Recently discovered a blogger who I could almost swear is a twin separated at birth. Not Nurse Ratched recently wrote about the nurse and doctor relationship in a post Toeing the Line: Nurse vs Physician .
This reminds me of an encounter with a physician I had a year or so ago. He was covering for another doctor and became furious with me because I paged him several times related to the patients pain control, or rather, lack there of.
She was young, depressed, and facing life changing diagnosis and post op surgery. I had taken care of her before the cut and now after I knew very well her baseline. I could not stand to see her in such agony.
When I asked to increase the frequency of the PRN diaudid, he took it away and ordered Morphine and Percocet. When I called to inform him they were not controlling her pain, he took them away and have her one lorcet 7.5 q6hrs. It was so heartless to me. He wasn’t listening and because I dared to bother him he was making my patient suffer.
I later learned he looked into reprting me. For what exactly, I don’t know. Advocating for the patient? Calling him?
I was following his orders and calling him when they were ineffective.
After working with him and his patients a while I determined the issue stemmed mostly from his lack of confidence in the care of his partners patience and also perhaps my inability to separate the patient’s emotional pain from her physical pain.
I haven’t since experienced a situation as this with him and I believe we both learned from the experience. I was eager to alleviate the pain of the patient, much of which was likely emotional in nature, and would not have been aided by any amount of dilaudid. He was reading the numbers on the page, going by guidelines, and doing his best to maintain safety, I believe.
His talents as a surgeon are remarkable but his confidence faltered in procedure and patients he was not familiar with. But my oh my how he shines at a job well done.
One afternoon, after watching him perform a cholecsytectomy, A student nurse raved about how wonderful he was while watching his surgery and how excited he was to involve and educate her. “He took it out and let me touch it.” Dr. Butthead did that? For a student? Not a med student but a student nurse, no less?
It became clear to me then that I often misunderstood him. When he came to the floor later that day I relayed the students compliment to him. I don’t think I’d ever noticed him smile before that day, but there it was. The pride of a job well done, the simple words of a student, and the compliment made to him by this annoying nurse were enough to melt the iron clad facade he often brandished. A breakthrough was made in our professional relationship and a newfound mutual respect was formed.
Insecurity can present in many ways. His presented as being a jerk to me. Mine presented as paging him all day. However, his confidence and mine have improved since then and his compassion for patients and nurses as well. No longer do I worry about calling him because we are now on the same page, but man it sure did take a while.
What I took away from the encounter was that sometimes the doctors fear and insecurity can present as douch-baggery. And sometimes a nurses eagerness to please can showcase as annoying and pestering.
Sometimes we need to be told we are good at what we do in order to show others we appreciate them, even doctors.
– Posted using BlogPress from my iPad
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