Thursday, January 8, 2015

Useless pages

I love nurses. A good nurse is worth her weight in gold, and I've worked with some of the best of them. Sadly, I have also learned that a bad nurse can really make your life miserable.

When I was a resident, I worked with some nurses who seemed sometimes bafflingly incompetent. They would page me about the most ridiculous things. This was one of my favorite pages I got from one of them:

A nurse paged me at seven in the morning. She was calling because she need to get the phone number for a patient's mother, so that neurosurgery could get consent to do surgery on him.

Except…

1) I already given neurosurgery that phone number (more than once)

2) consent had already been obtained last week

3) the patient was already in surgery

Nice.

14 comments:

  1. I would assume you have lovely voice doctor. She/he was just a fan!

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  2. peace = gentle spirit

    Unlike peace, I would be miffed ! - Paul

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  3. I've worked with my fair share of amazing nurses and shockingly incompetent nurses (who sadly were occasionally paid the most due to seniority...). Still I wonder -- could the nurse have had a end-of-night-shift brain fart? At least she paged you at 7 a.m. rather than 3 a.m...

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    1. It's good to see you back!, PGYx.
      In a manner of speaking, of course (lol).

      - Paul

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  4. Love this post! So funny! Your comedic timing is impeccable!

    -MS4

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  5. You'll like this one. Hospitalized: cachetic from malnutrition. Dropping a pound a day. PICC line still not placed. Urinated 2x on the 2nd hospitalization day, NPO, IV fluids the whole hospitalization time. 2 am nurse had a cow, went to call the doctor. I said no, leave him alone. She said they'll have my job if I don't call, your kidneys might be shutting down. I said well he'll have my a** in the morning, let him sleep.

    I almost added and let me sleep because I don't want to listen to that idiot any way.

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    1. I don't know how you know as much as you know, but quite frankly, I find it
      amazing ! Growing up, I watched my sister and her small group of friends;
      good kids who studied hard with a very big dream. I can still see their
      bright faces with a sense of purpose. They all dressed modestly, little to
      no makeup with short hair or in a pony tail as they had no time to fuss.
      Yes, they were serious students but cheerful nonetheless. So, Dr. Fizzy,
      when I read your blog and comments from folks like PGYx, peace and many others whom I don't know by name, I am reminded of my
      sister and her friends and can't help but smile. As to the question, why
      do I adore you all? The answer is simple: how can I not. - Paul



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  6. I'm on nightfloat. At my program that means I cover the stroke service, inpatient neurology ward service, the epilepsy monitoring unit, new ED consults and inpatient consults as well as outpatient calls. It's very, very, very busy.

    This is an actual page from a nurse at 4:30am the other day:

    Nurse: I just wanted to talk to about Ms. X's heartrate

    Me: OK, sure

    Nurse: She's bradycardic, for several days now

    Me: Right.

    Nurse: And she hasn't had any symptoms

    Me: Yep

    Nurse: So... I guess I was just wondering if that's going to be worked up

    Me: ... It has been. It's nothing to worry about

    Nurse: Oh. OK.

    Please don't page me at 4:30am to ask a question that has nothing to do with in-the-moment patient care.

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    1. One physician covering all those services and consults too!
      I think I understand. You're all clones from that movie "Good Will Hunting." There's no other explanation that makes sense!

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    2. I wonder if s/he thinks you're there working a regular shift so she can call you at any time about any issue related to the patient's care. A day shift nurse wouldn't think twice about calling at any time.

      As a resident I took overnight call on a large acute rehab unit after a full day of work. The patients often had many medical issues and a significant proportion of them were prone to decompensation. I was so grateful to the nurses who realized that I'd been up for 20-some hours and kindly saved any non-urgent middle-of-night issues (and taught their newer colleagues to do the same) for 6:30 a.m. calls near the end of their shift. They did it both to be nice and to maximize my chance of getting a few winks so that my brain would be fresher to handle acute issues like respiratory distress, chest pain, bleeding, and seizures.

      But there was always the rare, often new, nurse who would call at 3 a.m. for something that should have waited until later. On the plus side, those calls gave me reason to more thoroughly question them and personally assess more of their patients when they called for more complex issues. Made me value the nurses with great clinical judgment even more highly.

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  7. Happy New Year to you too, PGYx and thank you for the response back.
    Sometimes, I think I'm talking to myself ! - Paul

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  8. I was doing cross cover at the VA general medicine I was called at 2:00 am Nurse " Hi Doctor, for patient so and so has an order for a BMP" I said "Yes, primary team ordered BMP at 1600, this pt has hyperkalemia, I've been trending the potassium level and I've noticed that we still need a K level from last night" nurse " Do I really have to draw the blood, I mean can't we just wait until 5:00 am when the lab does it" that last comment made me mad, she woke me up to ask if she really needed to get the blood. I said "well what do you think? Primary team is expecting an overnight K level and they made the order at 1600, it's 0200 and we still have no labs yet." that same night I also had a nurse call me at like 0300 saying " Hi Doctor, for Mr. XYZ there was a CXR ordered like 2 days ago, now it's up, do you want to take a look at it?" I told her that I will defer to the primary team when they come at 0700 :(

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    1. For VA pages, those aren't half bad...

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