residents

I love where I work and I love that we are a teaching hospital. But sometimes I hate having to deal with residents. We definitely have some good ones - we've been really lucky because our team lately has been really good. But we currently have one doctor (a 4th year) who is... well, he's not good. He doesnt discuss anything with the team, he just writes whatever orders he wants, and he never returns his pages. One of his first days on our service he took one look at a patient's Dilantin level and decided it was too low. Had he looked back he would've noticed that that particular level was therapeutic for the patient, and he probably would've left it alone. Instead, he decided to increase her PO Dilantin to a stronger IV dose. The patient was later non-responsive and frothing at the mouth. Yep. Good decisions there. ...Another night we had a patient who was practically CODING and he didn't return his pages for over an hour because he was CHANGING A DRESSING. Seriously? ...Yesterday our patient who is ordered for IV lopressor (a beta-blocker) had a BP of 160's/70's, HR in the 70's. Nothing too crazy considering he has a history of hypertension, but he was ordered to get the lopressor so the nurse hesitantly gave it. The following convo took place:
RN: His HR is 47.
MD: okay.
RN: I had given him IV Lopressor and his BP is better, but it dropped his HR from 72 to 47.
MD: okay......? so, what do you want me to do about it?
What?? Are you telling me you're ok with a 73yo post-op patient with a HR in the 40's? How about order something that isn't a beta-blocker? How about switch his medication so that his HR wont come to a complete stop. I mean, come on. ...Doctors. They really should listen to the nurses more. :-p