Nurse-Doctor Relationships (LONG)

[MQ Edna]

I did my first weekend off orientation this past Saturday and Sunday, 12 hr shifts. During the week there is a charge nurse that will go between floor nurses and the docs. On the weekends this is not the case.

Both Sat. and Sun. I needed to speak to one particular doc. When I first approached him I was asked if this was an emergency. No, but I needed to speak with him about a patient. He was sitting in front of his charts and said he would look at the patients chart when he got to it. Now, what I needed to speak with him about was not in the chart and was simply information I needed to pass on. He told me again he would deal with it when he got to the chart. I gave up and walked away as it was not life or death. I can't convey his tone of voice in the written word, but suffice it to say, he was utterly condescending and rude in the way he spoke to me.

Sunday: Same doc. Looking for the MARs in the nurses station. I asked whose he was looking for and handed it to him (I was in the process of recopying it). He SNATCHED it out of my hand and walked away without a word. Later, I again approached him about a different issue (all of this is the same pt.). He again wanted to know if this was an emergency. When I responded "No, but..." he immediately cut me off and said he would deal with it when he got to the chart. I tried again. "It's not IN the chart..." "I will GET to it." Finally I said "Doctor JONES..." (not his real name of course). He looked up at me and said "WHAT." I was able to ask my question, got a smartass answer, and then I turned around and walked away. Again, the way he spoke to me conveyed how lowly I was in his eyes.

Now, I know some of you will say "that's not a big deal, you'll find that everywhere." Well, my point is that it IS a big deal when I am trying to take care of HIS patients and he's talking to me like I'm dogs***. The same doc has been known to throw things, curse at nurses and call them idiots. He's also known for telling his patients he is not impressed with their pain. I am not used to being spoken to like that and am not sure why it seems to be in my job description that I have to learn to live with it.

So, my question. I know this does not go on only in my little hospital. I would like to know if any of you have tried to do anything about this problem, what you did and what the results were. I am seriously considering going to the hospital administrator and would like some solutions to take with me. I don't understand why the hospital thinks it's okay to let its employees be treated so badly. With the nursing shortage the way it is, it seems it would behoove them to keep nurses happy. When I am seriously doubting that I chose the right profession after two days, there is definitely a problem.

Laura

[P_RN, ADN, RN]

No you are not alone and no it is not all that unusual.

May I point out to you that this physician is..............

AN ASS!!!

I believe I would have said that yes it is an emergency. I also believe that you showed more restraint than I would.

We had a bit of success with a "code pink." If a doc was "verbalizing loudly" toward one of our own......we would circle the wagons around him and just LOOK. Takes the wind out of their little sails really rapidly.

You did nothing wrong. You are only human and deserve to be treated as such. An occurrance report would not have been out of order. ....."On such an such day at ___ time Dr.____SS refused to receive report that his patient______needed/suffered/wanted....etc.

Send that through channels and keep yourself a copy each time you need to.

Again......you are not wrong. You are not wrong.

* I use him/he/his as reference to BOTH sexes because I have run into this more with the menfolks than the female folks.

[JennieBSN]

Grrrrrrrr....God, just give me 5 minutes alone with this guy...he'd have a new orafice when I was done w/him.

Look, like P said, you did nothing wrong. The *@#!! simply thinks he's GOD, like he was no doubt taught in medical school, and is used to nurses shrinking away when he flashes a little 'tude. I know you're a new grad, so this may be a little hard for you to do, but you have to stand up to this guy. I'd take 2 approaches...first, I'd put all information in the patient's chart, and if he asked me a question, I'd answer him as he'd answered me, 'it's in the chart.' If he started blowing steam (which he no doubt would), I would cut him off mid-yell and state, 'I am not a DOG. When you are ready to speak to me with respect and in a professional manner, we can finish our discussion.' Then I would WALK AWAY. I would ignore, ignore, ignore, and DOCUMENT, DOCUMENT, DOCUMENT. Because he will also undoubtedly complain to your nm/DON/whomever will listen to him, and you're gonna need backup. Carry a mini tape recorder. Record him being verbally abusive. Then when you're called onto the carpet (you WILL be...so get ready...), you've got cold hard evidence. He may get all huffy and pissy, but needs to be taught that he can't push at least YOU around. If you back down and/or continue taking his crap, it'll never get resolved. I have held my ground several times with seething docs, and have ALWAYS ended up the better for it. They can complain all they want, but not responding to verbal abuse is in no way 'insubordination,' and you can tell THAT to anyone who tries to tell you so. He's probably been complained about before, so I doubt merely complaining to the higher-ups will do anything. The only way to get change is to get HIM to complain FIRST, then come back with your 'evidence,' including direct quotes and/or explicatives used towards you. Taped evidence would be especially useful, plus letting your director know that you have a very well paid and eager lawyer who would be willing to speak with them if they threaten probation/discipline or if the abuse continues. She who remains the coolest and has the most backup wins. Even when it's going up against a BIG BAD DOCTOR. Some folks are gonna tell you to speak to him personally, blah blah blah, but I guarantee you he isn't going to give you ONE MILLISECOND of his time, nor will he listen to a *@#!! thing you have to say. He's used to throwing his weight around and thinks he doesn't have to be held accountable for his actions. You've got to hit him where it hurts...HIS EGO. By making him realize you DON'T think he's a GOD, and you DON'T think he has the right to talk to you like a child or pet, you can at least give him the big newsflash that he WON'T get away with treating YOU like a welcome mat, and after he's been ignored by you enough times he'll learn. Believe me.

