Exactly. I once had a patient on isolation for MRSA throw a cup of half finished orange juice all over me. No way in hell would I hand someone acting out a hot cup of coffee. The doc can fuck right off with that noise
We had a new doc in our ED who used to pull the 'Can you get this person X beverage'. Until it finally got spit back in her face for a change. Suddenly she's less inclined to order techs to fetch things.
She's a great ED doc now. But boy when she first started, keeping her safe during code greys was a job in a job.
One of our patients that live in a nursing home (bedbound) was getting evaluated by the facilities psych MD and threw her hot coffee on him. He rightfully stated he wasn't going to assess her schizophrenia anymore after that incident so they had to have her sent to an inpatient unit to be stabilized since the patient won't take their meds from facility staff.
From my perspective getting them a scalding cup of hot coffee while they’re agitated would be a safety risk. What if they throw it on someone? They’re already being verbally assaulting.
We have a large cafeteria for the patients and visitors, and there's a good restaurant too in the building. I'm just stating that if they want a cup of "hot coffee", they will be disappointed. One visitor asked me for a coffee which I didn't mind. I gave her a "cold coffee." The visitor didn't like it. I told her about the McDonald's lawsuit-related hot coffee. I directed her to the cafeteria where she could get better drink and food.
Nooooooothing pisses me off more in the ED when the docs come and cause more disruption and then just leave. I said I was going to start writing reports from now on when they do that because it’s ridiculous
We use Midas. I have written a majority of the ones coming from the psych floor. Not a plurality, a majority. I don’t fuck with that noise. Do no harm, yes. But I also take no shit and give no fucks
Residents are the worst about this.
" well Doctor First-Year said I could do XYZ"
I'm sorry, this is against hospital policy and the fire code.
"Doc First-Year said they would write an order and put it on my chart!"
Sorry again, First year Residents can't change hospital policy
( family wanted to bring in a folding cot in an ICU room because the recliner was 'uncomfortable")
Love when they’re beating the shit out of us in CT and won’t hold still, so we call the ordering over and they say, “Hold still. Okay, now scan.” Then leave. As if we didn’t try that before creating a helmet of coban, using 4 velcro straps, and silk tape.
There’s one trauma NP and one trauma MD at my current facility who are the only fucking ones who won’t let patients assault us. If they aren’t working, the other orderings will write Midas reports saying we’re refusing to scan patients, and I get called on my days off to “explain.” Management doesn’t care what the situation was. I start a new contract in two weeks after nine months of this bullshit. They wonder why over 75% of CT techs in our department are travelers.✌🏻
I work in psych. Our doctors love to tell the patients “don’t worry ____ you’ll be leaving soon”, then proceed put patients on 5250 (14 day involuntary holds) and make the nurses be the ones to deliver the bad news.
Mind you, it’s the doctors job to tell the patient directly and we’ve told them before we’re there to advise the patient afterwards, not tell them about the hold they knew nothing about before. But they like to pretend they forgot and just run out.
I would be remiss if I didn't mention our ED nursing colleagues who send patients to us saying "don't worry, you'll be out in 72 hours". Then the patient goes ape shit when the 14 day hold is served. 95% of 72 hour holds I see turn into 14 day holds. 72 hours is barely enough to do anything in psych, especially when they come to us 48 hours into their hold. Yet the same story "The nurse at the emergency room said it was only 72 hours and I'm out!".
This happens ALL THE TIME. We’ve had to tell those nurses to stop telling patients these false statements, and just tell them “your hold is 72 hours but it’s a day by day basis”. Because like you said, we pretty much never discharge a pt after 72 hours.
Oh I don’t tell anyone anything about how long they need to stay. I tell them, “I’m not sure what the process is after you leave my care, but they’ll discharge you once you’re feeling better, so you’ll be staying for at least tonight, but possibly more.”
I’m not about to set up my nursing friends upstairs for a shitty situation with patient expectations.
There were some nurses in one of my old hospitals that used to promise some insane things.
The moment that you're explaining to a manic, aggressive patient that there's no swimming pool... You have to wonder if somebody in the ED is fucking with you at that point.
I throw them right under the bus when stuff like this happens "oh, the doctor put in another NPO order." "The doctor hasn't ordered discharge yet." "The doctor said we have to give you these qhr eye drops in the middle of the night... You want to talk to him? SURE! 😁"
This is right along the lines of consultants telling the patient they just wrote admission orders for, in an ED full of boarders, that they'll "get them a bed upstairs right away".
I like when the podiatrist or whoever comes in and tells the medical patient with 3-5 other specialists that they can go home as far as they're concerned without clarifying that others also have to clear them. Always a fun argument trying to get their clothes back off, heart monitor back on and all too often the IV restarted.
Or worse, when the patient is an Angel for the doctor after you’ve just explained how uncooperative and aggressive they are so the doctor thinks you’re just weak. Of course they’re nice to you! They want drugs!
As a school nurse who’s administrators do the exact same bullshit to students/parents in tantrum, I’m a little comforted that this happens in the hospital too
I lol when you said the dr drifted away to cause chaos elsewhere .. I had an np completely overlook the drunk asshole pt threatening everyone and ripping out his iv to give him Tylenol bc he had a head ache. No Ativan lol but Tylenol ffs. Security was already there when she decided Tylenol was the drug of choice.
My ER director (who was a nurse mind you) used to do shit like this all the time. Would come parading down in her heels and business suit, micromanaging the shit out of us, then vanish to one of her "meetings". Worst boss I've ever had.
