lozenges

3:01 AM Lozenges Order Request Caught on Tape

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BOCA RATON, FL – The following is an exclusive transcript of the explosive dialogue that has resulted in a formal reprimanding of Dr. Ann Hedonia by hospital administrators:

lozenges
What’s the daily max limit on lozenges?

NURSE: “Hello?”

DOCTOR: “Yes, this is Dr. Ann Hedonia.  I was paged?”

NURSE: “Are you on call tonight?

DOCTOR: “Yes.”

NURSE: “Were you sleeping?”

DOCTOR: “Yes.”

NURSE: “Are you covering for patient Phleming in room 205?”

DOCTOR: “Yes.”

NURSE: “He is complaining of a tickle in his throat.”

DOCTOR: “Okay.”

NURSE: “He is requesting lozenges.”

DOCTOR: “Okay.”

NURSE: “I need a doctor order.”

DOCTOR: “Okay.”

NURSE: “How many lozenges?”

DOCTOR: “1 to 2.”

NURSE: “Frequency?”

DOCTOR: “Q 1 hour.”

NURSE: “Scheduled or prn”

DOCTOR: “prn.”

NURSE: “Maximum daily dose?”

DOCTOR: “There’s a maximum?”

NURSE: “I don’t know.  You are the doctor.  48 lozenges in a day seems like a lot.”

DOCTOR: “[inaudible]….OKAY, FINE… 20 LOZENGES MAXIMUM!”

NURSE: “Doctor, the pharmacy only carries Cepacol lozenges.  The patient is requesting to use his own Halls lozenges that he brought from home.”

DOCTOR: “OKAY!”

NURSE: “So I can take that down as an order for the pharmacy to reconcile his own home lozenges?”

DOCTOR: “YES! IS THAT ALL?!!”

NURSE: “Wait, doctor….”

DOCTOR: “WHAT?!”

NURSE: “I have to read back the order to you now.”

DOCTOR: “[expletive] MY [expletive]!!!” [dial tone]

End transcript.

When contacted via telephone by GomerBlog to comment about the released transcript and her abusive behavior towards the nursing staff, Dr. Ann Hedonia responded as follows:

“I can’t believe this is an issue.  Can somebody explain to me why a physician’s order is even required for lozenges?!  Shouldn’t we be leaving lozenges on patient’s pillows like mints in a hotel room?  Is there a year-long ENT fellowship for lozenge dispensation?”

“Are lozenges a controlled substance?!  Does the DEA require the use of triplicate prescription pads to write for outpatient lozenge use?!  Are lozenges addictive?!  Are there patients out there in lozenge rehab?!  Is there a national epidemic of patients presenting to ERs suffering from lozenge overdoses?!  Are there drug mules smuggling lozenges across the border?!  Is there a nefarious bloodthirsty lozenge cartel reigning over the black market for lozenges on the street?!  WHAT THE [expletive] IS GOING ON HERE?!?!”

Dr. Hedonia became more infuriated when asked about reports regarding angry responses to pages by nurses for official order requests for other miscellaneous items, such as Ensure supplements, warm compresses, clean sheets, and air mattress hospital beds.

Due to the explosive conversation, nurses can’t wait until the clock chimes 3 AM in order to page Dr. Hedonia for more lozenges.  “It’s the highlight of my night shift,” said an anonymous nurse.

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  • Show Comments

  • Avatar
    Ellen Haas

    Walgreens rule

  • Avatar
    Irene Grinberg

    When I was an intern I got a page at 3 am from the pharmacy. The vitamin C dose I’d ordered was not formulary. The vitamin C wasn’t due until 10 am. Do you know how many hours you get to sleep as an intern?

  • Avatar
    Jeff Halford

    Got a call just last night at 4:05 am for a nicotine patch !

  • Avatar
    Maggie Atwood Oliver

    Good stuff right here

  • Avatar
    Vanessa Cameron

    Ellen Haas Virginia Savala. Bring u back?! Ugh

  • Avatar
    Megan Petersen

    John Ozimek Erin Erin Meschter

  • Avatar
    Sarah Kohrmann

    John Longoria our docs work nine hour shift four nights a week. I normally limit pages to more consequential issues but if my patient needs cough medicine, or something similar, I I am going to do what I have to do to take good care of him or her. Our night shift stock work the same amount of hours as our full time nurses.

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    Oh Adams

    This is complete and utter crap. As a fellow doctor I can feel this physician’s pain. Whoever went through a residency and fellowship training and then practiced as a doctor knows what this phone call and what is the message behind it. I have had more than a few stories such as that except I kept a cool head and didnt swear. People need to understand the following.

