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.

thanks i already work with a dvm (vet) so i do have some idea, but i definetely think working with people is a lot more serious than workin with animals. sometimes i want to tell him things, but i realize that im not going to let a man with a bad temper ruin my day!!!

Specializes in Med/Surg.
Ouch! There's a scarily accurate undertone here...with some bitterness and frustration thrown in.

MDs are part of the team like everyone else. I hate how those in healthcare get so territorial about their role. Some RNs snub Aides and LPNs, some RNs are bitter towards MDs (for their own reasons most of the time it seems). I have heard of techs being snubbed by RNs even thought they have the same education (or more).

I have heard the horror stories, and yes, some doctors are complete idiots. Literally or figuratively. But respect goes both ways. Being a nurse is hard, being a doctor is hard. Sure the MD may not be running around changing IV bags, doing dressing changes, or inserting catheters, but that's not what they went to school for. They're figuring out the best way to treat a peds patient with cancer, manage a high risk pregnancy, or diagnose a rare disease. Pressure's on! You are ultimately responsible for that patient. MDs don't go to school for 10-12 years on average for nothing, even though it may seen that way to some. ;)

It may be a generational issue. As I recall, previously, nurses (RNs) didn't typically have much education (2 years only?), and their job was technical in nature. As such, they were subservient to the (usually male) MDs. We can thank Florence Nightingale for that. Why the FN crap is still taught in nursing courses today I'll never know.

Anyway, educational requirements have expanded, nurses are highly trained, highly competitive programs have attracted better, more capable students, and nursing stands on its own as having a scope of practice and autonomy. Also, most MDs today do not subscribe to the old hierarchy. Most see other staff simply as team members. I think that as the 'old school' doctors and nurses retire, there will be less politics.

All of that said, here's what I'd like to say:

"Yes, I'm obtaining a diploma in bed pan emptying and @$$ wiping. Of *course* that's all I'm good for".

P.S. I LOVED the OPs "hermaphrodite" comment. Hilarious! I almost fell off my chair. :D

If you're going to throw in your own example, then that negates all of your posts here telling us how wrong it is to vent. So just stop.

You're not saying anything that anyone here doesn't already KNOW. That doesn't mean we can't vent (as you obviously realize, YOU DID TOO). The point is venting, and it doesn't matter why.

The old "only 2 years" thing isn't so "old".....I have an associate's degree, and my job isn't just technical in nature, nor am I subservient to the doc. So check yourself, please.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

"so you don't want dr. jones involved in care of your patients? not much i can do about it. dr. jones is the intensivist this week. if you don't want him taking care of your patients. stop doing surgeries until he's off service. and by the way, i will not be discussing this with dr. jones. if you want him told that he's an incompetent donkey, *you* tell him."

"cpr is more effective when the chest compressions are done on the chest rather than on the abdomen. and no, i can't step in and do them for you. there are 7 mds and 3 medical students in here, any one of whom could do cpr -- and i know because i signed every one of them off on their bls -- but i'm the only nurse."

"i know the patient's wife is certifiably crazy. i know she's a pain in your behind, that she's called you every day for updates and that she screams at you every time you talk to her. but i will not go back and tell her that you're dead and can't speak to her. suck it up and deal."

"why yes, dr. smith. i'd love to have dinner with you after work tonight. i'd love to meet your wife." (actually i have said this. funny, but i've never been to dinner with the physician, either. as soon as the wife gets mentioned he remembers a previous engagement.)

Specializes in Cardiac Telemetry, ED.
Thank you for all of your posts. They were a logical level-headed breath of fresh air. I know this thread is supposed to be funny (and I can appreciate humor) but trashing healthcare team members is unfair. Some of this is too far. Both sides need to work together. The anger and bitterness that is evident in nursing obviously has complex causes that can't be addressed overnight. But I do think that everyone should at least do their best to be professional and polite, to everyone.

If you are truly unhappy with nursing, consider another career. There are lots of other options in healthcare. Instead of complaining, if you think that you can do better, why not go back to school and apply to med school and become an MD yourself? Actions are what is needed to make a difference.

The way I see it, you don't make it through med school by being an idiot. If you think nursing school is tough, it pales in comparison to med school. Those people worked their asses off to become MDs, and typically, they get my respect just for having the letters "MD" behind their name.

