How do you handle "the unhappy MD"? - page 2
My first experience with an "unhappy MD" made me feel worthless. From that moment on I decided to adopt my own "plan of attack" Case: I call the MD for orders at 3am. Instead, I receive... Read More
Mar 28, '03Originally posted by yannadey
I usually start off charming them "oh I'm so sorry to wake you at 2am doc but as you know its the policy " then i tell him/her what i need & suggest (if its a recurring problem e.g. injuries r/t falls) to make it a standing order they usually agree.
Mar 28, '03Originally posted by RN always
although I agree with starting out by saying "oh I'm so sorry to wake you" or "I'm so sorry to bother you" or whatever, we learned in school to never start out by saying that. The rational is that we are doing our jobs and it is THEIR job too so we shouldnt have to apologize for calling them, even if it is the middle of the night. When they decided to become a doctor they knew they would be getting calls at midnight so what do they expect? Or even calls during the day, they are the docs. They are the ones that need to be called. Oh I get so frustruated with this subject. I just don't understand why docs have to be like that.
Mar 28, '03Yeppers...we were taught the same thing: Don't apologize--you are doing your job, the doc is doing his job.
Depending on the doc, I'm not at all sorry to wake him up at 0300!
Mar 28, '03I agree with the 1st post, but I will admit that I jump to, "This is the problem and I need orders." fairly quickly with some docs. And then I shut up. Usually they just start reeling them off. I once had a doc tell me (in ICU) that he was taking his Dad to church for Father's day and he was not to be paged for the 2 hours the service lasted (he was on call). I waited for him to finish and said, "I'll just document that, and let the chief of staff know, so that ICU has coverage for Sunday morning." He cancelled the order........ some docs I am friends with and have known for forever and so I'll joke a bit with them--but they are not the ones that are swearing etc.!
Mar 28, '03I like to start with something like, "Wouldn't dream of calling you at this hour except I knew you'd want to be aware that (Mrs. Patient's BP is 210/130, O2 sats are 70%, whatever) She's our x-year-old patient admitted Tuesday for (brief rundown just in case this doc has no clue who Mrs. Patient is.) We've already (whatever interventions have been tried) with no luck. I'm sure open for suggestions ."
It acknowledges the suckiness of having to call him/her at that hour (and I know they're being paid a lot of money and they knew what they were getting into in med school, but they're human and any human deserves a little courtesy at that hour .) Also gives them a second to wake up. And I always thank them, again out of common courtesy.
Mar 29, '03Oh Gosh...I just got this hilarious vision of nurses actually barking (woof, arf, yip) into the phone at the docs LOL
Mar 29, '03I like Nurse Ratched's post very much.
Without apologizing for calling in the middle of the night, she allows them a moment to wake up as she concisely describes the situation, interventions made, and asks for the doctor's input in a way which lets him/her know the ball is appropriately placed in their court.
From my experience, doctors generally are not into chit-chat or up to playing the question-and-answer game at 3am. Being concise and having your ducks in a row before making the phone call (and having an idea in your mind of what you want/expect the doctor's orders to be) goes a long way for a positive outcome for a middle of the night phone call.
I agree that although these physicians know they will be called at all hours when they chose to be doctors is true, however they are still humans. The physicians I would call at night were mainly OB-GYNs and Pediatricians who were on-call for their group of physicians... doctors who spent their days seeing patients all day in an office or doing scheduled surgeries and then after making evening rounds, had a short evening with their family while fielding questions from their answering service from patients, and often coming to the hospital to attend deliveries or admit patients. I was not the only one calling the doctor at 3am because they were getting calls from other nurses at other hospitals, in other departments at our hospital, and from patients. When one of us needed to call doctor so-and-so we'd check with all the other nurses before calling so we could each speak with him/her all in one phone call. Our doctors seemed to appreciated that.