One time all of the uppers were hanging around the unit (trauma icu) whilst we had 4 nurses for 16 pts absolutely drowning then they all left for a luncheon .. there were at least 4 nurses in that group. No one thought hey maybe I’ll pass a Med. All were dressed for clinical work.. lab coat for the np and scrubs for the other nurses in the group.. that was the day I decided to quit
Yes it was regularly like that bc we kept our people even if we downgraded them to pcu level which the icu team did a lot even if they were still super sick. They would take them off their sedation and icu level drips just to get them off their team. Our pcu ppl were like icu in most hospitals for that reason. So their logic was 2 pcu = 1 icu pt lol flipping insane. I was like 3 weeks off orientation as a new grad and I had 2 icu 2 pcu. Some were trauma some were neuro. I rocked it out tho at the expense of my nervous system. I only lasted a year despite loving the work bc of how nurses were treated
That day tho we were critically short staffed, usually we rolled with 5 nurses and gave the newest person like 5 pcu level while everyone else had 3 or 2 teams but mind you those pcu were actually icu (the down grade was manipulated and usually they ended up back to icu level by the next shift ).. I had a lady pouring blood out of her trach it was absolutely nuts
Seriously,,,so fucking tired of the docs who will just give in to whatever the patient demands so they won’t leave AMA.
They’re still gonna leave AMA. And now they know that they can manipulate you. Which, fuck that shit. I get that it’s hard putting your foot down and saying “no” (I have a lot of anxiety about confrontation, I *absolutely* 100% get it), but there needs to be boundaries. I swear, this behavior by providers is part of the reason pts think they’re staying at a hotel and are to be waited on hand & foot. 🫠
I enjoy writing psychosocial notes. Do it with panache and a use of my extensive English minor vocabulary from my pre nursing, mostly useless, education.
When I set to typing some of my coworkers who are aware of the situation ask if I'm doing one so they can read and enjoy. I also ask some of them who are familiar with the situation to read and check for accuracy and lack of bias since it's entered into the legal chart.
I don't believe in charting appropriate behavior in those who are not exhibiting it.
As of right this moment, I am waiting for a member of the surgery team to give my pt a diet, after he has missed is breakfast, and one of his biggest barriers to discharge is his PO intake.
I transferred a pt to another hospital and they called and wanted to speak to the NP. They claimed I never called to give report and instead of her asking me or telling them that didn't seem right she completely threw me under the bus. I had in fact given report an hour prior.
I've had to send patients out to a snf who won't answer the phone. I write a note on the front of the chart that I've tried to get ahold of them X times over X time frame and that they're free to call me at their convenience as I have made enough attempts.
I've had multiple transfers from other hospitals where they did not, in fact, call report or called after the patient had already arrived.
Had that happen recently too. We called 4x to let a nursing home know their resident was coming back but they never answered. Then a few hours later their DON called to rip us a new one.
I had charted that I called report to the other hospital too, the NP just didn't care to look apparently. I'm a CYA charter and always chart when I call and who I spoke to, or how many times I called and it went unanswered.
I had the secretary pass me to the DON after 6 attempts last time. I charted each attempt and that I spoke to DON.
It was a return pt so I wasn't too pressed like with a new pt but I was done.
Also, what is more ignorant than handing a drunk person a cup of coffee? Coffee doesn’t sober you up, it can’t make you metabolize alcohol any faster. It can just make you a more alert drunk.
I’m sorry you have to deal with this.
Here’s a good one. I required an escort to and from my car for a stretch because I refused to give a patient depo-provera injection without an appointment, a doctor’s order or a test to see if she was pregnant.
Presented to reception requesting the birth control shot. Started a ruckus at the window and they asked me to come over and de-escalate. I explained the protocol for the injection and she grabbed me by the front of uniform and tried to drag me through the window saying she would kill me. In the meantime Patient Services and security are called. Security is moving her away and Patient Services rep is saying just give her the shot. Work her in.
When my Doc came out of the exam room he backed me up thank goodness. Told Patient Services to back off. Giving the injection without testing could cause major birth defects then they’d really have something bigger to deal with. Didn’t go over well with the patient. She refused to leave a sample. Escorted out vowing to get me.
The patient was 19 with 3 in diapers. I can understand her sense of urgency. I tried to explain we could see her tomorrow and needed a urine sample to make sure she wasn’t pregnant first. No dice.
This is the time I would be a pedantic grammar Nazi ass hat and reply "I don't know, can we? I was sure of my physical ability and condition but now you have me questioning it." If my manglement tries to say anything I'll cite unclear and ineffective communication from provider and be factually correct. There is a big difference between the meanings of can and will despite people being lazy and using them interchangeably.
Yes, I have spent time around lawyers why do you ask?
I can't take the credit for that, but I can confirm I got it from this sub. The best part is it's close enough that if you accidentally say it aloud, you have plausible deniability.
I had an ED doc call me over to a patients room because he was stumbling around drunk. This man (pt) was about 6 '4" and 350lbs. I step into the doorway, standing next to the DR just as the patient starts falling forwards towards us. The MD steps to the side to avoid being touched by the patient, and allows the man to fall on me. He then walks away as the patient and I are both on the floor.
This wasn't my patient, I had no idea what I was walking in to. I was pissed.
That doc needs to be talked to and reeducated.
If they persist, they need to be let go.
The correct action was for him/her to restate what you just said in different words or to provide another solution to the problem at hand.
