MD screaming at RN's in front of patients regularly

Nurses Relations

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I currently work with an Psych MD that is also the Medical Director of a psych unit. I've never met such a rude doctor in my life! I'm a pretty new nurse and have only been working at the hospital for less than 6 months.

She likes to raise her hand to dismiss us if she does not want to talk. If you say, but Dr._____ it's important" sometimes I get a "NO" AND a hand dismissal before I can tell her what is important. So of course I document and tell my charge. She is like this with other nurses and MHT's as well.

The other day she was heard throughout our small hospital, psychiatric youth unit, scream "GET OUT!!!!" to a new nurse and MHT. We have been using the medical treatment room to record height and weight (the only scale on the entire unit), take initial vitals, and remove clothing to do a skin assessment and contraband check. It's where our managment has told us to do it. We are in charge of all admissions and assessments on the unit, and often the ambulance just rings the bell and we have no clue what is on the other side.

Not to mention, this was done while a child was sitting inside the room, terrified because this was her first admission, with the door open to the community milieu, and her parents on the other side of the unit. How unprofessional can someone be? Apparently she had deemed this her "office", didn't mention it to ANYONE, and just went off because she can.

The tech who is a 20+ year veteran was hysterically crying and said " no one has every spoken to me like that in my life!" She was quickly given an extra 30 minute break by the appauled RN's to calm down. When this issue went up to management we heard one say "well, that's just the way Dr._____ is" while another manager came on the unit and told us he would handle it. He hasn't.

I've seen a tech told "you need to leave now, your not allowed on this unit" in a loud harsh tone as soon as she the MHT came into the room to listen to report. This happened in front of at least 15 people, including MHT's, Nurses and Therapists. I was later told by managment it was a "personal issue". Personal issue?! We were down an MHT, now having an unsafe level in staff because of a "personal issue."

One RN who took the issue to HR because of the verbal abuse was called the very next day by the DON to tell her that they didn't think that she was ready for a full time position and she would have to stay PRN, with no explanation.

I have worked with this nurse and she is attentive to our patients, never has any errors, is friendly with staff, and an all around great nurse in my opinion!

I would leave the facility STAT, but can't due to financial reasons and leaving a job this early into my nursing career seems like professional suicide.

If she was horrible all of the time it would be different, and more predictable, but she has many mood swings throughout the day and you never know what mood she will be in. Will she treat us like professionals or rip our heads off because we dare touch a chart (paper charts) that she hasn't reviewed yet. There is no way of knowing which charts she has reviewed while she is there so it's constant anxiety if we see her coming to put everything in it's "place." She is exceptionally more nasty with female staff.

I'm normally an assertive person. I've gone head-to-head with the Director of Nursing and the president of our school when an entire class was failed, and won! Almost the entire class, of mostly "A" average students were not kicked out of the program. The nursing instructor was fired, years of tyranny going out the door with her.

I've been nothing but respectful and "sweet" to this MD so it could never come back on me. But, enough is enough! It is not in my nature to not stand up for what I believe in. If she was not additionally the Medical Director of the unit, I wouldn't be as concerned with backlash.

What would you do?

Have you ever been insulted to a similar degree?

Thank you all for your replies! I feel more motivated to look for new employment, regardless of my current work schedule of 50+ hours weekly that leave me physically and mentally drained. I finally feel like my concerns are validated and this Dr. should be reprimanded for their obscene behavior!!!

Since you all have been so receptive, I would like to ask a few more questions so I can truly be "smart" about this...

I had been told, when I asked a manager on what incidents were reportable, that to write them if in doubt and if the management feels that it is unimportant that it can "just be ripped up." With the management wanting to push this under the rug, do you think that my incident reports will go through the proper channels?

I believe that it says on the IR, or at the very least I was told that an IR cannot be copied. Is this true? I do not want to violate any laws but I need a paper trail as was posted earlier.

Would a time stamped word document to each incident be used as evidence to the Medical Board I plan on reporting her to? I am still very concerned with backlash, as I have seen it myself happen to competent nurses in the facility and was told by senior members of the facility that "it's best to stay under the radar around here."

