Most ridiculous question from a nurse while on call

[pgg]

Alright, we've now beaten one anecdotal horse to death, and the tone of the thread is teetering on the precipice. Please bring it back on topic with some sense of collegiality and humor.

That part of the thread was just like a real code in a hospital.

30 people crowded into the room, half shouting the wrong thing, half doing nothing.

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[Rendar5]

That part of the thread was just like a real code in a hospital.

30 people crowded into the room, half shouting the wrong thing, half doing nothing.

 

[jl lin]

I absolutely agree that monitors provide information that helps us understand the patient’s condition. The EKG showed VT so I assessed the hemodynamics and found the patient was alert and I used another monitor to assess BP. I never meant to imply that this was a benign problem.

I like having monitors. I would much prefer to have a Swan Ganz catheter and arterial line in a hemodynamically unstable patient than none.

A couple examples to illustrate why I say, don't treat the monitor, treat the patient:

Two cardiac patients were admitted to our telemetry unit at the same time. Somehow the patients EKG monitors got switched and the EKG tech yelled, patient X is crashing in whatever rhythm it was. We ran to the patient’s room with the crash cart and the patient is alert and appears stable so we hook the patient up to the crash cart’s EKG monitor which is not showing an abnormal rhythm. Simultaneously another patient is found lying on the floor unresponsive and several nurses take the other crash cart to him and find he indeed is crashing. Fortunately the patient survived.

Another time I was in OHRU and a patient’s BP alarm began sounding and several nurses ran to him. The patient was alert. I understand that a patient can maintain consciousness for a short time after their heart stops, I have seen it happen. One of the nurses is screaming he’s in PEA, get the cart and the cart comes rolling in and the freaked out nurse begins taking the patient’s gown off him so she can start CPR. I am looking at the monitor and thinking why is the BP waveform flat but the patient’s PA tracings are normal. I assess and find that the patient’s arterial line has kinked off. When patients are alert and off the ventilator after surgery they use their hands to push themselves up in bed and that can cause a line to kink. That is why I say, don’t treat the monitor, treat the patient.

You can’t use a cookie cutter approach to treat patients, regardless if their problem is ventricular tachycardia or else.

An anecdote about ventricular tachycardia, calling codes and residents assuming responsibility for the patients:

One time a patient went into ventricular tachycardia on night shift and they called a code and the nurses and residents shocked the patient and gave a lidocaine bolus and started a lidocaine drip. That was the correct thing to do according to ACLS. But AHA clearly states that ACLS protocols are guidelines for management not absolute rules. ACLS is intended to educate the nurses, residents, dentists, paramedics and attending physicians who are not cardiologists. Cardiologists have a higher level of knowledge of cardiac disease and therapies. So the next morning I was the RN responsible for the patient I described. The cardiologist looks over the code documentation and wants to know why in the hell they had started lidocaine on this patient. He had the patient on an oral medication (forget which) to treat the VT and he was angry because starting the lidocaine would delay determining optimal oral meds for this patient. You can’t send patient’s home on lidocaine drips. The cardiologist DCd the lidocaine and increased the oral med all the while chewing me a new butthole. Never mind that I was home asleep while the clusterf**k was going on. The resident should have contacted the cardiologist to inform him but the resident thought, oh, hey, I know ACLS, and yes he did the right thing by ACLS but the wrong thing because he did not communicate with the attending and the resident did not see the big picture. Lidocaine was correct according to ACLS guidelines but wrong for this particular patient.

Another reason it may be more appropriate to phone the cardiologist rather than page an intern is the cardiologist may want a therapy such as overdrive pacing. I watched a cardiologist use overdrive pacing at the bedside once and he taught me how to do it and later I did the overdrive pacing while I was talking to the doc on the telephone.



You are absolutely correct that rate of VT is only one factor that influences perfusion. I did not say you cannot have severely compromised by a slower rate of VT. I was simply saying that disregarding all other factors the faster heart rates are more likely to compromise cardiac output and perfusion.

I have hundred of rhythm strips but unfortunately I put a box of them in my Quonset hut and the deck has become unsafe so I can’t get into the building until I build a new deck. But yes ventricular tachycardia can be at very high speeds but don’t take my word for it:.

[Ventricular tachycardia] complex is wide and bizarre, recurs regularly at at rate greater than one hundred beats per minute (usually between 150 and 200 but may approach 300). The Heart, J Willis Hurst

.Another form of ventricular tachycardia that can approach that speed is torsades de pointes. Torsades de pointes is very fast and also very dangerous because it can quickly progress to ventricular fibrillation. When the ventricular tachycardia is an unusually rapid zigzag our cardiologists call that ventricular flutter. I am not certain if that term is used elsewhere. Either of those and I’d be calling everybody I can get to help manage the patient..

It might have helped if I had said that my patient had been known to have sustained VT for some length of time. I can’t recall the details now but I’m thinking he had been in sustained VT for periods of twenty minutes before the day I called the doctor in the rain. I remember discussion about VT and one of the physicians said he had known of a patient who had been in sustained ventricular tachycardia for duration of 36 hours.

I did some searching and found a journal article describing sustained ventricular tachycardia of 70 days’ duration. As you might expect the rate of the ventricular tachycardia was fairly slow. I would attach the PDF but one, I don’t know how to do that and two, I am not sure that is legal. So here are excerpts –

.The American Journal of Cardiology.
.Volume 11, Issue 1, January 1963, Pages 107-111.
.Ventricular tachycardia of 70 days' duration with survival.

Although ventricular tachycardia has usually been considered to have a poor prognosis,.several cases of prolonged ventricular tachycardia have been reported. The purpose of. this paper is to emphasize again that prolonged ventricular tachycardia does not necessarily lead to death. To our knowledge, this report describes the longest nonfatal attack of ventricular tachycardia recorded in the available English literature.

.Several instances of prolonged ventricular tachycardia have been reported, most ending in death. (Elliott and Fenn,’ 32 days; Marra et a1.,2 30 days; Cooke and White,a 28 days; Weisberg et a1.,4 23 days; Armbrust and Levine,5 23 days.) May@ reported a 59 year old man with ventricular tachycardia, who had coronary artery thrombosis with infarction and involvement of the interventricular septum; he died after 77 days, apparently the longest duration of ventricular tachycardia in American literature. The longest case on record that we could locate in the world literature is that of Moia and Campana.7 A 24 year old man had repeated attacks of ventricular tachycardia for. three years and died of pulmonary complications after an attack of 123 days. There are, in addition, several reported cases of prolonged ventricular tachycardia with favorable termination.(Pordy et a1.,8 57 days) A nonfatal case of ventricular tachycardia of 70 days’ duration was reported in 1959 in Algeria by Raynaud and Bernasconi.

The largest nonfatal case that we could find in the literature was published in 1958 in France by Mathieu et al.17 They reported a 59 year old patient with ventricular tachycardia of 103 days’ duration that reverted to sinus rhythm with treatment.