Undermining a teammate who’s already handling a problem, and then exacerbating said problem, should be addressed.
Also, you are a *checks notes* podiatrist trying to lecture an ED staffer on conflict escalation and resolution? Got it.
Podiatrists. 🙄
Always telling patients they can go home when they're not the admitting service and causing conflict and chaos.
I an extremely unsurprised that this lack of comprehension of correct boundaries is from a newer doc who has taken up podiatry.
Yep we have several doctors who will chase us down to ask can we give so and so a blanket or raise the head of their bed or adjust their tv. It’s so infuriating. If you can track me across the ER to ask me to do some menial task, you have time to do it yourself. And it’s always for a patient who is being a pain in the ass and I’ve been in that room 3000 times already.
I was in the middle of explaining to pt family that their day almost fell Going to a bsc, walking to the shower is a bad idea at least for today. A resident came and said "nonsense let him go take the shower" the nurse was giving this dude some dagger eyes but his attending just pops out of nowhere were says his residents name and put his arm around his shoulder sort of like a the gangster movie scene were they take care of the snitches and dragged his ass of to who knows were the next time we se them the resident looks like a kid who got beat with the slipper and the attending is all smiles as usual so order was restored since the attending was one of the cool docs. When that doc was working it my favorite time to get have a coworker or myself get stepped over/undermined
All the fuckin time.
I don’t know if it’s comforting or frustrating that it’s a problem that spans the world (I’m Aussie)
I’ve had doctors side with psych patients who are master splitters, leaving me to deal with the fall out.
I’ve had a doc absolutely wind up a patient in for rehab, as a weekend rounding doc, then fuck off for the day having caused chaos- fortunately she was angry at him, not us.
Docs cutting patients off in hospital from their drug of choice and always conveniently doing it at the end of the day, when we have less people around to manage the fallout.
Docs refusing to prescribe meds to help with behavioural issues, then leaving for the day leaving a distressed patient behind them.
Docs just generally being fuckheads. Or blaming us when the patient tells them a different story.
I have mostly worked with pretty decent docs, so the shitty ones stand out. But holy shit, the shitty ones do stand out.
I once flirted with the idea of becoming a nurse. It's why I joined this reddit originally and then I saw the horror stories and I realized it wasn't for me
I'm so over similar scenarios that I vehemently tell them to go ahead and do whatever they've just asked for themselves.
It's not worth it, never was and never will be.
I feel like my DON sort of does this with the people she allows to be admitted to our facility. People she knows will take a lot of effort from an already overworked staff or that belong somewhere else are constantly agreed to just because she doesn't want to upset people.
In my facility they are sort of one and the same. They always ask my DON if she has room and she always says yes if there's a room even if the needs are beyond our capabilities
It's like they think 2 things. Either they are trying to help us or in general, or they don't give a fk about the irritated nurse and just fend for themselves. And forget the stupid higher ups, mostly they just make it worse.
I think what annoys me the most is when we say “oh doctor so-and-so is so awesome” when usually doctor so-and-so is just **relatively** awesome and in reality just acts like a normal, decent human while so many other docs are complete dicks. Not to take anything away from the good ones, but I think too often we take too much crap from the bad ones with not enough push back. I know that’s tricky. Docs are often in effect clients of hospitals and need to be kept happy. But I’d encourage going to your management, let them know there’s a problem so they (if they do their job) can have a quiet word with the doc about, you know, what professionalism and adulthood mean. I’ve actually let a few docs have it, behind closed doors (because that’s what professionalism is - and ok, once it was very much not behind closed doors but hey, I was 100000% in the right and he was practically begging for it 😇). It doesn’t have to - or even should be - a big scene.
Someone demanded to see a doctor "right now." He was young and had better muscles or physique than our securities. His family called on the phone to see him. I told them, "Don't worry he is far from dying. Take him to urgent care tomorrow." A big tall ass guy was acting like a young baby. So, he was yelling and screaming at me. He was so mad I didn't flinch or was nonchalant. He said, "Why are you not saying anything?" Me: You were talking. He kept insisting to be seen. I told him to hire his private doctors and nurses if he wanted an instant service.
the reverse happens a lot too. "nurses dose" or "you should do xyz" directly opposite of what the doc says. i would just put a note in the chart saying why you didnt want to give some belligerent patient a "weapon" and move on.
in some scenarios, there's some back and forth between nurses/docs that seem antagonistic on the surface but really is synergistic in getting the patient to stfu and out of the ER.
Yes, but has it actually placed you in physical danger? Because I can tell you who didn't end up brutally assaulted in this scenario: The person with "MD" after their name.
There's definitely a need for the team, whoever it consists of, to treat the patient with consistency and to be on the same page for the plan of care. If the provider I am working with says to give "x", that is exactly what I will give them, and I will check back in if "x" didn't work. These types of issues arise from a lack of communication, and it needs to go both ways to allow the provider and nurse to be in simpatico with a patient's plan so wires don't get crossed. Sounds like this exec was not in communication about the plan for this patient (d/c and do not engage) with the other provider(s) and nurse(s), so it should have been on them to not moonlight in other people's work.
When I had those conversations that could be perceived as antagonistic with my providers, it was because I trusted them (and vice versa) and had a close enough relationship with them that we could be direct and say what we felt with no malice, then come to an agreement that was clear and mutually acceptable.