About the incident reports - check your facility's policies and procedures. It may list specifics there. If it does say something like that, it might work to go to quality/internal investigation and work with them to document the instances. At both my current facility and my last job (2nd nursing job), incident reports went to risk management/internal affairs and were handled that way. We could also call the office and give a nugget of information without the report process. My second job - incident reports were done electronically and given a "tracking" number much like a package would be during shipping.

I don't know about copying. I've only had to do a few. The first two were at my first job (the one I was at for 13 weeks) - one was related to a visitor arresting on our unit (all codes were incident reports and this visitor was the husband of one of my patients...), the other to a family member interfering with a patient's care. My second job, I only filled out one incident report. That'd be because I called the rapid response team (per policy) for a patient's behavior (in this facility, floor RNs were not allowed to initiate restraints without rapid responsing a patient). Anyhow - the RRT didn't bother to call our unit or come to our unit to see what we were paging over (yay numeric paging only). So I called the on call for the patient's admitting/attending service and they handled it. But I had to write it up. Cause it could have very easily NOT been over behavior but over something much more serious.

In addition, I would like to add a conversation I had with another RN yesterday to add to this MD's ridulousness...

I was told to NEVER give a child an anti-anxiety medication or sleep aids that were prescribed by the on-call doctor, regardless of the child's mental state. That this MD does not believe in these types of medications and that I will "get my ass chewed." I actually truly appreciate any heads-up that anyone gives to avoid "getting my ass chewed."

It really should not be reprimanded if the on-call MD, that are also usually child psychiatrists themselves, write an order and not give it. Isn't it a fundamental rule that you follow Dr.'s orders unless they are detrimental to the patient? That if you call them about a heart rate in the 140's immediately after admission because they have been through something so traumatic that they just shake in terror and an order of Vistaril 25mg PO Q6 should not be denied because of the tirade you will recieve when she comes to the unit the next day. BTW, the anti-anxiety medications are almost always, with only very few exceptions, uncontrolled substances and the most liberal the MD's on call will be for insomnia is Benadryl.

Now that I think about it, shouldn't she be on-call 24-7 if we are expected to NOT follow a Dr.'s orders?

Well, consider the scope of your license. You assess, document and discuss with MDs, DOs, NPs and/or PAs about your patients. Seems like you are working within your license and that the on calls are working within theirs. Unless you have a "good" reason not to follow an order, and yes, usually it is like following the order could cause harm to your patient, then you should give it. Your responsibility all boils down to patient safety - noting and documenting assessment changes, vitals, medications and effects - if you are receiving orders for a medication there is a reason. Unless it a policy that on call coverage cannot write for XYZ on a patient then you have done nothing wrong. I would suggest the doc take it up with their coworker who wrote/gave the order, and/or suggest they be the only on call doc if they want it their way.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

There is only one REAL reason she behaves that way, it is tolerated. I would not and have never tolerated such behavior. The time to nip it in the but is immediatly when it occures. When she yells or does something else inappropiate you must IMMEDIATLY tell her that is unacceptable behavior and that you simply will not tolerate it. Once you have made that perfectly clear if she continues then it's time to bring it to managment (in writing, use buzz words like "hostile work enviroment". "assault", "threatening", "emotional abuse" etc.). Give them an appropiate time frame to deal with the situation, usually 30 days, and if they elect to not deal with it it's time to speak with a lawyer about filiing a suit. Usually actually filing a suit is not needed. Just let them know you are serious.

Personaly I would let her know (without actually saying the words) that if she continues to abuse the nurses I would be happy to catch her alone in the parking lot and teach her a lesson in civil behavior. That tactic has worked wonders for me many times, but I can't recomend it to anyone else.

Obviously you need to be looking for another job. Your managment's tolerating of it's nurses being abused speaks VOLUMES about how little they care about you.

please, write her up!!! what a rude dr.

Scream back, about nothing in particular.

Specializes in ED,NICU,SICU,MICU,CCU.

What would you do?

Have you ever been insulted to a similar degree?

I am a 10 year Paramedic an Fairly new Nurse...Nurses take lip from no one.

First lets start with, she is not signing your checks....nor is she the CNO or CEO...

Next time she opens her fat trap, put your best puzzled look on and look around the room as if your trying to locate whom she is speaking to in such a fashion.

Her tyrant is purely tolerated, as i say..you play with fire you will get burned....

SImply give her a taste of her own medicine & don't take her $hi!...you learned in communication that confrontation is a well used strategy.

