Should a nurse suggest a different doctor?

[brownbook]

If a floor nurse in an acute care hospital witnesses a doctor being rude and dismissive to a patient, minimizing the patient's complaints or symptoms. What should the nurse do?

Yeah, maybe the patient is well known to the doctor, maybe the patient is being overdramatic. But what if as far as the nurse knows and sees, the be patient has some valid complaints. At the least the doctor's bedside manner is inappropriate!

I'm not talking about a psych unit.

Would it be wrong for the nurse to give the patient a list of doctors with privileges at the hospital who cover the same service?

[Susie2310]

I remember a nurse telling me that if she knew someone wasn't a good doctor she would suggest to the patient/family that they could seek a second opinion.

I have had staff (non-nursing) drop hints to me about certain physician/s when I arrived for a medical appointment. They were very professional in the way they did this, and quite clever, but they sowed the seed of doubt in my mind and made me reflect on the fact that they seemed to be trying to tell me something. Further down the road I was very grateful that they had cared enough to do this, and was very glad that I paid attention to them.

[elkpark]

I would never take the initiative in suggesting that a client might want to change physicians based on what I observed, for fear of that coming back to bite me at some point (if the physician were to complain to my management). If a client brings up in conversation, though, that s/he is unhappy with a physician, whether just the physician's interaction style ("bedside manner") or the actual care provided, I always remind people that they always have the right to switch physicians and there's nothing wrong with getting a second opinion about care.

It's important to tread lightly in these situations, though.

[DeeAngel]

Write up an incident report and file it, this needs to start a paper trail.

[jodispamodi]

That would be walking a slippery slope, because if the doctor were to find out he could take a complaint out against you with the BON for interfering with the practice of medicine. This even includes suggesting alternative treatments. If you were to talk to the doctor and say hey I think patient x might benefit from acupuncture and he's agreeable thats one thing, but to say to a patient doc L is not a good fit but doc M or practice O is a much better fit for you is basically interfering with their practice of medicine. I wouldn't do this to save my soul. When patients tell me they don't like their doctors I respond with "trust your gut" or theres nothing wrong with a second opinion"

[NunNurseCat]

I do not allow personal feelings about a physician into a professional conversation.

That said if a patient complains about a physician, then I word my response something like. "Not getting along like buddies isn't a good reason to request a different physician. As a patient you should act on what you feel is best for your health. That is what is important."

[aflahe00]

If that's what the patient needs then yes. Why wouldn't you.

[aflahe00]

If the RN can't give a suggestion then who is going to do it. No one. Use your judgement don't make it personal and be professional about it.

[subee, MSN, CRNA]

I only told a patient to leave her MD once because He smoked pot at work in the call room and was going to be out of a job soon anyway.

[LadysSolo]

You have to be VERY careful in how you do this. For example, I had a patient one time who had surgery, and it was done rather poorly, and the post-op care was very poor. I suggested to the patient that perhaps her PCP should be aware of the surgery, and perhaps she should make an appointment. The PCP had a fit about how the wound was looking, and fixed the problem, without me making comments about the surgeon. Issue handled diplomatically!

[Ele_123]

If the patient expresses concerns to the nurse about the care the doctor is providing. It would be appropriate to remind the patient that they have the right to participate in their health care & tell them the ways they have to express these concerns- patient care hotline, house supervisor, or charge nurse. Giving the patient a list of hospitalists, neurologists, or whatever specialty and telling them they can choose a doctor if they don't like theirs doesn't seem right. If the nurse has documented concerns about the care a patient is receiving it needs to go through the appropriate channels- incident report, house supervisor, director of xyz medical service, etc.

[subee, MSN, CRNA]

You have to be VERY careful in how you do this. For example, I had a patient one time who had surgery, and it was done rather poorly, and the post-op care was very poor. I suggested to the patient that perhaps her PCP should be aware of the surgery, and perhaps she should make an appointment. The PCP had a fit about how the wound was looking, and fixed the problem, without me making comments about the surgeon. Issue handled diplomatically!

That's a good ending to a bad story. Diplomacy really does work to prevent wars:)