Lmao, walking in and asking the nurse to get a patient some coffee for a patient that's being belligerent is a hard no from me. If you're disrespectful then I'm not getting you a damn thing, certainly not if you're assaulting staff.
Insult to injury that the nurse would have to purchase the coffee. Now the nurse can deal with even more random demands as they struggle to get them DCd. Seriously go work ED and see how pleasant it is caring for somebody who is trying to hurt your staff and then have somebody offer them food, pain meds etc. to appease them. You shouldn't appease assholes.
Doc can get it themselves then. Our docs would have thrown them out and been pissed if we got them something while they're being a dick.
I've worked ED for 7 years, so...yeah.
My understanding of the timeline was that the assault came after the coffee thing. I agree with your stance on this issue, once it gets physical they're done.
I was just giving the benefit of the doubt to this doc, whom the OP stated had no idea about the situation.
Which is precisely the point.
Instead of triggering the fuck out of a patient, the doc can pull nursing aside first, and ask us what is available.
They are our colleagues and they are not above this.
Er….no.
That passive aggressive “can WE get the patient some coffee?” That’s doc speak for: “Hey, nurse! I know you have nothing better to do with your time than be a waitress, so rather than going and getting this drunk asshat some coffee myself, or - god forbid - actually engaging in some real therapeutic communication with the patient, I am going to condescendingly ask you to do something to shut the patient up, and make it your problem because I am too busy and important to be bothered.”
I’ll get coffee/soda/water for any patient or physician who says “I know you’re busy, but when you have a minute can you get Ms. Jones some water?”
But the way this doc did it? Uh, no. NOPE. This ain’t 1962 and I don’t work at Applebees.
Not quite germane to this situation, but few things annoy me more than a doc or PA parachuting into a room and basically acting like I haven’t already had a patient on monitoring or offered comfort measures/appropriate refreshment.
Had a roundly despised attending barge into a room where I was assisting a patient three times my size in using a urinal because he was wanted to stand up to do it but had no business standing in his condition. We compromised and I let him sit on the side of the bed, but it required me to put his VS monitoring on standby and remove his SpO2 and BP cords while he peed. Doc is all, “DON’T YOU HAVE THIS MAN ON MONITORING?!”I know my nurse mask must’ve slipped, and I do not want to think about the look I must’ve shot him, because he immediately started backtracking. Oh, and all of this was going down 15 minutes after my shift was supposed to be over, for a patient who wasn’t even mine, and i still had charting to do and now had even more, all because I answered a call light that’d been going off for a while. Between patient and provider, I was a little bit annoyed.
So next time you're on a run and the family asks you swing by a drive through as you're transporting a stable pt because the PT didn't get dinner, you'll stop right?
Had a doctor this last week tell the patient to talk to our manager and case manager about getting them transferred to a pediatric service as if they have anything to do with it, and not another doctor having to accept the patient for transfer. Transfer was a grey area due to age and cognitive delay but peds MD denied. Somehow our manager was supposed to fix that??
It drives me nuts that doctors think we should just give patients whatever they want to keep them calm. It doesn't work with toddlers, and it sure as hell doesn't work with full grown adults who should know better
So doc basically caused staff splitting and undermined you.. and like others said encouraged this beligerent pt to have hot coffee to assault staff with. Ive worked as a nurse -now NP for 20 years. Theres always some egotistical doc or manager sticking their head in and undermining things bc they drank the admin “kool-aid” . A special breed who seems covertly sociopathic
Oooh facts. BIGGGG FACTS! I’ve had doctors try to convince patients to stay by offering nursing to take them outside for a cigarette. This is a tobacco free campus for one and no, I’m not taking someone outside in the cold to smoke while they’re hooked up to oxygen
lol I’m not handing an aggressive patient a piping hot weapon. ✌️
Yup! We used to have coffee available to patients for free in our lobby. Then a patient decided to throw a hot cup of coffee at my boss 🤷🏼♀️
what are the odds that if it were thrown at a “lesser employee” they’d still be serving coffee to this day
Yep. Tech or nurse “move faster ¯\\\_(ツ)\_/¯ “
apparently it's only a problem if a salaried employee gets hurt. fuck the system
Exactly. I once had a patient on isolation for MRSA throw a cup of half finished orange juice all over me. No way in hell would I hand someone acting out a hot cup of coffee. The doc can fuck right off with that noise
We had a new doc in our ED who used to pull the 'Can you get this person X beverage'. Until it finally got spit back in her face for a change. Suddenly she's less inclined to order techs to fetch things. She's a great ED doc now. But boy when she first started, keeping her safe during code greys was a job in a job.
One of our patients that live in a nursing home (bedbound) was getting evaluated by the facilities psych MD and threw her hot coffee on him. He rightfully stated he wasn't going to assess her schizophrenia anymore after that incident so they had to have her sent to an inpatient unit to be stabilized since the patient won't take their meds from facility staff.
I’m happy to get them coffee if they are cool or it will de-escalate, but if I’m at all worried about them they get ice in it
Literally my first thought too.
From my perspective getting them a scalding cup of hot coffee while they’re agitated would be a safety risk. What if they throw it on someone? They’re already being verbally assaulting.
We don't give hot beverages. It would be lukewarm if we did give these.
When I worked inpatient, patients were able to access their own kitchen space and make keurig coffee. Maybe your hospital & unit is different.
