Getting yelled at by a doctor for the first time....

Nurses General Nursing

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So, I've been a nurse for about 6 months now and have been off orientation since the end of October, so I'm still pretty new and still learning new things. Today, I had a doctor yell at me for the first time.

Long story short, the attending dr and the consulting dr both agreed to discharge my patient. However, none of them were able to write a pain script for discharge. When brought to the attention of the attending that rounded that day, he basically said, "oh, well, she'll just have to stay another night and then go home tomorrow. I'm home now and won't come in to write a script."

The patient was devastated and stated her frustration with this. She also lives hours away and told me about having to get her son back home so he can get back to school. As her advocate, I did my best to try to make her discharge happen, because I feel like staying another night for just a pain script is a pretty poor reason to have to stay. I had called a partner of the attending who was also rounding that day, but was not the "on-call" dr. I didn't think anything of this because this dr was rounding with the on-call dr that day, and made the mistake of thinking that he too was on-call for that group. He was more than happy to help discharge the patient. The patient was so happy and thankful that I was able to get her out that day and I felt good that I was able to help her and her son.

At at the end of my shift, I had received a call from the on-call dr who had called me just to yell at me over the phone about the patients discharge. He said things like "How DARE you go behind my back and call another dr!!!" and "you better NEVER let this happen again." I've never had anyone speak to me the way he did and I kind of froze on the phone. I apologized to him for any mistakes that I had made and he hung up on me.

Has as anyone else experienced this? How do you deal with this? I was feeling so good and finally starting to feel like I'm doing a good job at work, now I feel like a horrible nurse....

LOL! I'm not sure where your rude comment came from. You literally gave your opinion on how "the doctor wasn't able to control his emotions" and you come back and mock me for saying that he should be able to?

I was polite in my response to you. I was trying to approach the situation rationally, but I guess you took that as an attack towards you personally, somehow. I guess you missed the part where I said "If someone disagrees with me, I want to know why and see if I need to change my view point."

Either you disagree with having mature discussions, or you don't care. Either way, maybe you shouldn't be giving your opinion on what behavior is acceptable.

EDIT: "Wow, opal bee, CNA, you have a PhD in psychology.." Are you mocking me for being a CNA, as well? I don't think the users on this website would take that very well. I might be a CNA, but that doesn't mean I lack critical thinking skills.

THIS

According to you: If I think someone's opinion is unrealistic or bizarre or silly and I can clearly think of major flaws with it, then why should I respect it?

I found it very bizarre to make a diagnosis about a doc you don't know in person. For me is pretty brave :woot: I was polite too and I only tried to express my opinion openly. I don't support violence in communication but I do know there are peacefully ways to handle it.

According to you: He's probably older, he's had 8+ years of training, plus however long he's actually been working as a doctor....

I do not mock you. It was just silly to diagnose a person you really don't know. That's all.

THIS

According to you: If I think someone's opinion is unrealistic or bizarre or silly and I can clearly think of major flaws with it, then why should I respect it?

I found it very bizarre to make a diagnosis about a doc you don't know in person. For me is pretty brave I was polite too and I only tried to express my opinion openly. I don't support violence in communication but I do know there are peacefully ways to handle it.

According to you: He's probably older, he's had 8+ years of training, plus however long he's actually been working as a doctor....

I do not mock you. It was just silly to diagnose a person you really don't know. That's all.

THIS

According to you: If I think someone's opinion is unrealistic or bizarre or silly and I can clearly think of major flaws with it, then why should I respect it?

I found it very bizarre to make a diagnosis about a doc you don't know in person. For me is pretty brave :woot: I was polite too and I only tried to express my opinion openly. I don't support violence in communication but I do know there are peacefully ways to handle it.

According to you: He's probably older, he's had 8+ years of training, plus however long he's actually been working as a doctor....

I do not mock you. It was just silly to diagnose a person you really don't know. That's all.

How did I make a diagnosis? By saying that he should act like a mature adult? :facepalm:

Looking at the part of my comment you bolded... Are you actually saying it's irrational to assume that a doctor has over 8 years of experience?

You DID disrespect me. You mocked me for being a CNA and sarcastically said I had a PhD in psychology and law. Otherwise, why would you put my username, title, and then sarcastically say that I had a PhD in two different fields and then state you were jealous? Oh please, do explain!

EDIT:

Not sure why you said this:

"According to you: If I think someone's opinion is unrealistic or bizarre or silly and I can clearly think of major flaws with it, then why should I respect it?" because I explained where I was coming from, said that I hold my opinions to the same accountability, and I said that just because I disrespect someone's opinion, doesn't mean that I disrespect that person personally.

It sounds like you don't think anyone's opinion should be questioned or be tossed out because it's simply "their opinion". And I'm still confused as to what you think "disrespecting someone's opinion" entails because you never explained how the previous poster's comment was "disrespectful". You say that comment was disrespectful, then you jump to insulting someone who tried to have a reasonable conversation with you.

Specializes in Pediatric Critical Care.
Hi NewbieNurse93, ASN, RN,

You must felt hurt and in pain by your doctor's anger outbursts. I really do feel you but I am going to give an advice and hopefully will help you in the future to maintain a healthy and respectful atmosphere at your work place. Please, please try always to communicate your needs directly with the person you are interacting with. You could explain to the doc in charge why Pt xy needed to be charged today instead of waiting another day due to her need to be....... whatsoever... if this does not help then nothing you can do about it. You could go back to the Pt and let her know that you tried your best and apologize for the inconvenient.

