Ever "talk back" an MD/ other person whose screaming at you?

  1. I'm pre-nursing. I'm addicted to these boards and have been reading posts all night.
    It seems like a lot of MDs don't respect RNs that much and/or just don't think they are that smart/competent/knowledgeable.

    Is it even possible to stand up for yourself when a nursing supervisor or someone higher up--OR an MD tells us off in a somewhat embarrassing/abusive fashion?? Will you automatically lose your job if you don't just sit there and take it?

    I'm really interested in medicine.
    I have chosen to go the nursing route for a variety of reasons- I thought about being an MD, but its just not realistic for me with the future I am looking forward to having with my Navy husband.
    Anyway, I plan on learning as much as possible. I don't look forward to being treated like a moron.. by anyone. that'll suck. ;(

    I'm also worried about working with all women. I read the "nurses eat their young" post... I literally just quit a job at starbucks because the females there (it was an ALL female staff), did not like me and made me feel really unwelcome (you know, talking behind my back to management-- rolling their eyes when I'd try to be nice and make friends with them.. high school girl clique crap.) I think part of it was a whole different thing-- as I just moved to hawaii and sometimes there is some animosity toward "howlees" (white people) from the locals (everyone I worked with).

    Anyway, my real question in this post is being asked because I am trying to actually fathom the dynamics of the relationship between nurse and MD in a hospital setting. (I would imagine in a private clinic things might be a bit different, but I don't know..)
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  2. 21 Comments

  3. by   Tweety
    You're going to have to learn how to play well with others, including those who don't play well with you and you're going to come across those in your career.

    You also have to keep in perspective that most of us are quietly, seriously going about our jobs and aren't interested in yelling, screaming, backstabbing, ratting you out, or eating you. While you come across people such as that no matter where you work (Starbucks included), don't judge the entire profession. Keep it in perspective.

    No one expects you to sit there and take it. Hopefully you will learn some skills in dealing with these types of people. To lash back out, argue back is not the right approach. Sometimes you need to interrupt and say "this conversation is over" and walk away. Other times you let them rant and then speak your peace. Sometimes you ignore it and just focus on the issue they are angry about. Doctors are not God. I'm fortunate to work with docs who mostly come in, see their patients, maybe ask a question or two and then leave. There are no "dynamics" to worry about. Mainy I enjoy a good professional rapport with and we speak, even joke around. Some get angry over things not done to their liking, and most of the time they are right - we've messed up somehow. I've also been fortunate never to have been yelled at by a doctor. I think I do define yelling a bit differently than some others. To me yellling, is well yelling (in a loud voice) and I've not seen or heard it......yet.

    Getting along as a male in a female dominated profession is easier than you think. That's going to be the very least of your worries as your worried about learning meds, doing good assessments, avoiding errors and saving lives.

    Good luck to you!
    Last edit by Tweety on Oct 1, '07
  4. by   SarasotaRN2b
    Well, I am not a nurse yet, but I work as a health unit coordinator (unit secretary) on a telemetry floor. I have to say that the majority of the doctors are very aware and respectful of the nurses...however, there are a couple that act more like spoiled children than adult professionals. I work nights and have noticed that the nurses will only call the docs when it is required...i.e. critical lab values, condition changes and orders to reflect these items.

    If the nurses find that the docs are majorly rude and abusive, it is not unusual for the charge nurses to write an incident report. This will be forwarded to the medical director who will call the doc to the carpet. For the most part though, the docs really appreciate the nurses.