All I can say is that we have definitely had pts in cardiac units that were stable with verifiable VT and we tried to cardiovert w/o success. It happens. The one dude I'm thinking of was quite creepy too. He was wide awake as well with pretty much any sedation we gave him. Propofol wasn't quite out yet. We actually ended up giving him IM Vistaril, and it seemed to chill him somewhat. Guy was a well-educated drug user from SKB. Anyway, he was definitely in VT.

Had a few others like this, but in those cases that went on without any conversion, eventually they started to crumble after a while. One guy was pretty much in VT for a freaking week. Man this was quite some time ago. This was when the internal defibrillators were bigger than the size of a pack of cigaretts. EPS and interventional stuff was more up and coming back then.

Wild days.

 

[jl lin]

Can you medical students stop being obnoxious to the nurses in this thread? You will hopefully grow out of it in a few years but until then keep your snide comments to yourselves instead of broadcasting to everyone how emotionally stunted you are in your mid to late 20s.

As for the middle of the night call for a CVL, isn't that just classic? I don't understand why someone needs to protect the sleeping people at home who are actually supposed to care for a patient. Instead, especially as an in-house general surgery resident, I would get called to do all sorts of random crap for virtually any patient in the hospital.

Also, the comment about people lying to get you in trouble is so true. I remember in my more foolish intern days, when I was curt with someone over the phone(but never really crossed the line), occasionally my attending would be notified about how I was verbally abusive, ignored 3-5 pages, was yelling... all sorts of fabrications. Some people just have no conscience. It's really a shame. They play their immature games and don't know who they are hurting with these lies. They think we just get a one-time tongue lashing and that's it, but these comments can potentially get us fired or worse.

I've been an RN for quite some time, and it's strange. It's a total anomally for me to have one of these kind of strange conversations with a physician in the middle of the night or otherwise.


OK, if CT has something written that the nurse is to call for a K+ <4.0 (b/c someone is on a lasix gtt or whatever), then that is exactly what the nurse has to do. You may not like it, but it's written. . .and well, things written on the chart are like written in stone unless written elsewhere as something other--note the exception clauses and such.


As far as the CL, well it depends upon why the pt might need one. But say there is nothing in the arms--cannot cannulate any of the veins there. What is the policy for feet? Seriously. I mean in a baby this might a no brainer, but otherwise, it could be a policy issue. I've seen it. Plus a pt or familly member--say mom of older kid is a no go on it. So depending on the policy, etc, where are you going to IV GTT and meds into the pt? And some tele floors and units have a policy that the pts there must have IV access at all times while in the unit or on the tele or step-down floor. Better to have access before certain pts crash than after--especiallly if they are hard sticks or don't have decent veins for cannulation.

So how in the hell are you supposed to explain not being able to get that IVF or meds as ordered into the pt? I mean it sucks, but it has to be dealt with. Way it goes. What if there is no IV team to troubleshoot and no other RN and even the nursing supervisor can't get a line in? Chances are, if they can't get a line in, you probably will not be able to a peripheral in either. So then what if a PICC or Midline is suggested? Chances are, if there is no NP, you will have to give the word and get consent on the PICC line if you are covering. If that is the case, you will have to get up anyway. It may depend on the place's policy. But it still probably have to fall back to you if all else fails. Now, if there is someone else covering the pt and wants surgery for a CL, I have NO problem with having them call you to give you all of the 411. I could give a rat's butt who calls who, so long as the patient gets what he or she needs.

And that is how most of us nurses are. We just want to get what the pt needs and do our job, period. We could care less about being some object of your derision.

So I don't know who is calling whom in the middle of the night; but trust me. Most nurses anywhere hate, actually loathe calling docs in the middle of the night--but if it has to be done, so be it. As long as I know I'm doing the right thing and working in the best interest of the pt, I could care less what the person on the other end thinks of me. It's like the CT surgeons that want the early morning calls from the nurses. Oooo, I'm so intimidated. I stick with the facts, and that's it. If it is someone I have a fun repoire with, then we laugh and move on to the next thing.

We know the calls in the middle of the night suck. And that is why I do everything in my power to discuss things with the fellow or resident before he or she goes down--last call kind of thing. Things are just easier that way, but then there are the frustrating things like losing a line and not being able to get another in.
I mean some of these things are truly a pain in the butt, but this is part of the whole deal.

And I love these horrible idiotic nurse call stories that only tell one side of things.

Maybe some of them are truly idiotic and so they deserved to be poked fun at or vented over. But I am willing to bet in a number of cases, the WHOLE story is not being shared with the group here. Experience should teach us that there is always more than one side of the story, many times two or more sides.

For example, say a kid is on a Lasix Gtt, and his glucose has been considently off the wall. In a couple of hours if this keeps up and it is trending so, we will be looking at a totally wiped out K+ and Mg++.--and I have seen the funky dysrhthmias and Torsades and instability that follows quickly--especially in kids. See the devil is ALWAYS in the details.

So let's be fair and consider that in reality, the whole picture may not always be fully presented in these disrespect the "dumb" nurse stories.

Try to be fair and reasonable.



I have never, in many years of being a RN, called a covering physician or NP for that matter, for anything that was idiotic or that was not at least noted to be called for. If it is written, and I signed off the order and another RN co-signs the orders so nothing is said to be missed--if this is done and there is something noted that must be called for, guess what? If it occurs, I am obligated to call you--even if you have busted your hump and you are so tired you cannot remember your full name or your gender.

And hell if I want to be the one to call and wake your butt up. But we all have to do our jobs. So I say know the devil in the details all the way around things before you are too quick to comment or disparage others that you are to be working with in order to help the patients.



Now, when a nurse calls you for an order for sedation for a patient with uncontrollable masterbation, then go on ahead and post away. Trust me, I'm sad to say I know of some cases of this--the details of which are just, well, gross. Nonetheless, its sadly true, true, true.

 

[Apollyon]

Guy was a well-educated drug user from SKB.

Point of order: "SKB"?

 

[AbbyNormal]

Now, when a nurse calls you for an order for sedation for a patient with uncontrollable masterbation, then go on ahead and post away. Trust me, I'm sad to say I know of some cases of this--the details of which are just, well, gross. Nonetheless, its sadly true, true, true.

 

[Winged Scapula]

Ha ha....I would have loved to sedate those guys. Instead our nurses would call me to "come talk to" these guys. Like some stern lecture from me would stop them.

 

[AbbyNormal]

I was working telemetry one night and one of my patients still had the introducer in his groin and the site was oozing a little bit so I had to check his groin every fifteen minutes. I would try to shove "it" out of my way and cover "it" with a towel every time I looked at the site but "it" was not cooperative. I could have used you to talk to him about flaunting "it" that night. The patient thought it was funny; me, not so much.