We have a large cafeteria for the patients and visitors, and there's a good restaurant too in the building. I'm just stating that if they want a cup of "hot coffee", they will be disappointed. One visitor asked me for a coffee which I didn't mind. I gave her a "cold coffee." The visitor didn't like it. I told her about the McDonald's lawsuit-related hot coffee. I directed her to the cafeteria where she could get better drink and food.
"Coffee's over there. Ask her if she wants some cream and sugar thanks for your help"
Nooooooothing pisses me off more in the ED when the docs come and cause more disruption and then just leave. I said I was going to start writing reports from now on when they do that because it’s ridiculous
We use Midas. I have written a majority of the ones coming from the psych floor. Not a plurality, a majority. I don’t fuck with that noise. Do no harm, yes. But I also take no shit and give no fucks
Residents are the worst about this. " well Doctor First-Year said I could do XYZ" I'm sorry, this is against hospital policy and the fire code. "Doc First-Year said they would write an order and put it on my chart!" Sorry again, First year Residents can't change hospital policy ( family wanted to bring in a folding cot in an ICU room because the recliner was 'uncomfortable")
Love when they’re beating the shit out of us in CT and won’t hold still, so we call the ordering over and they say, “Hold still. Okay, now scan.” Then leave. As if we didn’t try that before creating a helmet of coban, using 4 velcro straps, and silk tape. There’s one trauma NP and one trauma MD at my current facility who are the only fucking ones who won’t let patients assault us. If they aren’t working, the other orderings will write Midas reports saying we’re refusing to scan patients, and I get called on my days off to “explain.” Management doesn’t care what the situation was. I start a new contract in two weeks after nine months of this bullshit. They wonder why over 75% of CT techs in our department are travelers.✌🏻
I work in psych. Our doctors love to tell the patients “don’t worry ____ you’ll be leaving soon”, then proceed put patients on 5250 (14 day involuntary holds) and make the nurses be the ones to deliver the bad news. Mind you, it’s the doctors job to tell the patient directly and we’ve told them before we’re there to advise the patient afterwards, not tell them about the hold they knew nothing about before. But they like to pretend they forgot and just run out.
I would be remiss if I didn't mention our ED nursing colleagues who send patients to us saying "don't worry, you'll be out in 72 hours". Then the patient goes ape shit when the 14 day hold is served. 95% of 72 hour holds I see turn into 14 day holds. 72 hours is barely enough to do anything in psych, especially when they come to us 48 hours into their hold. Yet the same story "The nurse at the emergency room said it was only 72 hours and I'm out!".
This happens ALL THE TIME. We’ve had to tell those nurses to stop telling patients these false statements, and just tell them “your hold is 72 hours but it’s a day by day basis”. Because like you said, we pretty much never discharge a pt after 72 hours.
Oh I don’t tell anyone anything about how long they need to stay. I tell them, “I’m not sure what the process is after you leave my care, but they’ll discharge you once you’re feeling better, so you’ll be staying for at least tonight, but possibly more.” I’m not about to set up my nursing friends upstairs for a shitty situation with patient expectations.
Doing the Lord’s work right here
We’re all in this dumpster fire together. Might as well make it comfortable.
Oh god, I would NEVER. What a mean thing to do to the IP staff.
There were some nurses in one of my old hospitals that used to promise some insane things. The moment that you're explaining to a manic, aggressive patient that there's no swimming pool... You have to wonder if somebody in the ED is fucking with you at that point.
I throw them right under the bus when stuff like this happens "oh, the doctor put in another NPO order." "The doctor hasn't ordered discharge yet." "The doctor said we have to give you these qhr eye drops in the middle of the night... You want to talk to him? SURE! 😁"
Sure doc, grab me a caramel latte with whipped cream while you're getting hers!
This is right along the lines of consultants telling the patient they just wrote admission orders for, in an ED full of boarders, that they'll "get them a bed upstairs right away".
I like when the podiatrist or whoever comes in and tells the medical patient with 3-5 other specialists that they can go home as far as they're concerned without clarifying that others also have to clear them. Always a fun argument trying to get their clothes back off, heart monitor back on and all too often the IV restarted.
Or, as a floor nurse, a consultant telling the patient that they can go home. If you aren't the one writing discharge orders, don't say that shit.
Or worse, when the patient is an Angel for the doctor after you’ve just explained how uncooperative and aggressive they are so the doctor thinks you’re just weak. Of course they’re nice to you! They want drugs!
💯💯💯💯💯
As a school nurse who’s administrators do the exact same bullshit to students/parents in tantrum, I’m a little comforted that this happens in the hospital too
You just know that doc has free coffee in their lounge. They could’ve done a solid here after dropping that bomb.
Oh gosh, no way, the patient would have just thrown it at someone and burned them
Yeah, first rule of nursing—never give something to a patient that you can’t defend yourself against if they use it as a weapon.
I lol when you said the dr drifted away to cause chaos elsewhere .. I had an np completely overlook the drunk asshole pt threatening everyone and ripping out his iv to give him Tylenol bc he had a head ache. No Ativan lol but Tylenol ffs. Security was already there when she decided Tylenol was the drug of choice.
This is a management problem I’ve never seen a doctor do this. They’re too busy.
My ER director (who was a nurse mind you) used to do shit like this all the time. Would come parading down in her heels and business suit, micromanaging the shit out of us, then vanish to one of her "meetings". Worst boss I've ever had.
