Question

Sue Brown, RN, critical care staff nurse with 4 years of experience, just had a problem with one of the new resident physicians. The resident was inserting a pulmonary catheter and Sue notified him that the patient was in ventricular fibrillation. Sue also told him the hemodynamic waveform showed that the catheter had cleared the right ventricle and was now in the pulmonary artery. The physician retorted to Sue, “Don’t worry about a little ventricular fibrillation … it’s expected after right ventricular irritation. You know you should know this. Haven’t you ever assisted anyone with a pulmonary catheter insertion?” Sue repeated herself about the patient being in ventricular fibrillation and the physician laughed and said, “Don’t you think you are getting carried away?” Sue repeated herself again and defibrillated the patient, who responded. The physician said nothing, cleared the bed after two commands, and then just walked away. The patient was stable. Sue notified the patient’s attending physician, the medical director of the intensive care unit and her nurse manager. What is the issue here? Provide examples of Assertive, Passive Aggressive, and Aggressive approaches to dealing with the physician behavior. What is the best approach? What is your plan to resolving this situation and preventing future recurrences?

Answer 1

The Nurse has a very good Assertive approach by alerting the resident physician at right time who ignored it which can be even taken as medical malpractice

Passive aggressive behavior of the resident physician by insulting the nurse and avoiding her alerts

Aggressive behavior of the nurse by Defibrillating the patient at the right time and making the physician being aware of what to be done in that situation.

Being a Nurse she cannot complain to the physician head the right way to resolve this situation is informing the in charge nurse immediately or the nurse manager so that appropriate action can be taken against the physician for his negligence and endangering the patient life.