Just a *long* vent about our newest intern to rotate through... I feel like I'm going to explode. Management is aware, as are the upper residents, she's driving us all crazy!
The latest meltdown was over a patient in triage. All the classic c/o UTI, horrible UA and a temp. Her urine came back from lab with blood, leuks, nitrites, protein and epithelials. So the doc says the specimen was dirty, and she's not treating for a UTI unless we get a straight cath specimen? Really? Cause I wasn't aware the presence of epithelial cells completely negated the presence of all the other supporting s/s. Anyway, fussed back and forth over cathing the patient for no apparent reason and she was adamant about not giving abx until we had a cath sample. The 2nd year was at the desk, so we ran it by him and he said there was no reason to put the patient through that, and she needed to be treated regardless. So lil miss sunshine intern gets her scrubs in a bunch and says we (the nurses) are just like little kids "when mommy says no and you go running to daddy"
Hmm... I was under the impression that we are all educated and licensed professionals working together for the best interests of our patients. Apparently I was wrong. She is firmly of the mindset that her orders are law, and should be mindlessly followed. :bowingpur
Last week had an induction patient with borderline severe pressures. Hydralazine didn't do much, but mom was getting uncomfy and wanted an epidural. Anesthesia had already been called to come do the epidural, when she wrote an order for 40 of labetalol ivp. K, but lets see what the epidural does first maybe? Mom isn't rocking 200/110s, they were more like 150-160/80-90. Got the epidural, BPs dropped by a solid 30 points and doc is incredulous that we didn't push the labetalol beforehand. Seriously? I didn't go to med school or anything, but even I know epidurals can make blood pressure drop like a rock. As it was, baby didn't tolerate the drop anyway and mom got cut 30 minutes after for lates. If we'd given the labetalol it absolutely would have been a crash section. That was explained to her, "but I wrote the order, I just don't understand why these nurses aren't doing what I tell them to"
Her 3rd year has grabbed her by the hand and pulled her into a room multiple times because she's running her mouth in front of the totally wrong audience. FYI- the *nurses station* is probably not the best place to be complaining about how offended you are that we have the ability to think and are doing so before blindly following whatever drivil she came up with for an order, there's a *doctors lounge* for that crap. She's even been warned (by the other docs) that we'll be ones saving her behind next year when she's managing the high riskers and she needs to not make enemies, but she doesn't give a rip apparently...
I've never worked in a teaching facility until now. Nurses have far less autonomy where I work now and its frustrating. There is also far less respect for nurses. In a community hospital where there are no in house providers the docs seem to acknowledge or at least realize nurses can and will save their butts if they show respect and and support even minimally.
Actually, except for a few notable residents, I love where I work. We are the ones who manage the private docs patients, until they come grace us with their presence for delivery. Sometimes we manage treatment of the staffs too, at least when we have a resident who will take advice. In my 3 years on the unit, generally the residents give us more respect than most of the privates. Odd, but true. The private docs will leave the patient a bloody mess with sharps still on the table and just walk out of the room. At least the residents clean up afterwards and make sure I'm not gonna get nailed with a dirty needle
I'm not saying it's like that everywhere, but I think we've got a pretty decent setup at my hospital. I've been to teaching facilities where the residents did everything on everyone Not being allowed to internalize my already AROMd patient with questionable "is that mom or baby" FHTs got old really REALLY fast.
The residents, most of them at least, understand that they're still learning, and the nurses who've been around for more than a few months have some valuable input about what we're doing to/for a patient. I've heard a private say trained monkeys could do our jobs...:angryfire
FireStarterRN, BSN, RN
3,824 Posts
She sounds entirely too big for her britches. She'll have to learn the hard way, it sounds like.