Things you'd LOVE to tell the doc and get away with it....

Nurses General Nursing

Published

Since the patient version is so popular, and I had a bad weekend (and no hope for a better one this weekend....)

You've been giving this schizophrenic Alzheimer's pt 10 mg Ambien, plus 50mg Benedryl, plus 100mg Seroquel every night at their NH for years. Could you please, PLEASE explain why you stopped giving it to them when you put them in the hospital? Do I look like a lion tamer?

Yes, I am going to report you when you take the packing out of an abdominal wound with your bare hands, despite me waving gloves in front of your face. That's what the risk management software's for. BTW, did you not see the big isolation gear on the door? Pt. has hx. of MRSA in the wound, and you just stirred in it barehanded....

When I call you at 3 am and tell you your pt's BP is 212 over 179, resp are 32, and O2 sats are 78, could you please say something other than "So what do you want me to do?" Because, one night, I'm going to tell you what to do, and it's going to be something that only a hermaphrodite can physically do.

We all know this pt's a junkie; could you please, PLEASE, not admit everyone who comes to the ER with a pulse tonight? I've got two evolving CVA's and an acute MI, along with my OOB q5minutes Alzheimer's pt, my drama queen post lap chole, and one in restraints that the NH sent simple to get a break from him trying to bite them. I don't need a "demerol, phenergan and diet soda" q4h, too.

i have found that if being snapped at , yelled at, sneered at is met with a similar response, it is not likely to happen again!:smiley_ab

i love you you have the same attitude as me. no a doctor does not get to yell at me or act in a condescending manner. if i tell you i have a problem with a patient or your orders or a procedure and you ignore me or yell at me or treat me with anything but respect you can be sure i will document exactly what you said word for word and then contact the supervisor in writing. if you yell at me i will demand an apology. and yes i will refuse to do an order if i think it is unsafe. the courts will not support you if you interpret and med wrong and did not ask for clarification or give the wrong dose even if it was written by an md nor will they condone your part in allowing a patient to suffer because of an untreated condition because the doctor did not want you to wake him/her up . juries believe you have a brain and should have know or at least looked up or asked someonewhat an unsafe they will not accept "he yelled at me or he is the doctor and i did not want to wake him.

at my work i have several coworkers who say they love having me around because they know noone will be anything but professional. if a doctor ever spoke to me rudely in public i would respond with. "mike or steve (not doctor and no doctor ever calls me nurse i have a name as do they we are equals on the floor no there are no gods the only one i call doctor is someone who is a lot older then me (at least in their 60's only out of respect for a senior just as i would call a senior mr or mrs smith if they were the same age) "i find what you said to be extremely rude and condecending if you wish to talk to me please do it in a respectful manner or not at all i am going to walk away right now and give you time to think about what i have said. if you wish to talk to me again i will be down the hall". if it is the first time i speak to him/her in private if it is a second time it is loud and public. ( i said it to the new ed director he did not like it but he actually apoligized and i am his favorite nurse:lol2: he stills talks about how i stood up to him. now when he gets in a bad mood and gets a bit snappy i jokingly say to him now now you don't want me to show you the nice way again do you wink wink. i believe any nurse who blindly does what a doctor orders and does not question anything for fear of bothering them is an unsafe nurse and should not be on the floor. i have 2 brothers who are doctors one medical chief of the montreal neurological institute and they are both married to doctors so i have been around doctors for a lifetime socially. i showed them this post and they were blown away. they have never been rude or disrespectful of nurses or anyone for that matter and if by chance they might get a little short due to tiredness they usual recognize it without being told and apoligize. they have even said they are amazed that so many nurses cower to them and believe they deserve to be yelled at or disrespected. they honestly believe that without us their patients could die and they are greatful when we questions orders because they are human and they can make mistakes and they have. in the ed we are are a part of a team and are equals according to them and should be treated as equals. they feel the other floors should be the same.

as a previous nursing director, when a doctor complained to me that a nurse yelled at him and i went to nurse and found he yelled at her first. i said to the doctor while she should not have yelled neither should the doctor have. while i am not akin to mimicing bad behavior. i will not accept my nursing being disrespected either. he needs to stop yelling or disrespecting the nurses or i will proceed up the chain of command and i will enforce the rule 2 nurse communication only,in other words if he wants to speak to a nurse she needs to have a witness.

sure. i actually agree with what you are saying. i apologize for how i presented my views. as i stated earlier, i am not looking to upset anyone. i explained that i get frustrated simply because *i* care a lot about nurse-doctor interactions.

i do apologize for my "go to med school then" cliched comment. that was in frustration. i know of course that if you wanted to be an md you would have gone to med school. i am fully aware of the differences between the nursing and medicine models of care. i chose a poor way to express that i felt that some people were making comments discrediting the job of the doctors that should be seen as their peers. again, i took it more seriously than intended, as i admitted that it is a sore spot for me. i am only human, and humans make mistakes. ;)

i have to admit that most mds that i know respect nurses. so i'm somewhat shocked that others think this is not the case. i can't see myself being any other way, although i guess i feel frustrated by some of the stereotypical comments i see on this forum. respect must go both ways.

