Note: This is from a nurses blog. Under the comments there is discussion if foreign doctors are worst than American ones.
Beka - Last night wasn’t a bad night -- no 2 am discussions, but a good selection of Jamaican food for a middle-of-the-night “dinner.” My assignment wasn’t too tough - a gentleman who was easily extubated the day before and a 62-year-old frail female who had undergone a bowel resection and had been intubated 12 hours before for respiratory failure. As the night went on, she developed a growing metabolic alkalosis with a ph level nearing 7.67 due to her high NG output - pure green bile.
I called the surgical resident several times asking him to come and assess her. He took his time. When he arrived he decided an argument with the respiratory therapist was due at 3 am. He refused any diuretic therapy or ventilatory changes, and actually instructed me to begin tube feedings on her despite her distended abdomen and increasing ileus. TPN or HAL was already infusing, but the patient was also showing signs of sepsis.
By morning she was in visible distress although the resident had given every textbook answer there was to resolve her ileus. He refused any sort of motility agent. His arrogance, rudeness, and disrespect for nursing was obvious. I was left wondering, as a I tramped down 7 flights of stairs to street level at 8 am - what are nurses supposed to do with colleagues such as this? Have physicians always shown a belligerent attitude toward nursing? Is it in their history? Before I left I had her comfortable, but felt irritated by this resident who thought he had all the right answers.
What have your experiences been with arrogant physicians? And how have you dealt with these types of situations? Can we stop it? Do we have the power to do so?
Beka - Last night wasn’t a bad night -- no 2 am discussions, but a good selection of Jamaican food for a middle-of-the-night “dinner.” My assignment wasn’t too tough - a gentleman who was easily extubated the day before and a 62-year-old frail female who had undergone a bowel resection and had been intubated 12 hours before for respiratory failure. As the night went on, she developed a growing metabolic alkalosis with a ph level nearing 7.67 due to her high NG output - pure green bile.
I called the surgical resident several times asking him to come and assess her. He took his time. When he arrived he decided an argument with the respiratory therapist was due at 3 am. He refused any diuretic therapy or ventilatory changes, and actually instructed me to begin tube feedings on her despite her distended abdomen and increasing ileus. TPN or HAL was already infusing, but the patient was also showing signs of sepsis.
By morning she was in visible distress although the resident had given every textbook answer there was to resolve her ileus. He refused any sort of motility agent. His arrogance, rudeness, and disrespect for nursing was obvious. I was left wondering, as a I tramped down 7 flights of stairs to street level at 8 am - what are nurses supposed to do with colleagues such as this? Have physicians always shown a belligerent attitude toward nursing? Is it in their history? Before I left I had her comfortable, but felt irritated by this resident who thought he had all the right answers.
What have your experiences been with arrogant physicians? And how have you dealt with these types of situations? Can we stop it? Do we have the power to do so?