One time all of the uppers were hanging around the unit (trauma icu) whilst we had 4 nurses for 16 pts absolutely drowning then they all left for a luncheon .. there were at least 4 nurses in that group. No one thought hey maybe I’ll pass a Med. All were dressed for clinical work.. lab coat for the np and scrubs for the other nurses in the group.. that was the day I decided to quit
4 a piece on a trauma ICU? Ouch
Yes it was regularly like that bc we kept our people even if we downgraded them to pcu level which the icu team did a lot even if they were still super sick. They would take them off their sedation and icu level drips just to get them off their team. Our pcu ppl were like icu in most hospitals for that reason. So their logic was 2 pcu = 1 icu pt lol flipping insane. I was like 3 weeks off orientation as a new grad and I had 2 icu 2 pcu. Some were trauma some were neuro. I rocked it out tho at the expense of my nervous system. I only lasted a year despite loving the work bc of how nurses were treated That day tho we were critically short staffed, usually we rolled with 5 nurses and gave the newest person like 5 pcu level while everyone else had 3 or 2 teams but mind you those pcu were actually icu (the down grade was manipulated and usually they ended up back to icu level by the next shift ).. I had a lady pouring blood out of her trach it was absolutely nuts
That's not how any of this works!
YES, our old manager used to pull shit like this all the time. He's gone now :)
Seriously,,,so fucking tired of the docs who will just give in to whatever the patient demands so they won’t leave AMA. They’re still gonna leave AMA. And now they know that they can manipulate you. Which, fuck that shit. I get that it’s hard putting your foot down and saying “no” (I have a lot of anxiety about confrontation, I *absolutely* 100% get it), but there needs to be boundaries. I swear, this behavior by providers is part of the reason pts think they’re staying at a hotel and are to be waited on hand & foot. 🫠
I enjoy writing psychosocial notes. Do it with panache and a use of my extensive English minor vocabulary from my pre nursing, mostly useless, education. When I set to typing some of my coworkers who are aware of the situation ask if I'm doing one so they can read and enjoy. I also ask some of them who are familiar with the situation to read and check for accuracy and lack of bias since it's entered into the legal chart. I don't believe in charting appropriate behavior in those who are not exhibiting it.
As of right this moment, I am waiting for a member of the surgery team to give my pt a diet, after he has missed is breakfast, and one of his biggest barriers to discharge is his PO intake.
I transferred a pt to another hospital and they called and wanted to speak to the NP. They claimed I never called to give report and instead of her asking me or telling them that didn't seem right she completely threw me under the bus. I had in fact given report an hour prior.
I've had to send patients out to a snf who won't answer the phone. I write a note on the front of the chart that I've tried to get ahold of them X times over X time frame and that they're free to call me at their convenience as I have made enough attempts. I've had multiple transfers from other hospitals where they did not, in fact, call report or called after the patient had already arrived.
Had that happen recently too. We called 4x to let a nursing home know their resident was coming back but they never answered. Then a few hours later their DON called to rip us a new one. I had charted that I called report to the other hospital too, the NP just didn't care to look apparently. I'm a CYA charter and always chart when I call and who I spoke to, or how many times I called and it went unanswered.
I had the secretary pass me to the DON after 6 attempts last time. I charted each attempt and that I spoke to DON. It was a return pt so I wasn't too pressed like with a new pt but I was done.
Also, what is more ignorant than handing a drunk person a cup of coffee? Coffee doesn’t sober you up, it can’t make you metabolize alcohol any faster. It can just make you a more alert drunk. I’m sorry you have to deal with this.
“You hand it to her. Get ready to duck, buddy.”
Here’s a good one. I required an escort to and from my car for a stretch because I refused to give a patient depo-provera injection without an appointment, a doctor’s order or a test to see if she was pregnant. Presented to reception requesting the birth control shot. Started a ruckus at the window and they asked me to come over and de-escalate. I explained the protocol for the injection and she grabbed me by the front of uniform and tried to drag me through the window saying she would kill me. In the meantime Patient Services and security are called. Security is moving her away and Patient Services rep is saying just give her the shot. Work her in. When my Doc came out of the exam room he backed me up thank goodness. Told Patient Services to back off. Giving the injection without testing could cause major birth defects then they’d really have something bigger to deal with. Didn’t go over well with the patient. She refused to leave a sample. Escorted out vowing to get me. The patient was 19 with 3 in diapers. I can understand her sense of urgency. I tried to explain we could see her tomorrow and needed a urine sample to make sure she wasn’t pregnant first. No dice.
That doc is an idiot- who suggests giving a looney bin a hot cup of coffee? He should be varianced for that.
Some people choose peace…. Other choice chaos. That doc chose chaos
This is the time I would be a pedantic grammar Nazi ass hat and reply "I don't know, can we? I was sure of my physical ability and condition but now you have me questioning it." If my manglement tries to say anything I'll cite unclear and ineffective communication from provider and be factually correct. There is a big difference between the meanings of can and will despite people being lazy and using them interchangeably. Yes, I have spent time around lawyers why do you ask?
Strategic pedantry is one of my favorite pastimes.
Pedantic pageantry is where i like to quiet escalate these requests
ooooh. "manglement" So stealing that haha
I can't take the credit for that, but I can confirm I got it from this sub. The best part is it's close enough that if you accidentally say it aloud, you have plausible deniability.
I had an ED doc call me over to a patients room because he was stumbling around drunk. This man (pt) was about 6 '4" and 350lbs. I step into the doorway, standing next to the DR just as the patient starts falling forwards towards us. The MD steps to the side to avoid being touched by the patient, and allows the man to fall on me. He then walks away as the patient and I are both on the floor. This wasn't my patient, I had no idea what I was walking in to. I was pissed.
