What does it take to earn respect? - page 3
I have been a nurse for 30 years and have done anything and everything to advocate for my patients. Why can a doctor.. scream at me ...when I ask for their guidance in a patient care issue?... Read More
Apr 4, '12Quote from Been there,done thatBecause you allow them to. I had an instructor in college who never let any physician talk to her nor us as they wanted to. She stressed the need for us to demand respect because WE, not them, are on the front line of the healthcare battle. I had a doctor raise his voice one day and gently grabbed his arm and explained I was a man before I put on this uniform and I am still a man. I said if you cannot respect my title respect me being a man. As I said this I locked eyes with him and he apolgized. Anyone who says because he's a doctor and that allows him to do that is weak and crazy. Demand respect and you will get it.I have been a nurse for 30 years and have done anything and everything to advocate for my patients.Why can a doctor.. scream at me ...when I ask for their guidance in a patient care issue?
Apr 4, '12From my experience I can tell you that when doctors yell, it is because they don't know how to articulate the right answer. I have seen more often than not a nurse correct a doctor, whether it was prescribing a particular med or procedure. Not saying that everyone has their own reasons or that one type of healthcare professional is better than the next, but I can personally offer that it is those that get the most heat that make the world a better place!
Apr 4, '12Walk away! Ignore them! Then when they are not so unstable, take the matter up with them privately with a third person present. There are also such policies, named "Disruptive person" policies, required by JCAHO. Read this policy and speak with a chain of command person whom you trust.
This physician behavior was targeted toward me several times, I walked away. Once a colleague of mine, a male, did the same thing, and a doctor choked him! An my colleague was a Nurse Manager at the time. By that time I was practicing law and my friend called my office to ask for advice. I told him to contact management and call the police. He did and the police went to the doctor's office, and long story short, this doctor received anger management classes and changed. He was an Oncologist and danced at my wedding! We loved the guy, but the pressure at the time, was for him, overwhelming and he sort of cracked! Good luck to you. You do not have to put up with rude behavior. The great thing is, they look like fools and you just keep smiling. You then win!
Apr 4, '12I'm feeling a little overwrought on this subject for several reasons. Background first...
I too have been a nurse for 34 years this month. I have a very strong personality, and defend with tenacity, my passion for nurses-fighting for the practical tools needed to make our role more patient centered (really, not just words on a mission statement). I have earned certifications in all my specialties over the years, and have maintained current education during the 34 years+ .
My observations are these:
1) nurses don't get respect because they don't demand it or don't feel confident enough in themselves to demand it
2) nurses are still socially admired, but only if they stay in their socially accepted role (for the most part) handmaidens and assistants to doctors, follow orders, work for others
3) nurses don't get respect because they still can't articulate what nursing is-we can't come together as a group of professionals who agree on what it is that we bring to the table. We do things that can't be quantified-therefore it's nebulous and if it doesn't earn money or payment, then it doesn't count
4) we take in abuses on a daily basis-patients, their families, doctors, pharmacists, fellow nurses etc.
5) we have been made to fear for our jobs or made to be the scape-goat for lost income for hospitals, errors made by others which nurses have been made to be responsible for even if we couldn't have helped it-we always could have done more or done better-our best is sometimes not good enough
6) the little time we do spend with our patients has to be fought for and defended continuously
7) mistake proofing or efficiency efforts are not sought from administration/supervisors by the vast numbers of staff-it's a top down decision without due diligence, which in a nutshell tells us that our suggestions are not always taken to heart when trying to find valuable solutions that would help the bedside nurse do a better job and increase quality of care
8) most nurses have tried but have given up and have grown bitter and beaten down in trying to make a better situation for themselves and most importantly for the patient
9) because we are mostly women in this profession, we are undervalued, and underpaid-our salaries are topped out in 15 years-what does that say about the value of experienced nurses staying in the field who have to face the economic pressures as everyone else?
10) most people have no clue what certification in a nursing specialty is, which tells me that nursing(collectively) has not done a good job in communicating what excellence in nursing is to the public
11) we are under pressure to comply with impractical mandates that have no bearing on quality patient care, just have to do with reimbursement from insurers to the healthcare facility-just look at the recent research on the patient satisfaction surveys and quality of care provided, they don't correlate.
