What doctors do that bugs you...

[33-weeker]

1. in our nursery, the charge nurse assists the pedi while rounding. there's this one pedi who will ask questions about a baby (was mom's gbs neg., etc.) as she is looking through his/her chart.

'uh....well....um... you've got the chart.'

i actually said this to her once. she said, in a somewhat irritated voice 'that's ok, i can look it up', i replied 'i don't mind looking it up, but you've got the chart.'

2. obs who manhandle women's bottoms and then get mad at them when they aren't effective at pushing their babies out. you know, it's not just about pushing well, it's about being able to relax the muscles in your bottom at the same time. the woman relaxes in between, then as soon as another contraction comes, he begins poking, prodding and pulling - you can watch her tense and pull away from him, all the while trying her best to push, poor woman. i just want to shove him out of the way and apply a warm compress instead - way more effective. how about working with her body instead of against her.

is it just me, or does it seem like everything is going great, and then (some) obs gets there and mess it all up?

3. ob's who induce/section for no medical reason. :angryfire

4. obs who complain about the apgar scores.

(this especially bugs me when they fuss out loud to everyone in the room. just give the family a heads-up to sue why don't ya! )

you want to give 'em, doc? then you sign your name to them!

5. doctors who are so macho that they will do the opposite of what a nurse suggests just because they can - regardless of what is best for the patient.

some of us get wise to this and use reverse psychology to get what we want. :rotfl:

[flytern]

We have a doc in house between 8pm-6am (I work nites). The whole point of the in house guy is for discharging walkins, making precip deliveries, assist w/csections...

Never happens, walkin's who could be discharge, sit around to the morning, heaven forbid should be MD wakeup and discharge them. Even though the MD is 5 minutes down the hall, they usually miss a precip delivery.

Assisting w/secions, call them when the surgery is called, call them again when the primary MD is here, call them again when the patient is on the table.... because we have nothing better to do!

We also have an MD (who is as old as God himself). who makes sure every patient knows that thanks to him, the patient and baby are alive and well. Every delivery is a touch and go situation. Every babe (3 lb to 10lb) is a shoulder dystocia. Every decel (during pushing) is a crisis, that he's adverted. It gets to the point we can't even look him in the eye during a delivery, because he says the same speech each time!

However, he really is a good guy, gives his patient's good care, can't remember anybodys name.

[twotrees2]

I don't work OB, but I hope I can play. . .

I hate it when the MD downsizes a patient's trach and leaves the old one laying on top of the dresser with secretions drying to it (and not telling anyone of course). I found it several hours later. Gross.

~Jen

(for those whose MDs leave sharps for you to clean up, there should be, and most likly is a way for you to report/write up that. If not only through OSHA- not safe.)

i hate when docs come in to see a resident dont tell you they are there and later you find orders there not even knowing they had been there -

[twotrees2]

I have considered for years that it is quite possible she is bipolar. I have learned you have to take the proverbial bull by the horns and be very direct with her, as well as non-emotional, and set some boundaries. It's the only way to deal with people like this. But they wear on you, you know? And if she is bipolar, she should be on meds, not abusing everyone around her.

But like I said, half of what bugs me about this, is all of us staff have the same complaints w/this one dr. We have vocalized them on many occasions with our manager. To no avail, of course.

If this were a nurse causing such misery in others, she would be SO GONE yesterday. It's so unfair.

let me gues , they tell you without the doc you have no residents - at least thats what we get when we voice concerns about docs behaviors - in other words rhey tell us to just put up with it

[twotrees2]

Doc's that just cut you off midsentence when you are trying to talk to them. It is so rude!

Residents who use the reason I was making rounds to not return a page. We don't page you for fun.

or the on call doc yelling at you for calling them about something that isnt thier patient and it had been going on all day but days never took care of it - like its my fault noone on days took care of it.

or docs who call back and get angry cause you have to put them on hold to go get chart so can give accurate info cause you are all the way down the hall in a patients room. or get mad you dont answer page right away cause your in middle of treatment - well - then answer MY page or call right away - i got work to do too - cant just sit around all day waiting for a call back nor can i carry a residents chart from room to room so its with me at all times - not to mention the nearest phone is all the way down the hall................

docs who complain that test results stat arent in yet - excuse me but the lab and xray comes 2 hours to get here and by time they get back a stat turns into at least 5 hours - YOU call the lab, etc and complain...... we are not a hospital with our own lab etc

docs with bad handwriting that we have to call or fax for clarifying what they wrote getting mad - if they wrote neater maybe we wouldnt have to call

oh and docs getting mad at me cause on call doc orders something other than they would have - well then - dont have on call docs give us your home phone and we will be happy to call only you......

