There is a nurse who works in a nephrologist's office. Every time I call (from a dialysis unit) the nephrologist to notify about the patient's condition or to ask for orders, this nurse at the office demands to know the details about the patient first and then starts giving the order. There have been multiple incidents, this is among one of them-
I called the office because one of my patient's dialysis access (CVC) was infected, and I needed to notify the doctor. The office nurse initially asked so many questions about this patient which is none of her business, and then starts giving the order- Draw blood for culture, I will look the dose and will call you back with vancomycin order". I said," Mam, I need to speak to the nephrologist, and I don't accept orders from an RN". she demanded to talk to the charge nurse, and in response I told her that I was the charge nurse and was refusing to take orders from her. I know many nurses take orders from her, the nephrologist doesn't have any clue of what is going on with the patient. She reluctantly said, "Well then you will have to wait, I will let him know when he comes". I requested her to page the MD for me, and finally got to speak to him.
I have also noticed that she's been signing many orders for the MD. I haven't seen it with my eyes, but am sure it is not the MD's signature.
At one point, I was even thinking of reporting her actions to the BON, but I don't have any solid document or record. These are just telephone conversations....
