Dr. ripped my co-worker a new one for no reason

[pnkprincess]

I am a RN nursing student and what happend at work today makes me want to chnage my major. One of my co-workers paged a Dr. to see what time he was planning to make rounds, this was like at 1pm so it wasn't like we woke him up. The pts. family members had plans for x-mas shopping ect. and had already been waiting all morning to speak to the Dr. When my co-worker reached the Dr. he began yelling at her over the phone and said you can't tell me how to care for my pts. I got to hand it to her she held her ground and was assertive during the whole conversation. The charge nurse heard what was going on so she was atleast a witness and also the nursing supervisor just happend to walk onto the floor also. No Dr. has the right to treat anyone like this and this is not the first time he has yelled at a nurse on the phone, it was a different nurse the last time. She went to management and they were suppost to handle it. Obviously it has not been resolved. Any ideas on how to handle this situation? Should you hang up on them?

[shell911rn]

As an ER nurse, I get tired of patients and families who jump on me wanting to know when they will be discharged from the ER while the doctor is handling critical cases and being called up to the ICU or Tele for a code and all the while I'm trying to stabilize my other unstable patients. These same patients complain that it takes too long for lab reports and X-rays to come back. What do they know about how long it takes for lab and x-ray reports to come back? Their "emergency" was such that they had to come to the ER in the first place yet they can't wait for the doctor to give them the all clear. It especially bothers me when they see me juggling IV fluids and meds in one hand and a foley in the other and they peer at me with an irritated look on their face. I'll do my best to accomodate them if the situation is right. I may make one phone call or page the doctor twice, but if he doesn't respond, he's obviously busy with other more important matters. When a doctor comes back from a code, I'll often shove a patient's chart in his hands to get them discharged just so I don't have to listen to them anymore, but I'm not about to pull him out of a code or interrupt him when he's considering what to do for a critical patient just so some patient can go Christmas shopping or to a game. I don't think not monopolizing my time to make sure my patient gets discharged when they want to is not being a patient advocate. It's understanding the priorities in a hospital setting and what matters more. I know how my time and the doctors' times needs to be spent, the patient doesn't.

Now, with that said, I think a better system needs to be developed for the unit. Doctors should be able to write discharge instructions the night before with directions to only discharge patient if criteria for labs, vitals, etc. are met. The patient should then have an appointment to follow-up with the doctor that day or the next or within a week (depending on their condition). I think this would work especially well for Med/Surg. Whatever happened to hospital policy discharge times anyways? I've even seen them posted in rooms "Discharge time is 10am" yet we never follow them. Weird.

Michelle

[General E. Speaking, RN, RN]

I agree that your friend should not have called this Doc to see what time he was going to make rounds. It's not an unreasonable question if you already have him on the phone for some other reason but to specifically call him for that reason is not appropriate. With that said the Doc should have handled it better. If it were me, the next time I saw that Doc I would tell him I'm sorry I was wrong to call you but I wish you wouldn't have yelled at me, I didn't deserve that either.

Families get really irritated all the time waiting for the Doc's to round and frequently threaten to leave AMA. They don't realize that it's not a threat to us but only to themselves as their insurance companies will not pay their bills. Once I explain this to the patient they usually defuse.

I'm sure I would get irritated too but lets face it "That's just the way it is with Doc's" and certainly many times their tardiness is warranted, especially with surgeons.

ditto. also I tell the patients that if the doctor doesn't round early in the a.m. that he will most likely be in his office seeing patients. (afterall, if they were scheduled to have an office appointment- they would expect the MD to be in the office, right?) Then we will shoot for lunch rounds, if no doc then late afternoon (after office hours). Occasionally, I will call and ask when they will round (depending on the doc) if it is getting late in the afternoon. Do I call the ones that are prone to yelling? No way...

[mattsmom81]

I would never page a doctor to see what time he/she is making rounds and I really don't blame that doc for getting irate...it was an innappropriate call. This kinda stuff is why docs don't return pages from nurses IMO.

I agree about the 'not getting involved in messaging for family'. This stuff never ends if nurses start doing it. I give the family the office # and they can play phone tag. I tell them they can wait all day to see the doc but he comes by when he gets here, and no I am NOT calling him to see what time that is.

My generic response is "I only page for extreme medical emergencies and this does not constititue one".

[XIGRIS]

I had a doctor yelled at me over the phone. Another nurse pages him and it just so happened I was near the phone, so I answered it and told him what the reason for the page. He start yelling at me. I was calm and shocked. And he keeps in chewing my a** off so finally I said, " Hold on Dr. So and so, I'll put you on a speaker phone." I turn the speaker phone and told him, " Ok go ahead Dr. tell me again why you are yelling?" He never said anything. I keep asking him thru the speaker phone if I can help me for anything. No answer and he hanged up.