as the song goes..."why can't we be friends...".....:lol2:

the university of manitoba for example integrates all healthcare disciplines early on so they learn to respect each scope of practice and profession. this includes nursing, of course. watch this whole video, and you can see that is mentioned more than once. please watch:

http://www.youtube.com/watch?v=xnaf1unhn0m

i believe that all healthcare workers should work together.

sorry about the diversion, i explained myself, now i hope we can bury this one! i'm willing to accept fault here. i am truly sorry if i offended anyone and i apologize.

i too work for a hospital that promotes a team approach and that makes a huge difference. the nurses are resepected and administration doesnt put up with disrespect from either side...from the nurse to the md...or the md to the nurse....or the rt to md ...or md to rt. there is no captain of the ship...it is a team and the patient cant be healed by a doctor writing 50 orders on an order sheet. our attending put it best when he said " we write orders, we do surgery then we walk away....our nurses are 75% of the equation of whether our patients recover or not. this attitude has trickled down to everyone. now....instead of the nurses completly beratting md's....we are pretty defensive about them. when we see a deficit...be it nursing or md we acknowledge the behavoir right then and there. most of us use humor to do it....and it works . but.....back in the day the mentality of the doctor was " i am the captain of the ship" and nurses were beratted, cursed and treated like a dog.....that behavoir ......is not being tolerated anymore in most places. it leads to bad morale, disrespect and the end result is it impacts patient safety.

Specializes in Med/Surg.
Have any of you who work with "hospitalists" found them more congruent with nursing staff members? The private physicians seem to mess up every good care plan, contradicting anyone who doesn't agree with them........

The hospitalists we have now are all great, I have no problems dealing with ANY of them. One we had, who retired several years ago (we all breathed a sigh of relief when that happened, thank goodness!) was an absolute tyrant. Was KNOWN for being a complete orifice all the time, hanging up on people, etc.

I got a medical overflow patient who this hospitalist was supposed to come to the floor to see. Of course, when the patient comes up from ER, his blood pressure is something like 73/46. I call the hospitalist so he'll get up to see the patient sooner than he probably would have, apparently this guy's pressures weren't that low down there. After he DID come see the patient (after giving me a cursory "I know he's there" and hanging up on me, I wouldn't have called if his BP hadn't been going down the tubes!), he yelled at me about the fact that the patient had been given Levaquin for "pneumonia," as there was no evidence of pneumonia on his CXR. Um, dude...it's not my job to read chest xrays. I wouldn't even be in a position to SEE the xray! You've got a problem with the diagnosis and antibiotics, take it up with the ER doc that ordered it, you jack*ss.

On the flipside, we have had some internal med docs from the area covering hospitalist hours lately, and they've been GREAT. The one guy came up to the floor for a consult, I'd never met this one before. He comes in the charting room, "Hi, I'm Dr X...I don't think we've met, I am usually at X hospital, so it's nice to meet you. I'll do my best not to yell at you." This is said with a handshake, and a laugh. I laughed back and said, "Well, I'm cherry, and I'll do my best not to give you a reason to yell at me." He thought that was a hoot.

Another one, Dr O, was covering one night and came up to see a patient we'd just gotten from the ER. She was just super nice, as well. Since she was respectful enough to listen to my input about the patient, ask me questions and get my opinion about what she should order, I returned the favor by pulling up labs, and finding things for her, since she wasn't familiiar with our hospital or my floor. Scratch each other's backs and we'll get along JUST fine!

Specializes in corrections, psychiatric.

The prison doc was standing with hands on hips, bottom lip stuck out, saying "Who's going to get my vital signs for me?" I had no nurses to spare, they were either out on emergencies or passing pills. My response:

"You can either stand there with your thumb up your ass, or get your own vital signs and move on.."

He got his own vital signs...

Specializes in ICU.
The prison doc was standing with hands on hips, bottom lip stuck out, saying "Who's going to get my vital signs for me?" I had no nurses to spare, they were either out on emergencies or passing pills. My response:

"You can either stand there with your thumb up your ass, or get your own vital signs and move on.."

He got his own vital signs...

HARSH, very harsh...

But I love it!:up:

Well it's up to you guys if I was mean...

A doc I worked for (private practice) thought he was ALL THAT. Now, I did not agree, he was simply OK looking. We did have a few patients who did think so though, and of course since these women just happened to be a bit peculiar to boot, I mercilessly teased him when I put them on the schedule.

One day after the last patient and a hard day, he says, looking down at his chest and seeing two open buttons on his dress shirt, "Hey, Oh geeez, I've been flashing people all day!" I turned around and looked at his chest, and waved him off saying. "Oh, I wouldn't worry, noooooobody's even look'in." Now I meant to calm his fears like I might a female friend, ya know?! But, he looked up at me and frowned and then said, "that's the meanest thing you've ever said to me." (Oh, have I said R O F L yet?) This, the man who told me of his realization (at 42 yrs old) that he must be getting old because when he went bar hopping at his college reunion with his pals, a pretty student told him, "wow you are as old as my dad." Poor guy.

