I was thinking the other day, as I was reading some older threads, how often we hear concerns about doctors being rude or impatient with nurses. This certainly does happen. There are doctors out there who are just difficult to work with no matter how one approaches them. Thankfully, aside from a few exceptions, I have a good rapport with the majority of the doctors at my hospital. That isn’t to say that they are all saints and have never been short or rude to nurses (myself included), but that isn’t really what this post is about.
Being a “doctor” doesn’t give an individual license to be rude. Similarly, one could argue that neither does being a human being with the ability to communicate. Respect amongst colleagues is something we should strive for, and that is a two way street!
What I rarely hear about is nurses being rude or impatient doctors, but it does happen. My thoughts on this matter have some basis in reality, which is why I am posting about this.
There is a GP with privileges at my hospital who is very new. New to us, and also just brand-spanking new with the good fortune to take over a full practice after completing her residency. The GP she worked with retired, and she is now the family physician for his former practice. Where I work, GPs care for their own patients in hospital.
This doctor is lovely, really, but it takes her a very long time to complete her rounds and often she runs out of time, must go to the clinic, and come back after clinic hours to see the rest of her patients. On her weekends on-call, she is literally on-site the entire day. She asks many questions, often consulting on-call specialists with advice on where to go with a patient’s care, or calling the pharmacy to double-check information about medications. She asks many questions of the nurses, and often calls back to add or change orders.
All of the above is because she is new, and when one truly thinks about it, it’s perfectly reasonable. We always say to new nurses, if you are unsure, ask. That is exactly what she does, and wouldn’t you rather she was thorough and not just guessing?
I often see the nurses complaining about her. I’ve overheard the pharmacy techs and pharmacists complaining about her. She’s always bugging us about something or she called again to change her orders! I wish she’d just figure it out the first time!! I’ve heard nurses snap at her when she’s trying to ask them something about her patients. I imagine she may get snapped at by people on the other end of her telephone calls, too. Heck, I even overheard her own husband being inconsiderate to her on the phone – You’ve been there all day, what’s taking you so long? Have I ever felt irritated with her? Of course I have!
You know what? She doesn’t deserve it. She hasn’t even been practicing for a year on her own and she’s doing the best she can for her patients. Could she alter her approach in some instances? Sure she could. Could she manage her time better? Likely. But learning those things takes time, just as it did for us nurses. She’s like the physician equivalent of a new grad nurse and I feel badly for the way she is treated sometimes. It is a ton of responsibility, and a lot of knowledge that isn’t always going to be right at her fingertips.
My hospital uses a call group system for weekends, each group comprised of either one clinic or several smaller ones. One GP from each group is on-call for all the admitted patients in that group.
Last weekend she was on-call for her group. I had four of her patients in the little 10-bed department where I was working, all of whom had some minor issues that should be addressed that day, but were not urgent. I knew she would show up at some point, but like most of the weekend doctors, she started her rounds up on the larger med/surg unit and would work her way down to us eventually. Therefore, I didn’t call her, because there was no need to interrupt her.
She finally came downstairs at 1600 that afternoon. I said “Oh, hello!” and she sighed and asked, “Were you waiting for me?”
I explained as above, that we knew she would be along eventually so we didn’t need to phone her. She looked so surprised and grateful, and it was that moment that started me thinking about this topic. I wonder how many times she was needlessly telephoned that day simply because she hadn’t gotten to that patient yet, without anyone taking into consideration that she’s slower than our seasoned GPs, and whether or not their concern could wait for her arrival.
The following day, I intervened on her behalf when I strongly suspected her patient was about to either punch her, or shove her over when he was trying to leave against medical advice. She looked a little like a deer in the headlights, obviously trying to convince the patient to stay for his own benefit and having a very difficult time with his resolve to refuse care and leave. She wasn’t reading the body language, and I happened to walk into the room to bring a dose of antibiotic and found her hovering far too close to an agitated man (face flushed, fists clenched) for my comfort.
I tried my own, slightly different approach with the patient at first, but it was immediately clear that we would not get anywhere and he was going to leave no matter what. So I gently suggested that she go make her phone call and that I would take care of the patient until she returned. I removed his IV before he could just yank it out, got him to sign the release from responsibility form, and because I wasn’t “forcing him to stay”, he calmed down and agreed to at least pick up a prescription if she called it into his pharmacy.
She thanked me afterward, and we discussed the situation and I felt a little like the teacher in that moment. If we forced him to stay, he would likely never come back even if he needed medical care. By letting him go, even though we didn’t want to, I felt that at the very least, he would still get medical help if he needed it.
I’m not discounting this doctor’s intelligence or level of education, but in that type of situation, I have more experience, and she recognized and appreciated my help. That day we had a highschool work experience student observing, and she ended up seeing quite a bit of the “other” part of nursing, and the doctor said that she was lucky to have had me to follow for the day.
Anyway, there aren’t any great sweeping words of wisdom in this post. It’s more about me expressing my thoughts. I’m going to work hard on not becoming irritated with her, going to speak on her behalf when others do. It may not be much, but if it helps even a little, then I’m happy to do it.
Thoughts? Anyone else had a similar experience?