    1. Doctors are humans too and they need sleep too because the next day they still have to work till 5 pm or later. Waking them up frequently is not gonna make it easy.
    2. NO prescription is needed for halls. thats ridiculous.
    3. Believe it or not. Many times nurses use this “method” to punish doctors and keep paging them in the middle of the night for trivial matters. They know they cannot be reprimanded in return as they can claim they “were doing it for patient care”
    4. No offense intended. I have seen many nurses with average or below average intelligence and them not able to figure extremely easy stuff.
    5. The strong desire of many nurses to leave the shift exactly at 7 am (and not a minute longer) makes them page again and again at night so they don’t have to page at around 7 pm when they give a sign out.
    6. Strong negative bias and feelings that nurses harbor towards doctors (especially foreign doctor) as they consider they feel they are considered and treated as inferior and they have a strong desire to prove they are actually smart and show the doctors ‘who is the &^*ing boss.

  • Avatar
    Kathleen Ford

    Sasha I plan to speak to my favorite resident every morning at 4am. I will add lozenges to the list. Join me! “It’s the highlight of my night shift”

  • Avatar
    Rebecca Bliden

    Nurses need to grow up and stop thinking that just because a doctor is on call doesn’t mean they should call for stupid stuff at 3am!

  • Avatar
    Barbara Anne Neundorf

    Been there

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    Jon Longoria

    Depending on the docs schedule, this seemingly compassionate decision could potentially make things worse.

    An on call physician working into his 20th hour needs some sleep. Coughing (generally) will not kill your patient: the sleep deprived doctor who gets woken up just as he’s drifting off to sleep at 2AM for heparin flushes due at 9AM will.

    We all work hard, doctors and nurses alike. I consciously try not to put in orders that will drive the nurses – who typically work 12 hour shifts – bonkers because I respect the fact that they work hard. So if me – a doctor – can do that, please have compassion for those of us who are just trying to close our eyes for a bit when we’re elbow deep in a 28 hour call cross-covering 60 patients.

  • Avatar
    Valerie Anne

    I don’t know any nurses that try to haze residents this way, but trust me, the experienced nurse will win the bullfight, we’ve been at it much longer!

  • Avatar
    Valerie Anne

    a patient that needs q15 min vitals requires ICU care, so I guess you or the charge nurse will be waking up your attending at 3 am instead of you!!

  • Avatar
    Amelia Turnage Presnall

    My facility does have standing protocols for saline nose spray, chloraseptic, cepacol. And we’re “not allowed” to give a patient sleeping pills after 11pm, so no 2am calls for that either.

  • Avatar
    Amelia Turnage Presnall

    Megan Hedlund it’s no bother to me to wake your patient up every 15 minutes. I’ll be sure to let them know their physician ordered their vitals that frequently & that they’re free to refuse any care that they don’t want. I’ll simply document their refusal.

  • Avatar
    Chananya Goldman

    LMFAO. Ariel, Yarik, Yardanna,

  • Avatar
    Valerie Anne

    One place I worked we were told by upper administration that we were to call the MD at 5 am on post op day 2 to get an order for foley cath removal or renewal or else we would get written up for leaving it in. If the docs didn’t remember to renew it the night before when they left then we had no choice but to do so.

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    Sarah Kohrmann

    I’m all about saving non-acute issues for the attending in the AM (can you say EPIC sticky note?!), but some things that seem inconsequential to the MD are far from trivial to the patient. “Just some cough syrup” to me or the doc, for example, can mean everything to the exhausted patient who can’t stop coughing long enough to get 20 minutes of sleep… And patients know there’s a doctor in the house and have trouble understanding why they shouldn’t be bothered for something that will greatly increase their comfort. That said, nystatin powder is NEVER an emergency and the lozenges can wait too!!!

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    Kay Gaulke Hill

    We recently had a huge “scope of practice” lecture because one nurse did one stupid thing and a physician complained and so now all nurses aren’t allowed to use judgment for ANYTHING because it’s supposedly “outside our scope of practice.” Even things clearly that are, we are specifically told we have to get an order.

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    Megan Hedlund

    Calls like that get subsequent orders to check vitals q15 minutes for 24h to ensure no arrhythmia or hemodynamic compromise from the local anesthetic in the lozenge. Mess with the bull, get the horns. I’ve seen nurses do this to residents for no real reason but to haze them.

  • Avatar
    Lara Bethany Thoma Park

    i know this is a joke but if you don’t want to be called in the middle of the night don’t be an md or order cough drops for all your patients to begin with. that being said (written) I would try to put the pt off until morning (offer water, gelatin, etc) but sometimes they are insistent and in my state we are not allowed to give without an order.

