Friday, December 21, 2012

The Burden of Proof

Maybe I should just start calling this blog "things that suck about being new".  Ugh, but really, you know another thing that sucks about being new? Doctors.
There's a pretty limited number of docs that work the night shift at the new hospital- most of them are amazing and we already get along really well and they listen to me and recognize that I generally know my shit. I think it helped that a couple of them worked at Hood Hospital as well, so they already knew I was at least competent and stuff, and I guess the word spread among them. Most of them.
But the thing that's a bummer is for some of these people, the burden of proof is completely on you to prove that you're not an idiot, and you're a moron until proven otherwise.  Which, great, fine.  Talk stupid to me.  I'm a girl, and I look twelve, and I don't back down when someone's obviously trying to bulldog me, and duh, I work in the ER, I'm kind of used to being treated like shit.  This particular doctor strikes me as someone who I am probably not ever going to mesh with anyway- I'm pretty sure he's Hood Hospital's Dr. Stick-in-the-Ass' long lost twin- people who take themselves that seriously generally don't like my style and vice-versa. So, anyway, treat me like crap.  I can handle it.  But maybe  set aside the douchiness and your personal shitty biases against nurses for a minute when a patient's safety is concerned.
Elderly dude came in the other night that had some pretty vague, questionable complaints about dizziness- some random aches and pains-nothing too major.  Family provided most of the history and weren't really great at it- the patient seemed confused at first, but would provide information if he was prompted repeatedly and was oriented and lucid, but was just hard of hearing and didn't seem to want to be bothered. The elderly weakness workup proceeded, labs and scans were normal, Dr. Stick-in-the-Ass 2 gets ready for disposition, and something changes.  This guy is just not resounding the same way any more.   He looks like he's in pain but won't talk, he gets really diaphoretic and starts having weird runs of PVCs, is still awake but just won't follow commands or talk.  I drag him in to see the patient, he glances at him, rolls his eyes, and orders pain medicine.  Two minutes later as I get ready to give it, the patient is now drooling with snoring respirations.  I tell the doctor he needs to come in there, yeah, now.  His response?
"I can't even deal with you anymore with this patient. You're killing me. Seriously." (with a disgusted shake of the head)
He takes a look and begrudgingly orders a repeat scan.  I run the patient over, and oh, guess who now has a massive fucking head bleed?
Yeah.  I wish I could say this is the first time something like this has happened to me, but it isn't.  At all. I hate how in situations like this when the doctor knows he was wrong and fucked up, there's never any acknowledgment that a mistake was made or that he was being a massive douche canoe, but there is an abrupt 180 shift in the way I'm being spoken to.  Like now all of a sudden we're using our octave higher soft and gentle voice that we use with the patients, and I'm being thanked and fussed over every nursing intervention no matter how mundane.  Not like I need a pat on the back or acknowledgment every time I catch something, but I'd really almost just deal with these guys continuing to be asshats than suffer through this mister nice and respectful routine that we both know is fake.
Whatever.  Hopefully this situation has placed me in this guy's not an idiot column and he'll actually listen to me the next time something like this happens, but I kind of doubt it.  People like this seem to have a pretty short memory when it comes to their own fallibility.


  1. Some doctors are just convinced they are Gods (MD stands for minor deity of course) and won't ever change. We just hope they are few and far between and we only have minimal interaction with them.

  2. As an ED doctor that loves your blog (and works in your same city), I would be sending you flowers and buying you dinner for that business!! Nice pick up!

    1. That's very nice of you, but how you know where I'm at?

  3. This is one of those situations where the motto " we know the truth" applies. If not for you, that patient would have died in the car on the way home. You're a good nurse :)

  4. Sorry your docs suck. We aren't all like that.

  5. Good job, Girl! I was just thinking about this, as I'm in a new town with new hospitals. It is amazing, the transformation in many doctors' once dismissive attitudes when they realize you are not an idiot and are a hard worker.

  6. +20 points for using the term douche canoe. Love!

  7. Great save. Bravo!

    That's what it's all about.