Nurses talk to Nurses, Doctors talk to Doctors
Is it your general understanding that if there are any issues or problems within your health care facility, that doctors are able to confront a nurse to discuss their annoyance with something which was either done or not done, but the same privileged is not happening visa versa?
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 21st 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
1/ Fear of losing our job
2/ Lack of support from the hierarchy
3/ Fear of being written up or placed in some sort of discipline
4/ 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!!!!Last edit by Joe V on Apr 12, '13
About madwife2002, BSN, RN
Joined: Jan '05; Posts: 10,272; Likes: 6,107
Director of Nursing Services; from US
Specialty: 26 year(s) of experience in RN, BSN, CHDNApr 12, '13My old hospital is actually in the process of encouraging nurses to report physicians who treat them disrespectfully using the self-reporting error software. This generates a report to the head of physicians and the unit manager.
I do feel that this behavior is going to be a thing of the past in ten years if education keeps moving towards interdisciplinary learning and teaching. Having nurses, docs, RT, PT, and pharmacy in classes together is going to train everyone from the start to work together better. I do feel there has been a change in this environment during my career, which is only about 8 years long.Apr 12, '13The doctors that I deal with are overall very nice. They value and depend on nurses and we are given a lot of autonomy. I've only had one physician be incredibly rude to me one time. I was pulled to a floor I'd never been on and was dealing with a diagnosis I hadn't had a patient with before. No less, I am grateful that the docs I work with are so fantastic. Now if only they would all put in their own orders I'd be happy. And if some of them had a better accent...Apr 12, '13It sounds like your workplace needs a change in culture and policy and that this particular physician needs a major attitude adjustment. The story of the meeting makes me cringe, I just can't picture it ever happening in the hospital where I work. There is no excuse, ever, to treat a coworker in this fashion, and that's all a doc is. A physician is not a nurse's boss, superior, parent or deity, and it sounds like this person needs to be reminded of that.Apr 12, '13That is INSANE. INSANE that a physician can speak to a nurse like that and have an ENTIRE ROOM of people just sit back and allow it.
If a patient or family member had acted that way, someone would have called security post-haste.
Why make exceptions?Last edit by SoldierNurse22 on Apr 12, '13Apr 12, '13Quote from madwife2002I know it can sometimes be easier said than done but really, there is no reason for you to feel shame or embarrassment. The shame belongs to the individual throwing the highly unprofessional tantrum.
I know that some Doctors will actually show their anger and frustration towards you in a public area, increasing your embarrassment and shame.
The meeting you described sounds awful. I can't believe that he was allowed to go on and on if there was shouting and verbal abuse. There seems to be something amiss in the work culture if behaviour like that is tolerated. I'm sorry you had that happen to you.
I've been lucky. The workplaces I've been in have all had strong leaders who promote interdisciplinary dialogue and cooperation. I like and respect most of the physicians I work with and they in turn respect us for our professional knowledge and judgment. I've encountered a total of two who treated me or other nurses in a way that made me wonder if their frontal lobes were performing a tad under par or who were a bit too convinced about their own infallibility, but that's all. Most of them are greatApr 12, '13Sadly, I don't see this attitude changing in the very near future. We continue to live and work in a society that deems doctors as " supreme beings". I have witnessed, on several occasions, MDs make incredible clinical errors, prescription errors, pt confusion...the list could go on. It is we nurses that have " saved the day" on nearly all of these occasions. Having said that, it simply reaffirms my point that MDs are simply human beings...not " supreme beings" and they are subject to the same misfortune of human error as we are. The sad reality is, however, that too often, when an error is made by an MD we get interrogated about why WE didn't catch it. When we make these same human errors, we, again, get chastised for making the mistake. It is often a lose- lose position.
When we see patients blindly taking meds that have been prescribed ( because after all, the "doctor gave it to me)....family members that insist they need to "hear it from a doctor" and a management team that accepts this superior/ inferior behavior...we begin to question..." Are we a medical team? Or are we sheep being herded into pasture?"
I remember years ago...a hospitalist on-call MD ordering an anti-biotic for a pt with noted allergies to it....it was night shift and paging him went without it's own retribution...but when I brought to his attention that this was not an appropriate solution...I was told " MD out ranks RN every time!!!"Apr 12, '13This is my chief complaint about my current manager, there is no support or advocacy for the nursing staff. I work in a large clinic with 12 MDs. The majority of the MDs are professional and respect what we do. However there are two who act like king and queen of the castle.
