Who writes incident reports, you or the doc

[niteshiftnurse]

After having a terrible nite, I have come to realize that I'm sick of doctors that are rude. I had an admission last nite from the ER, which the pt was seen by the ER doc at 5pm. He arrived on my floor at 11pm. Shortly after his arrival, I had a discharge, transfer to ICU and an admission. There was an order for a consult to be called "today". The ER secretary didn't call the consult because it wasn't STAT. Chart checks on the floor were not done till 3am (that would be the next day) I had to call the doc at 6am because of no order for tylenol for a temp. He asked me if the consulting doc had seen the pt and I said no and explained to him (very nicely) that I didn't get the patient till almost 11pm. He said that the blame should go on the ER for not calling in the consult. About 5 minutes later he called back and wanted me to write an incident report about why the consult wasn't called. At that point I was at the boiling point (obviously he didn't make any points with the nurse in the ER, so TAG.........I was it). I told him if he wanted the incident report made, he should make it himself and turn it in as it was the ER's place to call. Needless to say, I got a visit from the head honcho from the ER and she informed me that it was the DOCTORS place to write the incident report. I already had it done so I gave it to her. Just wondering if anyone else has had this happen to them. While I still had my feathers ruffled, I asked her why a doctor would order a diet for the patient, po meds and accu checks when the patient was NON_RESPONSIVE. I really don't think he even saw the patient. She said that was a good point.

[whipping girl in 07, RN]

I have to agree with the person who said, let the doc write the incident report, since HE had the problem.

Reminds me of a recent incident where a doctor had not seen his patient in ICU all weekend. He made his "rounds" via phone, calling to see how the patient was doing, etc. During one of his phone calls, he asked how the patient was tolerating getting OOB. The nurse told him that the patient had a sat of .88-.90 on 1.00 NRB and therefore she had not gotten her up for fear of desatting. He told her to put an incident report on the chart so he could write her up for not following his orders. The nurse had been calling the doctor's house and cell phone all weekend (does not use an answering service so there's no paper trail when he can't be reached) trying to get some help with the patient's respiratory status and was getting no answer. When he'd "round" by phone, he was updated but gave no new orders. So after all this happened, the nurse was getting ready to leave and was telling me about it. So I asked her if she'd written the doctor up for not seeing his patients (or having a colleague make rounds). Of course she hadn't, so she called him back and told him that if he was going to write her up for not getting the patient OOB, that was fine because she could justify her actions with her nurses notes, but she'd be forced to write him up also for not seeing his patient.

Long story short...no one wrote anyone up, and he sees his patients every day now or sends a colleague. Still doesn't use an answering service though.

[Mimi2RN, ASN, RN]

If a doc wants a consult, HE SHOULD CALL FOR IT HIMSELF. How else can he discuss his patient. We never call in consults, it is always up to the PCP or attending to do it themselves.

As far as incident reports, it is up to you to write them if you choose, but don't write it for someone else. If he wants to complain, he'll find a way to do it. I would want to be writing a report on his obnoxious behavior!

[niteshiftnurse]

Just found out today that from here on in, if a doc tells you to write an incident report, we are supposed to tell him if he wants one, he has to write it. HAPPY DAYS ARE HERE AGAIN