 

[Winged Scapula]

I was working telemetry one night and one of my patients still had the introducer in his groin and the site was oozing a little bit so I had to check his groin every fifteen minutes. I would try to shove "it" out of my way and cover "it" with a towel every time I looked at the site but "it" was not cooperative. I could have used you to talk to him about flaunting "it" that night. The patient thought it was funny; me, not so much.

Meh.

Reminds me of my younger days, doing trauma with young male patients (and some dirty old men) who would have "itchy balls", scrotal swelling or some other genital complaint that I would have to come and examine.

Then there was the AKA ikth an open stump dehiscence and colostomy bag having sex in his room with his underaged GF. Yeah, that was a fun conversation. For some reason I was the "mature" one who was summoned to have these talks with the patients.

 

[NYRN]

One busy sat night in the ER I had this patient who I did not remember initially, but after the student came over to me looking like she saw a ghost and told me what he did, I remembered that he was here before and did the same thing to me. This lovely "gentleman" the last 3 times he was here would elope with his IV in which would cause me a lot of paperwork and a call to the cops in addition to catching him jerking off. Anyway, when she told me what he did, I went over to the cubicle and pulled the curtain wide open so everyone could see his hand in his pants. Everyone around his room turned to look at him and I said to him "nobody is impressed by your small thing, put it away or get out". Needless to say, he walked out and I got a round of applause. Never saw that guy again.

 

[glade]

OK, if CT has something written that the nurse is to call for a K+ <4.0 (b/c someone is on a lasix gtt or whatever), then that is exactly what the nurse has to do. You may not like it, but it's written. . .and well, things written on the chart are like written in stone unless written elsewhere as something other--note the exception clauses and such.

False. This is what nurses say, but then the same nurses will call you and ask "you ordered x, do I have to give it/do it?" What happened to "things written on the chart are like written in stone"? The only rule followed consistently by nurses is "do whatever makes my life easier." If it's easier to call someone, then they call. If it's easier to not call someone, then they don't. That's the long and short of it and we can sit around rationalizing it all we want twenty different ways, including by saying the classic "I'm just concerned for the patient, doctor, that's all, I know you're not, but I am."

 

[mooshika]

You who are screaming the loudest? You are just scared to death. Never seen such nasty displaced commentary and anger at a bunch of people trying to do a job just like you who, if they are as stupid and annoying as you say they are, ought not to be causing such a threat... unless of course they are threatening and in that case its on you to ask yourselves why.

 

[NYRN]

False. This is what nurses say, but then the same nurses will call you and ask "you ordered x, do I have to give it/do it?" What happened to "things written on the chart are like written in stone"? The only rule followed consistently by nurses is "do whatever makes my life easier." If it's easier to call someone, then they call. If it's easier to not call someone, then they don't. That's the long and short of it and we can sit around rationalizing it all we want twenty different ways, including by saying the classic "I'm just concerned for the patient, doctor, that's all, I know you're not, but I am."

You got it right, whatever makes it easier for me I have no interest in making sure the patient is getting what they need. You can't have it both ways. If the admission orders say call MD for xyz, and you get a call, you have no right to bitch. If you don't want to be notified of certain things, than don't use the standard order set, or make up your own parameters. The last time I checked, the patients are admitted under your ATTENDING and he/she might want to know about things you can care less about.

 

[glade]

Actually, that was my point. You can't have it both ways. You can't say "I'm calling you because the order says to do it and I never question orders" and also say "I'm calling because I can question orders and I choose to do so right now." Oh, and if the attending wants to know something so badly, call the attending. Except the nurse won't do that because she knows the attending will get upset and chew her out. So she'll call the resident and use them as her buffer since they're not allowed to chew anyone out. Don't be coy, we all know nurses do that.

 

[NYRN]

Actually, that was my point. You can't have it both ways. You can't say "I'm calling you because the order says to do it and I never question orders" and also say "I'm calling because I can question orders and I choose to do so right now." Oh, and if the attending wants to know something so badly, call the attending. Except the nurse won't do that because she knows the attending will get upset and chew her out. So she'll call the resident and use them as her buffer since they're not allowed to chew anyone out. Don't be coy, we all know nurses do that.

So we agree, we can't have it both ways. You can't expect nurses to blindly follow orders, then if they make a ridiculous mistake get pissed off because they should have questioned it. There has to be some sort of middle ground that the doctors and nurses agree on. When you work with certain attendings after a while, we know what they want for their patients and the set in stone guidelines aren't so set in stone. I'll give you a simple situation: Dr. X does not care if the patient voids before d/c home after surgery. When the residents put in the postop orders, a standard order set comes up that says pt must void before d/c, but if the attending is OK with them going home without voiding, we are not going to refuse to send the patient home because of what it says in the order set. I think for both doctors and nurses, common sense goes a long way.

I don't see nurses regularly paging the attending before the resident unless the attending requests to be paged for certain things. I also don't see attendings chewing out the nurses every time they are called. Even if they are angry, they act like the professionals they are, and have a conversation with the nurse or nurse manager about it, not fly off the handle like a child having a tantrum. Many times if the attending is going home for the day, they will tell us to page the resident for xyz.

In my hospital there were many high ranking attendings who were fired after many years of verbal abuse and unprofessional conduct towards staff. These people who are abusive to nurses, are also abusive to residents and med students. There is no place for this in medicine today.

 

[glade]

There has to be some sort of middle ground that the doctors and nurses agree on. When you work with certain attendings after a while, we know what they want for their patients and the set in stone guidelines aren't so set in stone.

I agree, there has to be a middle ground. And your example is a reasonable one. However, that's not what residents get called about (that they complain about). And I'm pretty sure you know that. And I'm also pretty sure that you know that when a resident gets upset about getting woken up at night and asked "you ordered this six hours ago, do I have to really do it?" the nurse's defense at that time is "I'm allowed to question any order, I'm a member of the team!" So let's not pretend that nurses really do whatever an order says and that an order is set in stone once it's in the chart. I order ins and outs to be charted all the time and nurses won't do it and nobody can do a thing about it. We all accept it because it's one of those "let's pick our battles" things.

I don't see nurses regularly paging the attending before the resident unless the attending requests to be paged for certain things. I also don't see attendings chewing out the nurses every time they are called.

Right. That was my point. The nurses don't regularly page attendings. If they did, they'd get ripped a new one. They know that. But they don't mind paging a resident because the resident cannot say a thing, even if the nurse is trying to harrass the resident (and let's not pretend that doesn't happen, either). I even used to get paged about things by nurses when I was the consulting resident and she'd say "you should call the primary about this." That's not my job, but if you want to pass it along to him, why don't you call him? "Oh, I can't do that at night." But you want me to do it? "Yeah." *click*

 

[NYRN]

I agree, there has to be a middle ground. And your example is a reasonable one. However, that's not what residents get called about (that they complain about). And I'm pretty sure you know that. And I'm also pretty sure that you know that when a resident gets upset about getting woken up at night and asked "you ordered this six hours ago, do I have to really do it?" the nurse's defense at that time is "I'm allowed to question any order, I'm a member of the team!" So let's not pretend that nurses really do whatever an order says and that an order is set in stone once it's in the chart. I order ins and outs to be charted all the time and nurses won't do it and nobody can do a thing about it. We all accept it because it's one of those "let's pick our battles" things.



