Awful Doctors - page 6

As a newly graduated nurse, I am still in the midst of trying to grow in self confidence and improve my critical thinking skills. I have only been working as a nurse for four months now and there is... Read More

  1. Visit  PMFB-RN profile page
    1
    Some of you are missing the point. It does NOT matter what mistake the nurse made / makes. The PHYSICIAN is not the person to "chew her out". It's quite possible a chewing out is called for as a learning tool. However the physician is not in any position to supervise a nurse. The only exception I can think of is when a nurse works directly for a physician, like in their office for example.
    Think of it this way. We nurses are not in any position to chew out maintence workers in our hospitals. They have their own chain of command and we are not their supervisors. Nor does nursing school put us in a position to be an expert in the field of faciliety maintence. If you have a problem with the preformance of a maintence workers you need to contact their supervisor and allow them to deal with it.
    tewdles likes this.
  2. Visit  kanzi monkey profile page
    0
    Quote from PMFB-RN
    Some of you are missing the point. It does NOT matter what mistake the nurse made / makes. The PHYSICIAN is not the person to "chew her out". It's quite possible a chewing out is called for as a learning tool. However the physician is not in any position to supervise a nurse. The only exception I can think of is when a nurse works directly for a physician, like in their office for example.
    Think of it this way. We nurses are not in any position to chew out maintence workers in our hospitals. They have their own chain of command and we are not their supervisors. Nor does nursing school put us in a position to be an expert in the field of faciliety maintence. If you have a problem with the preformance of a maintence workers you need to contact their supervisor and allow them to deal with it.
    Ordering clinicians are not always familiar with the nursing chain of command. They may not know who to take their grievance to, when that person is around, or what their role is. In a situation where something occurs and harm may come to a patient, the immediate line of communication is ordering clinician--><--nurse. Always. If a nurse feels "chewed out" inappropriately, the first thing to address is still the patient. Once safety is established, if the OC and RN are still having trouble communicating and resolution is required, then either party can seek support from their superiors/colleagues.

    I have seen and experienced similar situations (in both roles), and I have been in situations where a nurse became emotional about an error that I found very concerning (and also been that nurse "feeling" scolded). The first thing being addressed in a "miss" or "near miss" situation is the patient. If emotions are unresolved after safety is established, that issue can be addressed independently, when patient care is secure.

    Yes, verbal/physical/emotional abuse from one clinician to another happens, and it needs to be dealt with. But it's expected that emotions run high when patient safety is at stake. Sharp or "unfriendly" communication is not necessarily inappropriate when something need to be done quickly, and "chewing out" is subjective.

    If my mom's K was <3, I would expect it to be repleted quickly. If it was not, especially is she developed an unstable arrythmia, I would expect immediate recourse. I would not expect a long delay, and I certainly wouldn't expect involvement from a nursing supervisor to deal with a staff interpersonal issue taking priority to my mom's clinical stability.
  3. Visit  tewdles profile page
    2
    The fact that a physician may or may not know the correct chain of command does not give them license to verbally abuse a nurse.
    PMFB-RN and psu_213 like this.
  4. Visit  LadyFree28 profile page
    0
    I think most respondents have to put into perspective that the MD MAY have handled the situation inappropriately-emphasis on the MAY be cause we were not there-however, it does not overemphasize the point that this was a CRITICAL lab value.

    Still the OP has to take that lesson learned...pt could've coded, and she would be either answering the BON and/or looking for work. From her post, she has stated this.

    If there is a separate issue related to the MD's behavior, then that also needs to be looked into, discussed with the NM, etc.

    As for other co-worker's stating the MD does the same thing to other nurses, how long they have been on the unit? Are there an overwhelming number of new grads who have done similar failure to rescue events??? Since we don't have that information EITHER, the fact remains to focus on the OP utilizing her resources more so than the MD's actions...the delay of intervention for the critical lab value is more startling than the MD's response, that the OP posted, in my opinion.
    Last edit by LadyFree28 on Apr 29, '13
  5. Visit  metal_m0nk profile page
    1
    Nursing is not an easy job. There are a lot of knocks to take when you're first starting out. The trick is to learn to take your knocks, reflect, and move on. This too shall pass.
    Altra likes this.
  6. Visit  metal_m0nk profile page
    1
    Quote from RNperdiem
    Words like "abuse"and "bullying" used to really mean something different. These were powerful words reserved for intolerable situations. Even a mildly raised voice is now considered "abuse"?
    I must be getting older.
    I think at least part of the reason why what is widely considered as abuse is changing is because with the passage of time we are beginning to more fully understand the real physiological and psychological impact of our interactions with others.
    PMFB-RN likes this.
  7. Visit  PMFB-RN profile page
    2
    Still the OP has to take that lesson learned...pt could've coded, and she would be either answering the BON and/or looking for work. If there is a separate issue related to the MD's behavior
    *** The BON _IS_ an appropiate body to look into a nurses actions. A physician is NOT.

