Should I do anything about being yelled at?

Nurses Relations

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Just wondered what everyone thought about this. The other night I worked I had an elderly patient whose main issue was blood loss and heart related issues. Her daughter accompanied her and when I was admitting her to the floor and going over what we were going to do (the dr. ordered catheter, etc) (daughter is POA), the daughter said "she just needs the units of blood, I don't want you to place catheter!". So I said "OK let me check with the dr. and see if he has any objection to that." (This was a hospitalist admit, and it was nighttime so the night shift hospitalist was the contact). I called him and he asked a few questions and said "no problem d/c the catheter order". At no time during the report from the ER was there mention of acute kidney issues so I thought everything that I was doing was ok.

Then in the morning, the day shift hospitalist that wrote the order came in and started yelling at me at the nurses station during nurse report. It was very embarrassing. In short, she said "What sort of intelligence did you use to decide to not place a catheter on this pt?" I told her the story above and then she started yelling more saying "I can't believe that you would not do this order, you can't just rely on the night shift dr., they don't know what's going on with the patient. It was up to you to educate the pt about why it was necessary." I was so stunned I didn't even think to say until the dictation came up at 2 am and labs came up I didn't even know that this lady had kidney issues. But I did say, "the daughter was very upset about what occurred in the ER, so I didn't want to push the issue."

The dr. then said "what do you think? Do you think this is Burger King, we don't just give the patients things their way, we have to be smart and explain to them why it's needed because they have no clue".

Anyway, I get that I should have pushed the catheter issue more. But, after the yelling and after she left some of the other nurses were like "Gosh I'm sorry that happened to you, etc., I would have done the same thing." What I am wondering is if I should personally talk to this dr. about how I wish she had talked to me away from eyeryone else or if I should complain to my manager. what do you all think?

Specializes in ICU.

Funny, similar thing happened to me. I interpreted a certain order the way that I did, well a few hours later, the hospitalist calls me "did you take care of this paitent! Why did you do such and such!!!! do you think your a doctor? Do you always practise medicine without a license?" She went on and on and on. I tried to get my words in to explain why I did what I did and my interpretation of the order but she wouldnt hear it. She spoke to me worse than when I discipline my dogs. She went on to say that she was going to email so and so, and then said "you need to write yourself up right now". Which I was completely happy to. In speaking with a bunch of other people later on about her, she is apparently always a witch. One of our other docs said to just let it roll off my back. I had planned the next day to write her up for unproffesional behaviour. I decided not to, but if she EVER speaks to me like that again, im going to write her up. Probably wont do anything, but im sure if a doc gets enough complaints, eventually something may be done. I have no problem if she felt I did something wrong, speak to me proffesionally, I am more than understanding. I spoke with my manager, she told me to not even worry.

So my advise, if this doc is prone to behaving like this, write them up about their behaviour. Its not right. If they typically are not like that, you could let it pass, or you could talk with them the next time you see em.

But now I know with this doc, I will be way more carefull in interpreting her orders. If I have to call her a million times, I will.

Your response lies completely with the policy of your facility.

Do they expect you to smile and say "sorry doctor"... or will they support you?

I worked @ the Mayo Clinic Hospital, their policy is to have the doctor apologize to the nurse at the nursing station.

The next facility I worked at.. a doctor yelled @ me ( the first time in my 30 years of nursing) and they saw nothing wrong.

I quit on the spot... NOBODY yells at me for trying to do the best thing for my patient.

The doctor who admitted the patient should have TOLD THE PATIENT/POA/GUARDIAN why he/she ordered a catheter and why it was indicated. I hate how everything is turfed onto nursing. ahhhhhhhhhhhhhhhhhhh

Specializes in MICU/SICU.

Education of the daughter was certainly in order, whether it came from you or from the doc, doesn't matter. That being said...

The daughter's the POA. She refused the intervention. That's her right. End of discussion. And that's exactly what I would've said to that doc at the nurses station. ( In a professional manner and tone, of course).

As for writing him up, no. Not unless it's a real pattern. I tend to agree with the poster who dubbed it "running to mommy".

Specializes in Med-Surg; Telemetry; School Nurse pk-8.

We as nurses educate the patient/family as to why we perform certain interventions and how they relate to their tx. They have the right to refuse. Document, document, document. Now only will it CYA, but it's lovely to calmly & sweetly say to an irate doc -- this has all been addressed and documented in the chart...

Kill 'em with kindness -- and the professionalism they lack!

Specializes in ED/ICU/TELEMETRY/LTC.

With all that has been said, I can add only one more thing. And you can bet on it.

If this is the first time you have been yelled at, it won't be the last.

Ok, I know the point was the MD yelling but from what I read, wasn't the pt A&O? She would be the one that has the say in the catheter. The POA doesn't have a say unless the pt is unable to. I hate when people call and say "well I am the HCP and I want information" or " I am the HCP and if they don't do this, I will refuse that procedure". Ummm sorry, your mom is perfectly with it and she is the one to decide who gets what info and what procedures are done.