A few weeks ago, King MD was the back-up doctor. They take turns in this role to be the go-to person if the patient's regular MD is not in the office. They are supposed to remain at the office until all patients are seen and we are open until 6:00. Pts can be scheduled as late as 5:30, depending on what is going on. We have an infusion area, injection area, a coag clinic, lab, and phone triage to deal with. This MD insists that we call him at 4:30 (infusion area only BTW) to let him know how late we will be.
#1, how are we to know how late we will be when we still have patients to come in? Believe me, we have had train-wrecks come in for their 5:15 Coag appointments who have to be direct admitted to the hospital.
#2, only the infusion center is expected to call. I guess it doesn't matter that Coag patients are scheduled until 5:30 and that phones don't go on service until 5:15 at the earliest. Even if the infusion center is done by 4:30 (sometimes, but rarely), these other areas still need an MD on site.
#3, our hours haven't changed in 10 years. We are always open until 6:00. If you are back up doc, I don't understand why the expectation isn't that you stay until 6:00.
The other day, no one called him at 4:30 because we were busy. He left. We only found out after someone in triage tried to find him about a call. He got paged by QUEEN MD, who also hates being back-up MD and would very likely pull the same stunt. He ends up calling my boss and yelling at her about not being called at 4:30. Does she stick up for us? No, we get a big note on the bulletin board saying to make sure to call at 4:30.
I can understand calling when the last patient arrives to give an estimate of how long we will be. I can understand calling at 5:15, when the phones go on service. The other MDs will often call us when they are finishing up to see how long we think we will be.
With this particular scenario, if the infusion center happened to have been done at 4:30 and called him, how would we have known that the patient was going to call us at 4:45 when phones don't go on service until 5:15?
I am angered that the MD is a jerk, that he is allowed to be a jerk, and that our boss just rolls over and does what he says. It is infuriating!
We are professionals, but are not treated as such in many situations.Apr 12, '13It's a lack of respect, and partly why I intend to leave the nursing profession. I see too many of my coworkers just put up with being a punching bag.Apr 12, '13This is an age old problem. Years ago, about 15 years ago, I worked for a wonderful boss and administration, at a facility (in the Midwest) that did NOT allow this behavior towards their nurses. They were reprimanded, held accountable, and made to behave. A physician that threw a chart at me was suspended from admitting for 90 days.
I moved...to New England.....and I have worked at a couple of facilities that promotes the good ole boy club and allows nurses to be treated like second class citizens and the MD's like God's. I was stunned!!!!!!!! However.....It's the culture of the area.
Personally, I would not have stood there and been shouted at....I would have made it clear that I would not be spoken to in that manner and I would be happy to discuss this when they could speak in a normal speaking tone and be respectful...or we could finish the conversation in Human resources.....and I would have left the meeting. Walked out and closed the door. Period. My husband doesn't speak like that to me and neither will someone else.
No one can make you feel inferior without your permission.......Apr 12, '13I have actually witnessed an MD lie to a family, and blame the "nurse" for something he did. I called him on it, and insisted he apologize to me. The doctors don't understand, or care, that when we are blamed for their medical error, then we still have to take care of the patient. The patient and family then no longer trust us. I live in this community, too, and do not want my reputation smeared in this manner. I don't want people to think of me as incompetent, stupid, etc., just because a doctor decided to claim "his" mistake was mine. I just happened to walk up behind him while he was making up this lie, and caught him in it.Apr 12, '13At my present hospital, all the doctors are foreign, and most are from a country in which women are not valued. There are several who regularly run to administration to complain about everything under the sun, and administration caters to their every whim. After all, the doctors make money for the hospital; nurses don't. They threaten to stop putting their patients there. (Don't know if that is true or not; that is just what administration chooses to tell us.) I am from the stone-age, so I remember well how we peons had to stand and give up our chairs when a doctor entered the room, so I do see some progress. Esme is right~ it is the "culture" of the facility, and the culture of the one I am at right now is to blame and punish the nurse for everything, and treat the docs like the Gods they think they are. This hospital segregates us into classes; we even have separate holiday parties, etc., instead of all together like a team.Apr 12, '13At 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.
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