8.26.2010

I love my job *cough-cough*

So, I have never disagreed with a doctor before. I've grumbled about orders, like insane things as, get this patent out of bed 3 times a day, or patient must be out of bed to eat (the patient was 400lbs!), or meds that are scheduled every 2 hours, or something insane.

Today, I disagreed totally with the doctor's plan. Let's call her Dr Prissy. She's a bitty thing, but very opinionated and very "prescribing." Everyone knows that she will order 20 tests when only 5 are actually relevent. She will keep a patient in PCU for an extra day because the blood pressure is above 130/80. Little things like that. Anyways, she saw on of my patients who's I's were greater than his O's, meaning he had retained some fluid somewhere. He had been in the hospital for more than a month, survived hypovolemic shock, survived (and recovered from) complete kidney failure. So...he hadn't peed for several days of his hospital stay. Of course he would be positive. A one time dose of a diuretic (something to make you pee) is not going to fix it. NOT GOING TO FIX IT!

When I hesitated when she told me this she jumped on my case, "you disagree, you don't think that is appropriate?!" Of course, I hadn't processed all this, so I denied it. I always do that, I'm never good about standing up on the spot! Anyways, the intensivist (ICU doc) doesn't like her either, and wants nothing to do with her, so she wouldn't stand up to her. The next doctor I explained it to, and who understood my point was the surgeon who fixed his massive bleed in to his abdomen, Dr. Tall'n'Mighty. So anyways, he's all "his weight is only 2 kg off of his admission weight, I'll cancel it because I don't think he needs that. Will that work?" Yup!

I love Dr Tall'n'Mighty. He always has students with him, like a gaggle of geese, and most of them are women (go figure), but when I see them show up on our floor, I'm all, "Oh, there's Dr. Tall'n'Mighty's minions." Ha. They are, they're exactly like minions. They swoop in, do their deeds (not necessarily evil, just deedy) and swoop back to tell him. Then, they all show up together a few hours later.

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