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This is a discussion on ER Doctors that are hard to work with! in Emergency Nursing, part of Nursing Specialties ... We have a newish ER doctor, female and acts like jekyll and hyde. She wonders why we react to her...by ERIsland Apr 14, '01We have a newish ER doctor, female and acts like jekyll and hyde. She wonders why we react to her the way we do-of course her speaking to us like we are 2 year olds has nothing to do with it! How have any of you dealt with this problem?
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- Apr 17, '01 by buckboomerHave anyone tried directly confronting this abusive individual? The direct approach works best. Er nurses can take a little heat, and can usually dish it out! Be respectful, if possible, and talk it over with other staff. Then go up the chain of command, but don't expect much there. This individual should get the message. Think about pulling a few pranks, and see if she has a sense of humor. Maybe getting to know this individual better is another way to understand her points of view. Let her know yours, too. Remind this individual, abuse is violence and will NOT be tolerated. Buenas suerte
- May 8, '01 by NurseyKWe have one of these nut-jobs with us too. She believes that SHE is "in charge" (and, yes, to a certain extent she is) - but *not* of Nursing and Nursing Issues. She generally steps all over my (Charge Nurse) toes -- to the point when one day I actually threw the ER charts and Nursing schedule in front of her and said, "Here, since YOU are such a better Nurse than I -- handle this" (PS: she couldn't). The abuse ended for a while with me, but the target just changed to another experienced nurse on our nite shift. We tried going up the chain of command - don't bother...it didn't work. My solution: After a shift from he## with this woman, I mean, to the point where I could not even SEE straight, honestly, I locked the wacko in the break room and let her have it, politely yet firmly
Since this time, approx a few weeks now, I have not had a problem on MY nite shifts. Unfortunately, she is still giving others grief. They know what I did (they were there that nite) and see the obvious change in her attitude with me (when they work on my nites). Best thing I ever did. Heck, I should have done it sooner (when someone else suggested this to me).
Bottom line: Direct confrontation always gets the bully off your back.
- May 9, '01 by CEN35Well I can say that for the most part we really have an excellent group of docs with us. I think there are just one or two that annoy/irritate the nurses. Mostly its in the way they do things. Keep in mind, we all go nuts and can get worked up, when there are more people in the ER, that you have rooms, and sometimes hall space to accomodate the patients.
Over head page through the ER for a nurse, "To give a Tetanus". Thank God I wasn't working the time he did that one!!
Over head page a nurse to give "his patient", Demerol. Again, he should thank God I wasn't there for that either.
I'm not sure what type of problems you have? Most of ours are just plain outright r/t too the double standard. Certain docs think their patient is the priority no matter what happens. You could be working a full arrest, that's resucitated...one nurse charting, one getting another line, one helping the doc intubate, and the other mixing the Dopamine and being the drug runner (if the crash cart is not open). Then he will come in and insist someone leaves to gove his patient "Motrin" or some crap like that! It's irritating. The thing I found out that works the best, is just too ignore him if your busy. Don't respond, pretend you don't hear him. I have even went to the extent of telling him, that is not currently the priority, put it in the rack and someone will get too it.
On one paticular night, he came in at 10pm. He went to go see a patient that had been waiting in her room, for 2 hours and 15 minutes. She was upset because, we didnt go get her mother to sit in the room with her.
Doctor: "we need to consider things like this and take care of them".
Me: "There was no time for that earlier...we were very busy."
Doctor: "You can't say that to me, I work here too, and I know it gets busy. However, it still should have been considered and done".
Me: "You were not here earlier, when the halls were packed, when there was no place to put anybody else. The thought was considered on several occasions by myself, while I was in the middle of other things that required immidiate attention. I am sure others considered it also. There was nobody available to do it, that is the botttom line".
Doc: "I'm not trying to turn this into an argument."
Me: "Well thats what you are doing. It was not a priority"
My point? If someone was going out to get some patients family memebr, this doc would pull them aside and say I need you to do this on my patient first. If it was another docs patient needing demeral, he would pull someone aside and say I need you to get their family real quick first. Point is..... "His patients" are always the priority, regardless of whats going on with anybody else's patients. it's the me, me me me me scenario. so........the best answer was ignore him, tell him its not the priority. God help anybody that pages someone for a tetanus or something benign.......put it in the rack.....and it will get done.
geeeezeee I staryed off course? Anyhow, thats the extent of our doc problems.
In general, I have found you have to give them 3-4 months to really start to get to know them. Sometimes its more of a "I dont know you, and you dont know me" issue.
- Jul 2, '01 by LANAI work in a rural hospital with 4 ER beds with 2 for minor overflows. We have one MD and RN staffed around the clock (a LPN & clerk 12 to 16 hrs/24).
The MDs are sent to us from an agency. If they are extremely slow or incompetent, we tell our nurse manager, who promptly does something about it. We are fortunate in that she also will work one of the shifts, at least once a week (more, quite often), so as to get her personal opinion of the doctors.
Our manager listens to us and our patients. We provide a simple yes/no with comment section questionaire upon discharge. It is anonymous, except we do put the date on it, so as to know who was working on that day. This has helped us more than anything. We have a box for them to place it in upon discharge. The questions have to be worded in simple terms. We ask such things as was the staff professional, was your privacy respected, how well was your pain controlled? Everything has a check off answer. This goes a long way in getting administration to sit up and listen.
