swoopyswoop

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One of my post op patients that we bypassed is doing great. Just need to watch her dry gangrene demarcate. Get a call from the medicine attending we transferred her to for some other issues.

“The nurse says the patient’s foot looks worse and doesn’t have Doppler pulses.”

Me: “well what did you find on your exam?”

Medicine: ummmmm

Me: *in my mind* GTFO

My resident goes by and everything looks better than it did. Positive Doppler signals.
I have gotten many phone calls from medicine attendings reporting to me nursing findings without actually seeing the patients themselves. Even worse, sometimes I get nursing calls from medicine patients because the nurse thought the surgeon needed to assess the issue and just bypassed the medicine team.
 

TimesNewRoman

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I have gotten many phone calls from medicine attendings reporting to me nursing findings without actually seeing the patients themselves. Even worse, sometimes I get nursing calls from medicine patients because the nurse thought the surgeon needed to assess the issue and just bypassed the medicine team.
I would flip if a nurse tried to call a consult on my patient.
 

Jolie South

is invoking Domo. . .
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I have gotten many phone calls from medicine attendings reporting to me nursing findings without actually seeing the patients themselves. Even worse, sometimes I get nursing calls from medicine patients because the nurse thought the surgeon needed to assess the issue and just bypassed the medicine team.
Yea, I mean it happens ALL the time and as a fellow, I just have to politely go see the patient. When residents do it, I say examine the patient and call me back.

Where I am going to practice as sole vascular surgeon, I am not going to accept that practice.
 

TimesNewRoman

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Yea, I mean it happens ALL the time and as a fellow, I just have to politely go see the patient. When residents do it, I say examine the patient and call me back.

Where I am going to practice as sole vascular surgeon, I am not going to accept that practice.
Where you practice as sole vascular surgeon you’re going to say “thank you for this consult!” and go see them quickly and cheerfully. It’s a business, man.
 

dr zaius

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I think @Jolie South is Air Force so they will be the only person that can be consulted for a vascular problem. In that same vein it won't be a business, either. Pay will be the same regardless.

I get incredibly annoyed when I am called with nursing findings and the physician hasn't examined the patient. Especially when I'm on home call and they are in house.
 

WinslowPringle

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Got a consult last week for a bruise on the thigh. “Suspect blood vessel injury”. Patient is not on anticoagulation and it is a run of the mill bruise.

:1rolleyes:
Technically correct is the best kind of correct?.....


Reminds me of a consult I got awhile ago from an ED NP for a bruise. I've been trying to block the memory. Granted it was an abdominal bruise from a seatbelt sign after MVC in AM asymptomatic and hemodynamically stable patient who was eating while I saw him in the ED, but I wasn't consulted out of any concern for missed bowel injury, etc. Literally consulted because the CT abdomen without contrast report stated "subcutaneous edema, possible bruising". NP hadn't seen the bruise. I asked why the CT was without contrast; "I don't know" was the answer. Wasn't really wanting to have a Socratic teaching moment, but was curious at this point so risked the write-up and asked why she was concerned about the bruise: "because the CT report mentioned it." Asked what she thought a seatbelt sign could mean; "Maybe bleeding". Repeated my question why the CT was without contrast then....."Oh, maybe it should've had contrast?" Asked if she thought the patient was bleeding internally; "I don't know, that's why I consulted you." Asked what the first signs of internal bleeding were: answer - "maybe bruising."

I then quit talking and went and wept for the future of our nation for awhile.