Well it's up to you guys if I was mean...

A doc I worked for (private practice) thought he was ALL THAT. Now, I did not agree, he was simply OK looking. We did have a few patients who did think so though, and of course since these women just happened to be a bit peculiar to boot, I mercilessly teased him when I put them on the schedule.

One day after the last patient and a hard day, he says, looking down at his chest and seeing two open buttons on his dress shirt, "Hey, Oh geeez, I've been flashing people all day!" I turned around and looked at his chest, and waved him off saying. "Oh, I wouldn't worry, noooooobody's even look'in." Now I meant to calm his fears like I might a female friend, ya know?! But, he looked up at me and frowned and then said, "that's the meanest thing you've ever said to me." (Oh, have I said R O F L yet?) This, the man who told me of his realization (at 42 yrs old) that he must be getting old because when he went bar hopping at his college reunion with his pals, a pretty student told him, "wow you are as old as my dad." Poor guy.

Sometimes I see a man between 30-40(not to often though) who looks better than a 20 year old guy....the same with women so I quess he is just an ok looking LOL:)

Specializes in Neuroscience/Neuro-surgery/Med-Surgical/.

I would love to tell the residents to STRAP A PAIR OF BALLS ON AND MAKE A DECISION ALREADY! You don't need to run every order by the attending doc, I am your eyes and ears when you are not here, so listen to the experienced nurse.

Also, if you are going to write an order to notify you when a blood pressure is out of a parameter, please have a PRN medication ordered....and save the attitude, dumbass!

I truly do appreciate most of the residents, but some are just plain SCARY stupid!

Specializes in Medical.

"Thank you for attending this MET call for an unconscious, hypoglycemic patient. I appreciate that you want to assess her GCS for youself. However, a sternal rub is the standard to elicit a response - grabbing the patient's nipple and twisting it hard 180 degrees is not. I'm not sure if you noticed every woman in the room protectively and unconsciously cross their arms over their chests, but it really looked like it hurt. And she didn't respond so iI think we can assume she really is unconscious."

Specializes in Cardiac Telemetry, ED.

Gawd, you're sexy.

Specializes in OB, HH, ADMIN, IC, ED, QI.
The prison doc was standing with hands on hips, bottom lip stuck out, saying "Who's going to get my vital signs for me?" I had no nurses to spare, they were either out on emergencies or passing pills. My response:

"You can either stand there with your thumb up your ass, or get your own vital signs and move on.."

He got his own vital signs...

It seems to me that you've been around the prisoners too long, and have adopted their lingo and attitude!

Professionalism will go a longer way toward having the respect and cooperation of professional team members; and not demean yourself. I hope you didn't really say that. Explaining poor staffing would have gotten the doc to do that, if he did it when you used profanity. That's obscene attention getting behavior that doesn't become a nurse. :madface:

Specializes in OB, HH, ADMIN, IC, ED, QI.
i had the distinct pleasure of firing a pompous ass general surgeon who we had to take for my 13 yo sons ruptured appendix because he was on call that night. wow was he surprised! after a week in the hospital with a wbc that wouldn't go down and a fever and unable to eat or drink with his closed incision draining green supporative (?) viscous fluid and mr. surgeon refused to do a repeat abd ct or change antibiotics-- (i was told every day "maybe just another day and things will improve") i fired him, got a better surgeon who did a repeat ct, which showed multiple pockets of fluid in his abdomen. my son was taken back to surgery that afternoon and received different antibiotics. after that he finally got better but not without an ng tube, tpn and a central line. he lost 16 pounds in 16 days in the hospital. pompous ass has now retired--about 2 years too late.

congratulations on ridding humanity of another inadequate medical practitioner! i'm so sorry you went through that. you wrote "we had to have a {_______ ___ perform an appendectomy on) my 13 yo son's ruptured appendix". (apologies for correcting your english - i have a thing about that).

i assume that you live in a small community with only one medical facility, or there's some financial benefit for getting your family's health care where you work. if not, i'd like to suggest that you use a hospital for your own care and that of your family, where you don't work.

somewhere other than your workplace, you could have asked for the infection control nurse. she/he would have taken a culture of the drainage as soon as you called her about it (without a doctor's order), given the hx of a ruptured appendix. then the most appropriate antibiotic could have been ordered 24-48 hours later, that was specific for the organism found.

meanwhile changing the antibiotic following visual s/s of post-operative infection, to one was known to be effective for most bowel contaminants, should have been done the first physician must have been from the pre-antibiotic era, waiting day by day. it's possible but not probable that your son's infection was nosocomial, but that could be disputed, since rupture had already occurred.

physicians and nurses don't have to be past 60 to have lessened professional capabilities, if alzheimer's disease rears its ugly head. it would be safer if those of us past that age, had yearly cognitive assessments and neurological exams to maintain our licenses. that way embarressing and costly errors wouldn't be happening. malpractise insurance companies have been afraid to insist that those tests be done; and currently someone has to screw up terribly, for action to be taken. it's like the traffic signals that are put up after many fatalities occur at an intersection.....

of course, hindsight is usually 20/20. :twocents:

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