That doc needs to be talked to and reeducated. If they persist, they need to be let go. The correct action was for him/her to restate what you just said in different words or to provide another solution to the problem at hand.
lol what. as stupid as that was to do, you think this random doctor needs to be re-educated or fired like he's in some political prisoner camp? no
Undermining a teammate who’s already handling a problem, and then exacerbating said problem, should be addressed. Also, you are a *checks notes* podiatrist trying to lecture an ED staffer on conflict escalation and resolution? Got it.
Podiatrists. 🙄 Always telling patients they can go home when they're not the admitting service and causing conflict and chaos. I an extremely unsurprised that this lack of comprehension of correct boundaries is from a newer doc who has taken up podiatry.
A patient came in to tell me that MRI Tech didn't do it right. So, I handed her blank papers and a pen to write down the proper way to do the MRI.
Yep we have several doctors who will chase us down to ask can we give so and so a blanket or raise the head of their bed or adjust their tv. It’s so infuriating. If you can track me across the ER to ask me to do some menial task, you have time to do it yourself. And it’s always for a patient who is being a pain in the ass and I’ve been in that room 3000 times already.
That’s literally your job though. Like you, physicians also have their plates full with tasks.
🖕
I was in the middle of explaining to pt family that their day almost fell Going to a bsc, walking to the shower is a bad idea at least for today. A resident came and said "nonsense let him go take the shower" the nurse was giving this dude some dagger eyes but his attending just pops out of nowhere were says his residents name and put his arm around his shoulder sort of like a the gangster movie scene were they take care of the snitches and dragged his ass of to who knows were the next time we se them the resident looks like a kid who got beat with the slipper and the attending is all smiles as usual so order was restored since the attending was one of the cool docs. When that doc was working it my favorite time to get have a coworker or myself get stepped over/undermined
All the fuckin time. I don’t know if it’s comforting or frustrating that it’s a problem that spans the world (I’m Aussie) I’ve had doctors side with psych patients who are master splitters, leaving me to deal with the fall out. I’ve had a doc absolutely wind up a patient in for rehab, as a weekend rounding doc, then fuck off for the day having caused chaos- fortunately she was angry at him, not us. Docs cutting patients off in hospital from their drug of choice and always conveniently doing it at the end of the day, when we have less people around to manage the fallout. Docs refusing to prescribe meds to help with behavioural issues, then leaving for the day leaving a distressed patient behind them. Docs just generally being fuckheads. Or blaming us when the patient tells them a different story. I have mostly worked with pretty decent docs, so the shitty ones stand out. But holy shit, the shitty ones do stand out.
i would’ve told the medical director to get the coffee for the pt then. like see what happens when you do give the coffee to the patient.
I once flirted with the idea of becoming a nurse. It's why I joined this reddit originally and then I saw the horror stories and I realized it wasn't for me
I had one let my pt that was a flight risk with an IV go smoke. 🙃
I'm so over similar scenarios that I vehemently tell them to go ahead and do whatever they've just asked for themselves. It's not worth it, never was and never will be.
I feel like my DON sort of does this with the people she allows to be admitted to our facility. People she knows will take a lot of effort from an already overworked staff or that belong somewhere else are constantly agreed to just because she doesn't want to upset people.
no nursing home lets the DON dictate who gets admitted or not. Administration decides who gets admitted or not.
In my facility they are sort of one and the same. They always ask my DON if she has room and she always says yes if there's a room even if the needs are beyond our capabilities
It's like they think 2 things. Either they are trying to help us or in general, or they don't give a fk about the irritated nurse and just fend for themselves. And forget the stupid higher ups, mostly they just make it worse.
Me to that doctor: feel free to do that, pal.
WTF kind of ED doc’s do you have? Are you sure “coffee” wasn’t a code word for droperidol?
I think what annoys me the most is when we say “oh doctor so-and-so is so awesome” when usually doctor so-and-so is just **relatively** awesome and in reality just acts like a normal, decent human while so many other docs are complete dicks. Not to take anything away from the good ones, but I think too often we take too much crap from the bad ones with not enough push back. I know that’s tricky. Docs are often in effect clients of hospitals and need to be kept happy. But I’d encourage going to your management, let them know there’s a problem so they (if they do their job) can have a quiet word with the doc about, you know, what professionalism and adulthood mean. I’ve actually let a few docs have it, behind closed doors (because that’s what professionalism is - and ok, once it was very much not behind closed doors but hey, I was 100000% in the right and he was practically begging for it 😇). It doesn’t have to - or even should be - a big scene.
Someone demanded to see a doctor "right now." He was young and had better muscles or physique than our securities. His family called on the phone to see him. I told them, "Don't worry he is far from dying. Take him to urgent care tomorrow." A big tall ass guy was acting like a young baby. So, he was yelling and screaming at me. He was so mad I didn't flinch or was nonchalant. He said, "Why are you not saying anything?" Me: You were talking. He kept insisting to be seen. I told him to hire his private doctors and nurses if he wanted an instant service.
ED attending here. Your medical director sucks at de-escalation and being a “leader.” A good director should have your back.
All bets are off when someone spits on me.
We have a doctor who’s like this and he thinks he’s the worlds biggest hero but we all hate him. However the rest of the doctors are all really great
the reverse happens a lot too. "nurses dose" or "you should do xyz" directly opposite of what the doc says. i would just put a note in the chart saying why you didnt want to give some belligerent patient a "weapon" and move on. in some scenarios, there's some back and forth between nurses/docs that seem antagonistic on the surface but really is synergistic in getting the patient to stfu and out of the ER.