Good luck....let us know what happens.

[MQ Edna]

Thanks to you both for the support. I will definitely be following your suggestions and writing down everything that happens. (I don't know where I could carry a tape recorder!)

It will be hard for me to speak up, but I imagine it will get easier the more often it happens.

Thanks again!

Laura

[prmenrs, RN]

"Dr. So-and-So, I put fresh deodorant this morning AND I even brushed my teeth. Do you think we could have a conversation about your patient [ ] before they wear off?" Smile.

"So. I guess you're not too happy about being here this weekend, either." Smile.

Tell him a joke. "Hey, did you see Survivor last night?" If he says no, I was on call, you say, "Oh! I'm sorry to hear that. Is there something I can look up on the computer to help you get out of here faster?"

He's being a jerk, of course, but try to get him to see you as one of the good guys. See if you can change his attitude. If you can get him to lighten up a bit, BOTH of your work loads will be easier, and it doesn't take very long.

Sucking up? ABSOLUTELY!!

Why? For the patient! You'll get what you want for the pt., and he'll be a little more pleasant as well.

If these things don't work, call him in the middle of grand rounds, of the night, or just after he leaves. "I'm SO sorry, Dr., but you never got back to me about this issue." Try to sound as innocent as possible.

[tonchitoRN]

Love the solutions. We also had a doc who was notorious for being an a-hole. But what I did notice are the nurses he did get along with were the ones who called his bluff, said a joke or just stood up to him.

Let me relate a story about a nurse who was an a-hole. She was very used to getting her own way and when she did not she threw a temper tantrum and complained to the higher ups. Unfortunately in office politics she was considered a "favorite". Well she came to my unit and had one of her tantrums. I turned around and ignored her. She of course complained to my nurse manager who pulled me into her office for my side of the story. I said yes it is true I ignored her. I said because she came to our unit making demands and when we would not jump to her requests she had a tantrum like a child. So I ignored her like I would do to any child who is having a tantrum. Shut them up real fast. Sometimes you just gotta stand your ground.

[Y2KRN]

Hey Laura,

If you are off today please call me! I don't have your home e-mail address I thought that Scott had it on there but, I can't find it.

talk with you later,

Denise

[CEN35]

lots of good advice and thoughts here laura........nothing for me to add! :) rick

[km rn]

Physician - " I am so sick of all of these phone calls by you people - do you think it is fun to get all these phone calls?"

My reply - "Well you know it no great pleasure to call someone that acts like you but I have your patient's best interests at heart so listen up.

I got written up - but never had problems with that physician again.

We also had one physician that would blow up and then later feel bad and come back and suck up. He was nasty to me during rounds one am. Then later came in and was sucking up - "I'm happy that you are ____'s nurse today - you do such an excellent job, etc..". I told him to knock it off - his pseudo-nice apology meant nothing unless he did it in front of the same people rounding with him. I didn't appreciate being made to look like a fool in front of everyone rounding with him. I told him he had a pattern of doing this and it wouldn't be accepted anymore - that he better find a better way of coping with his anger/stress than taking it out on the bedside nurse. He didn't know what to say - but I never had an issue with him again.

[frustratedRN]

amazingly i get along very well with most of the docs better than the nurses i work with.

thats because i work mostly nights and these docs are all young. they actually listen to what i have to say and consider my input important.

most of them dont like to be called dr..they ask you to call them by their first names.

if it were an issue of urgency i would have insisted he listen to me regardless of what he said. id just keep talking.

if it wasnt urgent i would have written it down and taped it to the front of the patients chart so that he could address it when he "got to it"

id also document that a note was written and taped to the chart due to the attitude of that doctor.

with all the problems im having im so glad thats not one of them