You are being generous, I would have her on paper to the Board of Medicine in her state along with whomever doesn't rain on her parade in management..

She can not simply create a hostile environment because her cotton is slightly moist today...

SIMPLY PUT....SHES WANT TO BE A ***** WELL NURSES WERE BORN TO *****'S

FORMULATE A PLAN AND KNOCK HER OFF HER HORSE SHE IS ONLY THE MEDICAL DIRECTOR

Specializes in Psychiatric Nursing.

Since I've delt with many situations in the past, I'm pretty well versed on how to be passive-agressive without it being led back to me. I just wasn't comfortable before, but with EVERY single nurse that has replied to my post is in aggreance, I have hatched a plan....

Without too many details, it's basically going to be a way of showing her all the consequences of her behavior that can affect her professionally. Do I think this will stop the behavior, nope! But, I do think it will have her absolutely furious that anyone dare point out her problem, quite blatently, and be unable to pin-point the individual who so generously brought it to her attention. This, in turn, will make her do something that cannot be ignored. :)

Specializes in CRNA, Finally retired.
Also my experience with those in this field....not wrapped too tightly, and

quite prone to "self-medicate" with RX's and booze. This is ASSAULT, at least where I live.

I've been fortunate enough not to encounter this often. But now that I'm 65 I just tell it how I see it.

A surgeon lit into me because I was giving someone a break. Just told him that if he needed a drink that badly, just go to his locker and take care of business - I wouldn't breathe a word. You all don't have to take this crap - you're going to let a sociopath control your work environment? Deal with it. Plan what you're going to say when this abusive woman is on the unit and put the ball in her court. Sometimes you can lessen your oppression and sometimes you can't; but she's going into 2 year old tantrum mode. Surely, as a team you can shame this solitary woman into better behavior.

Specializes in ICU.

We had a doc who would loudly curse and carry on over nothing . Families hated him. He was out of control and needed meds.

One day he went into a rage and a male employee told him he was behaving like an ass while another employee called the adminstration and said he is too out of control to be with patients. That got their attention. They came running and watched him rant and rave.

He went through some kind of process and was gone within months.

Specializes in ICU.

you can always call security or even a code "out of control person" anonymously and let them deal with her. That would be freaking hilarious.

Specializes in ED,NICU,SICU,MICU,CCU.
Do I think this will stop the behavior, nope! But, I do think it will have her absolutely furious that anyone dare point out her problem, quite blatently, and be unable to pin-point the individual who so generously brought it to her attention. This, in turn, will make her do something that cannot be ignored. :)

Formulating a plan of attack is clearly the way to go...she is NO position to CONTROL you.

She simply constructs the patients medical regimen. That does not give her any authority to control or speak to you in a way she deems fit. :sarcastic:

You work automatous of her, you only carry out her orders when YOU feel they are SAFE. Not because she barks them at you.

If she would have been a paramedic speaking to you like that you would be on the phone with his supervisor about the audacity of his approach to a RN...I have been there :no:

Why is she any different? Because she is an MD? :no:The medical director? :no:If she was a NP would you feel the same way? :no:

Don't fear for your job and take her 2 year old temper tantrums any more. Stand up for yourself and god damn it stand up for Nurses! :roflmao::roflmao::roflmao::roflmao:

If that fails, watch her walk to her car, than call EMS and tell them she is emotionally disturbed and yelling jesus is coming to get her. If she is that ballsy with you, she will give them a load of fecal matter and than she find herself on the ground faster than she can say Haldol

Specializes in ED,NICU,SICU,MICU,CCU.
I've been fortunate enough not to encounter this often. But now that I'm 65 I just tell it how I see it.

A surgeon lit into me because I was giving someone a break. Just told him that if he needed a drink that badly, just go to his locker and take care of business - I wouldn't breathe a word. You all don't have to take this crap - you're going to let a sociopath control your work environment? Deal with it. Plan what you're going to say when this abusive woman is on the unit and put the ball in her court. Sometimes you can lessen your oppression and sometimes you can't; but she's going into 2 year old tantrum mode. Surely, as a team you can shame this solitary woman into better behavior.

I love it! I love the old school nurses who just couldn't give a good God Damn about how someone is about to take what their about to say! So long as you don't drop a F bomb in the process he or she dose not have to like your approach!

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