Question

Dr. Blademan, who you recently paged to report an abnormal laboratory result, approaches you, shouting angrily, “Why did you page me with that report? You know I make rounds in the evenings, and I would have been here soon.” You attempt to explain that the patient was symptomatic, that the abnormal laboratory result was high enough to be labeled a critical value, and that you believe prompt reporting was in the best interest of the patient. You also are thinking about the fact that “in the evening” could be anytime from 6 pm to 11 pm for this particular physician. Nothing you say in defense of your decision appeases the physician, who has digressed to general statements about the lack of consideration that nurses give doctors.

What do you perceive to be the true message here?

How will you respond to the physician’s comments?

What techniques can you use to prevent the situation from escalating?

If the situation continues to escalate, what would be your next course of action?

Answer 1

The true message here is that doctors consider themselves far more superior to nurses. Only possible reason for doctor to not hear what the nurse had to say about the worsening condition of the patient. The nurse who had been providing continuous care to the patient thinks there is some abnormality in the reports and it might be fatal if the results are not relayed to the concerned doctor as soon as possible. The doctor is being unprofessional in his work and this kind of medical negligence can cost lives and have serious implications for both the doctor and the institution.

A nurse's work is based on logic and reasoning. They don't work on assumptions. Their work is based on experience and knowledge earned through the years and studying.

My responce to physician's comments will be simple. I would try to explain the physician, my point of view. How today's reports differ from everyday reports and why it was not advised to wait in reporting an anamoly. Doing so could have been life threatening for the patient. I will try to show the comparison in reports and how today's reports were way out of range. If the physician doesn't understand what I was trying to convey, I would even go as far to consult another doctor or physician's opinion on the matter. Because that's one of the last resort I could opt to justify my urgency in contacting the doctor.

If the situation continous to escalate, I can seek help from another doctor/physician and get their opinion on the matter cause the outraging doctor seems to have a perception that nurses don't respect doctors as much as they should. So another's doctor opinion might be one of the last resort that I could opt for in order to justify my course of action and why there could have been no delay in reporting the sudden change in reports.

If the situation continous to escalate, I would have no other option than to contact the authorities or the senior medical panel to try and explain my case and the course of action I had to opt. It might be the only possible way of diffusing the situation because a patient's life is more important than to discuss a Doctor's convenient time to visit the doctor.