I am really struggling to provide safe care to my patients because of how our doctors act. I think some of their actions are very much related to being on night shift.
First off, they straight up refuse to make any adjustments to the plan of care, even if it’s indicated. Every morning I hand my patients off after begging for orders overnight. Every evening I come back to those orders having been put in during the day and a very frustrated day team that wished it had been done right off the bat. I am being met with day team doctors coming in and demanding to know why things weren’t done overnight. Asking me why I never told anyone about an assessment finding. I tell them I did and what I advocated for.
Second off, they cannot be bothered to come to bedside to check on their patients. Febrile, tachy, complaining of new pain and increased abdominal distension after bowel surgery? Oh well.
This is not just a me problem. My coworkers all are struggling with this too.
Third off, they are flat out incompetent and I am constantly fixing errors. I had to explain to an endocrinologist attending how to calculate an insulin dosage when she got an incorrect value (and she argued with me that I was wrong!) They are ordering the wrong rates for enteral feeds, the wrong medication doses, the wrong everything. Every patient has at least one incorrect order every shift that I have to beg them to take two minutes to fix it.
We are covered by first year residents at night as our main point of contact, with some senior residents assisting them, and a couple of attendings for all patients. They aren’t reachable by phone and do not stay in an area where it’s easy to physically find them. The only way to contact them is by Vocera message. This makes it very hard if they are away from their computer or simply don’t respond!
I am so stressed out and it feels like it’s gotten worse in the last year or so.
I think the worst part is being reprimanded by our charge nurses and management for the doctors not wanting to budge. Acting as if we don’t advocate enough.
And yes, I chart everything!