Right. That was my point. The nurses don't regularly page attendings. If they did, they'd get ripped a new one. They know that. But they don't mind paging a resident because the resident cannot say a thing, even if the nurse is trying to harrass the resident (and let's not pretend that doesn't happen, either). I even used to get paged about things by nurses when I was the consulting resident and she'd say "you should call the primary about this." That's not my job, but if you want to pass it along to him, why don't you call him? "Oh, I can't do that at night." But you want me to do it? "Yeah." *click*

If a nurse is really paging you because he/she wants you to d/c something just because he/she doesn't want to do it, that is inappropriate. No disagreement there. I+O is important, but if the resident refuses to make it easier to do it such as refusing to order foley caths in all of their patients, its less likely to get done. Doesn't make it right, but its the truth and we both know it.

The only situation I can think of off the top of my head is that would require a page to ask if something needs to be done now is when orders are in duplicate or get mixed up when crossing over into another service or when patients go to the floor after surgery/admission from ER.
I'll give you an example below:

Abx are given in OR by anesthesia and then the patient goes up to the floor/ICU. I have seen medication errors happen because the stat dose ordered/given by ER/anesthesia at 1300 and surgery orders the same abx to start @1600 and then q 8 h. The stat dose was given too close for the routine dose to be given. In cases like this, I need clarification. Do you want to change the time they are given to q 8 from the dose given in OR or do you want to change the order to start at 0000? I don't think this is unreasonable.

There will be some nasty nurses that harrass residents. These are the same nurses that are also nasty to other nurses, techs and clerks. They need to be reprimanded, but when you do so, it has to be done in the correct manner. Going off on them is only going to get you in trouble. You can go to the charge nurse or the nursing supervisor and let them handle it.

The nurse who called you and told you to page another doctor to notify them of a problem is wrong. If he/she feels that the problem is serious enough for a call to the attending at any hour, he/she should do that him/herself and document that. Even if you did call for her, she would not be off the hook if you got pulled into the OR or something and couldn't do it and something happened to the patient.

 

[jl lin]

False. This is what nurses say, but then the same nurses will call you and ask "you ordered x, do I have to give it/do it?" What happened to "things written on the chart are like written in stone"? The only rule followed consistently by nurses is "do whatever makes my life easier." If it's easier to call someone, then they call. If it's easier to not call someone, then they don't. That's the long and short of it and we can sit around rationalizing it all we want twenty different ways, including by saying the classic "I'm just concerned for the patient, doctor, that's all, I know you're not, but I am."

Clear bypass and TOTALLY untrue. If there is an issue where some question and judgment may be used, the nurse may be asking if this is something you still want to follow in light of new data or what is going on NOW.


Just STOP it. This is assasine.

I don't know if someone gave you undue attitude or if you are stuck in the need to give them undue attitude, or both.

Clearly this post shows there is some unheatlhy attitudes and dynamics going on.

I'm not going to sit here and give you endless scenarios of where this approach applies. It does apply, but the wise nurse knows she needs to be careful with it. Why? Influencing exhausted residents, fellows, or attendings to feel that they need to get defensive is NO HELP to the patient. It begins to cause a clouding of judgment--pride and exhaustion can and does get in the way a times. And it doesn't help if say their senior residents or whatever have pushed them too hard or disrespected them, and you know how that story goes: "****e runs downhill."


Now, how YOU choose to take something presented to you both as a human being and a professional is TOTALLY up to and on you--even if you are exhausted and disrespected at times.

I have spoken to nurses at times about how that they have to check their attitudes. Sorry. I've also had to speak to other in healthcare, whether physicians or others about checking attitudes. Now one is the "star player," and NO ONE is god. The god-attidudes is beyond counterproductive. Frankly, if I were a pt, which I have been, I'd want such attitudes very FAR away from me and my care.

But some people still have attitudes no matter what. You know what you do? You do your best to not let them control you and get in the way of what the patient needs and what's in his, his, or their (families) best interest.

If some nurses have somehow abuses the rightful use of clinical questioning and judgment, find a more productive way within YOURSELF in which to handle it.

You can't change everyone; but it doesn't necessarily make a nurse wrong for using critical thinking and question something, especially in light of new data. And in fact, if that data is compelling enough, YES, her license might depending upon doing this--not to mention the patient life or well-being.

You cannot be there at all times with each patient. Please, please remember this. You are only human. This is one vital reason amoung others that nurses are necessary. No physician, especially those carrying many cases/pts, is omnipresent. That's why nurses have the ability to take verbal orders and you don't have to fly to them every second an order needs to be adjusted or changed or discontinued. Frankly, I'm not a huge fan of verbal orders. I like the accountability in writing the order directly from the person giving it. But it's not always possible, and that is why you are given x amount of time to cover/sign-off the order legally.



Your post seems like some kind of reactionary response; unfortunately you influence others to think and behavior in a like manner--non-productive and unprofessional, as you careless post such things.

 

[jl lin]

If a nurse is really paging you because he/she wants you to d/c something just because he/she doesn't want to do it, that is inappropriate. No disagreement there. I+O is important, but if the resident refuses to make it easier to do it such as refusing to order foley caths in all of their patients, its less likely to get done. Doesn't make it right, but its the truth and we both know it.

The only situation I can think of off the top of my head is that would require a page to ask if something needs to be done now is when orders are in duplicate or get mixed up when crossing over into another service or when patients go to the floor after surgery/admission from ER.
I'll give you an example below:

Abx are given in OR by anesthesia and then the patient goes up to the floor/ICU. I have seen medication errors happen because the stat dose ordered/given by ER/anesthesia at 1300 and surgery orders the same abx to start @1600 and then q 8 h. The stat dose was given too close for the routine dose to be given. In cases like this, I need clarification. Do you want to change the time they are given to q 8 from the dose given in OR or do you want to change the order to start at 0000? I don't think this is unreasonable.

There will be some nasty nurses that harrass residents. These are the same nurses that are also nasty to other nurses, techs and clerks. They need to be reprimanded, but when you do so, it has to be done in the correct manner. Going off on them is only going to get you in trouble. You can go to the charge nurse or the nursing supervisor and let them handle it.

The nurse who called you and told you to page another doctor to notify them of a problem is wrong. If he/she feels that the problem is serious enough for a call to the attending at any hour, he/she should do that him/herself and document that. Even if you did call for her, she would not be off the hook if you got pulled into the OR or something and couldn't do it and something happened to the patient.

