Some doctors I tell ya...

Okami_CCRN, BSN, RN · Feb 10, 2014

I understand where you are coming from, but was this a teaching patient? Could you have called the resident for that order?

We never call attending physicians for cathflow orders, we usually have the residents drop the order.

Maybe this could be brought up to the IV team, I know that we are working on a protocol for clogged PICC's.

nynursey_ · Feb 10, 2014

Sometimes you just have to vent:
So I've dealt with plenty of unpleasant doctors but last nights encounter takes the cake. After having to call a doc early in the morning to get an order for cath flow for a clogged PICC, I was reamed out for being inconsiderate and waking him up for something that could be dealt with in the morning. I understand people do not like to be waken up, totally get it, I can be a bear too BUT as a health care provider i think it is ridiculously rude and unprofessional to act like that. My morale is that whatever happens on my shift, I deal with it. I absolutely HATE when people leave stuff for the next shift as if they don't have their own cares that need to be done. It is our job to provide for our patients and I'm truly sorry to wake you up but honestly I'm just doing my job and looking out for my patient. I just don't understand doctors that feel the need to be complete a*******! What should have been a decent shift was completely ruined from this encounter, something which could easily been a one minute friendly conversation.
So frustrating!

I'm not sure I agree with the physician's assessment that it "could be dealt with in the morning." I've always been taught that a clogged PICC should be addressed immediately. Then again, as another poster mentioned, if you were employed in a teaching hospital, maybe an intern or resident could have made that call, avoiding rousing the physician. Then AGAIN, I'm not sure about your hospital, but we always have a night float on that we can call for those sorts of orders.

I also do agree with happyloser that this could be an awesome opportunity to speak to the IV team in assisting to develop some sort of standard order set for clogged PICCs to be utilized by either the night pharmacist or … some other member of the IV team.

I understand your frustration, OP. Getting browbeat for doing your job is really, really frustrating regardless of the justification.

jcarl12 · Feb 10, 2014

I do not work in a hospital. It's a short stay and rehabilitation center so we don't have an IV team or doctor on site. We don't have a choice but to call the physician unfortunately

nurseprnRN, BSN, RN · Feb 10, 2014

Then the physicians know that, and it comes with the territory, and they know that too.

Before he comes in, pull an article or two stating the standard of care for clogged PICC lines. The IV Therapy Nursing Assoc should have some on their website. If they say a clog should be dealt with promptly and not left until morning, there you are. If they say you could leave it until morning, you can apologize to him. I'm betting it's the former, though.

nynursey_ · Feb 10, 2014

Then the physicians know that, and it comes with the territory, and they know that too.

Before he comes in, pull an article or two stating the standard of care for clogged PICC lines. The IV Therapy Nursing Assoc should have some on their website. If they say a clog should be dealt with promptly and not left until morning, there you are. If they say you could leave it until morning, you can apologize to him. I'm betting it's the former, though.

Sound advice! It never hurts to be armed with EBP or a facility's procedure regarding the urgency of addressing clogged PICC lines. If they facility says an MD must be notified, then there it is in writing.