However, and you will see this once you are out of school and are a practicing RN, what these RNs have seen- the things they are venting about- MDs dropping the ball, MDs acting like jerks, MDs discounting the observations of nurses, patients being harmed because of MD incompetence/arrogance/not giving a crap and so on, really do happen out there in the real world.

Does it mean I have a problem with all MDs? Does it mean I am unhappy with nursing? No and no. In fact, I really do like the majority of doctors I work with, and I am glad I'm a nurse.

So please, do not preach to me about professionalism, respect, or my career choice. If, as you say, actions are what is needed to make a difference, then why don't you stop posting on AN and go to med school yourself?

Specializes in Operating Room Nursing.

I have a funny story on what I did tell the doc and got away with a few days ago...

We have a radio in my operating room. Some surgeons are quite happy and even insist on some music in the background, others do not like music and ask for it to be turned off. I'm quite happy either way.

I had the radio on and this fellow-Dr X (not a consultant, a visiting surgeon from another country) came in and turned it off. During the case I asked what happened to the radio? The other surgeon (Dr Y) said that Dr X wanted it off, but he really wanted the music on. Doctor X said that the nurses want the radio on, Dr Y wants the radio on, the anaesthetist wanted the radio on, but that didn't matter because HE wanted the radio off!.

There was a silence and everyone in the room just looked at him like he was a complete idiot.

I said to him 'this is MY operating room, I clean it, restock it and work here everyday therefore it is MY radio and I say that I want it turned on'. I then asked the scout nurse to please turn the radio on.

Had he asked nicely for the radio to be turned off I would have no problems. But I cannot stand arrogance and such obvious disregard for the team.

We nurses are still getting by sharing one tiny filthy dirty break room with every tech on two floors. Our coffee machine is actually off limits to us now, with the so-called "recession." We actually have to bring in our own coffee now. I bet you all have a great coffee machine up there in your lounge, though.

Are you kidding!?? A coffee Machine? I'll be they have their own Barrista! ;)

I'm sorry, I suppose we just don't share the same views.

It's not that I am opposed to you venting, rather I just wanted to address the fact that another poster on here claimed to be rather disrespectful and unprofessional towards an MD (another member of the team). In fact, it was another poster who pointed this out.

I don't think my point was necessarily offensive. There's a difference between actions and words. I was simply addressing that. Albeit in perhaps not the best way.

Thank you for your advice, and I do plan on applying to med school (no flaming please). Hence why this is a personal sore spot for me. I'm sick of the hierarchy in healthcare. I hope that I will be part of the new generation of doctors who values the input from nurses.

I hate seeing the negative comments, as it reinforces the many stereotypes that people have already. Nursing is known for lateral violence. No need to extend that perception. Denying this won't help, but acknowledging it can.

I'm all for venting, but actions are another story. That was my main issue, and it was directed primarily at one poster. Instead of focusing on my comments, perhaps we should be finding out why the OP handled that call the way she/he did. As suggested earlier, the MD likely was looking for the RNs input.

P.S. We don't offer 2 year RN programs in Canada anymore, almost all provinces require 4 year degrees for RNs. LPNs now have a 2 year diploma. In my case, it IS true that nurses have a higher level of education than they once did. I was simply pointing that out. Personally, I don't care if you are an LPN (2 years), RPN/Psychiatric Nurse (3 years), or RN (4 years).

I hope everyone lets this go. Back to venting....

ouch! there's a scarily accurate undertone here...with some bitterness and frustration thrown in.

mds are part of the team like everyone else. i hate how those in healthcare get so territorial about their role. some rns snub aides and lpns, some rns are bitter towards mds (for their own reasons most of the time it seems). i have heard of techs being snubbed by rns even thought they have the same education (or more).