I respectly disagree somewhat. Especially in critical care, pt's details, status, and data can change, which leads to a need to have the patient re-evaluated by physician or to somehow have a order tweaked, changed to something else, or somehow amended in light of the new information.

Oy. . .and veh.


This person's post just set nursing back about a 1000 years. Apparently there are issues and some confusion going on about things.

 

[NYRN]

I respectly disagree somewhat. Especially in critical care, pt's details, status, and data can change, which leads to a need to have the patient re-evaluated by physician or to somehow have a order tweaked, changed to something else, or somehow amended in light of the new information.

Oy. . .and veh.


This person's post just set nursing back about a 1000 years. Apparently there are issues and some confusion going on about things.

I think everyone knows that things do change and then orders change in an ICU setting. The nice part about the ICU is that with standing orders for nearly everything, we don't have to call about everything.

I really think what glade meant was that he was getting called by floor nurses asking if a long standing order should continue just because it a PIA for the nurse to do or if they aren't sure how to do it. IF there were a situation where the condition changed or if there were circumstances that could lead to a medication error and the call was legit, I would think he was wrong.

I hate to admit this, but I have seen nurses do what he says they do. I don't think it happens as often as he says it does, but it goes on. I think it tends to be new nurses who are scared to do something or lazy people who don't want to do it.

I have to wonder why if it was a new nurse that she didn't go to other nurses and ask before calling. If more experienced nurses told her to call in order to blow her off or if they are not helpful to her, then there are other issues going on.

 

[pgg]

The entertainment value of this thread is inversely proportional to the number of nurses posting in it.

Thanks, killjoys.

 

[WholeLottaGame7]

Just STOP it. This is assasine.

Half assassin, half asinine? I don't know what that would be, but it sounds pretty awesome.

Anyway, I think everyone can agree that there are some nurses that are obstructionist, just as there are residents that are short-tempered. That's not really up for debate. What really seems to be the issue here is a lack of respect and people skills on both sides.

From the med student/future physician side of things, I have found that if you're nice to people and ask for things respectfully, there are very few nurses that are obnoxious for the sake of being obnoxious. And the ones that are, it's usually something with their personality and nothing you can do anything about anyway.

 

[smq123]

To bring it back to stupid calls...(but ones that don't involve nurses)

In our program we have to answer questions from the answering service, and some of the people who work for that service are a little...questionable. One of the PGY-2s told me about this call she got from the answer service overnight:

Answering service: Mrs. Smith called - her daughter has a fever.
Resident: Ok....what's her phone number? I'll call her back.
Answering service: 555-123-4567.
Resident:555-123-45....wait. That's *MY* number!! What's the *PATIENT'S* number??"
Answering service: Ohhhh....oops. Oh well. She'll call back if it's important, right? *click*
Resident:

 

[jl lin]

Half assassin, half asinine? I don't know what that would be, but it sounds pretty awesome.

Anyway, I think everyone can agree that there are some nurses that are obstructionist, just as there are residents that are short-tempered. That's not really up for debate. What really seems to be the issue here is a lack of respect and people skills on both sides.

From the med student/future physician side of things, I have found that if you're nice to people and ask for things respectfully, there are very few nurses that are obnoxious for the sake of being obnoxious. And the ones that are, it's usually something with their personality and nothing you can do anything about anyway.

Sorry for the typos. I flew those posts off too quickly, right before work. LOL

My bad and how asanine of me--and I do mean aSSanine.

I agree about being nice and respectful. And I also agree about the obnoxious nurses. My colleagues and I have let them no how negative and unproductive this is, and that it reflects poorly on all of us, as well as the fact that it sets a bad tone.

So I have to agree on that end of things.

But I also have to be fair and see that I have seen some just be into some form of silly nurse hate--or do what is done to them--that is, well, ****e runs down hill. . .so. . .

That is the problem with displacement. The cycle of dumping continues until someone is strong enough in themselves to just put a stop to it.

 

[jl lin]

To bring it back to stupid calls...(but ones that don't involve nurses)

In our program we have to answer questions from the answering service, and some of the people who work for that service are a little...questionable. One of the PGY-2s told me about this call she got from the answer service overnight:

Answering service: Mrs. Smith called - her daughter has a fever.
Resident: Ok....what's her phone number? I'll call her back.
Answering service: 555-123-4567.
Resident:555-123-45....wait. That's *MY* number!! What's the *PATIENT'S* number??"
Answering service: Ohhhh....oops. Oh well. She'll call back if it's important, right? *click*
Resident:

Seriously. This is for real? Was this before digital phoning or *69? LOL

 

[jl lin]

The entertainment value of this thread is inversely proportional to the number of nurses posting in it.

Thanks, killjoys.

Yea but there's enough hypersensitive stuff coming from all sides on sdn. Come on. There are two (+) more sides to all things.

 

[smq123]

Yea but there's enough hypersensitive stuff coming from all sides on sdn. Come on. There are two (+) more sides to all things.

That may be true, but that wasn't his point.

The original purpose of this thread was to vent, and laugh at, some of the stupid calls we get as resident physicians. They're probably funnier (or more infuriating) because they often come at 3 AM after we've been up for nearly 24 hours....an experience that most nurses, who work almost exclusively shift work, do not share.

pgg's point was, I believe, that this thread has been derailed from its original purpose mostly by nurses who have jumped in to defend other nurses and discuss why nurses carry out certain orders, the appropriate response to certain physicians, etc. And, the more nurses that respond, the farther the thread drifts away from its original purpose - which was a place to laugh and share stories. If you look at the past few pages of the thread, almost all of the posts have been written by nurses.

It's not a question of who is being hypersensitive, who is "right," etc. It's just a matter of the nurses who are posting on this thread are also derailing it from its original lighthearted purpose.

While I do not want to make anyone, least of all nurses, feel unwelcome in this forum or these threads, this forum is, at the end of the day, designed for physicians who are currently, or once were, residents. So, if any of the physicians reading this have a story to share, please do so. Otherwise, please keep the "nurses are right vs. nurses are dumb" or "I'm not being hypersensitive, YOU ARE!" types of posts out.

Thanks.

[/serious note]

 

[mooshika]

That may be true, but that wasn't his point.

The original purpose of this thread was to vent, and laugh at, some of the stupid calls we get as resident physicians. They're probably funnier (or more infuriating) because they often come at 3 AM after we've been up for nearly 24 hours....an experience that most nurses, who work almost exclusively shift work, do not share.

pgg's point was, I believe, that this thread has been derailed from its original purpose mostly by nurses who have jumped in to defend other nurses and discuss why nurses carry out certain orders, the appropriate response to certain physicians, etc. And, the more nurses that respond, the farther the thread drifts away from its original purpose - which was a place to laugh and share stories. If you look at the past few pages of the thread, almost all of the posts have been written by nurses.

