Have you ever disagreed with a doctors decision?
Yes more than once
Once I had a patient that had allergies to PCN. The Dr had ordered Ticar IV. I called the Dr and simply asked him "Dr did you know this patient is alergic to PCN?" He became angery and ordered me to give it as he had ordered it. I told him "Since your office is across the street why don't you come over here and give this med? Because I can't in my right mind do any harm to this patient."
Well now he says "Let's change that order to..."
Another time when my patient was running a high Temp. I had followed protocal and used my nursing skilles to bring this Temp. down. Nothing had worked and even though it was in the middle of the night I felt the need to call the Dr.
I called for orders and the Dr. told me to do nothing. I simply asked him if that was an order and should I write it in the chart. He gave me orders.
And just the othe night my 80 year old crani patient was having seizures, and vomiting, her B/P was droping, she was unresponsive to painful stumili, pupils were pinpoint. The Dr was not wanting to give orders to move the patient to ICU. I had 7 other patients that needed my care and I had not seen them even once and we were 2 hours into this shift. My co-workers were providing care for them. My charge nurse had talked to the Dr. and house suppervisorwithout results. I had called the atending Dr. 2 times and he took forever to call back.
So I called the Care Assistant Team (CAT) which has just began working our hospital just for situations like this. CAT consist of 1 ICU nurse, 1 Resp. Therapist, 1 ED Nurse, 1 Orderly, and 1 ED Dr. Now in retrospect I think I should have called CAT sooner.
The end result was that when the ICU nurse from CAT arived on the scene she called a code, called the Dr in question. And when the ED Dr got there to supervise the code he sent the patient to ICU, and called the attending Dr and told him to come down to see the patient. The Dr refussed to come, and the ED Dr said he would take the matter in his hands then told me not to worry.
By this time the house supervisor was on the scene also. She took the patients daughter out of the room and into the lounge to talk with her and to calm her. Thank goodness because the daughter was beggining to freak by this time.
The patient was in ICU for 3 days and died. I know I did my best for this patient. And the ED Dr has filed to have the Dr in question removed from our hospital and to not be allowed to have priveglies there any longer.
I loved how this CAT team worked and got what the patient needed.
I hate to make any Dr. think I am a witch. However I have the life of someone who is trusting in me to make sure they have the best of care, and that is my goal.
So yes I have had to fight with the Dr and I will do it every time they do not do their job. If they don't want to be bothered them don't be a Dr.