unsafe orders- dealing with incompetent physicians

[jkruger95]

Have you ever worked with a physician who clearly does not get healthcare? A new physician who's unwilling to accept help and advice from nursing staff? A physician who belittles nursing and states nursing staff is incompetent when in fact THEY are the problem? I work for a hospital on a med/ surg unit and our unit has been honored for achieving high HCHAPS scores consistently throughout our organization.

we have a new physician who's come on board and is stating our staff is incompetent and lazy.

the fact is that she enters orders without mindful review and it's up to nursing to clean up the mess.

She is down right unsafe.

I've been in nursing for 16 years and have never experienced something of this magnitude.

I don't feel safe carrying out her orders and would like your input.

I have multiple examples and scenerios, but last evening I was taking care of a patient going through DT's. His blood ETOH on admit 2/6 was .399. He is 36 with diagnosis of pancreatitis. we obtain a withdrawal assessment and administer Ativan IVP per the score we obtained. granted our current CIWA scale has room for improvement, my score and the score the physician obtained were grossly different. She approached me after I had obtained his most recent score which did not indicate Ativan, and was frazzled stating, " he's having head convulsions....he needs Ativan every hour." the patient was sleeping when I went in to assess him. She spoon-fed him answers to our assessment questions so he'd get a high score. by the time she left the room, instead of the patient feeling better as he had reported to me just minutes earlier, he stated he was doing really bad. to an addict who knows he's about to receive Ativan, this would make sense.

the doctor was telling the patient it was important for his nurse to do a thorough assessment and she went through each category with me telling me why she thought he should score higher in each one. for instance, the seizure/ tremor category she wanted h rated 7 the highest score, even though he wasn't tremor ing at rest. her assessment was inaccurate.

I told her nursing wouldn't given Ativan every hour unless indicated per CIWA protocol, so she ordered scheduled Ativan 1 mg debt hour in addition to the PRN Ativan ( to be given per protocol)

i felt bullied and angry and I don't know what to do.

[Mainergal2000]

Get out and quick! So you don't lose your license! I worked for a doctor who belittled us in front of patients and drug reps, found a job while I was there and quit. Can't you report him or her? They should not be practicing if he or she is making you do things that are not for the safety of the patient. You are their advocate.

[jkruger95]

I reported it to risk management today and have requested a formal meeting with the union. this meeting would be for our entire unit.

Can I report her to the board? I'm trying to find out more info on that. I don't want to work one more hour under this physician's orders.

[tmartin83]

This makes me thank sweet baby Jesus that I dont have crappy MDs or residents like this.... Id leave quick, fast, and in a hurry! As first poster stated, you are your patient's advocate, not the doc's butt kisser.