It's not a question of who is being hypersensitive, who is "right," etc. It's just a matter of the nurses who are posting on this thread are also derailing it from its original lighthearted purpose.

While I do not want to make anyone, least of all nurses, feel unwelcome in this forum or these threads, this forum is, at the end of the day, designed for physicians who are currently, or once were, residents. So, if any of the physicians reading this have a story to share, please do so. Otherwise, please keep the "nurses are right vs. nurses are dumb" or "I'm not being hypersensitive, YOU ARE!" types of posts out.

Thanks.

[/serious note]

I don't see any off-topic posts by people you either assume are nurses or actually are. I see a lot of posts that directly insult nurses, or claim that they are lazy, stupid, annoying and an appropriate topic to make jokes about. It was never really lighthearted was it? It is a pretty sensitive topic, and there are a considerable number of people with nursing degrees who are either now in medical school or about to be, or actually finished. Why is starting a thread that specifically targets annoying things nurses do acceptable at all?

See, you bought into this job where they (unreasonably) expect you to work 32 hours straight. You can't blame that on anyone else. Also, admissions are made under your attending's license, not yours, and residents in teaching hospitals are the number one reason nurses have to do extra work due to your general inexperience. In more cases than not, I have seen nurses save your butts more often than act "stupid." I realize you get calls at night that seem ridiculous to you, but that's your job. Nurses work their tails off, and if you are getting "problems" with calls, maybe it's not time to start complaining about the other people on your unit who are just soooo stupid. Maybe it is time to look somewhere else.

How about a thread that talks about the different ways that the floor nurses saved your rear ends?

 

[AnteriorSegment]

Thank you for that cos some of the stories were hilarious.
And I was staying out of here for a couple of weeks because
of the non-hilarity going one.
Kind of reminds me of the craziest chief complaint etc...

 

[csmittyB]

I don't see any off-topic posts by people you either assume are nurses or actually are. I see a lot of posts that directly insult nurses, or claim that they are lazy, stupid, annoying and an appropriate topic to make jokes about. It was never really lighthearted was it? It is a pretty sensitive topic, and there are a considerable number of people with nursing degrees who are either now in medical school or about to be, or actually finished. Why is starting a thread that specifically targets annoying things nurses do acceptable at all?

See, you bought into this job where they (unreasonably) expect you to work 32 hours straight. You can't blame that on anyone else. Also, admissions are made under your attending's license, not yours, and residents in teaching hospitals are the number one reason nurses have to do extra work due to your general inexperience. In more cases than not, I have seen nurses save your butts more often than act "stupid." I realize you get calls at night that seem ridiculous to you, but that's your job. Nurses work their tails off, and if you are getting "problems" with calls, maybe it's not time to start complaining about the other people on your unit who are just soooo stupid. Maybe it is time to look somewhere else.

How about a thread that talks about the different ways that the floor nurses saved your rear ends?

Why don't you go to a nursing forum and start one if you are so interested in that topic?

Here is a page you may be interested in:

http://www.facebook.com/group.php?gi...8999830?ref=ts

 

[jl lin]

That may be true, but that wasn't his point.

The original purpose of this thread was to vent, and laugh at, some of the stupid calls we get as resident physicians. They're probably funnier (or more infuriating) because they often come at 3 AM after we've been up for nearly 24 hours....an experience that most nurses, who work almost exclusively shift work, do not share.

pgg's point was, I believe, that this thread has been derailed from its original purpose mostly by nurses who have jumped in to defend other nurses and discuss why nurses carry out certain orders, the appropriate response to certain physicians, etc. And, the more nurses that respond, the farther the thread drifts away from its original purpose - which was a place to laugh and share stories. If you look at the past few pages of the thread, almost all of the posts have been written by nurses.

It's not a question of who is being hypersensitive, who is "right," etc. It's just a matter of the nurses who are posting on this thread are also derailing it from its original lighthearted purpose.

While I do not want to make anyone, least of all nurses, feel unwelcome in this forum or these threads, this forum is, at the end of the day, designed for physicians who are currently, or once were, residents. So, if any of the physicians reading this have a story to share, please do so. Otherwise, please keep the "nurses are right vs. nurses are dumb" or "I'm not being hypersensitive, YOU ARE!" types of posts out.

Thanks.

[/serious note]

Listen, I know you are a moderator, and I am not stepping to you or anyone.

No problem with venting or having laughs; but when they come in over and over as a means of pretty much singling out nurses, believe this, regardless, it IS a problem for everyone. And it undermines mutal respect. It sets the tone for this to continue to ms, as they read and are influenced socially in this attitude and the rationalizations for them.



Seriously, let someone start and continue with stupid doctor experiences. . .there WILL be backlash.



It's about a seven letter word that the Queen (of Soul) used to sing about. R-E-S-P-E-C-T.

Do what you want and have your way with your thread; but it undermines and demeans your profession and my future profession.


It's hard to respect such a mentality where it essentially comes down to feeling ahead or superior in some way, exhauted or not (rationalization), directly by diminishing and demeaning another group--at their expense. (BTW, I have to worked > 36 hours, but that's another story--and with these occassions there were no call rooms for any downtime at all. Taking any time off your feet and closing your eyes for a while beats working on your feet hour after hour after hour and having to be accountable for what you do without any downtime.)

Again, there are ALWAY two and MORE sides to stories and perspectives.

So there is no respect for attempting to elevate or even lighten things for some while disrespecting, without balance, another.

Life doesn't work that way. And things do have a way of coming back to roost.



I've heard productive things about what this hospital is doing with regard to productive nurse-physician relations:

http://www.choa.org/default.aspx?id=3347

 

[jl lin]

I don't see any off-topic posts by people you either assume are nurses or actually are. I see a lot of posts that directly insult nurses, or claim that they are lazy, stupid, annoying and an appropriate topic to make jokes about. It was never really lighthearted was it? It is a pretty sensitive topic, and there are a considerable number of people with nursing degrees who are either now in medical school or about to be, or actually finished. Why is starting a thread that specifically targets annoying things nurses do acceptable at all?

See, you bought into this job where they (unreasonably) expect you to work 32 hours straight. You can't blame that on anyone else. Also, admissions are made under your attending's license, not yours, and residents in teaching hospitals are the number one reason nurses have to do extra work due to your general inexperience. In more cases than not, I have seen nurses save your butts more often than act "stupid." I realize you get calls at night that seem ridiculous to you, but that's your job. Nurses work their tails off, and if you are getting "problems" with calls, maybe it's not time to start complaining about the other people on your unit who are just soooo stupid. Maybe it is time to look somewhere else.

How about a thread that talks about the different ways that the floor nurses saved your rear ends?

I don't know moo. I feel badly about this kind of thing; b/c if you look at it, it is usually not about dissing respiratory threrapists, or social worker, or another other discipline.

It usually it about disrespecting nurses--the one group that physicians must interact with more than any other discipline. Of course there will be reports of things here and there. But as I have said over and over and over, there are two plus sides to all stories--if not ALWAYS than certainly most of the time.

