Nurses Talk To Nurses. Doctors Talk To Doctors

[madwife2002]

Nurses talk to Nurses and Doctors talk to Doctors, is this a general understanding of the circle of life within your health care facility? Or is it true to think that Doctors can express their discontent of a nurse but it is not considered acceptable for this to be reciprocated.

Unbelievable within the 21^st century America that nurses are unable to talk to doctors about the way they behave or their attitude. Is this because we are a female dominated profession or because we are considered the second class citizens of health care professionals?

Are we considered experts of our field or is it assumed that we are 'just nurses' by the medical profession?

Last year a MD openly shouted and verbally abused me at a MDT meeting, in front of guests who were observing our quality meeting, the tirade went on for what felt like 20 mins, twice I asked the MD to step outside the room so we could discuss the matter privately but he refused to even acknowledge I had spoken. My boss was present in the room and said nothing. After the meeting was over, my boss asked us to stay behind then actually apologized for the behavior of the MD, a couple of the MDT members actually cried they were so upset about the whole incident. I informed my manager that it was not acceptable that she should apologize for the behavior of the MD, and we discussed why she didn't step in to stop the meeting.

Later on that day one of the MD's nurses (NP) visited the unit, I told her that her boss was a pig. I incorrectly assumed we were having a private conversation, and she reported me to the MD who was horrified. Not only did he report me to my director but went to the CEO to complain. I was giving a PIP and the MD informed me he was disappointed with me using such horrible language!

Lesson learned it is ok to shout, scream, bully and intimidate a nurse manager but dare that manager express how she feels, instant write up! Now I am not condoning my behavior I should not have voiced my opinion of the MD but I am only human. I have to say though we did manage to sit down and discuss how we the Dr and myself would behave in the future and our relationship went from bad to really good, but at what cost. I can only imagine if I had told him what I really thought about him, where I would be today.

I know every day in the hospital environment and other health care facilities, Nurses are being verbally abused and bullied by the medical profession and I do not believe we are given the support we deserve. Outside in the real world not one of us would put up with such horrendous treatment, not towards ourselves and certainly not allow our children to be treated this way. I would go as far to say that a fair few of us are actually nervous and frightened of our Doctors, and there are not many of us who would actually challenge or stand up to them. How many of you feel that you would actually be supported if you did challenge a doctor?

I know that some Doctors will actually show their anger and frustration towards you in a public area, increasing your embarrassment and shame.

Nine times out of ten, there has been a process breakdown which has caused the doctor some frustration and they often want to take their anger out on the nurse who is looking after that patient at that time, even though they might not have been involved and are at the end of the line. Knowing it is not your fault does not help you when you are being publicly humiliated at the hands of an irate doctor who refuses listen to excuses.

I have witnessed doctors do this to co-workers and then march straight to the manager's office to complain, the manager in turn calls the poor Nurse who is already distressed into her 'office' to discuss why the doctor is so upset with them.

The excuses often make me laugh and I am sure you may have heard these once or twice in your career

'You know what he is like' (so this makes it alright then)

'He was on call last night' (and this is my problem why)

'Don't worry he shouts at everybody, he'll be fine tomorrow' (Oh goody I won't be shouted at again this week)

And the best of them all ...

'Don't take it personally' (I didn't notice that the tirade was directed towards anybody else)

We are experts in our profession and it is our profession, yet we are constantly belittled and dismissed as though we are still 'handmaidens'. So we must ask ourselves why we continue to let this happen. There are more of us than there are of doctors so why do we not stand together and be counted.

There are many of us who are frightened of losing our jobs if we upset the doctor, we do not have anywhere to really go to get support to manage a bullying co-worker yet alone a doctor. I believe if I did some research the top answers for why so many of us would not challenge, would be

• Fear of losing our job
• Lack of support from the hierarchy
• Fear of being written up or placed in some sort of discipline
• Being Black listed from other health care facilities

I am not suggesting that all Doctors are bullies and tyrants but the ones who are out there cause a great deal of discontent and havoc, most of them are allowed to continue this behavior for years and it is not contested. I do not have the answers, I wish I did I could write a book on it and it would be a best seller.