We ask no more from the doctors than we expect from ourselves. We don't put up with rudeness to our patients. (Sometimes we quietly & secretly cheer it when it happens to a deserving patient.) Some of the doctors get mad at us. If they don't like the rules, then we don't want them back. Our manager expects us to stand up to the doctors, if they are rude. If we don't write them up, then she comes down on us.
If they are incompetent, then we call our manager, and, immediately, if it is life threatening. We, also, immediately call in our local ER Medical Director or local back-up MD. Our doctors know our competencies and know that we won't call for stupid stuff.
Don't be afraid to stand up to your doctor for your patient's sake. If weren't for your patients, then you wouldn't have a job.
Hope I have helped. Bottom line, you need documentation and a manager to back you up.
- Nov 18, '01 by LilgirlRNWe have a realtively new guy working with us, miost of our docs have been in our ER for about 8 years. This guy has been with us for about a year or so. He doesn't practice ER medicine, he practices internal medicine. If you've been en ER for very long you know that you can usually bend the docs a little bit, get them to conform to the standard set by other more experienced, more seasoned ER docs, but NOOO, not this guy. Treats us all like we don't have a clue, I was an ER nurse when he was still in high school.
We recently had a patient in that was very ill, his regular hospital was on diversion so he shows up via ambulance and we know nothing about him. 75 yo WM, very pale, HR 140's, BP the low 90's, very large abdomen. We do room assignments on day shift, his nurse was an LPN, very seasoned, but an LPN none the less and an RN must do all assessments. I told his nurse to start a line right away and what labs to get including a hepatic profile. The doc intervenes and says a hepatic profile won't be needed. Later when all of his labs came back, and his crit was around 20 and the differential smacked of alcoholism, he orders the lab work that I said needed to be done in the first place. I took the opportunity to call him on the carpet for it... I said think of all the time you would have saved if you had ordered what I suggested in the first place, he turned bright red, not used to having someone question his thinking. Now I order what I think is appropriate for the patient and he doesn't say a word. Do you guys get to order labs, xrays and what not, do you have set protocols depending on symptoms?
- Nov 19, '01 by kayceeI agree with Rick on the gettin to know each other part. Sometimes Docs need time to get to know the nurses before they develope trust. Same goes for nurses trusting the Docs. If there is a specific problem I always found direct confrontation in a professional manner with the Doc is the best way. If they are incompenent of course you need documentation and to bring it to the attention of the ED medical director.
If it's a personality conflict again the direct approach is best.
Give her some time to get to know the ER and the staff. If that doesn't work request a staff meeting with your manager and director and discuss the issues.
- Nov 21, '01 by deespoohbearWe have one arrogant ER doc in our small facility. Sadly, he is also the medical director for the ER which makes it very difficult to get anything done about him. This guy is a real jerk. He is condescending to the nurses, the patients, and whoever else he can humilate. He makes cracks about how much people weigh, both patients and staff. He makes sexist remarks about women. He is constantly telling one of our ER techs that she is too old to be doing that kind of work. (She is in fact one of the best techs the ER has). We have complained multiple times, written up hundreds of PERTS, documented until our fingers are ready to fall off, and nothing works. This doc happens to be the darling of our hospital administrator who thinks he does no harm. The patient surveys forms even come back stating how much of a jerk this guy is and how poorly he treated them, and still nothing happens. This doc pretty much leaves me alone because I just don't let him get away with it. If he says some kind of smarta** crack to me, I just dish it right back. Direct confrontation is usually the best route, but I would make sure I had a witness or a tape recorder with me. You know how stories can get changed.
Hope this works. And if anyone has any suggestions on how we can rid our ER of the jerk I mentioned, I would be very open to suggestions!!
- Dec 5, '01 by Bekka_LassI understand where you're coming from...We have an ER doc that runs our ER from a state in New England(sigh) ..our ER is in the Midwest..he works like 10 days then leaves for the rest of the month...How effective is this? You can't reach him when there is a problem...or he calls back 1-2 days later on his cell phone and then says "sorry cant help you with this". He is condescending to patients, new staff(the older ones dont let him get by with it), he has run off several good doctors all because he is greedy, He is intelligent and can do the work but sometimes prefers to surf the internet instead of see patients while on duty, he has been caught in lies but still he is administration's "golden boy", our ED's reputation and care level has decreased since he took over.
However, I am a true believer in what goes around comes around and believe with the occurences of the past week things may change. We had an elderly female come in the other night having a severe allergic reaction..her tongue was twice the size it should be, she was drooling, he was informed no less than 8 times that this pt needed entubating, he yells "give her the drugs" which we had as well as we had the entubation cart ,an extremely reliable RT(he wont let the rt's entubate, he prefers to do it himself), it took him 55 minutes to see this patient by which time the primary nurse was yelling for help NOW, ofcourse, the patient was past intubation, too much swelling, he attempted a tracheotomy, she began bleeding profusely, unfortunately the patient died, we were crying and all of us had trouble sleeping that day, everything was documented as well as the nurses having private documentation of their own to CYA for a later date because I am sure this will come back to bite "someone" on the a**, as the coroner on arrival was very upset and even took photographs, I have no clue as why he did not listen to us, the Ed was busy but by far she was the most critically ill pt there at that point, he on most occasions(however I do recall telling him several times once that a patient was in Myasthenia Crisis and he was slow to respond..the pt was entubated as soon as she was seen by her neurologist) has listened to us but unfortunately for this pt he did not and it was made clear to him over and over the gravity of the situation. This situation may atleast open some eyes and hopefully change some things but it is a pity it had to happen at all.