related to another post I made on reporting a MD

[angelbear]

I made a post previously on an MD that is kept on staff at the facility were I work who doesnt like to be called and gives wacky orders just for spite. Ok here is the deal I was working the floor the last few days and one of my pts was very ill. All she had was a prn aeresol and nothing else I could give her and she was obviously in resp distress. O2 sats were in the low 80's. Not even a prn o2 order. Our procedure manual states that we need a MD order to initiate o2(which I think is stupid) Anyway there was nothing I could do for her other than elevate the HOB position her for comfort give the prn aeresol. Then I called our on call NM to report the problem. She told me to go ahead and initiate the O2 so I let her know what the manual read and she told me to go ahead and she would get the order in the a.m. I had left her a message the day before stating my concern and my feeling that she needed more than what we could give. I asked her if she had gotten that message and she said yes she had and the pt would see the MD at the schedueled time. She did not want me to call the MD because of how he usually responds. I was very upset. Turns out the MD did see her the next day and admitted her to ICU for double pnemonia He was very upset that this had gone on for days and he had not been notified. I swear I am so frustrated. I am also glad that I documented the crap out of the whole thing both nights. Why the heck have nurses working the floor if you are not going to listen to them and why have MD's on staff you are afraid to call? I swear I feel damned if you do and damned if you dont. What does one do in a situation like this?

[Nursie30]

2L of o2 is a nursing judgement, anything above needs a doctors order, check the books, its there

[mattsmom81]

Angelbear are you saying you are not allowed to call the doctor about your patients in your facility? Or that you can only call if the NM OK's it?

I'm trying to understand how things work in LTC...as I am an acute care night nurse. I don't have to ask anyone's permission to call my docs.

[FranEMTnurse, CNA, LPN, EMT-I]

I got one of those old f...., I mean docs fired once. He was taking over the care of my Urologist's hospitalized patients for a couple days.

I had a urethral stirrup done, and was in a lot of pain. The surgeon gave me Morphine in my epidural, which I cannot tolerate. I told him prior to the surgery, but he did it anyway.

So when the nurses saw how I reacted to it, they gave me Atarax, Benadryl, and eventually hung an IV Narcan to finally stop the pruritic and projectile vomiting side effects. I was then given Demerol for the pain.

Well, in came the old doc, spoke in ancient language ex. bugs for organisms, etc. and told my nurse he thought I was exaggerating. He then took me off the Demerol, and ordered 5mg Percocet PRN. Needless to say, that made me cry, and disgusted the nurse.

When the IV nurse came to change my IV, she had already heard what happened, she told me I could still get the Demerol if I wanted it, and she went and got a shot for me. That was the first time I saw that particular do anything like that. She certainlly made a positive impression on this patient.

When the survey arrived, I wrote on the very top of the docs section the words, "Dr....needs to retire! Then I proceeded to write the details of my experience.

When I went to see my urologist a couple weeks later, I saw a sign posted in the waiting room the old doc was only going to be in the office once a week until a replacement was found. I just grinned from ear to ear, and thought, "Wonderful, now he can't hurt anyone else."

When I read my medical records, they stated I was in there for pain control.