Eversince that incident, this doctor never yells again to any of the nursing staff.

[rjflyn, ASN, RN]

all i know is if a doc ever yelled at me on the phone guess the next thing he/she will hear is the reciever hanging up. if they call back and start at it again guess what....yup same thing. just because they are a doctor doesnt automaticly entitle them to respect... its earned just like i have to earn it too.

rj:rolleyes:

[Reddy,RN]

ditto. also I tell the patients that if the doctor doesn't round early in the a.m. that he will most likely be in his office seeing patients. (afterall, if they were scheduled to have an office appointment- they would expect the MD to be in the office, right?) Then we will shoot for lunch rounds, if no doc then late afternoon (after office hours). Occasionally, I will call and ask when they will round (depending on the doc) if it is getting late in the afternoon. Do I call the ones that are prone to yelling? No way...

kriso, you started out so sensible here I was surprised to see you end up in a weird place. From what you wrote, it looks to me like you've accepted that yelling works to prevent unnecessary calls from you. Aren't you rewarding yellers that way? (And penalizing the courteous?)

mattsmom81, thanks. I'll have to remember that.

[Mistorri]

Although I do not believe the Dr. should have yelled at the RN, I agree this is not a reason to have him paged. HOWEVER...this person is only a student, and good thing. This is a good thing to learn as a student, not after finishing. Students must realize that we WILL have to deal with yelling Dr.s, family members, and at times, other coworkers. (sad but true)

All I can say is take this as a lesson learned, and never do it! Don't let anyone take you away from your dream of becoming an RN, not even a Dr. who was probably just upset because he was busy and got interupted for a frivolous reason. Tomorrow's another day, don't hold a grudge, and just make sure you are the best nurse you can be!

This is some really sensible advice! Good job! This is all so true. Dealing with rude people comes in all professions. I think the nurse making the call meant well. She was trying to help the family. But, that call would have been better not made. I work in Hospice now. But have met or spoken with some really rude and mean doctors. Usually one who is taking on a Hospice patient in a Nursing Home. Usually he is THE doctor for most of the nursing home patients. Then the admitting nurse (me or others) get yelled at because no one at the Nursing home has faxed info on the patient, or other things that were out of our control. I think some people, not just doctors feel better about themselves when they have belittled someone else. I have met nurses who do the same thing. Especially coming on shift at a hospital and taking report. They do not think they might make a mistake and are themselves just human. They feel they are Super Nurse and everyone else knows who they are! LOL. The other nurses have just become accustomed to the rudeness and try to overlook it. I know also that hospitals will tell nurses they are "working on soothing out situations where doctors yell without knowing why the nurse even called". Funny, you never see a change. So just be prepared for anything in Nursing. You will eventually see it all! Nothing will come as a surprise. On the other side of the coin. I have met some terrific doctors! You know, we all come in all personalities. I just wish Nurses were more respected. They are very important as the eyes and hands of a doctor. No reason to be treated like mud on the bottom of the docs shoe.

[ktwlpn, LPN]

The physcian is "employeed" by the patient to proved health care and patients family has every right to question when the doctor is going to come in to see the patient. The patient and the patients family time is just as importent to them as the physicians time is to him. .......................If they are my nurse and the doctor doesn't show up when stated, I start paging them and continue to page them until they arrive. Counseled frequently because torgues off the doc's, but havve the highest patient satisfaction of anyone in my department.

QUOTE]

so-who takes care of the rest of your patient load while you are repeatedly paging the tardy doc? Sure they do have the right to question when the doc may round and plan their d/c pick-up but let THEM make the calls to the doc or his office...don't demean your standing as a professional nurse by playing messenger...

[NurseFirst]

kriso, you started out so sensible here I was surprised to see you end up in a weird place. From what you wrote, it looks to me like you've accepted that yelling works to prevent unnecessary calls from you. Aren't you rewarding yellers that way? (And penalizing the courteous?)

mattsmom81, thanks. I'll have to remember that.

I think this is a situation not untypical of human relationships. Yes, people getting angry are sending a message: don't do that again. Let's face it, it is a common, and commonly effective, method of altering behavior. (Anyone been yelled at by their parents, or their spouse?) However, I agree that, in an "ideal world", no one would get yelled at. The person being yelled at can also take action, the multiple suggestions given on this thread provide great examples.