All I suggest is you do not lose your cool remain calm, ask the Dr to speak privately, try hard not to retaliate.

After all the doctor may have been on call last night, he shouts equally at everybody at some point, you know what he is like just don't take it personally!!!!

[nrsang97, BSN, RN]

At my previous position I voiced concerns about how our NP and MD's treated nurses during rounds, and was told "Well that is just how J (the NP) and Dr.X are." I said that it was unacceptable and was ignored. I have been chewed out by the NP for following orders that were given by the neuro surgery team to transfer a patient because the ICU team was not consulted before transfer took place. I told her they should communicate and not make me the middle man. I have enough to do. The patient was indeed ready to transfer. She just wanted him kept one more day.

I have had MD's yell at me on day shift for orders that they never wrote weren't followed. I told them they never wrote the order only talked about it in rounds. I didn't follow the order because they never wrote it. So frustrating.

I got chewed out by the head MD in our ICU because I didn't have I&O, CSF output, VS trends for 24 hours (in front of a A&O x 3 pt as well). I had to remind him I was charge, we had no clerk, I had just finished up with my other pt, we had only one aid, and I had to answer the phone and door to let visitors in and put in orders for those who didn't know how. I said I understood how he felt I should have that knowledge, but he should have understood I was not only doing my job that day but the job of 2 other people.

I brought this to management and was told I should have had that info. Really when did you expect me to get it between answering every single phone call that bounced to my spectra link, and the door, and take actual care of my patients? Management lets doctors speak to us that way.

My new manager is awesome and wont let that crap happen.

[QTNurseBSN]

Does anybody know how to stand up for themselves? This day and time why would a nurse allow a doctor to yell at them in the first place. I would pretty much speak my mind and say "I don't know who you are yelling out but please believe it isn't me!". There is a word called RESPECT! Sure they can dispute or get frustrated as doctors, just like we as nurses can dispute or get frustrated. But one thing you will NOT do is yell at me or talk down to me unless you are ready to get yelled back at. It doesn't solve the issue, but it let's the doctors know they have stepped out of line. If you say nothing, they will continue to do it. I am not easily intimidated by a physician because my overall focus is on what's best for the patient, not bowing down to a doctor!

[RNperdiem, RN]

In teaching hospitals like mine, the attending doctors set the tone and expectations.

In many services, the residents know they cannot get away with disrespect if the senior doctors are sticklers for proper behavior(and the vast majority are).

Theatrical tantrums are a perk of power, and most doctors do not have that level of power; it is not limited to medicine either. That doctor knew what he was doing.

[osamejrn]

I took it a few times until I finally had enough! After a few years of nursing under my belt I had an on-call physician call my unit one afternoon and ask for a nurse that didn't work on my floor. I explained this to him and he insisted that I was wrong. So, I went around to make sure I wasn't mistaken and a pool nurse wasn't actually on. As it turned out, the regular staff was on and I again explained to him that there was not a nurse by that name on that floor. He then became very angry with me, insisting that he received a call from my floor! He had made me angry as well with his attitude. But, I can usually keep myself from becoming belligerent with someone, something he obviously had not mastered yet by what came out of his mouth next. He then said, "Well you can call me back whenever you finally get your stuff together!" I totally lost all composure with that man and said, " I DO have my stuff together, YOU need to get your stuff together! I told you there isn't a nurse by that name on this floor!" He hung up on me.

[nurseprnRN, BSN, RN]

Some of you have heard me tell this story before.

Years ago, I worked at Stanford University Hospital in the cardiac surg ICU. The Chief of the service was Norman Shumway of blessed memory, he who did the first work enabling human heart transplantation (though California law at the time made it impossible for him to be the first to have a donor heart to use), and we had a great unit with one of the very best nursing managers I ever worked for. The first of July he would come into the unit for rounds with the new house staff, and took them around. While pouring his coffee from one cup to the other to cool it, he would say, "You see these nurses? These are the best nurses in the world. If one of them ever tells you to do something, you do it. And if I ever hear of any of you abusing one of them, you are out of here." He repeated the same thing in the OR, minus the coffee.

