My patient is tamponading and death is at the door

[1mg.epi]

Don't you hate it when your patient is at deaths door and the heart surgeon is blaming you over the phone?

8 hr post cabg, chest tubes stopped putting out blood. Swan, Art line, cvp, CO all pointed to tamponade, blood sugar was going out of control , even with an insulin gtt.

I called the surgeon at 2am. I gave him my assessment and numbers, his reply was, "You are killing my patient!! It is a blood sugar problem and if you do not get it under control.Whe patient will die. Once again I attempted to explain to him. He started cussing and telling me how all nurses are so stupid. I HUNG UP ON HIM.

I then called him back and asked if he was ready to discuss his patient. He cursed at me and hung up on me.

10 min later he arrived at the unit. I had repeatedly attempted to contact he and he would not answer his call.

He then proceeded to tell me in front of patients and staff how I was going to kill his patients if I did not get the blood sugar under control. Well the patient was in so much distress that I could not get the GD BS under control. Doing blood sugars q10 min supplementing the gtt with IVP insulin.

Well he had called the surgical teem in and did not even tell me. I truly thought we would open the chest in the room. I had the chest opening cart at the bed side.

Well he brought the patinet back from surgery just befor the end of my shift. The anesthesia doc. told me, behind the surgons back, that the patient was full of large clots pressing on the heart and lungs. He congradulated me on my call.

The heart surgeon sat down next to me and said, "There was a whole in the left atrium. I don't know how that got there." All I wanted to say was, "You were the only one in there with a knife ass whole."

[Anonymous]

I hear ya.. I hate it when we know what's wrong and those who can fix it.....don't..

I had a patient when I worked sugical who had fecal material coming out of his gt drainage into the foley bag. It stunk to high heavens, hard belly and tinkles..

Did the surgeon listen to me on Sat. Nope. Did the charge nurse nope.. He spiked a fever on Sun.. He was already on antibiotics.

The on call surgeon went in on Sunday.. Seems the original surgeon puntured THROUGH the stomach with the foley.. HMMMMMMMMMMMMM and right into the small intestine..

Can anyone say peritonitis???

OMG.. Thank God for our eyes, ears, and noses..


WR,,, three commas for Becca

[HemoStat]

Hi Epi!!!
I worked in an open heart ICU for 3 years, and finally got out because the chief surgeon had one temper tantrum too many!!! Why are the nurses the first ones the surgeons blame when a patient crumps??? Why do they want a doctoral dissertation when you call for emergeny orders??? Why do they think they have to humiliate you in front of your peers??? Why can't they say "good job - you really caught that early"??? Why do they make it so tough on us shift after shift after shift, until they wear us down and run us out???? *Why-oh-Why???* she asks -

It all boils down to one thing, and one thing only:

THE GOD COMPLEX

And there ain't no cure for that malady, my friend!!!! Sometimes you just have to let their crap roll off your shoulders. The only person who really has to acknowledge you is you. If you can go home after a night like the one you described, look at yourself in the mirror and like what you see, you did a good night's work. Your patient may never remember you, or even know how hard you fought to keep him alive, but your Maker will. And in The End, His opinion is the only one that matters.

Just know, Epi, that WE, your peers here, who know and love you, APPRECIATE YOU. And we are proud and lucky to have you among us.

Keep up the good work!!!

HemoStat
(ps - we should get COMBAT pay for shifts like those...)

[1mg.epi]

Thank you HemoStat for the support!!!!

You know I got out of CVI because that surgeon and I went around and around. I even one day quietly whispered in his ear with respect what I thought of him. I did it in such a way on of my peers thought I made him a little nervous. When I walked out of the room he asked what did I tell him. I replied, "Just what I think of him." We had one male nurse quietly told him they were going to take him out back. That nurse was a big old boy.

On one of the threads here some one posted that a surgeon was like that and they put a fart cushion under him. The surgeon quit. I LOVED it.

[GrandmaLoriRN]

What a lovely letter of support.
Don'tcha just wish these docs would take the time to read some of these posts?
Sometimes I wonder if they REALLY know just what we do to cover THEIR butts. And, if they knew, would they be at all appreciative?
We are the ones dealing with family, using PRN orders to the limits and sometimes beyond, quietly ordering labs, CXR, gasses...and the list goes on, just so we don't have to call at 2am. I figure if I am calling at that hour, something is WRONG and I just HATE it when they blow me off.
Sorry...just venting a bit. I just wanted to thank you for your encouraging post.

[carmen]

I recently wrote a letter to oprah. She is doing a show on her doing other peoples jobs. I told her to come to the ICU. I know it can be so frustrating being our patients voice when no one will listen. Sometimes, i feel like a hardass. One day, this Icu doctor told me I was "high-strung" My patient had a pneumo and was on bipap. The chest tube placement was ordered at 5pm. I followed up with trauma residents at 6pm. When I got to work at 7am the next am the chest tube was still not in place. NIce man , eventually died. Then they want to lower malpractice claims!!Sometimes I want to quit but I cry. I don't know what else I would do. I have been in the hospital since I was 22. I am now 43.

[carmen]

oh yeah!! Before I started to vent I wanted to say, DOCUMENT, DOCUMENT, DOCUMENT!!!!!!!

[LVNtoRN]

Doctors like that shouldn't be tolerated. Go to your Manager. We have couple of doctors that had been put on medical committee for behavioral misconduct!!!!!!

[Dixiecup]

I hope you all are documenting all of this stuff. Can you call family members to the bedside to see this, so they can sue the pants off these doctors? One thing I did was copy the chart, black out the patients name, and keep the chart for myself. I had the medical record number. If it goes to court you will have evidence. Nurses are the best, and we don't deserve this. Hospitals need to work on the rift between MD-RN. The rift is unsafe for patients.

[grapejam88]

Am I wrong...in nursing school, I could swear I was taught that it was illegal to copy anything even if it has the identifiers blacked-out and keep it at home. Please advise me. I don't want to be in the wrong.