The point is: to learn what is effective. The downside of calling docs has already been mentioned: they will stop returning calls, or return them slowly. Not to be mean, but to balance their multi-tasking. If they know that ward X never calls them unless it is a true emergency, then their response time, and their attitude, will be much better--just as it is for you, with patients.

I know how frustrating it can be. I had a patient waiting to be discharged, who kept asking me when he was going to be discharged, and I didn't know. (I am a student). And, in fact, I think it was actually a problem with the ward RN responsible for that patient. What made it particularly frustrating is his roommate kept bugging me to take him out for a smoke, which I could not do until the first patient was discharged.

In a personal regard, a woman in our Church (who recently passed away) had surgery to remove what could be removed of a tumor (she had a rare, slow-growing, and nearly 100% fatal, cancer). She had asked not to have a colostomy (but apparently had given her surgeon just enough edge to do so, but we didn't know that). After surgery, the surgeon told us (she had no family locally) that he hadn't been able to remove as much of the tumor as he had hoped (which meant that there was a more definite--and shorter than hoped for--time frame for her demise) AND had a colostomy. It was quite frustrating for us, because she kept asking how the operation went, and none of us could say anything (she didn't know she had a colostomy until after the doctor visited her).

NurseFirst

[angel337, MSN, RN]

having good communication skills and good judgement is so essential in nursing. it can literally make or break your career. you have to prioritze those doctor pages just like anything else. ask yourself...is this worth being paged for? is the patient at risk? what will i accomplish NOW if i page this doctor? i know that families can also be initmidating, especially when they are pressuring you for information that only a doc can/or should give. i don't have the patience for anyone screaming at me and i have no problem telling a doc that. i am just as human and as important as they are. patients and their families need to know your limits as a nurse and once you tell them that they usually understand. you can only do so much and it is not your job to constantly make excuses for the doctors. i once told a family diplomatically and firmly that i had no control over when the doctor would stop in to see them and if they like, i would give them the number to my nursing supervisor and she/he would handle it. i then documneted when and how many times i paged the doctor and when i endorsed the matter to the nursing supervisor. your time as a nurse is precious and you will learn quickly what is important and what is not. don't let that one experience detour you from your decision to be a nurse. being a nurse has made me more assertive and confident in myself and i don't regret my decision for choosing it as a career. Good luck :)

[wooh, BSN, RN]

Rude docs are a reason I absolutely adoring working nights. There are all those times when you think, "This could wait until morning, or I could call now." The nice docs, I'll wait until morning unless it's got to be addressed NOW. But if you've ever been rude to me, well then, your patient realizing at 3am that they're constipated, that's leaning awful close to an emergency situation for me. After all, I wouldn't want you upset that I'm not quickly notifying you of your patients' conditions. Yes, I am passive-aggressive, and I'm darn proud of it. It may not be the most professional thing in the world, but neither is trying to avoid phone calls by instilling fear in the nursing staff. I AM NOT SCARED OF YOU!!!!

[Riseupandnurse]

I hate calling doctors but will do so without hesitation if my patients actually need something from them. Let them huff and puff. There is one that actually thinks I am both super unorganized and secretly have a crush on him, so that I will go out of my way just to hear his sarcastic voice. :angryfire

But the families make too many nonessential demands on the nurses. This is because the customer service mentality in health care has gotten totally out of control. Patients and families believe that they are entitled to 100% satisfaction with their hospital experience, because that's what the administration keeps telling them. And who should guarantee all that? The staff nurse, of course.

As an example, my brother, who is not a stupid man (the head of European corporate compliance for a multinational corporation), went ballistic while waiting for his discharge from a laminectomy hospitalization. He had made up his mind that 10:00 or so would be a good time to be discharged and when his doctor didn't show up, whose fault was it? The lazy nurse, who couldn't be bothered to call the doctor to let him know that my brother would like to leave. My other brother, a geophysicist, told me that our mother's nurses were incompetent because they wouldn't call the doctor to get him into the hospital when my brother arrived to talk to him about our mother's hip surgery, forcing him to wait three hours. This despite the fact that they saw what a doctor's schedule is like all through our childhood by living with our father, a general practitioner. My brothers were completely convinced that the hospitals meant it when they said patients and families could expect complete and speedy customer service, presumably with the nurse as the hostess/secretary.

It's high time for nurses to stick together and let the families gently and kindly know that they should feel free to call the doctors themselves for estimated times of arrival and general information. It wouldn't take long for the doctors to turn this situation around, as it should be turned around, as the public still has some respect/fear of the physician. And let nurses get back to concentrating on our nursing duty to our patients, which is why we went into this profession in the first place.