    As for other co-worker's stating the MD does the same thing to other nurses, how long they have been on the unit?
    *** Obviously I have no idea about this particular physician. My experience tells me it's highly likely. We all know certain physicians who seem to enjoy bullying nurses and who seem to think that since they are a physician they are in a position to tell nurses off.
    carolinapooh and tewdles like this.
  8. Visit  LadyFree28 profile page
    1
    Quote from PMFB-RN

    *** Obviously I have no idea about this particular physician. My experience tells me it's highly likely. We all know certain physicians who seem to enjoy bullying nurses and who seem to think that since they are a physician they are in a position to tell nurses off.
    ^Ahhh, the "experience" factor...how could I forget that? ....

    Again since WE WERE NOT THERE, I refuse to partake in what the physician did...the more important PRIORITY is addressing the OP's failure to rescue; the MD can be sorted out later. A lot of posters decided to do so...that doesn't make any who chose to PRIORITIZE as nurses do in terms of responding to the issues. No one is disputing how some physicians treat nurses. Again, for me, the PRIORITY is making sure she is able to prevent this occurrence from happening again, and asking for help, especially when a potential critical event is faced.

    The doctor followed up and the expectation was that the critical value was dealt with TIMELY, and in turn, the doctor still responded on the importance if that. AGAIN, not there for the TONE, but doesn't diminish that the doctor was correct.

    We are collaborators with doctors...we must be able to communicate clearly and TIMELY in order to make sure we minimize additional complications, or we are all going to be up a certain creek that starts with an s and ends with a "t"...making this post about "us v. them" doesn't erase the OP's potential disaster. If anything can be made of it, the FIRST thing is honing those skills and utilizing their resources, and ADVOCATING for the pt by being assertive while talking to the doctor, regardless how the doctors feel about nurses...making sure we, as nurses are doing our part, using that doubt, fear etc. by getting help, etc...the suggestions made by other posters.
    Susie2310 likes this.
  9. Visit  tewdles profile page
    1
    MDs do not have the right to verbally abuse nurses. A potential disaster does not require the type of "guidance" this nurse received.

    The patient was not harmed.

    A stern discussion in a private setting would have achieved a great deal more.
    carolinapooh likes this.
  10. Visit  LadyFree28 profile page
    3
    I'm sure no one is disputing that, tewdles. However, when posters are allegedly "missing the point" when the reality is that something WORSE could've happened...2.8 K is CRITICAL, that was where posters decided to go...doesn't make it right or wrong. Again, since most of us were not there, the FACT remains us that she had a potential issue that even if her feelings were hurt, the gravity if the situation that could've went DOWNHILL.

    Pardon me if for me, addressing a critical issue and giving someone strategies to promote success is waaay more important than a MD who we have no idea whether the MD was "bullying" UNLESS I personally know the MD, and since I do not, like many have stated before, could the MD did it better, absolutely. Are we going to virtual hug the OP without giving her important pearls of wisdom for her success?

    I can only speak for myself...a resounding NO.
    Susie2310, psu_213, and panamishe like this.
  11. Visit  kanzi monkey profile page
    2
    Quote from tewdles
    The fact that a physician may or may not know the correct chain of command does not give them license to verbally abuse a nurse.
    Didn't say that it did. Also don't know that there was verbal abuse--I wasn't there.

    In the interest of ensuring that the potassium was repleted, a conversation between the nurse and the OC was certainly warranted. If the MD was inappropriate in her exchange with the nurse, someone should look into that after the patient is cared for.

    Obviously no one is advocating for perpetuation of MD-->RN abuse. Not handing out licenses, just pointing out that critical labs are the priority over interprofessional personality dynamics.
    psu_213 and Altra like this.
  12. Visit  tewdles profile page
    0
    So, some of you seem irritated with my response.
    This thread is about awful doctors...thus my response.
    Of course I wasn't there...I am responding to the description of a verbal altercation that was not cool as described.
    I get the whole thing about the critical lab...there is generally some sort of a catalyst for those who have little self control and poor interpersonal skills.
    We could have a thread about what nurses can do to try to prevent abusive docs from going off on them, but that is not the focus of this thread.
  13. Visit  LadyFree28 profile page
    1
    Sorry tewdles, no irritation here. Feel free to disagree.

    The OP stated in her original post that the doctor was "horrible." The OP gave ONLY scenario regarding the critical lab, and there were a few coworkers who hugged her and stated that the doctor had a habit doing that.

    Total subjection, mostly because:

    1) WE don't know what happened
    2) Do not know the skill mix of the unit (dr may have 5 plus years v. Unit may have 0-2 years experience, including charge nurse, ESPECIALLY the ones who hugged her and stated that there was a similar reaction; however, I won't make that assumption)
    3) and the title is subjective to the OP's feelings.

    For the sake of not keeping or making this an epic thread on objective v subjectivity, AGAIN, there are people who CHOSE to make her critical value misstep a teachable moment and a priority. No one is excusing the doctor, either. I am very comfortable in my response, and still feel that her critical lab value and assisting her with that FIRST is more important, and I'm sticking to that. Again, feel free to disagree, no irritation here...we are all entitled to our opinions without alluding to missing points and especially without flame, even flaming emotions on a percentage of doctors who cannot manage their emotions and should and do get called on the carpet for their behavior.
    tewdles likes this.

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