WWYD?

[KateRN1]

Short version: I saw a pt for another nurse last week and drew a PT/INR. (No meter, hand-carried to lab.) I left instructions on the lab slip for the lab to call physician with result. Next day, I was on my way 40 miles+ out to see a new pt, receptionist called and said that Dr wanted a nurse to call the result to her, even though the lab had called and the result had been faxed. Bizarre, but whatever. Problem is, I had not seen the actual result and would've been calling the doc with a result that I had not personally verified but had been told by the receptionist. I asked if the nurse in the office would do it, since I hadn't seen the result and let her know that pt had been admitted to the hospital for scheduled cardioverson (different doc).

So I get a call this morning from the DoN wanting to know why I had refused to call the doc with the result of the PT/INR. What? I didn't refuse to call, just said that if it needed to be done immediately, then office nurse would need to do it, otherwise it would have to wait until I got into the office later that afternoon so that I could verify result. She reamed me for making a nurse who didn't know the pt call the doc with the lab result.

BTW, nowhere on the 485 did it say that result was to be called to the doc, no one told me ahead of time that it needed to be called by the actual nurse seeing the pt. The nurse who handed me the pt didn't even bother to give me a working phone number and I went out there blind. And I get talked to about needing to be a "team player!"

So, should I have called the result that the receptionist told me and trusted that she was right?

[MirandAck!!!]

I think you did right! It was not reported to you from the regular nurse that you needed to call the doc! Don't stress!

[tabster224]

I know for myself, I would have preferred to verify the results myself. I don't think you did anything wrong. Sounds like the DON needs to chill

[caliotter3]

I had a similar type of misunderstanding with the boss of one agency and as a result I no longer work for that particular agency. I think you were right. So was I, but I don't like fighting with unreasonable people.

[tewdles, RN]

Director of Nonsense??? No reason the nurse in the office shouldn't have called that doc... you were not the case nurse, just filling in, you had no verification of the result...your DON is full of crap. Nice of her to support you...no wait...support...uh....hhhmmm...wonder what her job description is.

[patrice meursault]

Bizarre since most PMDs get results from the lab on a daily basis. How does this Doctor handle his outpt. lab draws? I know the DON is overreacting, but someone needs to address this particular MD/DO.

[KateRN1]

I had a similar type of misunderstanding with the boss of one agency and as a result I no longer work for that particular agency. I think you were right. So was I, but I don't like fighting with unreasonable people.

I wholeheartedly agree, Caliotter3, and that's exactly why I'm looking for another job. Sadly, this company has such a bad rep that I think it's actually costing me to have experience there.

Bizarre since most PMDs get results from the lab on a daily basis. How does this Doctor handle his outpt. lab draws? I know the DON is overreacting, but someone needs to address this particular MD/DO.

My only guess is that this is a new doc who still thinks she needs to show nurses "who's boss." I agree that someone needs to reign her in with her unrealistic expecations, but it won't happen because the DoN is afraid of losing business. She'll be losing nurses instead, as we're all looking for other jobs at this point, down to the secretary.

I want to thank you all for your support. I really searched myself about this, considered that maybe I was in the wrong and should've called in a lab that I hadn't seen, but just couldn't come to that conclusion. What was I supposed to say, "Well, I haven't actually seen the report, but the secretary says the INR was 3.2"? And knowing that the doc had received a faxed copy already, that's just stupid.

More info: this pt was actually the DoN's pt (she takes cases when she needs extra money--not fair to those of us who are struggling on two visits a week, but anyway). It turns out that the pt died at home the day or day after she was discharged from the hospital. Maybe the DoN was upset about the death, maybe her panties were too tight, but no way did I deserve the way she spoke to me today. She said that she wasn't going to give me any more cases if I can't be a team player, then actually hung up on me. I was speechless. I have not been treated that way by a DoN since I was a lowly nursing assistant at a SNF. I am praying for another job to please come through soon because I can't take much more of this.

[nurseby07]

I agree with what you did. 100%

I am more concerned with having to drive 40 miles for a patient. WTH? I saw 5 today and logged 8 miles.

[tewdles, RN]

Are you kidding? "I am more concerned with having to drive 40 miles for a patient. WTH? I saw 5 today and logged 8 miles." The CHC I was just employed with could have cared less how far we drove and did not take the time in the car into account when assigning patients to us...so it was common for me to travel more than 100 miles in the course of the day and have 3 Oasis and 3 routine visits assigned. It was expected that I/we would simply finish our documentation on our time. Free. All of the RNs were salaried and often worked until 6 or 7 pm. Notice that I said that they "assigned" my visits. I "case managed" 48 pts, had no idea who most of them were, and a central scheduling office assigned all visits. I essentially had NO control over who I saw when. The company is doing well tho...the owner drives a maseratti.