Horrible things that Doctors do to Nurses

In my last post prior to this one I talked about my sincere respect for Junior Doctors and all they go through.  And that wasn't bullshit. I do respect and admire them.   But for the sake of balance let's talk about all the horrible things that doctors do to nurses.  The number one thing that causes Registered Nurses to run away from the ward and frontline care is their Physician colleagues. Number one. Numero Uno. We don't hate cleaning up body fluids, or dealing with bedpans and death and dying.  We don't mind washing patients, doing dressings or getting our hands dirty as well as all the skilled jobs that Nurses have to do.  We leave the wards and healthcare in general because we want to get the hell away from Physicians.  The junior ones are still pretty human towards the Nurses.  They work hard, take a lot of crap and we respect them.  But once they get past the level of "junior" I just want nothing to do with them.  Not personally or professionally.  Not anymore.

The abuse of Nurses  by their medical colleagues is nothing new.  Even Claire Raynor reported a surgeon throwing instruments at her decades ago.  My godmother, an RN in the 1960's and 1970's, tried desperately to talk me out of Nursing school.  "Doctors are mad at the world and it's the Nurses that they lash out at;  you never want to work with one of these people" she told me.  At that time I pictured my friendly family doctor and just laughed her off.  I had only ever had experience with doctors as a patient.  Working with these people is a whole different experience. The medical profession has a cruel streak and it is directed at Nurses.  Always, always has been.

I don't even go to the doctor when I am sick.  I try to tough it out unless I become convinced that I am going to die. He might find out that I am an RN.  I told him that I am a homemaker, but he might find out that I am really a Nurse. Then he'll act like a creepy bastard towards me.  It's no better with female doctors.  They hate Nurses even more I think.  The word is 'hate'.  Make no mistake about it.   And it has nothing to do with the bad nursing care on the wards (docs don't give a shit about nurse staffing), or the grumpy nurse who was mean to them when they were struggling students.   Doctors need to decompress and registered nurses are not only an easy target but the only target.  If they treated anyone the way they treated RNs they would probably be in jail.

I have seen many a Nurse fired for a physicians' mistakes.  Too many to recollect all.  Doctors are valuable and an RN is easy to blame and cheaper to sack.   Doctors will lie through their teeth in order to pass the blame onto an RN.   They lie about orders they gave or did not give. A lot. If a treatment goes bad they can pass the blame onto the scummy, incompetent Nurse. It's very, very easy for them to do. 

As an NHS staff nurse I once had a new patient admitted to my ward.  He has necrotic toes and was in agony.  I looked on his drug chart and no pain medicine had been prescribed.  I cannot give pain medication without a hospital doctor's order and approval from pharmacy.  This is a time consuming process.  I phoned the doctor on duty to get the order.  His reply was "fuck off" and he hung up on me. I called him back.  He told me to tell the patient to "deal with it" and hung up.  I called him back at which time I got about 15 minutes of abuse and name calling.  Then he refused to call me back.  I finally got a doctor to prescribe for my patient.  But that time the patient had been in agony for way too long.  On the ward round the next day the abusive doctor says to the patient "You poor thing, your nurse never bothered to give you pain medicine, I will deal with her" and then he actually smirked at me.  I've come to expect this kind of behaviour.  If I told the patient what really happened I would lose my job. 

Path lab once called me to tell me that my patient had a hgb of 7.  I looked at yesterday's results.  Yesterday her Hgb was 11.  She was weak and short of breath.  I took her obs and her blood pressure had dropped.  My job in this situation is to look for signs of bleeding and notify the doctor of my findings. I called to notify the doctor of the critical lab value "I'm too busy for this crap, so just fuck right off" was the response I had from this patient's doctor.  Then he hung up on me.  Later on during the ward round the consultant wanted to know why a blood transfusion had not been prescribed yet.  "The nurse never reported the low Hgb to me" replies the doctor who had hung up on me nearly 4 hours before.  That got me a long lecture from the consultant explaining (yelling at me in the middle of the ward) to me why a sudden drop in hgb is something that needs to be reported to the attending doctor.  Well, Duh.  I did try.

