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- Aug 16, 2007
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We just got a new hospitalist at our hospital, and I have to say, he is awesome. He came up to me, introduced himself, by his first name none the less... wanted to know my name, looked me in the eye, held a conversation, and actually listened when I talked to him about the patients.
The few times I had to page him, he was fantastic, thanked me, and was very polite. Gave me orders and told me he would be coming by later on as well to check on how everything was going, as we had a CHF lady we were diuresing.
Most of our hospitalists, don't even speak recognizable English, let alone acknowledge the nurses anyways, so the guy is already like my favorite person, and he wasn't bad to look at either 😛, not to mention the extremly good manners and treating me like I had some intelligence.
He had ordered an echo, and the tech told me her ejection fraction was <20% and I should call him, so I looked in her chart, and saw nothing about that in there, and so I paged him to let him know. He called me right back, and when I told him, he told me that was something they already knew about, and that he did the echo to check for pericardial effusion, but that he appreciated me letting him know, and he could see why it would be a concern, and asked me how she was doing now, and if I would let him know if she changed before he got there, still 100% polite and I'm just in shock and awe at this point how kind he is being. And don't forget, I HATE paging a Dr, and I've paged 3 times now and I feel horrible about it, esp since most Drs gripe the first time, and he's being great after 3 times.
Well our lady started to trend down after the 2nd dose of IV lasix. She was saturating at 100%, but she couldn't "breathe", couldn't even speak barely, and at first I was thinking air hunger, but her bp was trending down, she felt nauseous, and her feet and hands started to feel cold to touch when I assessed her pedal and radial pulses to check her perfusion. She just was giving me a bad feeling all around, and I couldn't even get a radial pulse. She was still able to respond to me, had an apical, was breathing.. etc. But I could tell she just was off. And I decided I needed to page him, this was only 40 minutes after the last one, it just happened really fast.
He asked me what I wanted him to do after I gave him my rundown of what was going on, and I told him I wanted him to come, and he said Ok, and literally ran in the nurses station 1 minute and 30 seconds later. We went back there and He decided right away to bolus her with fluids, and he was trying to get a radial, no dice. Brachial... nope... Femoral... no.. Manual BP.. no.
Ok .. Bolus going wide open, page RT. Get a mask on wide open instead of the cannula, and he' sill trying to get a manual bp. Nothing. She is responding to him, but he can't get a bp or a extremity pulse.
We trendelenburg her, and he decides he wants dopamine drip, except in our hosp, they can only be run on the cardiac floor or ICU. I work on orthopedics. We get medical overflow and ortho, period. No Dopamine, at all, ever, He says well let's just start it and transfer her, but we aren't allowed to do that, so the man is resourceful, he is thinking "what is the best way to do what I can to get around the hospital politics bull**** and get what my patient needs, I'll call a code."
So he tells us to call a code. We said call a code? He said yes, call a code... Code called.
Of course 3/4 of the hosp converged. And wow, Apparently when a Dr calls a code for a dopamine drip and the patient is not coding, it's ok for ICU nurses to be (what i want to say is a 4 letter word that starts with C, because it's the word that best describes it, but I'll use bitch) bitches. They ranted, and raved, and complained, and I was so humiliated by the fact that they would act like that, in front of a patient and her husband, in front of other co-workers, in the face of the fact that what they were doing was necessary to stabilize someone , and to a doctor.
In the elevator he tries again to take her blood pressure and the elevator stops and the ICU nurse just snapped I'm going now, and pushed the bed forward, and he was leaning over trying to listen and had his stethoscope connected to try to hear another bp
I've never been so pissed, and he kept it sooo cool, and remained so polite and nice, and never snapped or said anything unkind or snotty, and If I was him, I'd have made some kind of remark about being a nurse and him being a doctor, but he never did. He did his job, we got her down to CVICU, and as I was finishing up my charting and about to leave, he came over to tell me I did a good job, and thanked me.
I really wish I could have bitch slapped those nasty nurses because I don't know who they think they were.
Now I am not saying this because I think the Dr is 'better' than me as a nurse. I'm not of that mentality. There are some doctors we have that I don't have that much respect for, but I still show them the same amount of respect , and they would never know I don't like them personally. Because they are my co-workers, and number one my job is to work with them to take care of the patients.
