I just want to vent out a little because I had to call a doctor at 7PM because my patient was complaining of alot of things. First chest pain that radiates to her back .They did trops, X-RAY and ECG they were all negative. However, at the beginning of my shift she was complaining of numbness and tingling on her face all morning and reported to the MD since potassium was low. He ordered for a replacement to that. However all vitals were normal.
Few minutes after that I was called by my supervisor and was told not to call the doctor and to call her first. I don't know, but I feel like that my call to the MD was not valid.
I just want cover myself because what if this patient complaint was really something? Then they would asked me why I did not do something after finding out the patient report.
Just kinda discouraging to start my 12 hour shift.
I had to call a doc to report hgb of 6.2 at 2330 one night. He was very angry (politically correct) and hung up on me. Then he called the charge nurse and said I could never call him again, all calls from me had to go through charge. Charge told me to not be offended, he did this with all the nurses.
A few years later he was put in prison for all kinds of bad things.
Our patients get sent home, or sign themselves out AMA. If they come back within 30 days of release, we don't get paid. And of course they come back because they live on the streets or don't have the money to comply with discharge instructions. I'm surprised we have a job at all, according to highers up, we never get paid for anything.
This is all facilities, profit and non profit. But believe me, execs getting their cushy bonuses regardless
Tell em to give a policy and procedure for md notification . Hospitals suck balls nowadays they try to be bad and good . No sir your one or the other not both . Get the policy in writing and follow it to a T . Them supervisors are nothing but some nurses that couldn’t cut the floor work and they sail you down the river like Moses if they get the chance .
Tell em to give a policy and procedure for md notification . Hospitals suck balls nowadays they try to be bad and good . No sir your one or the other not both . Get the policy in writing and follow it to a T . Them supervisors are nothing but some nurses that couldn’t cut the floor work and they sail you down the river like Moses if they get the chance .
This is all facilities, profit and non profit. But believe me, execs getting their cushy bonuses regardless
I have only worked in this hospital lately. That's good to know. We still ain't getting paid because they always comin' back for the drugs, if nothing else.
- old dude with dementia, on top of many other things, had no BM x 48h on appropriate bowel regiment. A nurse decided to manually disimpact him. At 3 AM.
Patient became acutely agitated, then delirious, then ended up in restraints in ICU.
When I found that genius of nursing, the first thing I knew that she was feeling like by doing this (please insert politically incorrect expression of your choice) nursing intervention she was advocating for patient. Then I was asked in the most naive tone one can imagine: "so, we should call you every time if we feel we need to do something on behalf of the patient?"
Ling story short, this nurse won't call me any more, because I won't let her closer than a mile near anyone I take care of. Name me an evil provider if you like after that.
Your call to the physician was appropriate. The nurse manager at my previous job tried to make a rule that night shift nurses have to ask the charge nurse permission to call a doctor. At that, I laughed in her face. I doubt your supervisor knows enough about your patient to make a judgment on whether or not the patient’s symptoms are “something” or “nothing.” I would not recommend calling your nurse manager before an MD because she cannot legally give orders for the patient. You are the one who is ultimately responsible for this patient, not the manager. And as someone else said, if something happened to this patient, your manager would 100% throw you under the bus. I don’t recommend my approach of telling the doctor if they are on call I will call them about anything pertaining to a patient if I feel it is appropriate to call, regardless of the time, unless they specifically state, “don’t call me about this patient again.” I then let them know this will be documented as an order in the patient’s chart. :)
I had a dear friend who worked in Critical Care for many years. When a young doctor started getting irritated and angry about middle of the night phone calls, she took him aside and told him that if he continued to act that way, the nurses would quit calling him, and he might not be informed of things he needed to know. He took it to heart and became one of the easiest doctors to call. Words of wisdom!
Worst case scenario? If your patient is deteriorating, then one benefit of calling a Rapid Response is that it gets the attention of multiple other people that may (or may not) agree with you. It's sad, but when I worked the floor I did see nurses that had to go "over their doctor's head" with a rapid response to get taken seriously (and their patient taken care of).
I did that and got written up for “questioning orders” ?
Keep calling and document everything he says including if he says anything about not calling him.
Nope, that does not belong in the patient's health record. That belongs on an incident report. Certainly document every time you called the provider and what if any orders were given.
If she doubles down on the call her first thing let her know that you’ll be documenting that in the chart as well.
Nope, that does not belong in the patient's health record either. That too belongs on an incident report.
Dirty laundry belongs on an incident report not in the EHR and you have a chain of command -use it.
The purpose of the incident report is for quality improvement purposes and that includes internal peer review of physicians and mid-level providers.
If the problem is with a resident, fellow or intern make your concerns known to the attending.
KatieMI, BSN, MSN, RN
1 Article; 2,675 Posts
Well... to begin with, do you REALLY still believe to higher ups about anything in the world?