i have heard the horror stories, and yes, some doctors are complete idiots. literally or figuratively. but respect goes both ways. being a nurse is hard, being a doctor is hard. sure the md may not be running around changing iv bags, doing dressing changes, or inserting catheters, but that's not what they went to school for. they're figuring out the best way to treat a peds patient with cancer, manage a high risk pregnancy, or diagnose a rare disease. pressure's on! you are ultimately responsible for that patient. mds don't go to school for 10-12 years on average for nothing, even though it may seen that way to some. ;)

it may be a generational issue. as i recall, previously, nurses (rns) didn't typically have much education (2 years only?), and their job was technical in nature. as such, they were subservient to the (usually male) mds. we can thank florence nightingale for that. why the fn crap is still taught in nursing courses today i'll never know.

anyway, educational requirements have expanded, nurses are highly trained, highly competitive programs have attracted better, more capable students, and nursing stands on its own as having a scope of practice and autonomy. also, most mds today do not subscribe to the old hierarchy. most see other staff simply as team members. i think that as the 'old school' doctors and nurses retire, there will be less politics.

all of that said, here's what i'd like to say:

"yes, i'm obtaining a diploma in bed pan emptying and @$$ wiping. of *course* that's all i'm good for".

p.s. i loved the ops "hermaphrodite" comment. hilarious! i almost fell off my chair. :D

ok.....you are taking this way to seriously. in healthcare we have alot of things we do say to each other and dont say. in most places it is no longer the doctor is the captain of the ship. now...healthcare is geared towards a team approach. and some of the things i wrote...i have have actually said. but...it was said in the right place , at the right time. you dont ever ...ever....ever place blame when a event happens and it is clear that it is the result of one persons actions/inactions. but...it has to be addressed and yes...as healthcare team members we ahve toaddress the behavoir so it wont reoccur. and yes...those of us that have been nurses a few years ...and have that good rapport with the md's can use morbid humor to "get their attention". it works....in a non demeaning way. it is all about who you say it to, where you say it....and the rapport you have with that individual doctor. the actions/inactions of all all healthcare team members can kill patients. you have to keep a good rapport with everyone....and sometimes morbid dry humor...helps address issuesso they wont affect the next patient. ok?:idea::yeah:

I'm sorry, I suppose we just don't share the same views.

It's not that I am opposed to you venting, rather I just wanted to address the fact that another poster on here claimed to be rather disrespectful and unprofessional towards an MD (another member of the team). In fact, it was another poster who pointed this out.

I don't think my point was necessarily offensive. There's a difference between actions and words. I was simply addressing that. Albeit in perhaps not the best way.

Thank you for your advice, and I do plan on applying to med school (no flaming please). Hence why this is a personal sore spot for me. I'm sick of the hierarchy in healthcare. I hope that I will be part of the new generation of doctors who values the input from nurses.

I hate seeing the negative comments, as it reinforces the many stereotypes that people have already. Nursing is known for lateral violence. No need to extend that perception. Denying this won't help, but acknowledging it can.

I'm all for venting, but actions are another story. That was my main issue, and it was directed primarily at one poster. Instead of focusing on my comments, perhaps we should be finding out why the OP handled that call the way she/he did. As suggested earlier, the MD likely was looking for the RNs input.

P.S. We don't offer 2 year RN programs in Canada anymore, almost all provinces require 4 year degrees for RNs. LPNs now have a 2 year diploma. In my case, it IS true that nurses have a higher level of education than they once did. I was simply pointing that out. Personally, I don't care if you are an LPN (2 years), RPN/Psychiatric Nurse (3 years), or RN (4 years).

I hope everyone lets this go. Back to venting....

In the medical school you will enounter many negatives thoughts about nurses,this is a no win-win battle.

My favorite thing Id like to tell them....gee...so many to choose from...hmmm

1. Yes doctor ,..I completly understand why you didnt want to give them anything for that low blood pressure.Umm hmm...yep makes sense to me . Ahh...by the way can you grab that zipper there for me . You know I always DO have such a hard time zipping up these darn body bags.

2. So...let me get this straight doctor. The patient is still breathing 54 times a minute, they are so lethargic that they will not even open their eyes to voice anymore....and you want to know why I am calling you. Hmmmm.....ok. I tell you what. Ok...I am so very sorry I disturbed you.....tell ya what. Hows about I just give ya a call back in lets say 2 hours when they go apneic. That would be 3 am. Would that time work for you?

3. I am old , tired and my back hurts. If you arent going to put them on a drip to raise their blood pressure . You need to bring your a** down here bc I am telling you right now I am NOT going to do chest compressions on them.

