Health.
"You put me and my unborn child's life at risk"

My response would have gone something like this:

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.

Ah yes.. perfect !!!

Can I keep you in my back pocket for those times I need to have a great, speedy comeback ? :D

I never think of the good stuff until waaaaaaaaaaaaaay later. :rolleyes;

Specializes in ED, ICU, Heme/Onc.
Report the incident....Doctors need to be held accountable for misbehavior just like anyone else.....

I totally agree. The medical director and the CEO of the hospital need to be aware of this.

By the way, the doctor demanded that you and another "more experienced" nurse practice medicine without a license and diagnose the rash for her. It might even be worthy of the disciplinary action by the AMA. Docs are quite territorial about their scope of practice (just read the med student forums and the CRNA/Anesthesiologist debates) - they just might be willing to make an example out of this doctor.

I do hope you documented that you reported the rash to the physician before she went into the room to examine the patient - just to CYA.

Blee

Specializes in Alzheimer's, Geriatrics, Chem. Dep..
...something like this:

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.

EXCELLENT!!!

ha ha ha

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