Out of curiosity though, if we have dopamine in our crash cart.. which we do, could a Dr not hang it if he wanted it for a patient?
I'm just trying to figure out what we could have done different there.
The few times I had to page him, he was fantastic, thanked me, and was very polite. Gave me orders and told me he would be coming by later on as well to check on how everything was going, as we had a CHF lady we were diuresing.
Most of our hospitalists, don't even speak recognizable English, let alone acknowledge the nurses anyways, so the guy is already like my favorite person, and he wasn't bad to look at either 😛, not to mention the extremly good manners and treating me like I had some intelligence.
He had ordered an echo, and the tech told me her ejection fraction was <20% and I should call him, so I looked in her chart, and saw nothing about that in there, and so I paged him to let him know. He called me right back, and when I told him, he told me that was something they already knew about, and that he did the echo to check for pericardial effusion, but that he appreciated me letting him know, and he could see why it would be a concern, and asked me how she was doing now, and if I would let him know if she changed before he got there, still 100% polite and I'm just in shock and awe at this point how kind he is being. And don't forget, I HATE paging a Dr, and I've paged 3 times now and I feel horrible about it, esp since most Drs gripe the first time, and he's being great after 3 times.
Well our lady started to trend down after the 2nd dose of IV lasix. She was saturating at 100%, but she couldn't "breathe", couldn't even speak barely, and at first I was thinking air hunger, but her bp was trending down, she felt nauseous, and her feet and hands started to feel cold to touch when I assessed her pedal and radial pulses to check her perfusion. She just was giving me a bad feeling all around, and I couldn't even get a radial pulse. She was still able to respond to me, had an apical, was breathing.. etc. But I could tell she just was off. And I decided I needed to page him, this was only 40 minutes after the last one, it just happened really fast.
He asked me what I wanted him to do after I gave him my rundown of what was going on, and I told him I wanted him to come, and he said Ok, and literally ran in the nurses station 1 minute and 30 seconds later. We went back there and He decided right away to bolus her with fluids, and he was trying to get a radial, no dice. Brachial... nope... Femoral... no.. Manual BP.. no.
Ok .. Bolus going wide open, page RT. Get a mask on wide open instead of the cannula, and he' sill trying to get a manual bp. Nothing. She is responding to him, but he can't get a bp or a extremity pulse.
We trendelenburg her, and he decides he wants dopamine drip, except in our hosp, they can only be run on the cardiac floor or ICU. I work on orthopedics. We get medical overflow and ortho, period. No Dopamine, at all, ever, He says well let's just start it and transfer her, but we aren't allowed to do that, so the man is resourceful, he is thinking "what is the best way to do what I can to get around the hospital politics bull**** and get what my patient needs, I'll call a code."
So he tells us to call a code. We said call a code? He said yes, call a code... Code called.
Of course 3/4 of the hosp converged. And wow, Apparently when a Dr calls a code for a dopamine drip and the patient is not coding, it's ok for ICU nurses to be (what i want to say is a 4 letter word that starts with C, because it's the word that best describes it, but I'll use bitch) bitches. They ranted, and raved, and complained, and I was so humiliated by the fact that they would act like that, in front of a patient and her husband, in front of other co-workers, in the face of the fact that what they were doing was necessary to stabilize someone , and to a doctor.
In the elevator he tries again to take her blood pressure and the elevator stops and the ICU nurse just snapped I'm going now, and pushed the bed forward, and he was leaning over trying to listen and had his stethoscope connected to try to hear another bp
I've never been so pissed, and he kept it sooo cool, and remained so polite and nice, and never snapped or said anything unkind or snotty, and If I was him, I'd have made some kind of remark about being a nurse and him being a doctor, but he never did. He did his job, we got her down to CVICU, and as I was finishing up my charting and about to leave, he came over to tell me I did a good job, and thanked me.
I really wish I could have bitch slapped those nasty nurses because I don't know who they think they were.
Now I am not saying this because I think the Dr is 'better' than me as a nurse. I'm not of that mentality. There are some doctors we have that I don't have that much respect for, but I still show them the same amount of respect , and they would never know I don't like them personally. Because they are my co-workers, and number one my job is to work with them to take care of the patients.
Out of curiosity though, if we have dopamine in our crash cart.. which we do, could a Dr not hang it if he wanted it for a patient?
I'm just trying to figure out what we could have done different there.
