Wish I Coulda Said It Out Loud!

Published

Specializes in Utilization Management.

Ever have a thought pop into your head but you just didn't dare say it then?

Here's your golden opportunity!

Had to wake a doc up at 0400 for an order due to a significant (read: very very bad) change in patient condition. So of course, the doc yells, "You woke me up for THAT?!"

What I said: Yes, Dr. I did. Would you like to treat the patient for that now?

What I wanted to say: You idiot, you're the ON-CALL! Just what did you think ON-CALL meant when you took this job?! :Crash:

Up Vote Up Vote ×

I have had a similiar situation with a CHF patient in declining status who was DNR/DNH. Doc spoke to me like I was 12..."And what happens when we have CHF Tres?" Ended up with doc lecturing me. MY response "Gee doctor I didn't realize DNR/DNH meant DNT." Dead silence "DNT?" me "Do not treat" He then hung up, 10 minutes later he called back. (Good thing too, I was getting ready to call our medical director.) And he changed the necessary orders to provide relief for this dying gentleman.

Sometimes.......

Good for you for hanging in there and getting what the patient needed. I work with some nurses who will not try again or call specific doctors on NOCS.

Take Care,

Tres

Up Vote Up Vote ×
Specializes in Utilization Management.

Good for you for hanging in there and getting what the patient needed. I work with some nurses who will not try again or call specific doctors on NOCS.

Oh, I just love waking up crabby, egocentric docs for decompensating COPDers in the middle of the night. It's what makes my job fun. :chuckle

Welcome to my world.:thankya:

And now, back to the regularly scheduled thread....

Up Vote Up Vote ×

Doctors sometimes think they're "The Lords of the Knowledge". And some even think it's their mission to teach nurses, these little flies that keep reminding them of the so called patients who need care!

But there are exceptions...

Up Vote Up Vote ×
Oh, I just love waking up crabby, egocentric docs for decompensating COPDers in the middle of the night. It's what makes my job fun. :chuckle

Welcome to my world.:thankya:

And now, back to the regularly scheduled thread....

You know really kills me......these are the same doctors that order a patient to be extubated at 8pm. Well......yah things can go wrong why do they order an extubation in the evening.

Up Vote Up Vote ×

I say yes, I woke you up for this, do you want to give orders or do you want me to call the attending? Works everytime. One surgeon left orders not to be called unless patients BP dropped to or below a certain level. Guess what, he was dropped while Doc was still in facility. Had him paged, he yelled at me, and I yelled right back. He came back, problem was fixed, and after that every time I dealt with him he was good as gold. He even admitted he hated to cover call for that particular floor because the patients were "so touchy". I just looked at him and said, "get a new job." He said that was a good idea and got one. Now he does only out-patient surgery. Minor things that usually have no problems.

Up Vote Up Vote ×
Specializes in LTC, assisted living, med-surg, psych.

Yes, thank God, there are exceptions, and they are worth their weight in gold!!

Here's an example: A while back, I had a post-CVA pt. whose systolic blood pressure had been climbing slowly but surely all day, and was edging up into the 170s when I came on at three PM. Naturally, I was concerned, so I phoned the MD to see what we should do to get it back down. He told me he was OK with that, and even didn't mind if the pressure went a little higher......then he explained to me, in detail, what he himself had learned from the latest medical studies that advised doctors not to lower BP too rapidly in CVA pts. Evidently, the quicker you lower the BP, the less blood there is to perfuse the vital organs, and of course decreased perfusion can extend the damage to the brain caused by the stroke.

Well, DUH.......makes all kind of sense to me. :idea: The thing that impressed me the most, however, was the way the MD involved me as a collaborator in this patient's care by sharing his knowledge with me. I've never forgotten that, and since it wasn't common knowledge at the time, I made sure to share it with my co-workers, which I'm sure the rest of the docs came to appreciate since they no longer got these frantic calls about moderately elevated BPs in the middle of the night! :)

Up Vote Up Vote ×
Specializes in Skilled nursing@ LTC.

How about " Maybe if you came more than once a year to see your family member, maybe you wouldn't be so shocked about the way they look, act, etc. I just love the family members who come in once a year and can't understand why their family member looks so different from the last time they were there. The urge to tell them off is almost overwhelming :doh:

Up Vote Up Vote ×
Specializes in LDRP.

Lazy students who say something along the lines of "I'm going to fail because of her" (referring to a professor/clinical instructor/etc). I want to say "No dear, you are failing because of you!"

Up Vote Up Vote ×

working in hospice, there was one md who consistently would order mso4 2mg sl q4h prn, even those with the fungating ca's or bone mets. and he happened to be our medical director and S-T-U-B-B-O-R-N.

what i said: ok dr. so and so, i will call you back to report that the patient remains in excruciating pain and ask for further orders.

what i wanted to say: YOU STUPID, IGNORANT S.O.B.- IS THIS WHAT YOU'D ORDER FOR YOUR MOTHER WHEN YOU SEE HER GRIMACING AND HEAR HER MOANING, GROANING, CRYING AND SQUIRMING IN PAIN?!!!!!!!!

Phew....that got alot off my chest. :rolleyes:

inevitably i told the medical director that i already had charted in my nurse's notes the md order, my response, patient response, callbacks for further orders, md response, patient response.......eventually he got paranoid about the implications of undermedicating and asked ME what i wanted for pain relief. and he agreed. and these patients passed peacefully ever after.

2mg, U-N-B-E-L-I-E-V-A-B-L-E.

Up Vote Up Vote ×
Specializes in Education, Acute, Med/Surg, Tele, etc.

Hey but then you have your oncall switcharoos! I had one doc talk down to me for a patient that was in significant pain over the weekend. Oh he was so mad that I called! He ordered an IM injection (can't remember what it was now..it was about 3 years ago) and I had to tell him that my facility (assisted living) didn't have those available. Oh man that really set him off! I told him any PO medications are fine, and that I can get an oncall pharmasist or if he really wanted the IM injection I could send her to the ER for evaluation and treatment. He was just nasty and ordered a PO...and lucky for me I kept my cool the whole time!

Then about a week later or so I had to call him about something else, this was during office hours though. He yelled at me that he wanted to know EVERYTHING about his patients immediately when they occur! Umm duhhhhhhh I did and he screamed at me! Ya ya ya!

He got so mad that we were assisted living and not a skilled facility that he had her moved out. She was just the sweetest thing, had Parkinsons and would have her good days and bad, but generally quite capable of living in assisted living for quite a few more years...poor thing!

Last I heard she declined so badly because she was taken to a SNF and just lost the will to live, and has sence passed away. Sad sad sad!

All this because her doc was wishy washy and mean!!!!! (I tried to have her change MD's but she didn't want to...).

Up Vote Up Vote ×
+ Join the Discussion