It's no wonder nursing is not respected. We are busy, we are trying to balance our lives with our families and work and at times undervalued at every step of our lives. We miss important engagements, we sacrifice alot of our time and talents during our career, and we save lives. Yes nursing saves lives-
Knowing that you do make a difference, should give you great confidence regardless of the 11 reasons I gave-that are MY observations. You may have other reasons, but it's time that nurses articulate clearly and concisely what it is that nurses do for your patients. If you don't know, then you need to figure it out. Finding out that what you do as a nurse is more than task oriented activities during the day-checking boxes and doling out meds-will help you defend your role and give you a sense of great pride in stating proudly what you offer. Sometimes we have to be reminded.
I know that a touch, a explanation of a procedure, taking time to explain or update family on their loved one, delaying a procedure for the patient to get that one last talk with the doctor, smiling, comforting, listening to the patient, doing the things that allay fears and anxiety, collaborating with other members of the healthcare team to give better care, or communicate a patient's issues or changes in status, performing procedures confidently, are SO very important.
Nurses need to be respected, and as long as we stay quiet and fearful, we will never gain the respect we deserve.
Apr 4, '12Check your facility's code of conduct. If your facility does not have a process for dealing with disruptive behavior, shame on them. There are actually places out there where people have mutually respectful relationships. If your facility will not back you up, you might want to look elsewhere for employment. Not only is this disrespectful to you, it is a huge impediment to patient safety.
Apr 4, '12I had a doctor once who earned my thorough disrespect. The day I left him as his patient was the day he earned the name; Dr. Fester. It doesn't bother me one bit that I left him for a better, more proficient one. I realize this isn't the subject as titled, but I was mede to feel like you do by him. I now have the respect of my docs.
Apr 4, '12Gently touch him by the arm nowadays and you'll be sued for assault. No touching at all. I will say respectfully, men don't treat men the way women are treated. You may be able to get away with your response, but for women, the vast majority will not confront. They will tolerate then report and watch nothing done (unless it is a pattern of behavior).
Apr 4, '12Quote from Been there,done thatI haven't been yelled at in a long time. Mostly because where I work now is a mid-sized teaching hospital and lots of young and learning people so lots of tolerance. I have a plan for the next time some one yells at me: I will a) hang up the phone or b) physically walk away from the situation (unless it is a code) and find a charge nurse who can talk to the offender and address the issue, if he/she can't play nice and not yell then he/she will not be spoken to. I refuse to be disrespected. This would require quite a bit of provocation but I think would get the point across. Where I work management backs us up though and encourages everyone to be respectful and I know first hand it is not like this everywhere. Once a doctor yelled at me for calling him at home around 11pm and I documented his behavior in the patient medical record as well as writing a verbal order that said "Do not treat patient BP of 180/110" and reporting him to corporate. That may have been a bit much but I had had it at that point. You may have more training but you are not smarter or more deserving than me. I respect you, you respect me. Neither of us can work without the other and I am a quality nurse. Don't mess with me.I have been a nurse for 30 years and have done anything and everything to advocate for my patients.
Why can a doctor.. scream at me ...when I ask for their guidance in a patient care issue?
Apr 4, '12They cannot. I would bet money your hospital has a disruptive physician policy or something similar...Invoke It! Talk to the Medical Director of the facility, not your charge nurse. All physicians must usually answer, in person, to the medical director when a complaint is filed. They will do it as long as they are allowed to get away with it.
Apr 4, '12First, how are you doing in terms of self-respect? A little shakey there? Still not completely sure that you are as good as they come? No, I am NOT blaming the victim, not at all, so please do not flame me as if I was doing that when I am not! My only point is that handling a bully requires confidence, and it is O.K. to recognize that you could use a little help bolstering yours, if that is the case.
Second, when some bully starts yelling at you, DO NOT RETREAT! Stand right where you are, face him or her, and look him or her straight in the eye. KEEP YOUR HEAD UP and stand up straight; DO NOT SLOUCH! (Footnote: I am assuming that the bully is just a jerk and not a physical threat. If he or she is a threat, forget the "stand right where you are" thing, run like hell, and get security up there STAT). I know that these posture techniques are hard when you are "under fire," and it will feel a little scary to do it. How do you overcome fear? Simple; act like a fearless person, even if you are faking. Pretend that you are an actress in a play playing the role of an wariortress.
Third, do not try to shut him or her up, and do not answer any of his or her questions or respond to any of his or her statements, not even if they respond by screaming loader. Just stand there and let him or her rattle on (for now). Wait for them to stop briefly. They will, trust me, even if only because they will be confused by the fact that you are not playing the victim role as they expected you to.
