Yelled at yet again

[purpleiris]

Need to vent!

Yesterday I got an admission from the ED. I paged the admitting physician for orders and one of the orders was for a cardiology consult. It was 5 PM so I paged the cardiologist. He called back and wanted to know why I paged him. I told him I paged you to tell you "this patient who blahblah". He repeated why did you page me? I said because the admitting physician ordered a consult from you for her patient. He started yelling at me for bothering him when he already knew about the consult. And yet again, I sit and listed to a physician yell at me for no reason not that I think there is ANY reason to yell at a colleague.

I am so sick of physicians yelling at nurses. How do you deal with getting yelled at?

I want a new nursing job, one with NO physicians! Doesn't that sound peaceful?

Well thanks for listening...

[BroadwayRN, ASN, RN]

Having nursing call my consults is as ridiculous as when the nurses have their techs call me.

Whoa! Say what? I have never had a tech call a doctor. Are you serious? In NY a licensed person is the only one who can call a doctor. (at least where I work)

I think it's great that you're a doctor and you're enjoying this forum with nurses but is there a particular reason why you hang with us? No harm meant, just curious. I think I'd like working with you too!

[Spidey's mom, ADN, BSN, RN]

Nurses calling consults is ridiculous.

You call a consult when you need a particular clinical question answered, NOT just for a generic "we need you to see this patient" stuff.

For example, if a pt with chest pain/MI is found to have a small subdural bleed, then the cardiologist might consult the neurologist to ask if its OK to anticoagulate him. The neurologist is going to want a lot of information--the precise location of the bleed (i.e. "left side" is not good enough) any h/o CVA or ICH, previous h/o anticoagulation, current mental status, etc, in order to make his decision. 99% of the time, the nurse will not know this info, and therefore the nurse has no business explaining that in a phone call.

For the nurses who "call" consults, what do you tell the consultant? "We're consulting you because we have a patient with high blood pressure?" That would make my blood boil if I was a consultant.

Consultants are designed to answer clinically specific questions and they need to speak to other doctors to best facilitate this. I imagine if the nurse calls the consult, the consultant is just going to have to page the referring doctor anyways, regardless of what the nurse says. Which makes the policy of putting the nurse in the loop totally stupid.

Exactly! This is not my role.

My understanding of why it is written in the physician's orders is to get reimbursement.

steph

[Virgo_RN, BSN, RN]

I'm a pathological workaholic and obsessive about every facet of the patients on our service. I am not generally friendly and all that matters to me is work.

You wouldn't like to work with me. Few do.

Personally, I don't expect doctors to be friendly all the time. I work with some pretty crusty docs that won't crack a smile for anything, but what it comes down to is patient care. As long as you're not being outright abusive, I don't care if you're direct and to the point and don't care for frivolous niceties. We're at work, not a party, after all.

I do have a funny story (to me, anyway), though. I recently had to call a hospitalist for something or other, and he gave me a telephone order. Unfortunately, in my haste to get off the phone, I forgot which doctor I was speaking to, and we always have several hospitalists on call, in addition to the cardiologists and the primary care docs. I realized it as soon as I hung up, and said aloud "Oh, darn, I can't remember which doctor just gave me that order!". My charge nurse was standing right there, along with a couple of other nurses, the ward clerk, and the monitor tech, and we decided it would be a fun game to try and guess which doc it was.

The first question was did he have an accent? No. Okay, well that rules out Doctor A and Doctor B.

Was he really polite? Well, yes, and his voice was really soothing. Ah, it must have been doctor X. You'll know for sure if when you call him back, he isn't irritated.

So I call him back, and tell him sorry I'm calling you again, but I have to write that telephone order, and I forgot which doctor I was talking to. He says in a completely unperturbed, soothing, and thoroughly friendly tone of voice "Oh, it's Doctor X.".

I'm glad I didn't put money on that one.

In contrast, there's this cardiologist that you know if you have to call her, she's going to gripe about something completely out of your control. I like to call her "Doctor RayOSunshine" (behind her back, of course). But, she does have very nice handwriting. She must have flunked Illegible Handwriting 101 back in med school.

[TiredMD]

Whoa! Say what? I have never had a tech call a doctor. Are you serious? In NY a licensed person is the only one who can call a doctor. (at least where I work)

When I was an intern, I would called fairly frequently by techs, and the conversation was usually like this:

Tech: "You need to come see Mr. _____."

MD: "What's going on with him?"

Tech: "I don't know, but his nurse said she needs you."

MD: "Is there an issue?"

Tech: "Sorry, I don't know, and she's in another patient's room right now so she can't talk to you."

I go down there, and of course they need a Tylenol order renewed . . . sigh.

I think it's great that you're a doctor and you're enjoying this forum with nurses but is there a particular reason why you hang with us? No harm meant, just curious. I think I'd like working with you too!

The Maury Show is having one of those "inspiration stories of overcoming adversity" shows. But I only like Maury when he's doing the paternity and lie-detector shows, so I decided to post here instead.

[cherrybreeze, ADN, RN]

When I was an intern, I would called fairly frequently by techs, and the conversation was usually like this:

Tech: "You need to come see Mr. _____."

MD: "What's going on with him?"

Tech: "I don't know, but his nurse said she needs you."

MD: "Is there an issue?"

Tech: "Sorry, I don't know, and she's in another patient's room right now so she can't talk to you."

I go down there, and of course they need a Tylenol order renewed . . . sigh.

The Maury Show is having one of those "inspiration stories of overcoming adversity" shows. But I only like Maury when he's doing the paternity and lie-detector shows, so I decided to post here instead.

LOLOL! I'm sorry, had to comment on this. I get so sucked in to those dang paternity lie-detector shows he does! My ex was here Christmas morning and I had it on, he was like "HOW THE HECK CAN YOU WATCH THIS CRAP?!" I have no idea, but I always do!

Thanks for the laugh!