This isn't as minor as just an "inconvenience", though. This isn't like they wanted orange jello, but the cafeteria only had green jello today. It might be an inconvenience that they patient had to wake up at 6:00am to be taken to MRI, or that their afternoon nap was interrupted by the physical therapist coming.

Holding up a discharge can be kind of a big deal, and there needs to be a good reason, because:

(1) Insurance isn't going to want to pay for that patient to have a sleepover in the hospital when they were medically ready to be discharged - so then either the patient gets billing, or the hospital loses money.

(2) That patient staying also means a nurse taking care of them instead of a patient that actually needs to be there.

(3) If that patient stays, that means their bed isn't available for someone else - and some hospitals are already overflowing due to influenza patients.

Sure, you could explain to the doc that they need to be discharged today because of "_____", but the reason isn't because its inconvenient for them, or they need to get their son back to school. Its because delaying the discharge without a good reason is (a) a terrible waste of healthcare resources and (b) not the right thing to do for the patient.

____________

OP,

it was good that you advocated for your patient to be appropriately discharged. If you think it may be a problem, you could consider sending a quick email to your manager letting her know about the situation just in case the doctor complains to her. I think she will back you up, based on the reasons above, but its just nice for her to get a heads up instead of the doc springing the complaint on her out of the blue.

Could the communication have been improved? Maybe. You could have let the MD know that his colleague was available to provide the script. Or, he could have contacted his colleague to ask them to help. There is always room for improvement, but you were right to try to get the patient discharged. I bet if you had escalated it to the nursing supervisor, they would have agreed, too.

Specializes in Med-Surg/Neuro/Oncology floor nursing..
Hi macawake, I think you totally misinterpreted my message. I am not suggesting that we should accept the angry behavior, but instead try to understand the reason behind it. We all like to be treated in a respectfully way, but you will be miserable if you expect others to be nice and respectful all the time. There will be times when people will lose their temper either at work or privately. We are human. Unfortunately, there are many who don't have the emotional intelligence to control their anger, but this does not mean they are bad people. They simply don't know how to express themselves without yelling or using hurtful words. To answer aggression with aggression isn't the best solution to fix the issue, instead try to talk to the person calmly face to face and express your needs for respect and professional behavior. And if this does not help and the person continues to dehumanize YOU then I suggest bringing it up to another person on the stuff. This is a personal view based on my 7 years experiences in the medical field. We don't have to agree. I respect your opinion and I expect you to respect mine.

I dont know if I was verbally attacked by a colleague I'm not going to stand around and try to understand that persons anger. I frankly don't care if they are simply a jerk, having a bad day or whatever the reason is..don't take your anger out on me because you are really mad someone took your parking spot. Its not like the OP went over the docs head to get an order for a medication that the doctor simply said he would not prescribe. He was going to write the script the next morning anyway..its not like it was a difference in the way the patient was treated. By not holding the doctor accountable for his boorish behavior is doing him a disservice. One day he's going to talk to the wrong person the wrong way and it won't be pretty.

Specializes in med/surg.

You did good and I know how you feel. I used to work a lot of nights and woke up a few doctors that were not pleasant and some down right awful. It comes with experience and patience and most of all with the understanding that these doctors are just men, with a little more knowledge then most. Some of them will act like Gods, some will be humble , some will be mean, some will help you, some who really have no clue, and you still have to work with them and keep your job. By saying you were sorry, and next time you will know not to do that. That's enough. Don't let it bother you. This guy was probably mad that he hadn't thought of the solution you did. In the end you did what was in the interest of the patient. Good for you.

Specializes in Oncology.
Here in Florida, I believe most narcotic scripts need an actual signature on them and not a printed/stamped signature.

Interesting. In NYS paper scripts aren't used any more.

Specializes in Med/Surge, Psych, LTC, Home Health.
NurseCARD, I agree with your advice but not with your insult. Please avoid to judge people. So, if a patient gets mad at you and yells, are you going to call him also a .....? I really feel sad about your judgment.

I am sorry. The doctor ACTED like a jerk. Better? :bugeyes::up:

He is just a doctor, not someone with some special super natural powers or something. Well you got your practice. Now toughen up and be ready for the next time. What I mean is start practicing in your mind, how you will face the next situation. Don't assume because people are doctors they will act professional. Be professional in how you approach the next situation but nip it in the bud.

Specializes in NICU.

You did nothing wrong,but you should have called him back and tell him either he does right by the patient or you will escalate the problem.Never apologize.Who knows what got his goat today I am sure it has nothing to do with you.Doctors are a very unhappy lot these days,but no excuse fo boorish behavior.I had object thrown at me ,kept my cool and reported his ass.

Specializes in Nephrology, Cardiology, ER, ICU.

Staff reminder - please remember that while we encourage lively debate, lets keep it clean (profranity has been removed) and polite (posts have been deleted)

Thanks.

Specializes in M/S, LTC, Corrections, PDN & drug rehab.

Don't feel bad about what you did, I would've done the same thing. There was absolutely no reason for that patient to stay another night just because her doctors didn't want to come in to write a script for a narcotic.

I echo above comments. If a doctor, or anyone, is yelling to me on the phone I will calmly tell them I can't continue the conversation unless they stop yelling & if they don't then I hang up. In person I do the same thing. I will not tolerate yelling at me so I will tell them to stop yelling or I will walk away. I will also write up a colleague if they are yelling/throwing/being inappropriate. That behavior should never be tolerated & is never okay.

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