With all this said, there were always a couple who would be grumpy no matter what you did. I remember one who would sounded like she was sleeping through the phone call every time... we knew to tell her what we wanted and she'd say "ok" and then you'd hear the phone rocking in the cradle as she tried to hang it up in the dark. Hilarious and scary at the same time...
I've never had a doctor curse at me. Once had one who liked to make smart a$$ comments which I ignored completely. I have always thought if anyone cursed or screamed at me I'd firmly, and with conviction, reply, "My own parents never spoke to me that way and I'll be darned if you're going to do it right now." Thankfully I've never had to see how that one would go over.
Mar 29, '03I liked Ratched's post too. It costs me nothing to say "Sorry to have to wake you" before swinging into my schpiel, it gives the doc a moment to collect his/her thoughts, and it starts the conversation off on a pleasant note. I do it as a courtesy, not as a groveling, abject apology.
Mar 29, '03I would have to agree with every post here. The doctors have a job to do and so do we. Like we really want to call the MD; that just means that are A$$es are busy trying to stabalize a pt one way or another. I work at a large teaching facility so I have to interact with many different interns, residents, consulted docs, private physicians, etc. Luckily I've been here so long that the privates and second year and up residents know me and also know that if I CALL I NEED SOMETHING. With the newbies, they get one or two chances to show me what "type" of doc they are, the god complex or the we are all here for the pt attitude. The god complex ones get three fold the amount of calls. "oh Mr. soand so has gas, oh, MR soandso had a increase in his hr by 10 beats; just wanted you to know, and so on" you get the picture. They learn to treat me with respect b/c I can make their life a living hell! (which I don't mind doing HE HE HE)
All in all, with the docs I know well, I give them the benefit of the doubt when they are grumpy....I mean we ALL have rotten days here and there>>>
Just remember....KILL them with kindness........If that doesn't work, report them to the medical director or their supervisor.
We can write docs up don't forget.
Apr 1, '03I agree with Scoob(RNAlways-hey sister!) I wouldn't apologize because it would only start a trend and ruin it for everyone else. It's not what you say but how you say it and depends on who you're talking to. I know some docs who are pleasant no matter what time, issue, patient problem. Those I wouldn't mind apologizing to cause...well...you know...you just like em. But the other buttmunchers would get the 411 and that's usually what they want. For you to get to the point. It IS crucial to have all your info together before calling.
Apr 1, '03I have had to communicate with 2 nasty doctors in 2 days. I do sympathize with anyone who has had a nasty doc ruin their day. I think the nasty, mean self centered doctor was a nasty, mean, self centered person with a feeling of entitlement long before they became a doctor. I just limit my communication with them to get what I need (politely) and then put them out of my mind. I will not let them make me feel less about myself.
An old friend gave me this advice about letting other people bother you...."Don't let anyone live rent free in your head". So since they are not paying me rent- If they pop into my head-I push them out and think of something more pleasant.
With that said---I can't help but admire altomga's style.
Apr 6, '03This is SO politically uncorrect, but it worked for me at one time. When I first got out of school, I was pretty ignorant,and I knew it. We lived in an area where the doctors got away with a lot, and they didn't hesitate to jump the nurses. In my hometown (not where I nursed) my father was an old-time aggressive doctor and I heard him ream nurses out on the phone from the time I was born. The only thing that ever stopped him was the realization that the particular nurse he was talking to was just too dumb to appreciate the brilliance of his comments. So when I got out of school I adopted what I called the "Gomer Pyle" defense. They yelled; I grinned and said something complimentary or off the subject. Or I would ask a goofy question with the most sincere tone of voice I could muster up. It never failed; they stopped dead in their tracks, looked flustered, and then got this look: "Oh, I am dealing with a complete moron!" They gave up and walked away. Of course, it didn't work indefinitely; only a few months and then they were pleased to realize I wasn't a complete cretin. Must have learned a lot; maybe it was due to being around their stellar selves.
Like I said, it's not politically incorrect, but it saved me from many a confrontation in my green-as-grass days, and was very funny to boot.