  • Avatar
    Sarah Hammond Gamble

    Exactly, Valerie. There’s no such thing as nursing judgement when it comes to prescribing meds, at least in my state. Thankfully many of our docs are now just putting in PRN orders for things like Tylenol upon admission. No one wants to wake a doc up at 0300 for something little, but those of us who like our licenses have to do it.

  • Avatar
    Valerie Anne

    This is a multifaceted problem. 1) new nurses don’t have clinical judgement, that comes with experience 2) it’s not always clear who is supposed to be paged, and, many times we will call the medicine team and they say to call cardiology or whatever other specialist is on the case 3) the calls for the meds are required by law, unless there are standing protocols that allow for Tylenol or any other meds we have no choice but to call or we are practicing medicine without a license. Some EMR’s will prompt the doctor to order Tylenol and Maalox for all patients when putting in admission orders which cuts down on these types of calls.

  • Avatar
    Edna Wong

    2am emergency creon refill.

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    Angie Flesher

    Ha, we have standing orders for sleeping pills but nothing for lozenges. Can’t say I’d wake a doc up at 3am for it, though. Also glad I’m not a floor nurse anymore! Lol

  • Avatar
    Conni Errickson Miller

    This is not a satire. This is real life. Followed by a 3:12AM call for a sleeping pill. :)

  • Avatar
    Eliza Milliken

    Sophie Waller please chart B12

  • Avatar
    Eliza Milliken

    Sophie Waller please chart B12

  • Avatar
    Gomerblog

    That probably sums it up!

  • Avatar
    Gomerblog

    That probably sums it up!

  • Avatar
    Cynthia Sue

    Lmao! Never could understand why there’s not a standing order! Yesterday someone came got us from CT scan in the ER cuz the pt left their lozenges in their room upstairs…

  • Avatar
    Cynthia Sue

    Lmao! Never could understand why there’s not a standing order! Yesterday someone came got us from CT scan in the ER cuz the pt left their lozenges in their room upstairs…

  • Avatar
    Valerie Anne

    If you are getting calls all night for things like this you are either getting payback for being rude to the nurses or the floor is staffed with a ton of new grad nurses who don’t know any better

  • Avatar
    Valerie Anne

    If you are getting calls all night for things like this you are either getting payback for being rude to the nurses or the floor is staffed with a ton of new grad nurses who don’t know any better

  • Avatar
    Margaret Helene O’Connor

    This one actually made me LOL!

  • Avatar
    Margaret Helene O’Connor

    This one actually made me LOL!

  • Avatar
    John Bachert

    Patient “Phleming” – haha!

  • Avatar
    John Bachert

    Patient “Phleming” – haha!

  • Avatar
    Cashew Ricker

    Aspen Laneman
    My mom misses you! When is your next call shift? Maybe she’ll call you at 3am for old times sake?!

  • Avatar
    Cashew Ricker

    Aspen Laneman
    My mom misses you! When is your next call shift? Maybe she’ll call you at 3am for old times sake?!

  • Avatar
    Jessica Bentley Stepp

    Always loved the 3 AM calls for Chapstick or to go look at a kid’s bug bite.

  • Avatar
    Jessica Bentley Stepp

    Always loved the 3 AM calls for Chapstick or to go look at a kid’s bug bite.

  • Avatar
    Wendy Harmon

    Wish I was a floor nurse, bwa ha ha!!

  • Avatar
    Sasha Shenck

    Kathleen, this should probably happen sometime soon.

  • Avatar
    Jana Caldwell Ricker

    Kim Rutherford Heaton, Val Meyer, Karen Lechner, Louese Jackson Kirk, Zoann Whiteside Jackson

    This is just too funny

  • Avatar
    Joanie Sapienza

    Another good one I get in the ICU and the floors is nystatin powder to you know where at 4 am! Ugh!

  • Avatar
    Joanie Sapienza

    Hahahhahahahahahahhaa! Good one!

  • Avatar
    Joanie Sapienza

    Baaahahahahhahahwhhwhwahahahahahhahaah! I can relate to that when I am house mole and get called at 3 am for them! That call comes when I am in the middle of a code or asleep! Lmao! I want to toss the phone in the loo

  • Avatar
    Jon Longoria

    One of my colleagues got a phone call in the middle of the night for the patient having had a nightmare. This was on an adult inpatient service, mind you.

    What on earth are we supposed to do about that? Boogeyman closet check qHS?

Comments are closed.