It makes no sense to continue to badmouth and undermine nurses, and even in jest, as it goes on, it actuallly makes physicians look childish, not respecting their part in communication/interaction issues--not seeing other points of view.

And I'll tell you, if this is a problem--communicating and interacting and having respect for nurses, do not think it does not reflect a similar problem with patients--especially those that are well beyond genuflexing in the presense of the title "Dr." Come on.


But of course, "Hey the old boy's club is just having fun and venting." Hmm, at the expense of others with which they must work and those that often advocate for patients and families. Again, totally nonproductive. . .not to mention lacking in setting the tone for professionalism.

And of course, it would look bad to rip on the patients and families too much; so the next best group to displace upon are nurses.


Great model.


You'll see it, or you won't.


If you won't, by all means, continue to disrespect nurses; but you might consider that you add more fuel to their fire by rationalizing your need to disrespect them.

 

[smq123]

It usually it about disrespecting nurses--the one group that physicians must interact with more than any other discipline. Of course there will be reports of things here and there. But as I have said over and over and over, there are two plus sides to all stories--if not ALWAYS than certainly most of the time.

It makes no sense to continue to badmouth and undermine nurses, and even in jest, as it goes on, it actuallly makes physicians look childish, not respecting their part in communication/interaction issues--not seeing other points of view.

Ok, that's it.

Now I'm getting really angry.

This is a forum that was designed for, and run by, physicians. It's not called the "general residency AND NURSING forum"; it's the general residency forum. It's a forum that is moderated by 2 residents, a fellow, and an attending physician.

First, some of you are complaining that threads like this are disrespectful of nurses, while completely oblivious to the fact that it is HIGHLY disrespectful of a nurse or a nursing student to come into THIS forum and lecture people on how to treat nurses. A few weeks ago, an NP even had the gall to try and incite an MD vs. DO war! I suggest that some of you complaining about how disrespectful residents are of nurses to step back and take a look at your own behavior.

Finally, again, this is a forum for residents. While open and excessive bashing of nurses will not be tolerated, neither will nurses coming in and derailing threads by complaints that such threads are "disrespectful." There are plenty of sites on the internet (i.e. allnurses) where nurses can have their chance to vent.

The next person to come in here and try to continue this ridiculous resident vs. nurse back-and-forthing will be infracted and the thread WILL be closed.

I hope I have made my position quite clear.

 

[jl lin]

Ok, that's it.

Now I'm getting really angry.

This is a forum that was designed for, and run by, physicians. It's not called the "general residency AND NURSING forum"; it's the general residency forum. It's a forum that is moderated by 2 residents, a fellow, and an attending physician.

First, some of you are complaining that threads like this are disrespectful of nurses, while completely oblivious to the fact that it is HIGHLY disrespectful of a nurse or a nursing student to come into THIS forum and lecture people on how to treat nurses. A few weeks ago, an NP even had the gall to try and incite an MD vs. DO war! I suggest that some of you complaining about how disrespectful residents are of nurses to step back and take a look at your own behavior.

Finally, again, this is a forum for residents. While open and excessive bashing of nurses will not be tolerated, neither will nurses coming in and derailing threads by complaints that such threads are "disrespectful." There are plenty of sites on the internet (i.e. allnurses) where nurses can have their chance to vent.

The next person to come in here and try to continue this ridiculous resident vs. nurse back-and-forthing will be infracted and the thread WILL be closed.

I hope I have made my position quite clear.

It was more about "Come on. Let's reason together about this." No derailing on my part. I know nothing about the NP interaction, and I honestly have not read through the whole thread.

My concern was with regard to a general sentiment that I have been noting through the threads that seems disrespectful towards nursing in general.

I find it productive for people to reason things out and hope to achieve some sense of balance--not go to extremes.

Also, you may be happy to know that personally I have had probably 98-99% excellent interactions with residents and various physicians. I have a great rapport with almost every single physician I've ever interacted, and I have worked with many over a very long time.

In my experience, just as most nurses are not stupid and obnoxious, the same can easily be said for physicians. Thank God. I wouldn't have lasted as long as I have, and also I wouldn't have been encouraged by a number of these physicians to pursue my goals regarding medicine.

So, from my perspective, it is not at all "us versus them."

 

[MedicoBoomstick]

-:-

 

[Eta Carinae]

Ok, that's it.

Now I'm getting really angry.

This is a forum that was designed for, and run by, physicians. It's not called the "general residency AND NURSING forum"; it's the general residency forum. It's a forum that is moderated by 2 residents, a fellow, and an attending physician.

First, some of you are complaining that threads like this are disrespectful of nurses, while completely oblivious to the fact that it is HIGHLY disrespectful of a nurse or a nursing student to come into THIS forum and lecture people on how to treat nurses. A few weeks ago, an NP even had the gall to try and incite an MD vs. DO war! I suggest that some of you complaining about how disrespectful residents are of nurses to step back and take a look at your own behavior.

Finally, again, this is a forum for residents. While open and excessive bashing of nurses will not be tolerated, neither will nurses coming in and derailing threads by complaints that such threads are "disrespectful." There are plenty of sites on the internet (i.e. allnurses) where nurses can have their chance to vent.

The next person to come in here and try to continue this ridiculous resident vs. nurse back-and-forthing will be infracted and the thread WILL be closed.

I hope I have made my position quite clear.

Indeed.

 

[ResidentMD]

It was more about "Come on. Let's reason together about this." No derailing on my part. I know nothing about the NP interaction, and I honestly have not read through the whole thread.

My concern was with regard to a general sentiment that I have been noting through the threads that seems disrespectful towards nursing in general.

I find it productive for people to reason things out and hope to achieve some sense of balance--not go to extremes.

Also, you may be happy to know that personally I have had probably 98-99% excellent interactions with residents and various physicians. I have a great rapport with almost every single physician I've ever interacted, and I have worked with many over a very long time.

In my experience, just as most nurses are not stupid and obnoxious, the same can easily be said for physicians. Thank God. I wouldn't have lasted as long as I have, and also I wouldn't have been encouraged by a number of these physicians to pursue my goals regarding medicine.

So, from my perspective, it is not at all "us versus them."

I see your point (and I am an MD). However, I think you are missing the point of this thread. The thread was made as a place to vent for residents who get called at 3 am in the morning with ridiculous things. The original intention was NOT to insult nurses. It might as well have been "stupidest thing done by your med student" thread (which I guess is out there somewhere, its just not active right now).

Along the line, some nurses got pissed and started the "we arent stupid, you are" type of posts. And that derailed it.

I have seen a derogatory attitude towards nurses among some forum members. However, its on similar lines as "DO's suck/FMG's suck/Carribeans suck/non-Ivy league schools suck" type of things. These are biases that you cant change (and like most pointless biases, never lead to anything good and only create bad blood)..and if you think you have the time to change these biases, it might be spent in a better way rather than trying to do it on an anonymous forum. You just cant change the biases some people have.

