Rounding with Physicians?

[november17, ASN, RN]

The other night I went into work. I got my report and I was merrily on my way into patient's rooms, assessing, blablabla (You know the routine). Anyways, I was in this patient's room setting up his CPAP for him. I had just gotten started pouring sterile water in the container when one of my nurse-for-30-years-about-to-retire coworkers popped in. "Hey, Dr. X is here. He's going into Patient Z's room." I said, "okay, thanks." I finished pouring the water and started to connect the tubing. My coworker said, "I think that Dr. X is more important than that right now!" (the patient was in the bathroom and didn't hear any of this). I shrugged and said, "okay." I dropped what I was doing. Mind you, this was a completely stable surgical patient that had a very uneventful stay.

I left the room and went across the hall to where Dr. X was. Anyways, I went into this room with Dr. X. He proceeded to give the "same ol song and dance" to this patient.

Dr.X-"Hello, how's it going?"

Pt-"Great"

Dr.X-"blablabla we'll get you out of here tomorrow"

Pt-"blablabla okay great"

Dr.X walked out and proceeded to write a bunch of orders while I stood there. In the meantime, Pt CPAP's call light was going off because he needed assistance getting out of the bathroom. After writing a progress note, Dr. X made some witty comment before walking off the floor. The order read something like, "Pt may leave if OK with other physicians", or something to that effect.

Kind of a bla routine thing, right?

This isn't the first time something like this has happened. What is the big deal about rounding with physicians? Everytime I round with them nothing really interesting or new comes to light. They just write their orders and leave. Most of the time if I have something to tell them I catch them when they first come in and explain what's going on - Or they can read it for themselves in the progress notes (and if they miss something, then I guess they can get a phone call @ 3am; they'll learn eventually right?). Seriously, is this just a holdover to the old days? Or is it something that is really necessary? Maybe it's just the floor I work on and the physicians that place their patients here? I'm not trying to say that I am against rounding with physicians, but at the same time why should I be bending over backwards to track them down? Shouldn't it be vice versa? Maybe an older nurse can explain this to me.

[canoehead, BSN, RN]

Remeber not to turn your back on them as you leave the room, and genuflect prn.

[Sabby_NC]

Ahhhhhhh times have changed I guess.

Sounds like that other person could have gone in there for you considering you were busy with the other patient eh? You know help you out a little on that one!! either done the round or finished hooking up your patient to C-Pap. Hmmmmm:uhoh21:

I loved doing rounds with our surgeons etc.

Was a nice time to catch up and yack with them.

Thankfully most of them visited in the morning up too lunch time so we got that out of the way early.

I worked in an awesome hospital (it has severely changed since then) where we all called each other by our first names. Made the working environment a family atmosphere.

[jmgrn65, RN]

We don't round with our physicians except the heart surgeons, but most of the units in our hospitals doesn't round. I certainly wouldn't drop what I was doing to round with, just for the sake of rounding.

[EmmaG, RN]

On a travel assignment, I worked at a large teaching facility. In my day of orientation, it was excitedly announced that I, as a mere nurse, would actually be allowed to round with The Team.

Whoopee!

I too experienced the nurse calling me "The Team is here! The Team is here!"

So, what the heck. I joined The Team and huddled with them outside my patient's doorway.

After listening to the student deliver a looooong monologue about the patient and why he was in the hospital, they proceeded to discuss the presentation. And discuss. AND discuss. In the meantime, I'm watching my call lights flashing, my pager is going off, I'm dancing about thinking of how I'm getting farther and farther behind... and they continued to discuss.

I attempted to bring up some relevant and current concerns about the patient, but they just smiled and kept talking. Finally, they'd go in to see the patient, then retreat back to the hallway to talk some more :stone

I'd hear them say they were going to order *whatever* but hours later, still no order. Concerned about planning my care around *whatever*, or knowing the patient would have to be prepped for *whatever*, I'd page to ask if they'd change their minds. But no, not to worry. They assured me one of The Team was entering the orders. Of course, the order for *whatever* would come through hours later, and nine times out of ten was ordered STAT!

*sigh*

I hate teaching hospitals. I know that these people need to learn and I respect that. The frustration of how slow they are to respond (or rather, act) only to have it turn into "HURRY UP! DO IT NOW!" was too much for me. God bless anyone who works and thrives in that environment. I couldn't do it for any length of time without throttling someone.

As far as rounding with real docs, I do it if I have the time. That doesn't happen very often, and most don't expect it. At my old job, the clin spec did so, and passed pertinent information to the primary nurses. That seemed to work just fine.

[jnrsmommy]

Generally, I usually don't round w/ the docs, mostly because they're pretty good at sneaking in and out of the floor..lol. Seriously, I do try to get in the room w/ the docs if there's something I want to talk about or I know my pt has questions and I want to make sure they ask and not forget. And I definitely go in if the doctor has a thick accent, just to make sure that the pt understands.

[SICU Queen]

Remeber not to turn your back on them as you leave the room, and genuflect prn.

:rotfl:

[EastCoast]

Hi. Jumping in.

As a previous bedside nurse on the ICU i found rounds helpful. Learning. Building relationships. Establishing credibility. I also felt as a Nurse Manager that your patient's call light was everyone's call light. Rounds i think are important. THoughtful patient focused conversation is never a waste of time but handholding and standing there like a moron seem a waste of everyone's time.

As an NP who rounds daily in the hospital I will almost always ask the nurse if there are issues. I don't expect a nurse to round with me. I can take care of myself. If i write a ton of orders I give the nurse a copy as i find it annoying 3 hours later when the nurse doesn't know about the lasix i ordered. It seems to work on both ends and the patient seems to benefit. I read the notes on the computer that the nurses write. Most of the nurses I encounter I find are pretty good, still every once and a while at 3 am i get a call and can't for the life of me figure out how that nurse got through clinical.

I recently saw a temperature is the computer as 31.2 celcius. I asked the nurse (student) if this alarmed her. She said no. She didn't understand taking the temp after giving the patients his meds and H20 would affect the temperature.

Last. . .you can't teach some of these old doc's new tricks.

[Dolce, RN]

I never mind rounding with a doc if he/she specifically asks me to. However, I don't like it if they expect me to drop whatever I am doing and follow them from room to room. If there is a specific reason (like the woman who was upset and they were worried she would sue) than I will.

I don't expect them to round with me! Why should they expect us to round with them?

[elizabells, BSN, RN]

Remeber not to turn your back on them as you leave the room, and genuflect prn.

Don't look 'em in the eye, either. Makes them all cranky.

[RNperdiem, RN]

In ICU this is where you bring up issues so you don't have to call them later. You get to know the medical plan for the day and hear what they plan to order.