And that is why I never knew that cardiac surgeons were supposed to be egotistical jerks until I left there. Nary a tantrum or a thrown instrument or an unkind word to a patient, either. It can be done, but it starts at the top. The chief residents out of that program went all over the country to run programs of their own and they carried that culture with them-- if the programs at Johns Hopkins, or Minnesota, or San Diego are peaceful, thank Norman. The only one of his residents that I ever knew that was a jerk is in private practice-- I had occasion to contact him to ask him a clinical question a few years ago and he's still a jerk.

[SaoirseRN]

Out of all the physicians I work with, only a few are ever problematic and if they are out of line, you bet we can report them. Our medical director is great and takes concerns about professional conduct very seriously. He is also a pleasant and respectful person. I met him informally at a party (coincidentally enough, the party's host was a physician friend of mine), and he simply introduced himself by his first name.

[Altra, BSN, RN]

What's described in the OP is not the culture where I work, and I am so glad.

[TraceyMarino]

One night shift, in the wee hours, I had a patient who was crashing, and needed to be intubated and transferred. I called the doctor on call, who hassled me about my assessment, accused me of over-reacting, and of course I did not know what I was talking about. I said, "you know why they invented rapid response teams? Because doctors like you won't listen to nurses like me. You better get in here, or I am calling the ER doc to come care for your patient. If that happens, you will hear about it from someone other than me, and they won't be very nice about it!" This doc was on the floor transferring the patient in 10 minutes, and actually apologized to me. No problems with that doc since I called him on his behavior and reminded him that nurses cover his butt 24/7!

[Marisette, BSN, RN]

I believe this type of bullying behavior goes on often and is seldom reported. I work for a for profit organization and physicians bring in the patients. I have attended meetings where physicians verbally abuse nurses and other health care professionals and they are brought to tears while administrators allow this or contribute to beating up the nurse. Human resources does not get involved if a nurse is brave enough to report this type of bullying. If we speak up, we may be the scapegoat, for future attacks during meetings. If we choose to leave the employer, we find it difficult to find other employment because "the corporation" has basically bought everyone out. And for nurses in their, 50's like myself, their are few options, even with numerous years of experience. Employers are not looking to hire older nurses. There are always reasons, not the experience they seek, why would you leave your present employer after so many years, and so on.

[Double-Helix, BSN, RN]

I agree with you. Nurses, another health care providers such as CNAs, bear the brunt of the frustrations, bad tempers, and general meanness of doctors and even upper management. I do think that until we stand up for ourselves (united) the idea that nurses are somehow second-class healthcare providers won't really change that much.

I think the other crux of the problem is that, in general, physicians aren't employed by the hospital. They are granted privileges, but they choose where to send their patients for treatment and they could easily choose another hospital. Many hospitals will bend over backward to satisfy and placate the doctors because they are trying to protect their bottom line. Confronting a doctor might result in losing that doctor's patients, and the money the hospital could make from them.

[gcupid]

Whether it be negative or positive, Ive come to experience nurse/doctor relationships are specific to the culture of the particular hospital and/or specialty unit. The last straw for me at my previous place of employment was that the majority of nursing staff supported the physician in nurse abuse. It was so dumb. You can't talk to me anyway. If there were more men in the profession, it wouldn't even be a problem.

Another example which I find to be stupid. 4-5 nurses passing the chart around for what seems like 30 minutes trying to read the doctor's orders, all bc they are afraid to call and get a clarification. I'd rather use that time towards a break or getting everything organized for the next shift. But it will not change bc the md's are spoiled by this behavior. If you can achieve a medical degree surely u can write legibly or put in your own correct orders or hire someone with the credentials to document the orders you want carried out.

[lovingtheunloved, ASN, RN]

I don't let anyone talk to me that way, doctor or not. Because I do home health, I never actually see the doctors, just talk to them by phone, and there have been numerous times that I've said, "Call me back when you can behave like a professional," and hung up on them. Nobody gets to scream at and berate me. Period.