Assertive with your providers.

Specialties Emergency

Published

I know I'm a rough around the edges kinda gal, but I'm old school nursing where docs r 'Gods'. So I tend to still approach them in a submissive fashion.

Tonight at work, had a situation that left me feeling humiliated by a doctor, in front of my coworkers.

I know the doc was just frustrated at how a situation turned out.

I tried really hard to keep it together and I could feel myself getting all red in the face.

I don't want to act rude or unprofessional, even though the way I was treated was unprofessional.. But I don't want to make it a habit of this doc just belittling me like it's acceptable.

How do you guys deal? Any tips on how to handle/reply in a professional way if this happens in the future?

I really wanted to tell them I really don't appreciate being spoken to in that manner, but I think at the time I was in so much shock all I could say was I'm sorry.

First, let me say that I'm really sorry that happened to you. Although I haven't been publicly humiliated by a doctor in the workplace, it has happened to me in another setting, and it is really an awful thing to deal with.

I tend to be deferential toward the docs as well. It takes time for me to get comfortable enough with them to call them by their first name.

I work in a really small ER, and if there is a problem between a doc and a nurse, or any two staff members at all, it has to get worked out. This means sitting down and talking it out later on, when emotions aren't so high.

When I worked in a large hospital, it was much easier for doctors to avoid being held accountable for their behavior toward other staff.

Ideally, you should first try and work it out with the doctor, and then if that doesn't work, you have grounds to write an incident report. I would suggest that you go to your manager and ask for help. Maybe your manager could give you some pointers on how to approach the doctor and what kind of language to use. Plus, by asking your manager for help, this will put the incident on his or her radar in case this is a pattern of behavior by this particular doctor.

Specializes in Leadership, Psych, HomeCare, Amb. Care.

Don't wait till the next time.

Now that the situation has cooled down, you walk up to the doc & ask to speak to him/her to the side.

You recap the situation, and let him know how it made YOU feel to be spoken to that way, especially in front of others.

Specializes in Emergency & Trauma/Adult ICU.

Agree with the post above in terms of taking the opportunity to speak with the doc privately. However, I am leery of focusing the conversation on "how it made me feel". How you feel ... is kinda irrelevant in the workplace. You can use the conversation to focus on "meaningful exchange of information" and "working together for the best possible outcome for the patient". If the doc has any ability to read social situations at all or to read between the lines -- she'll get what you're saying -- that you're calling her out on inappropriate communication. You can get your point across in an appropriately assertive manner without looking like a "you hurt my feelings" victim.

Specializes in Emergency.

There are various ways to handle different situations, each one is unique to the individuals, the personalities, etc. There is no one way that is right or wrong for all situations, you have to deal with the whole situation and identify the best strategy for that particular situation. Having said that I think a guideline that has worked well for me is to try to figure out how to make this a teaching moment as opposed to a personal confrontation. I don't mean that the seriousness or gravity of the situation is watered down at all, but that with a little thought and skill these situations can often be turned into a teaching situation where the offending party is taught how to get what they want without it having to be a confrontation and argumentative meeting (which almost never goes well for either party).

To do this, one has to try to figure out the motivators for both parties, and in doing so, ignore for the moment that the action taken was inappropriate. Once you have identified the situational factors (motivation, additional stressors, etc) that prompted the inappropriate actions, then you can focus on teaching that individual why their actions were wrong, and what actions would have resulted in a better immediate outcome as well as a better long term outcome.

Specializes in Leadership, Psych, HomeCare, Amb. Care.
Agree with the post above in terms of taking the opportunity to speak with the doc privately. However, I am leery of focusing the conversation on "how it made me feel". How you feel ... is kinda irrelevant in the workplace. You can use the conversation to focus on "meaningful exchange of information" and "working together for the best possible outcome for the patient". If the doc has any ability to read social situations at all or to read between the lines -- she'll get what you're saying -- that you're calling her out on inappropriate communication. You can get your point across in an appropriately assertive manner without looking like a "you hurt my feelings" victim.

No, it doesn't have to be you hurt my feelings, I'm a victim. It's pointing out how his behavior is affecting others, without making them feel defensive. Once they throw up the wall, all else is lost. Sometimes people, including doctors, need to hear "it's not all about you."

"I found it disturbing when you started yelling at me in front of my coworkers, patients, and their families. This type of behavior can also be upsetting to observers who want to have confidence in their caregivers. I ask that in the future, that you treat me like a professional and discuss these matters in a more private setting."

Thanks for tips. Not sure when I will work with doc again but I'm def going to nip this.

There's a huge difference between a doc getting mad, and personal attacks. It was a good learning experience. I just want them to think I'm going to allow this to continue.

Not going to...

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

I don't put up with crap from doctors. They are the leaders of the care team, the key word being "leader". It's not "master" or "boss". Those who exhibit leadership and respect get respect back. Those who act like dictators or act condescending or unprofessionally will get brought up short by me in a hurry.

I don't put up with crap from doctors. They are the leaders of the care team, the key word being "leader". It's not "master" or "boss". Those who exhibit leadership and respect get respect back. Those who act like dictators or act condescending or unprofessionally will get brought up short by me in a hurry.

My grandmother took this approach when she was still practicing. I'll be taking this page from her (and indeed your) book. There's no need for one party to be ugly to another (unless the other party started it, lol).

I don't put up with crap from doctors. They are the leaders of the care team, the key word being "leader". It's not "master" or "boss". Those who exhibit leadership and respect get respect back. Those who act like dictators or act condescending or unprofessionally will get brought up short by me in a hurry.

I admire this- I really do. But, for some of us, when we're in the moment, we can sort of "freeze up" and not really know how to respond. It is only in hind sight that we're able to see how we could have handled the situation differently. I agree that the best way to handle these things is in the moment, but again, some of us are poorly equipped that way.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
I admire this- I really do. But, for some of us, when we're in the moment, we can sort of "freeze up" and not really know how to respond. It is only in hind sight that we're able to see how we could have handled the situation differently. I agree that the best way to handle these things is in the moment, but again, some of us are poorly equipped that way.

I get that. I worked for years in a place where the surgical residents thought they were demi gods and the rest of us were their servants. They thought we should do whatever they said without question. I learned to pretty much always be on guard when dealing with a physician I don't know pretty well. Before an interaction with a strange physician, or one I know is a PITA I mentally prepare with some quips ready. Comments like "thank god there was a doctor here to tell us that", "Thank you captain obvious", or even "would you like to rephrase that RIGHT NOW!?"

When dealing with residents I will not hesitate to wake up their attending at 3AM and report the sorry behavior of their resident and follow it up in writing.

It helps I am a large and strong man and would be happy to catch them alone in the parking lot to have a "talk" with them.

Several episodes of quick retorts, escalating to waking up their boss, and finally having a one on one "talk" with them has earned me a reputation as somebody not to be messed with among the worst of the offenders.

Now I don't mean to make it sound like this is a regular thing. The vast majority of docs I work with are great and are admirable people. We get along very well and work well together. Occasionally a doctor needs to be put in their place. When they correct their behavior I reward them with cheerful and willing cooperation and I try to make them look good in front of their boss.

Part of the service I offer my nurses as Rapid Response RN is I am only too happy to make calls to physicians who are well known to be demeaning or condescending in place of the regular (usually inexperienced) nurse. I always make the nurse sit beside me when I do this so that she may learn.

Because of the nature of where I work we deal with a lot of residents who are from cultures where women are not respected and treated as equals like they are here. I have a little talk I use on these types that will usually improve their behavior.

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