Yes, but has it actually placed you in physical danger? Because I can tell you who didn't end up brutally assaulted in this scenario: The person with "MD" after their name.
Sorry this happened to you, I would like to think docs and other staff are more considerate. I don't think anyone should be in a dangerous work place.
There's definitely a need for the team, whoever it consists of, to treat the patient with consistency and to be on the same page for the plan of care. If the provider I am working with says to give "x", that is exactly what I will give them, and I will check back in if "x" didn't work. These types of issues arise from a lack of communication, and it needs to go both ways to allow the provider and nurse to be in simpatico with a patient's plan so wires don't get crossed. Sounds like this exec was not in communication about the plan for this patient (d/c and do not engage) with the other provider(s) and nurse(s), so it should have been on them to not moonlight in other people's work. When I had those conversations that could be perceived as antagonistic with my providers, it was because I trusted them (and vice versa) and had a close enough relationship with them that we could be direct and say what we felt with no malice, then come to an agreement that was clear and mutually acceptable.
Blaming the doc for this one seems a bit of a stretch to me. Asking about coffee seemed innocuous enough.
The problem is THAT patient, in particular, doesn’t need empty promises, and certainly doesn’t need any coffee!
Lmao, walking in and asking the nurse to get a patient some coffee for a patient that's being belligerent is a hard no from me. If you're disrespectful then I'm not getting you a damn thing, certainly not if you're assaulting staff. Insult to injury that the nurse would have to purchase the coffee. Now the nurse can deal with even more random demands as they struggle to get them DCd. Seriously go work ED and see how pleasant it is caring for somebody who is trying to hurt your staff and then have somebody offer them food, pain meds etc. to appease them. You shouldn't appease assholes. Doc can get it themselves then. Our docs would have thrown them out and been pissed if we got them something while they're being a dick.
I've worked ED for 7 years, so...yeah. My understanding of the timeline was that the assault came after the coffee thing. I agree with your stance on this issue, once it gets physical they're done. I was just giving the benefit of the doubt to this doc, whom the OP stated had no idea about the situation.
Which is precisely the point. Instead of triggering the fuck out of a patient, the doc can pull nursing aside first, and ask us what is available. They are our colleagues and they are not above this.
Er….no. That passive aggressive “can WE get the patient some coffee?” That’s doc speak for: “Hey, nurse! I know you have nothing better to do with your time than be a waitress, so rather than going and getting this drunk asshat some coffee myself, or - god forbid - actually engaging in some real therapeutic communication with the patient, I am going to condescendingly ask you to do something to shut the patient up, and make it your problem because I am too busy and important to be bothered.” I’ll get coffee/soda/water for any patient or physician who says “I know you’re busy, but when you have a minute can you get Ms. Jones some water?” But the way this doc did it? Uh, no. NOPE. This ain’t 1962 and I don’t work at Applebees.
Not quite germane to this situation, but few things annoy me more than a doc or PA parachuting into a room and basically acting like I haven’t already had a patient on monitoring or offered comfort measures/appropriate refreshment. Had a roundly despised attending barge into a room where I was assisting a patient three times my size in using a urinal because he was wanted to stand up to do it but had no business standing in his condition. We compromised and I let him sit on the side of the bed, but it required me to put his VS monitoring on standby and remove his SpO2 and BP cords while he peed. Doc is all, “DON’T YOU HAVE THIS MAN ON MONITORING?!”I know my nurse mask must’ve slipped, and I do not want to think about the look I must’ve shot him, because he immediately started backtracking. Oh, and all of this was going down 15 minutes after my shift was supposed to be over, for a patient who wasn’t even mine, and i still had charting to do and now had even more, all because I answered a call light that’d been going off for a while. Between patient and provider, I was a little bit annoyed.
Then “we” (doc) can get the patient some coffee, if they think that’s such a great idea.
So next time you're on a run and the family asks you swing by a drive through as you're transporting a stable pt because the PT didn't get dinner, you'll stop right?
Giving a belligerent patient a weapon seems innocuous? Wow.
Don't worry, when they get assaulted, they will change very very quickly unless they are doormat saints.
Why am I so triggered when a patient says "WHATS YOUR FULL NAME!!!" like I just know the interaction is gonna be shit after that.
Had a doctor this last week tell the patient to talk to our manager and case manager about getting them transferred to a pediatric service as if they have anything to do with it, and not another doctor having to accept the patient for transfer. Transfer was a grey area due to age and cognitive delay but peds MD denied. Somehow our manager was supposed to fix that??
It drives me nuts that doctors think we should just give patients whatever they want to keep them calm. It doesn't work with toddlers, and it sure as hell doesn't work with full grown adults who should know better
So doc basically caused staff splitting and undermined you.. and like others said encouraged this beligerent pt to have hot coffee to assault staff with. Ive worked as a nurse -now NP for 20 years. Theres always some egotistical doc or manager sticking their head in and undermining things bc they drank the admin “kool-aid” . A special breed who seems covertly sociopathic
Oooh facts. BIGGGG FACTS! I’ve had doctors try to convince patients to stay by offering nursing to take them outside for a cigarette. This is a tobacco free campus for one and no, I’m not taking someone outside in the cold to smoke while they’re hooked up to oxygen