Monday 15 February 2010

What's in a word?

Had a big, and slightly unprofessional, fight with some of the OPD nurses today. Was working quite hard first thing as the only doctor in the department, when they called me out of my room to give some iv tranexamic acid that had been prescribed overnight. Now I had two issues with this; 1. they'd delayed patient treatment by 3 hours (and this was pretty important as it's a drug to stop bleeding and the patient's blood level was 4.6. That's not good) and 2. iv drugs are on the whole a nursing task (and of late I'm discovering that more and more 'nursing' tasks are being redistributed to doctors, rather unhelpfully at a time when we're losing doctors). I told them as much, however they disagreed and told me that certain drugs (anti-venom, iv morphine, iv pethidine and tranexamic acid) have to be given by doctors. I told them that the first three might be but it was nonsense about the last. I then involved the pharmacist who took my side. However to no avail and so I gave the drug and told them I'd be talking to the head matron.
Over the next hour I slowly calmed down and realised that I had commited the ultimate doctor error; getting the nurses off side. I know from experience just how much of a mistake this is and what the dire consequences can be. So I called a meeting with the nurses involved, the matron and one of my seniors. I apologised for my behaviour whilst also reiterating my frustrations. And then it came to light what had upset them the most. It wasn't that I had questioned their care, nor that I had questioned their nursing skills, nor even that I had involved pharmacy in the disagreement or threatened to complain about them. It was the use of the word 'nonsense'. They feel this to be one of the worst words that you can use (along with 'stupid' and 'ridiculous') and were highly offended by it. A further apology later (and an attempt to explain the definition of nonsensical, ie not making sense) and it was all sorted. Although we still have to give the iv tranexamic and no one was interested in my concerns about patient care.

1 comment:

  1. Wow, that all sounds incredibly frustrating, particularly when the patient sounds really quite sick. Incredible that the same nursing characteristics can play out anywhere on the planet.

    Still sounds like you recovered it

    O x

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