Forth, when they stop to take a breath, make your voice calm, loud enough to be clearly heard, but not shouting, and lower the pitch of your voice as low as is comfortable for you and say, in a slow, monotonous rhythm something like, "Doctor, this is not a personal matter. I need to talk with you about the care of our (be sure to say "our") patient. Is this a good time to talk or should I call you later?" These are not magic words. There are dozens of other tactics that you can use at this point. The critical thing is:
1. Unless it is truly a medical emergency, do NOT address any of his or her questions, or respond to any of his or her statements until he or she earns those responses from you by behaving properly (or att least, better).
2. Maintain eye contact and stay where you are standing, with your shoulders back, chest out, and head high, facing him or her, regardless of how he or she responds initially. His or her response will change, just continue to pretend that you are calm and brave, and wait him or her to run out of steam. Do not skip this step. Your posture is essential, for both the way it will unbalance the bully, and the way it will enable you to act strong even if you feel afraid. It is O.K. to feel afraid, but not O.K. to act afraid. (Again, if you feel physically threatened, get out of Dodge the quickest way you can.)
3. If all of the above are ineffective, tell the doctor where you are going, and then invite him or her to follow you. Ignore the bully’s reaction (it will almost certainly be nasty, but just ignore it), turn and start walking. (Notice how you are now taking control of the physical environment? This is tactically important.) Go immediately to somewhere where there are other people. At least one other person, any person, though more than one is better, when possible. Turn back toward the bully, and ask, in that same low, slow, monotonously calm voice, "can we discuss patient _______ now?" (PS: the side benefits are greater safety for you, and at least one, preferably more, witnesses. However, the primary effect is that you have taken control of the environment.)
4. If he or she continues to act out go to the nearest telephone and call nursing administration. Tell them you have an urgent problem and need an administrator STAT. If the bully tries to take up the attack again, tell him or her that the administrator will be there soon "to help us handle this properly." Mean it when you say it, and repeat it as many times as you must.
Again, I am not blaming the victim! However, "victim" is a role, just as "bully" is a role. For the bully to play his or her role, he or she requires someone to play the role of victim. If no one will "play the game" properly, the game cannot go on very long. DO NOT PLAY THAT ROLE no matter how scared or awkward you feel! You might be very surprised how much it will confuse, and then de-escalate, the person trying to use you as someone to play the part of his or her "team mate" in the bully game.
Best wishes; now hold your head up high and give `em hell, girl! YOU are now the one in control and you will not relinquish that control, whether the bully changes his or her behavior or not.Last edit by CountyRat on Apr 4, '12 : Reason: Corrected spacing error.
Apr 4, '12To the OP, I can offer you understanding and my old .45 and an alibi. Seriously, I was yelled at once by a Doctor. This knot head yelled at me in front of Staff, Patients, and other Doctors. After he shouted for about 10 minutes that I was everything but a Child of God. I said to him I may be all those things but at lease when I make my wife happy, she doesn't light up the neon sign over the bed reading, "A great miracle happen here." The other Doctors laugh this clown off the floor. Even the grumpy, old head of surgery for the hospital laugh. The yelling idiot never spoke to me again.
Apr 4, '12Quote from CountyRatthe bolded - in a nutshell.First, how are you doing in terms of self-respect? A little shakey there? Still not completely sure that you are as good as they come? No, I am NOT blaming the victim, not at all, so please do not flame me as if I was doing that when I am not! My only point is that handling a bully requires confidence, and it is O.K. to recognize that you could use a little help bolstering yours, if that is the case.
perhaps a tad too simplistic for some, but truer words never spoken.
if you genuinely see yourself as one who is worthy, as one who holds value...
all other relationships will fall into place.
with self-respect, you know you don't deserve to be treated as an inferior, secondary peon.
therefore, you just wouldn't allow it.
walking away from one's fury, usually sends an effective message.
when i observe people acting like idiots, it's hard for me to take it personally when i perceive it to be their problem, not mine.
i guess my point is, if you work on increasing your self-esteem to the point where you expect to be treated with due civility, then your biggest problem is deciding how to interact with him/her...
which is a heck of a lot easier than dealing with these jerks AND feeling insecure simultaneously.
you've received lots of sound advice.
but what countyrat says about self-respect....please, that warrants lots of consideration...
because w/o it (self-respect), you are subject to at least twice the struggles of daily living, if not more.
it doesn't happen overnight, but take it from one who has walked the walk.
there is no feeling that compares to embracing oneself - truly loving and respecting oneslef... flaws and all.
it is so true that no one can make you feel any certain way - you're the one in charge and no one else.
don't give anyone else that power over you.
leslieLast edit by leslie :-D on Apr 4, '12