    Kris
  5. by   diapason05
    Is there ever any time to learn from the MDs (will they ever TALK to me about diagnosis..) or will I just be learning all the time on my own. I am somewhat dreading some of the less-fun aspects of the nursing job, but I really want to learn.. Maybe someday after I'm an RN, I will go back to become and NP... but I don't want to be a family practictioner unless I feel like I can be competent enough to diagnose -- or order the right tests and know when to send people to specialists. Maybe nursing will prepare me to diagnose.. but I've been researching and it doesnt seem that way really.
    I really want to learn. I'm sure I will learn a lot in nursing school, but I'm almost "jealous" that the MDs may know more than me about how to diagnose disease.... but I don't want to go through med school, so I'll have to learn some things on my own I guess?
  6. by   cmo421
    Quote from diapason05
    Is there ever any time to learn from the MDs (will they ever TALK to me about diagnosis..) or will I just be learning all the time on my own. I am somewhat dreading some of the less-fun aspects of the nursing job, but I really want to learn.. Maybe someday after I'm an RN, I will go back to become and NP... but I don't want to be a family practictioner unless I feel like I can be competent enough to diagnose -- or order the right tests and know when to send people to specialists. Maybe nursing will prepare me to diagnose.. but I've been researching and it doesnt seem that way really.
    I really want to learn. I'm sure I will learn a lot in nursing school, but I'm almost "jealous" that the MDs may know more than me about how to diagnose disease.... but I don't want to go through med school, so I'll have to learn some things on my own I guess?
    Most MD's will talk to u about how and why they reach a certain diagnosis. Many love to teach and share what they know and how they got there. You will learn not only from them, but also from the many experienced people around u. Nursing may not prepare u to diagnosis per say, but with experience comes lots of knowledge and gut feelings that u also will be able to share. Doc's also love to hear ur opinion(most). I had a pt a few years ago in the burn unit who was developing a weird blister like skin issue. They had thought he had TENS but the blisters would tear easily and the skin split when touched. I had seen a similar thing years before and asked the doc what he thought about phemphigas(SPELLING?). Guess what, it was. We spend so much time with pt's,sometimes we are very helpful in picking up things the doc's do not see or think of, we think outside the box more then most.I could tell u of many times nursing has actually been the one to "diagnosis".Now some will not be reseptive to ur opinion,its all in the approach. Wait and see what happens when u get ta do ur thing. U might change ur mind and continue to medical school. MAny times I wish I had. But nursing fits me better I think,and with so many areas of advance practice,it is endless what u can do. Good Luck!
  7. by   jmgrn65
    Quote from diapason05
    I'm pre-nursing. I'm addicted to these boards and have been reading posts all night.
    It seems like a lot of MDs don't respect RNs that much and/or just don't think they are that smart/competent/knowledgeable.

    Is it even possible to stand up for yourself when a nursing supervisor or someone higher up--OR an MD tells us off in a somewhat embarrassing/abusive fashion?? Will you automatically lose your job if you don't just sit there and take it?

    I'm really interested in medicine.
    I have chosen to go the nursing route for a variety of reasons- I thought about being an MD, but its just not realistic for me with the future I am looking forward to having with my Navy husband.
    Anyway, I plan on learning as much as possible. I don't look forward to being treated like a moron.. by anyone. that'll suck. ;(

    I'm also worried about working with all women. I read the "nurses eat their young" post... I literally just quit a job at starbucks because the females there (it was an ALL female staff), did not like me and made me feel really unwelcome (you know, talking behind my back to management-- rolling their eyes when I'd try to be nice and make friends with them.. high school girl clique crap.) I think part of it was a whole different thing-- as I just moved to hawaii and sometimes there is some animosity toward "howlees" (white people) from the locals (everyone I worked with).

    Anyway, my real question in this post is being asked because I am trying to actually fathom the dynamics of the relationship between nurse and MD in a hospital setting. (I would imagine in a private clinic things might be a bit different, but I don't know..)
    Tweety gave some very good advice.

    whether or not I take getting yelled at depends on alot of factors; is it a valid reason, is it in front of or near patients, is it directed at me, and is it threatening?
    Depending on the doctor also, I have let some yell so they can vent, because I know it wasn't at me. If it is in front of a patient then yes I say "lets take this some where more private" If it is somehting not valid or something out of my realm (like i had absoutley nothing to do with it) then I do say something.
    No one has to take being yelled at.
  8. by   RN BSN 2009
    Yup! Just remind them about the good ol osha and how quickly you have no problem calling on the drop of a dime to report workplace harrassment!
  9. by   leslymill
    Your fear is well grounded. 25% of all physician's diagnosis are wrong.
    Nursing diagnosis and medical diagnosis are two different animals .
    The nursing thought process evolves around nursing. You can never directly diagnose medically. You can only communicate the SO of SOAP.
    (subjective and objective observations).
    ie you know your patient is exhibiting all the signs of an MI, but you don't tell the MD that he is having an MI. That is inappropriate The doctor wants a clinical picture of what is happening SO HE can diagnose. You tell him. Pt is pale, dyspnic, mild diaphoretic, C/0 neck and jaw pain radiating down left arm, pulse is thready and irregular. I placed him on a monitor with O2 at 2 l/m his v/s are dah dah dah. Monitor shows SR with multi-focal PVCs, EKG is in progress NTG X 3 not working ...etc
    The doctor will order the tests and treatments to determine his diagnosis.
    If you love for the field is in diagnosis, I would try to strive for that in medicine. I wouldn't let your fear of not being able to do it as a layperson stop you. Actual your fear of diagnosing wrong is probably your greatest asset in getting them right after training and trial and practice.That is why it takes a Doctor 8 years to get a PHD. You will get great satisfaction from nursing, but you may not get the satisfaction you may truly crave.