That being said, I have gone head to head with a physician because I was advocating for my pt. In the end, the family appreciated it and the dr was put in his place. LOL I have also had a dr YELL at me and lecture me in the nurses station because a night nurse didn't document something. I very nicely said to her "I am sorry but no matter how many times or different ways you ask me the question, I don't know the answer to it. The nurse did not document it and she did not pass the info on to me in report." Needless to say, she apologized three different times that day and said she was sorry we "got off on the wrong foot." Her issue was actually with the night MD who took the admission-she didn't like the orders.

Specializes in ER, ICU.

I agree with the doc in that if there was a good reason for the cath you should have known what it was. Having family dictate nursing care steams me to no end. There are times you have to stand up for your standard of care. That said, the doc should not have yelled at you in front of everyone. You would have been well within your rights to walk away, or say "please stop yelling at me, can we discuss this in private?" Or "I'm willing to discuss this when you stop yelling at me" and leave. Or even better "why don't you take this up with the night doc since they are the ones that gave the order".

Just wondered what everyone thought about this. The other night I worked I had an elderly patient whose main issue was blood loss and heart related issues. Her daughter accompanied her and when I was admitting her to the floor and going over what we were going to do (the dr. ordered catheter, etc) (daughter is POA), the daughter said "she just needs the units of blood, I don't want you to place catheter!". So I said "OK let me check with the dr. and see if he has any objection to that." (This was a hospitalist admit, and it was nighttime so the night shift hospitalist was the contact). I called him and he asked a few questions and said "no problem d/c the catheter order". At no time during the report from the ER was there mention of acute kidney issues so I thought everything that I was doing was ok.

Then in the morning, the day shift hospitalist that wrote the order came in and started yelling at me at the nurses station during nurse report. It was very embarrassing. In short, she said "What sort of intelligence did you use to decide to not place a catheter on this pt?" I told her the story above and then she started yelling more saying "I can't believe that you would not do this order, you can't just rely on the night shift dr., they don't know what's going on with the patient. It was up to you to educate the pt about why it was necessary." I was so stunned I didn't even think to say until the dictation came up at 2 am and labs came up I didn't even know that this lady had kidney issues. But I did say, "the daughter was very upset about what occurred in the ER, so I didn't want to push the issue."

The dr. then said "what do you think? Do you think this is Burger King, we don't just give the patients things their way, we have to be smart and explain to them why it's needed because they have no clue".

Anyway, I get that I should have pushed the catheter issue more. But, after the yelling and after she left some of the other nurses were like "Gosh I'm sorry that happened to you, etc., I would have done the same thing." What I am wondering is if I should personally talk to this dr. about how I wish she had talked to me away from eyeryone else or if I should complain to my manager. what do you all think?

If I had been the patient I would have got out of the bed and smacked him. The patient can refuse anything they want and there is nothing the arrogant idiot could have done. I personally will never have a catheter or any other form of invasive procedure. If any arrogant ignorant doctor wishes to try and forced me he will be in court so fast for battery and also find himself in front of the medical disciplinary commission. The sooner we get rid of self important little idiots like him, the better

Be careful, as POA is only enacted (at least in my state) when the patient can't speak for themselves. Was the patient alert/oriented? If so, it would be the patient's decision to refuse, and not the daughters. With that being said, no reason for the MD to yell at you about it. Review the reasons for interventions (easier said than done, I know!!)--and my response to the MD would have been--in the documentation there was no supporting evidence that came up from the ED to warrant the placement of a catheter, therefore, given the refusal, I needed to intervene at that moment, which was with the night hospitalist.

As a complete aside, the POA, one would assume, would KNOW what the patient's medical condition/history is, therefore, should know that her mother has issues with her kidneys--patient education could revolved around the fact that usually with multiple blood products in the elderly, lasix is usually given between units and an I&O is needed. But, I also know that catheters are a huge infection control issue, and people are educated on this, so it is difficult to get someone on board with needing or consenting to one. Report it to your manager. Make sure you document. And perhaps the day hospitalist can go argue with daughter on the need for a catheter.

I would have continued with report while completely ignoring her.......

Specializes in none.

Go to your supervisor or manager. You will get yelled at in you career. Sad fact of the business. One family got me firer from a hospital. They wanted me to do private duty for their father when I had seven other patients on Med/Surg. I had been with their father most of my spear time. He was dying. There wasn't much for me to do. So when it was time for me to give out med, I told them that I had to give meds out and that I would be back in about an hour. During the time that I gave out meds, another patient had a grand Mal Seizure. I was able to rush back to the PIA family in 55 minute. They told my supervisor that I had left their father for two hours. They yelled at me, told the supervisor that I was a baster, and that they wanted me firer. I was working agancy so out I went. Never to work a that hospital again.

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