[GeminiTwinRN]

Two days ago I had a pt on my step down unit who was a 4 ppd smoker. He had suffered a horrid injury when a huge tree limb fell on his leg. His foot had necrotic tissue, he had a minimal sensation as well.

The pt. was requesting a nicotine patch. He was trached and aggresively trying to pull out lines, trach, etc. Since we are attempting to place him in a rehab bed, we could no longer restrain or have a 1:1 sitter. He simply wanted a ciggie.

Anyway, I knew the answer was going to be no, but I paged the doc anyway per the request for the patch. The dr. called back and was extremely rude. "no, no, no! absolutely NOT! this pt. is likely to lose his foot, and he absolutely cannot have a patch. he needs all the blood flow he can get, and the patch will impede it!" typed out, this doesn't sound so rude, but it was his TONE and LOUD SHOUTING that set me off. I said "I understand" and hung up the phone.

A few minutes later, the dr. appears in front of me. He is on his cell phone, but commences the shouting and shook his finger in my face. I immediately asked him to stop shaking his finger at me! I told him I understood exactly what he was saying, and there was no need for further conversation between us about the situation, but that I would appreciate it if he would go to the pt's room and explain it to the pt. and his family. He told me that "I am very busy, I have lots of IMPORTANT things to do, and I have no time to go speak to the pt."

I just looked at him. I said "you mean you are refusing to explain to the pt. and family the reasons why he cannot have a nicotine patch?" He answered yes.

That was it. I just removed myself from him, and went to the pt's room to explain it. It was over, just like that, but I had not allowed the dr. to shake his finger at me and speak to me like that. There were a few other things said, but he didn't do that again.

I just never understand why in the world a dr. can take the time to answer a page, then come up to the unit and NOT make time to go in the pt's room for the 20 seconds it would have taken to explain to the pt. Never have, never will understand that.

Put your game face on, and don't take abuse in any form. If a dr. is shouting at you on the phone, hang up or inform them if they don't lower their voice, you will hang up. If they are shouting at you and shaking their finger at you, simply tell them you won't tolerate it. Walk away, or do what I did.

Believe me, I went on about my day. I had done what I was supposed to, which was to make the request known to the dr. I had my answer, and that was it.

Good luck!

[RNperdiem]

I have found in the rudeness and harassment issues, doctors are not the big offenders. They are way outnumbered by patients and their family members. Nurses I think are more intimidated by Docs-at least early in their careers.
What worked for me was my responsibility to be the patient advocate. Sometimes you have to be a little pushy to get what you need from the docs. It is nothing personal, just doing what I have to do for the patients.
Give it time. A thicker skin comes with increased self-confidence. Increased self-confidence is earned by doing the job right.

[Susan9608]

If someone is being truly inappropriate with you, whether it is a doctor or a patient's family member or another nurse, I think a good course of action is to let your nurse manager know, particularly if you are too upset to respond yourself. Your nurse manager should be your advocate, particularly when it comes to the doctors. I know my nurse manager never allows the doctors to treat our nurses badly. The one time a doctor did it to me, I reported it to her, and she spoke with him, and he later apologized to me.

Even though people say you need a thick skin and that you can't let what others say bother you, sometimes it just does. When this happens to me, I usually take a minute - generally in the bathroom as that's the only place to guarantee privacy - to collect myself and then I go back about my job.

I've found that answering someone back immediately after being insulted, screamed at, whatever has not worked to my favor, because the filter between my brain and my mouth seems to disappear when I get flustered. (Once, when a doctor screamed at me, I just stood there, and when he was done, I said, "Were you talking to me? Because I quit listening once you started yelling." And on another occasion, when a doctor asked me very rudely, "Didn't they teach you this in nursing school?" I said to him, "Didn't they teach you to speak English in medical school?" He was foreign with a thick accent.) So my advice would be to take a moment to cool down, gather your thoughts, and then discuss the issue with either the offender or your manager.

Good luck.

[PedsER-RN]

The way I look at it is, they are no better than anyone else. Ignore it. If it gets excessive, confront him/her, write it up, or tell your NM. I'll never forget the time I had a trauma pt that came with 2 non-functioning EJ's. It's pretty much protocol here that for a trauma, they get 2 IV's. We started one and while it flushed great, it wouldn't draw. So I popped in another and was in the process of drawing blood off it when the trauma surgeon blew up "I TOLD you to draw off the EJ!!!! DIDN'T I??? Take out the damn IV NOW!" So I just calmly stood there, looked him in the eye, and said, "do you want me to finish drawing the blood for the trauma panel first, or do you not want that either?" So I finished drawing the blood and dc'd the 2nd IV. I didn't really care that he had yelled. He just made himself look stupid. Funny thing, later he came up to my when I was cleaning the room after the kid was transferred and apologized: "I'm sorry I yelled at you; that wasn't right of me to do that". I accepted his apology and we both moved on. It hasn't happened since.

I know it's hard when you first start out b/c you're already scared and unsure of yourself. Thick skin comes with time; I used to be super-sensitive, and still am outside of work, to a degree. Something my mom told me years ago: "Don't ever let someone make you think they're better than you are. They sit on the pot and take a crap just like everyone else". Kind of gross, but it puts into perspective that everyone's human.

Good luck. It'll get better.

[Tweety]

It hurts to be criticized.

You will learn over time which battles to choose and which to let roll off of you. Hang in there.

[Sassybottom]

If the comment is unjustified, I just remind myself of all the positive things I have in my life.

I will also secretly think of childish negative things about the other person too i.e., their skin is wrinkled, they are too skinny, they have no love in their life, etc.

[Luci2Lu2]

Try to remember even though you are doing the right thing often another healthcare provider may make comments that make you feel bad. You need to remember our profession is all about doing the right thing, the right way, to the right person at the right time. So cheer up and welcome to the world of nursing.

[nyapa]

I can't think as quickly, or have the 'guts' to say what some of you guys have said. Doctors in the main seem to be improving, but I agree with another poster; families and the pts themselves are becoming more aggressive, and I find it very hard to cope with. I do say though that "I am here to help, not to be spoken to like that, and I do not have to put up with this behaviour" will then walk out. But I don't think I have ever been that brave to say that to a doctor...and I am not ashamed to say that my skin is not as thick as I would want it to be.

[MzMouse]

I find it helps to remember that the person (be it doctor, fellow nurse, whoever) that is handing out put-downs is often the one with the problem. They are either insecure in their own abilities, having a terrible day, or just plain a jerk.

It's tough though, I know. I am not one who can think of comebacks on the spot, but then, I don't want to stoop to their level.