Natalie was a nurse on my ward.  She had a patient with a really complicated dressing change.  The dressings that needed to be used were expensive and much more specialised than simple gauze.  The damn things had to be ordered from pharmacy which is a mission itself. The patient had waited 5 hours for a dressing change by the time Natalie obtained the necessary materials.  She set them up on a trolley and was on her way out of the treatment room and down the ward to the patient when a doctor saw her.  He wanted a trolley for his notes and couldn't find one.  So he grabbed the trolley from Natalie, dumped all of her materials onto the floor, did a little dance on them, piled his notes onto the trolley and walked down the ward.   At that point pharmacy was out of the stuff and the patient had to wait days for more.  Which of course got blamed on "lazy, neglectful Nurses'.

Report these Physicians at your own risk, Nurse.

I had a patient express a desire to have a sleeping tablet prescribed.  I cannot prescribe, obviously, so I called the doctor on duty to get an order for something.  "Tell her that this isn't a hotel" was the response of the doctor just before he hung up on me.   Then he never returned my calls.   The senior doctors above him consider it beneath them to take calls for this kind of stuff.  She never got her sleeping tablet.  The patient complained the next day about the Nurse not bothering to give her a sleeping tablet. The doctor told her that "no one had asked him".  Liar.

When a doctor refuses to return our calls, hangs up, tells us to fuck off, insults that patient, lies etc etc we are not allowed to document it that way.  We have to write " notified doctor of patient's request, awaiting orders".  Not "doctor told me to to fuck off, that Gladys is a pain in the arse, and hung up on me".  If the doctor lies and says "but the nurse never told me......"  There is nothing that the Nurse can do.  The doctor's word is the doctor's word.  And that is the case even if their are other Nurse witnesses to his behaviour.

In a sudden emergency a doctor gave a strong verbal order to one of my Nurse colleagues.  "Nurse give this patient 10 mg of dangerdrugacin" he shouted.  The rule is that we are not allowed to give anything without a doctor's order in writing.  But an emergency is an emergency and if you ask a doctor to write out an order in the middle of one he will rip your head off and kick it down the ward.  The Nurse gave the drug that the doctor verbally ordered.  The patient had a terrible reaction and died.  The Nurse got fired.  They had to blame someone to appease the family so they used the fact that the Nurse gave the drug "without a doctors order".  As the doctor never put anything in writing, he was off the hook.  Two other people heard the doctor give the order to the Nurse and said so.  She still got fired.

I had a 30 stone patient admitted to my ward with respiratory distress.  While I was admitting her I noticed that she had a stage 3 pressure ulcer on her sacrum.  Her husband informed me that even though she can walk she refuses,  and rarely moves at home. She sleeps, eats and does everything in her mobility scooter.  I asked if she had been in hospital or under the care of nurses in the last year and he said no. The doctor came into see her.  I told him that she had a pressure ulcer that looked infected.  "Well that is the fault of the Nursing profession, you Nurses don't turn people" he shouts in front of the patient. I calmly informed him that the patient came into hospital with the ulcer. "Well it's still your fault" he says.  At that point I asked the patient if she could stand up.  She did so and asked her husband to bring her scooter up to the ward so that she could go out for a fag.  When she was outside  I asked the doctor if a pressure ulcer in a  fully mobile patient who has not been in hospital under the care of Nurses was still the Nurse's fault. "Oh Fuck off, she has a pressure ulcer because she is a fat pig" he said.   I then asked him why he told the patient and her husband that it was the fault of the nursing profession that she had a pressure ulcer.  "Because I can" he said.

Doctor came to see the patient and told her that she could go home.  Then he left the ward for 10 hours.  He did not write her discharge orders or her drug prescriptions before he left.  It took me 10 hours to get him back to the ward to do this.  I am unable to discharge the patient without it.   When I called him I was told "I'm busy, tell the patient to fuck off about her discharge" etc etc.  When he finally came back to the ward the patient said to him "Doctor, you told me that I could go home this morning , why have the nurses made me sit here all this time".   "Because the Nurses on this ward don't have it together" he told her.