4. Can you repeat that in English please? Ok...you dont seem to be understanding me. can you repeat that in English please? Oh...your english skills are not very good? Hmmm...maybe if you just ...did charades Id get the jest of what you are saying. Do you know charades?yeah...that might work. who needs to really know how to speak english....Hey ,maybe we can save the hospital a few bucks ...instead of the communication interpretation phone line I can just start doing my discharge teaching in charades. You can do your consents in charades.You can draw a line across your neck and say you discussed the possibility of death r/t the procedure. I can see your point....yeah...really who needs to know how to Reallllyyy speak english?

5. really? It doesnt bother you that the patient used to could walk and talk and now they cant? You really dont think that warrants a phone call at 1 am? See doc...thats what I thought too....but the patients son got real upset when grandma got out of bed to go to the bathroom and kept dragging that whole right side around. hell ...its right amusing...granny just keeps going round and round in circles. You are completly right! I shouldnt have called u. I understand your rational completly. I mean....talking is way overrated. I mean ...I understand where you are coming from. If she hasnt said all she needs to say by the ripe old age of 63 then its her own darn fault.

An example being....I have said all but one of these things to a doc....in the right place...in the right setting to get my point across with dry humor and to KEEP THE BEHAVOIR OF THE MD from reoccurring. I used dry morbid humor....to get that point across....when I have a good rapport with the doc. they do the same with us. But we work together as a team....not as anything else. It works out better for the patients....we work well as a team...and have the mutual respect for each other so we are "OK" to address issues without offending/demeaning one another.It goes both ways though. They use the same dry humor to address issues with the nurses. The other day we were getting ready for a evd ( brain drain placement)...we use nonpreservative saline to prime the line. having an off day one of the nurses stood back ...looked at the set up....and said to the doctor....somethings wrong, what is it that I dont have here? The same doc I did the body bag comment to, picked up a vial of the saline she had used to prime the line and said " ok...after I put this in....will the patient be considered pickled or pruned?".It was the saline filled with preservative. LOL....he used dry humor ...got his point across....now every time she sets up for the EVD placement she will not repeat that same error. That...is an example of how you can use humor to say what needs to be said ....in a non demeaning way. It is our way of keeping each other in check and working in a cohesive team atmosphere. This...team approach is mandated by our attendings and CNO. It works .....it improves pt safety...addresses things that need to be addressed....it works for us.

Specializes in Recovery (PACU)-11 yrs, General-13yrs.

What I would REALLY like to say when the doc has a major tantrum about not getting what they want-equipment that someone else is using, specific OT room, bed for pt when the hospital is full- "Just because you're having a tanty does not mean that I can pull the solution out of my a**e and make the problem go away. I do not keep a secret supply of stores there for just such an occasion as this"

and also "If you want to be friendly that's great, if you want to be professional and distant, that's great, but do not change from one to the other. Be consistent"

With reference to respect etc etc. I'm sure we all treat the docs with respect and professionalism, but if that isn't reciprocated it's a very difficult thing to keep going. And have you noticed that the nice doc's have less problems with their patients than the snarly ones? I loved the plastic surgeon who always ended his phone calls with-'thankyou for letting me know' after I called re the pt's temp of 37.5, (cos that was part of his protocol-contact if temp 37.5 or more!) He was such a control freak that he was easy to work with, everyone knew exactly what was expected, and he was always a gentleman, and did beautiful work-just a shame he retired as we all got old enough to need his services!

Specializes in ICU, Telemetry.

To the idiot doc who asked me what medical school I went to because I started a sentence "Doctor X, I'm very concerned about Mr. X's latest troponin--"

I don't have to be a meterologist to know that it's raining, and I don't have to be a cardiologist to know that a pt with a hx of prior MI, with a troponin of 4.9, SOB, diaphoretic, C/O "elephant on my chest" and a BP of 210/180 needs to be in ICU -- forget that, needs to been in freakin' helicopter on his way to the flagship hospital in the capital. And as soon as I can control the urge to kick your sorry, lazy, stupid self satisfied gluteus maximus from here to the Pacific, I'm calling the admin rep to see if we can save the pt.

BTW. Pt died.

+ Add a Comment