[SmilingBluEyes]

let me gues , they tell you without the doc you have no residents - at least thats what we get when we voice concerns about docs behaviors - in other words rhey tell us to just put up with it

oh yea exactly. We have been told to "do our best".

[twotrees2]

This isn't really an OB thing, but it DOES drive me nuts.

When I have a patient on the medical unit who is a mouth-breather and is "comfort cares only", one or two doctors write irritating orders, like an order for "good mouth care" or "mouth care QID". It drives me crazy because that is NURSING CARE!!! Do they think we don't know when our patients need mouth care??

I was very tempted to write a note to the doc who ordered mouthcare QID and let him know that we're actually doing mouth care q1hr, but thanks for the suggestion. He may as well have written an order for nursing care PRN.

unfortuantley some of us have had to ask for orders like this as no matter how much we talk to cnas, nurses to watch cnas and directors who dont even approach it cause thats a minor issue to them - sad but true.

oh heres another i just had the other day - the discharge stated skin intact - but upon assessmnet the resident had a 2 in incisoin draing from a cyst they had lanced - no orders for wound care and doc got mad we asked for some and said "just put a 4x4 on it for heavens sake" - yeah well ok but we still need an order for something like this and it should have been reported he had t to begin with!! - sheesh.

[augigi, CNS]

Do you need orders for wound care? Isn't it nurse initiated there?

[twotrees2]

Do you need orders for wound care? Isn't it nurse initiated there?

with this type of incision some want packing to keep it open to keep draining and some dont - cant just make up a dresing in my opinion with an incision- for scrapes, skin tears , mild ulcerations we have protocol which addresses this and we choose the right one but when an incision comes in i belive anyhow it shoud be asked for. matter of fact the last lanced area i had the doc wanted packing to keep it open and heal from insideout - another doc with same type of incision just wants a 4x4 - big difference and out of my scope of practice to preescribe which dressing they want. and i think i wsa most annoyed that the discharge said skin intct and i go to do my skin assessment find a dressing on an area take it off and find an incision - thats not intact by any means.

[HMtravelRN]

Hmmm... What do doctors do that bugs me...

BREATHE !!! [EVIL][/EVIL]

:rotfl:

[wooh, BSN, RN]

2. If MD calls to send in induction, but there's no room at the end, magically this patient has all kinds of problems (PIH w/ a blood pressure of 100/60)

or macrosomia (would 1 more day in utero be that much of a weight gain?).

When I was doing adult med/surg, we had a patient throwing a fit about getting a private room. We were full to the max, to do that required lots of shuffling, and actually moving someone from a private to semi-private. When we said we couldn't do it, he ordered a stool for c-diff, which automatically put her on contact precautions and got her a private room. I enjoyed repeatedly charting no stool sample r/t no bowel movement at this time, pt reports last BM x hours ago. Finally 18 hours after the order was written, I got to chart, "Moderate sized hard formed stool sample sent to lab." When the stool goes "clunk" into the cup, it doesn't take the lab to tell you it's not c-diff!:chuckle

[LDRNMOMMY, BSN, RN]

We had a doc the other day induce a pt with Pit who was 38 3/7, primip who was orginally admitted for obs after an MVA. After her period of obs was over she wrote orders for breakfast then NPO for Pit once a room became available. We were in a jam for beds, holding postpartum patients no room at the inn. The charge nurse called her to question the order and the MD's response was "She is term with no evidence of abruption, I am not going to send her home so something can happen" Like what?? Go into spontaneous labor when the baby is ready! Oh yeah her cervix on admission was 0-1/thick/and high. Her stip looked beautiful the whole time she was obs. There was no medical reason to induce her!

[NurseNora, BSN, RN]

I called the physician in the middle of the night with this report: "Your patient Susi Smith is here; she's a multip, 8cm, 100% effaced, +1 station. I need you to come in now."

He took longer than usual to come in and missed the delivery--because I sounded calm and didn't tell him he had to hurry!