How many times have doctors left orders for meds on the drug chart that should not have been there, only for the Nurse to get blamed when the drug was given?  Seen that more times than I can count.

Nursing homes and social workers take 6 weeks to arrange a place for patients who need one.  At least.  The hospital nurse has no power over this.  But that doesn't stop consultants for screaming at Nurses because "that patient is still here, don't you understand that she could get an infection because you fucking nurses didn't get her out of here, it is YOUR FAULT IF SHE DIES, YOUR FAULT".  Usually this kind of stuff is said within ear shot of all the patients.

I once saw a doctor scream "You dirty pig" at a housekeeper (A HOUSEKEEPER) who dropped some cups on the floor. He then turned to the husband of a patient he was chatting with and said "We have to keep these dirty pig nurses in line or they would hand out the filthy cups that landed on the floor to the patients".  The husband just nodded.   The doctor knew that she was a housekeeper and that she was heading back towards the dishwasher with the cups. He was just being an asshole, because he can.

If a doctor forgets to order lasix cover between units of blood it is "the nurse's fault, because she should have reminded me".  If a doctor order's something incorrectly "it is the Nurse's fault for not catching it".

If a doctor doesn't come and see a patient for hours and hours despite repeated calls from the Nursing staff it is also "the nurse's fault".  If a ward nurse is forced by management to take care of 30 patients on her own, it is also her fault if the patients get neglected or an order gets missed, according to the doctors.    If kitchen sends up the wrong food: doctor screams at the Nurse.  CT department can't fit that scan in today: doctor screams at the Nurse.  Social services delays nursing home placement: Doctor screams at the Nurse.  Patient who has been ordered to be nil by mouth sneaks food behind the Nurse's back: Doctor screams at the Nurse.  Patient refuses prescribed treatment or medication: Doctor screams at the Nurse.  Pharmacy takes forever to dispense drug and refuses to stock the ward: Doctor screams at the Nurse.  Patient decides to be noncomplaint with his fluid restriction nd renal diet and sneaks 10 litres of cherry fucking coke behind the Nurse's back: Doctor screams at the Nurse.  You know damn well that neither can we watch your patients constantly nor get them to listen to us! Physio and OT avoid patient: Doctor screams at the Nurse.  And he usually does this in front of patients to undermine the Nurse and make himself look like the hero.

Fuck this shit, Doctor.  I am not a babysitter.  I am not some self sacrificing angel who exists to take the fall for you. And neither am I a punching bag because your are frustrated with your job.  Nurses CANNOT control your crazy, noncompliant patients, the allied health professionals, the waiting times in the GI department, nor pharmacy, nor social services nor blood bank nor relatives nor transport.

It's no better in the United States.  The doctors here don't do shit.  We Nurses have been told that if a doctor wants to prescribe a med that HE has to enter the order into the system.  But he doesn't want to 99% of the time.  He says "enter it yourself or your patient doesn't get it".   And then he hangs up.  If I enter it wrong or the patient has a bad reaction I will get the blame because I entered it.   Or the doctor can say "I told her 2mg not 4 mg" even though he really did say "4 mg".  They can basically change their order after the fact this way and pass the blame onto the Nurse.   Thank god I only have 6 patients here.  The doctors throw so many orders out at the Nurses but they refuse to enter them into the system.  If I had 15+ patients like I do in the UK I would have to spend the entire day on the computer entering their orders for them.  If the patient is actually going to get the treatment, the order has to be in the system.  If the Nurse doesn't do it for them, and the patient doesn't get their treatment, the Nurse gets blamed.  I can feel the eyes of the patients and relatives burning holes through the back of my head while I am on the computer.  They probably think I am on facebook or something.

Oh my, I could go on for 100 pages with these kinds of stories. 100 pages easy.  But you get the gist.

If a Nurse leaves general ward nursing, she gets away from this. Full stop.  Well usually.  You might want to read this: http://torontoemerg.wordpress.com/2012/01/25/the-persecution-of-amanda-trujillo/#comments

It always kills me when doctors say that Nurses leave ward nursing because we don't want to be bothered with bedpans.  The truth is that we want to get away from Physicians.