UGH what do you think?!>?

Nurses New Nurse

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I had a pt last night that had a total knee replacement done on the 21st, well this pt last night was tachycardic, irregular HR and running a temp of 102.4. Previous shift medicated him with tylenol and got the temp down to normal. At 0400 lab comes to draw blood and I just happen to see her in the hallway and she states that the pt told her he had ran a fever and she was going to do blood cultures (as she was filling the bottles with blood to do the blood culture.) I thought oh ok couldn't hurt whatever and didn't think anything of it other than I didnt know lab could just decide what labs they thought were neccessary but whatever. At 0730 the nurse relieving me got a phone call from lab saying they had blood culture samples but no orders and that they needed orders to run them. I stated what had happenned and that they were no orders, the nurse getting report said well just write the order. I wrote the order and thought nothing more of it and came home. I was just called at 1400 by the charge nurse and informed that the Dr for this pt was upset and wanted to know why we ordered Blood cultures I told her what happenned and she was very understanding but said not to ever do it again and that she would let it go and not write anyone up. My question is ok I know I should have questioned this more but I was tired and ready to go and thougt it couldn't hurt to figure out why this guy was running a temp after surgery what would you have done?

Specializes in Trauma ICU, MICU/SICU.
I did not call the Dr because this particular doctor will ALWAYS yell if you call him at night. Respirations were fine normal 18-20, O2@2L O2 sats 98%. Never thought about urine dip what does that check for?? Yes dr was aware of temp frmo previous shift his response "give tylenol and I will see the pt in the morning." I did speak with my charge nurse and talked about the possiblity of something being wrong such as PE, UTI whatever. This is amoung one of the MANY reasons I will be leaving this hospital Dr.s are catered to and we are told not to disturb them unless your pt is going down hill. BS that's why they became Dr's and if they don't want to be woken up then they got in the field. I hate that the Dr's here can treat us like crap and we are expected to take it. This particular Dr I called last night for a similair situation and his respons to me was "why are you calling me at 0100 you better make sure no one else needs me for the rest of the night I Do NOT want another call tonight." I HATE this Dr I swear he thinks he is GOD and we should bow down and kiss his feet (um no not me!) Sorry this turned into a rant!:angryfire

Sorry it took me so long to reply, haven't been on in a few days. Sounds like all you had was a temp to work with. Since doc was aware and didn't order anything on days, I wouldn't have gotten anything on nights unless a big change. but, its all a learning experience.

Urine dip looks for protein, blood, ebc's etc. Can be done at the bedside with results in under 2 minutes.

Good like finding a better place. Any chance of getting a job in a teaching hospital.

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Specializes in Med Surg/Tele/ER.
I did not call the Dr because this particular doctor will ALWAYS yell if you call him at night. Respirations were fine normal 18-20, O2@2L O2 sats 98%. Never thought about urine dip what does that check for?? Yes dr was aware of temp frmo previous shift his response "give tylenol and I will see the pt in the morning." I did speak with my charge nurse and talked about the possiblity of something being wrong such as PE, UTI whatever. This is amoung one of the MANY reasons I will be leaving this hospital Dr.s are catered to and we are told not to disturb them unless your pt is going down hill. BS that's why they became Dr's and if they don't want to be woken up then they got in the field. I hate that the Dr's here can treat us like crap and we are expected to take it. This particular Dr I called last night for a similair situation and his respons to me was "why are you calling me at 0100 you better make sure no one else needs me for the rest of the night I Do NOT want another call tonight." I HATE this Dr I swear he thinks he is GOD and we should bow down and kiss his feet (um no not me!) Sorry this turned into a rant!:angryfire

Good for you on leaving! This kind of stuff just makes my blood boil! What person in their right mind would call if it were not necessary? I do not care if a doctor likes it or not.....if my pt is in need, & the doc did not write orders to cover needs...guess what? :idea: Ring, Ring, Ring!

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Specializes in Med Surg/Tele/ER.

double post....

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Specializes in Travel Nursing, ICU, tele, etc.

I would never have let a lab person go ahead and draw labs without my approval. Sometimes phlebotomy will draw an extra tube or two, but blood cultures are a lot of extra blood to draw "just in case". And I would never have had written an order a Doctor never gave me. (Unless there are some kind of standing orders.) That is practicing medicine without a license. You knew that the Doc was aware of the pt's condition, so I guess I don't blame him for being upset.

On the other hand, to feel that you cannot call is absurd. A post surgical ortho patient can need so much that first night, that I think you are so right in getting out of there. I worked ortho for 2 1/2 years and calling Docs that first night was commonplace. Pain control issues were the biggest issue, along with low urine output and fever. Good luck to you with your next position, hopefully there will be nicer Docs to work with.

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I would have called the MD for the temp & tachycardia. I would not care who the doc is! This is your patient and your license. You worked hard for your license! That doc needs to be reported to administration. You should never be afraid to call a MD, thats what they get paid the big $ for.

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