So again, I see the logic in your posts, and I do see that you arent one of those RNs who has come on here and started telling off physicians. The point is - the thread was meant to vent. So just let it be as that. If you want, you/some other RN can feel free to start a "most ridiculous response from a resident on call" thread in the nursing forum. Its just a venting thing. We wont interrupt.

P.S. I generally dont comment on such threads...its just that you seem like a nice person who didnt seem to be getting the point

 

[Surg0611]

In an attempt to get this thread back on track ...

Page @ 3:24 AM Pls call re patient in 432

Me: Dr. Surg0611 returning a page
RN: Hey Doc. I can't find DP or PT pulses in the patient's right foot.
Me: <deep sigh> He is having a BKA tomorrow, he hasn't had pulses in the right foot for days.

 

[smq123]

*beep beep beep* at 11:30 PM.

Me: Hi, Dr. smq123 returning a page?
RN: Hi! Are you ultrasound?
Me: .... Um, no.
RN: Oh...sorry! *click*
Me:

5 minutes later, 4 textpages come pouring in from 3 fellow residents and the PROGRAM DIRECTOR. Evidently, not only did she page me, she bombpaged everyone in the program, and they were all paging me to find out why *THEY* were getting paged when they weren't on call.

 

[francisco84]

Listen, I know you are a moderator, and I am not stepping to you or anyone.

No problem with venting or having laughs; but when they come in over and over as a means of pretty much singling out nurses, believe this, regardless, it IS a problem for everyone. And it undermines mutal respect. It sets the tone for this to continue to ms, as they read and are influenced socially in this attitude and the rationalizations for them.



Seriously, let someone start and continue with stupid doctor experiences. . .there WILL be backlash.



It's about a seven letter word that the Queen (of Soul) used to sing about. R-E-S-P-E-C-T.

Do what you want and have your way with your thread; but it undermines and demeans your profession and my future profession.


It's hard to respect such a mentality where it essentially comes down to feeling ahead or superior in some way, exhauted or not (rationalization), directly by diminishing and demeaning another group--at their expense. (BTW, I have to worked > 36 hours, but that's another story--and with these occassions there were no call rooms for any downtime at all. Taking any time off your feet and closing your eyes for a while beats working on your feet hour after hour after hour and having to be accountable for what you do without any downtime.)

Again, there are ALWAY two and MORE sides to stories and perspectives.

So there is no respect for attempting to elevate or even lighten things for some while disrespecting, without balance, another.

Life doesn't work that way. And things do have a way of coming back to roost.



I've heard productive things about what this hospital is doing with regard to productive nurse-physician relations:

http://www.choa.org/default.aspx?id=3347

Not really on topic of anything in this thread... not that much of what is in this thread is on topic BUT.... I don't think Otis Redding would like being called a Queen. His rendition (the original) of Respect is WAY better and the lyrics don't make him sound like a prostitute asking for respect from her pimp.


Now lets get back to funny ridiculous pages at 3am

 

[pgg]

pgg's point was, I believe, that this thread has been derailed from its original purpose mostly by nurses who have jumped in to defend other nurses and discuss why nurses carry out certain orders, the appropriate response to certain physicians, etc. And, the more nurses that respond, the farther the thread drifts away from its original purpose - which was a place to laugh and share stories. If you look at the past few pages of the thread, almost all of the posts have been written by nurses.

Exactly.

Nurses aren't unwelcome here, but you need to understand that you are guests on this forum. Just as it would be rude and inappropriate for physicians drop in on allnurses and fling around 600-word, indignant, and uppity collections of implausible anecdotes in your "dumb docter doesn't see the hole patient but ah do!" threads, your posts here admonishing us for griping about your colleagues are, well, obnoxious.

And FWIW, outside threads like this (which exist because of goofy or annoying things nurses do) you'll generally find that most of us have good, respectful relationships with the nurses we work with. Even if they are responsible for about 93.2% of the annoying crap we have to put up with.

So unbunch your panties and stop mother hen hassling us about our attitudes. There's room for you on SDN, but not if you're going to bother us in a thread that, until about 3 pages ago, was a source of laughs.

 

[Paseo Del Norte]

Sorry, all this thread needs is another nurse; however, good lord Jl Lin, you are killing me! This started as a vent thread and it was prefaced that way and emphasised as a blow off some steam exercise. Nurses call for stupid things, let the docs vent.

 

[fab4fan]

This is why I pretty much only post in the technology forum anymore. <shrug>

 

[jl lin]

I see your point (and I am an MD). However, I think you are missing the point of this thread. The thread was made as a place to vent for residents who get called at 3 am in the morning with ridiculous things. The original intention was NOT to insult nurses. It might as well have been "stupidest thing done by your med student" thread (which I guess is out there somewhere, its just not active right now).

Along the line, some nurses got pissed and started the "we arent stupid, you are" type of posts. And that derailed it.

I have seen a derogatory attitude towards nurses among some forum members. However, its on similar lines as "DO's suck/FMG's suck/Carribeans suck/non-Ivy league schools suck" type of things. These are biases that you cant change (and like most pointless biases, never lead to anything good and only create bad blood)..and if you think you have the time to change these biases, it might be spent in a better way rather than trying to do it on an anonymous forum. You just cant change the biases some people have.

So again, I see the logic in your posts, and I do see that you arent one of those RNs who has come on here and started telling off physicians. The point is - the thread was meant to vent. So just let it be as that. If you want, you/some other RN can feel free to start a "most ridiculous response from a resident on call" thread in the nursing forum. Its just a venting thing. We wont interrupt.

P.S. I generally dont comment on such threads...its just that you seem like a nice person who didnt seem to be getting the point

Dear Resident MD,

Thank you for a thoughtful and respectful reply.

I am also reassured by a moderator stating that she/he/they won't tolerate slamming nurses.

But you are right. If someone has decided to take on a certain bias, it's hard to try to help them out of it, b/c they don't want to do so.

Nothing more to add here.

Thank you again for your response.

 

[zenman]

I see your point (and I am an MD). However, I think you are missing the point of this thread. The thread was made as a place to vent for residents who get called at 3 am in the morning with ridiculous things. The original intention was NOT to insult nurses. It might as well have been "stupidest thing done by your med student" thread (which I guess is out there somewhere, its just not active right now).

Are residents not taught more productive ways to vent than to waste time posting? You could be sleeping for Christ's sake.

 

[smq123]

All right, that does it.

As entertaining and as useful as this thread was, recent posts by a few nurses have derailed it. Despite infractions being given out and in-thread warnings being given, it is STILL being derailed. A taunting post at the end will do nothing to help it.

If you want to discuss with each other over how residents ought to vent, please do it over PM, since this thread will be closed.