    About the yelling...I agree with jmgrn65......it may seem like their anger is directed at you, but it just venting. They always have a valid point and that is why they are loud and firm. They just want your attention. Don't let that fear bother you either. Most hospitals do seem to have at least one doctor needing more training in BS Manners (usually surgeons who treat them all like their under anesthesia....JK..no I aint)
    Last edit by leslymill on Oct 1, '07
  10. by   Dalzac
    I have snapped at 3 Doc's and they all deserved it. And I have to say that standing my ground made 2 of them respect me more and I have no idea why. I was amazed I didn't get fired for one of them, because one was truly a very big and world-known heart transplant doctor. I think it was because I was right.
    there are backbitting people in every job you will have, but with time you get over it and so do they.
  11. by   wooh
    If you're looking for a fight, you'll probably get one. I do my job, and I don't take any crap. But if a MD or coworker is having a bad day, I'll be forgiving, like I'd hope they'd be if I'm having a bad day. But I certainly don't go into my days expecting altercations.
  12. by   RNperdiem
    Medicine has their own dynamics and hierarchy just like nursing, or even worse. A medical student is depending on the attendings for recommendations later in their careers; you can't afford to get on their bad side. Ask my brother in his short med student coat if things are any different in medicine. If you think docs snap at the nurses, med students take their share too.
  13. by   summersent
    Quote from Dalzac
    I have snapped at 3 Doc's and they all deserved it. And I have to say that standing my ground made 2 of them respect me more and I have no idea why. I was amazed I didn't get fired for one of them, because one was truly a very big and world-known heart transplant doctor. I think it was because I was right.
    there are backbitting people in every job you will have, but with time you get over it and so do they.
    Why would you worry about getting fired for speaking up and standing your ground? To my knowledge doctors arent the ones who hire nurses.
  14. by   DaFreak71
    Quote from summersent
    Why would you worry about getting fired for speaking up and standing your ground? To my knowledge doctors arent the ones who hire nurses.
    Because in some places nurses are more expendable than doctors. If a MD whines about someone telling him off, depending on how aggressive he is being about it, it might result in termination. But I'll be that's a bit rare.

    With regard to standing your ground, I'd do it in New York minute. My husband is a RN and he's been snapped at by a few docs for things that were not his fault. He don't play that game. As a result, the same MD's now treat him more like a peer. They pull him aside and talk in depth with him about the patients condition, etc.

    To quote Dr. Phil (for what it's worth)--"You teach people how to treat you".

    So if you are all passive and walk on egg shells around the MD's, they're gonna treat you like a moron (most won't but there are some that sure will). If you act like you are an assertive person who isn't afraid to speak up, it's amazing how people will leave you alone. I've noticed this in my personal life. Here's a real life example (I'm a student nurse by the way):

    I was in clinical one day and we were under a time crunch to finish our charting and get to post conference ASAP. I had a patient who needed their pain meds at that exact moment. Afterward, I grabbed the chart and began charting about it. MD comes up to me and says, can I see that chart? I said--give me five minutes and I'll bring it to you. My classmates jaws collectively dropped. How dare I tell a MD to wait until I was finished with the chart. After all, we had been trained to not sit in their chairs, to not ask them questions, to basically avoid eye contact with them (ok, that's a bit of an exaggeration, but you get my point). When I was finished charting (about three minutes later) I gave him the chart. He responded by saying "Wow, you've got beautiful handwriting". No animosity whatsoever.

    Don't let these threads scare you out of becoming a nurse. There are extreme situations where ever you go, but it isn't true that you are destined to end up with co-workers who treat you like crap or have MD's talk down to you. And hey, if that should be the case at the job you take...leave. Nurses are in demand and you can find another job quite quickly.

    Don't be scared. Just focus on getting your pre-nursing classes out of the way, then focus on school. You'll get a better idea of the workplace dynamics when you do clinical. Or at least a glimpse. :spin:

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