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Very good, Shay. :cheers: We all need to stand up for ourselves like you did.
But now I gotta know, was there any way a PICC could've been inserted that night by Radiology? Is there no on-call?
The patient obviously needed a line badly. Inner wrist. Owie. I've had to stick them there, though no one likes to. It should've been patently obvious to Dr. Dolt that if the first line was in the foot, then the patient was quite a hard stick. Ya think?
Please update us with the doc situation too, ok?
Was the doc an attending in house when you called them or was he at home. Just wondered, because the day i see one of our docs insert a peripheral line is the day it will snow someplace it shouldnt.
Normally if we cant get a site, we go through the chain,,supervisor tries, if she cant or is busy we get P-med to come up and do it, which they usually can. If for some reason they cant get a line, the patient will usually have a picc or central sub-clavian put in the next day, but noone is gonna come do that in the middle of the night either. If they are bad enough that they cant survive without a line overnight, they should be in ICU anyway.
Kudos for you for holdin your ground though.
ShayRN
1,046 Posts
Last week I felt I was verbally abused by a doc. I am probably too nice to some of them at times, so maybe they think it means I am a push over. We had an 89 year old NH patient come to the floor from ER with an IV in her foot. The bag was empty, so ofcourse the site was no good. I told the nurse to just pull it, the last thing we need is a thrombus because we were trying to unclot a site in the foot. She also was dehydrated with an INR>6 and a b/p 88/40's or so. So according to hospital protocol, she tried twice and couldn't get it. Then I (the floor "expert") tried twice and blew the vein. So we called IV team and it was after 10:30, so they weren't taking any more calls. I called the doc and said, what should we do? Any ideas? He started SCREAMING at me. "This is the second time we have had issues on THIS unit. What do you want me to do you say? I say, she needs the site, go put one in, NOW!" I said to him, very FIRMLY, "Doctor, there is no need for you to yell at me this way, I am telling you we cannot get the site in and am asking you what other options you want to consider. So, you can stop it right NOW!" He kept yelling, "I said get a site in her. This is ridiculous, it is just basic medical practice." So I repeated, "there are NO VEINS TO START AN IV, what other options do we have, I can't get a line, what part of that are you not understanding?" He just kept yelling and saying, "just go put a line in her NOW." Like, I didn't want to, right? So, finally, I said, listen, I am going to call a house supervisor because this is getting us NOWHERE. I did call and she happen to know a nurse on the intensive unit who worked as a float on the IV team. She was gracious enough to come up and start a line, (on the inside of her wrist.) That line blew the next day:sniff: So, anyway, I wrote up my conversation with the doctor and sent it to the administration. Someone up there must be pretty upset, because they actually called me on the unit tonight to find out what happened. When I told them, he said, Oh, that was completely inappropriate. I am going to forward this to his chief of staff and I can assure you it will be dealt with....Nothing may ever come of it, but it makes me feel good knowing I stood my ground for myself and MY PATIENT!!!!