Should I do anything about being yelled at? - page 3

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... Read More

  1. 0
    Quote from kw11
    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

    Get the hottest topics every week!

    Subscribe to our free Nursing Insights newsletter.

  2. 0
    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.
  3. 0
    I would have continued with report while completely ignoring her.......
  4. 0
    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.
  5. 0
    Hospitalists work for the hospital, just as nurses do. They are bound by the same rules, even if they have MD, PhD and any other letters of the alphabet behind their names. Commuter has the best answer for inappropriate behavior (my PICU manager encouraged this approach as the behavior was unprofessional), and yes, this person needs to be written up.

    The POA is a bit of a sticky wicket, but sometimes when one is not feeling well, even though A & O, they may decide to let their POA speak for them (don't feel to great about this, though).

    My former facility has a "decision tree" regarding the use of catheters. There must be a clear, justifiable need for placement to introduce another source of infection to a patient.
  6. 0
    Quote from kw11
    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 a physican has a *problem* with how you practice nursing, that is one thing and she/he is perfectly within rights to question. However under no circumstances should you tolerate being "yelled at" or any other sort of verbal abuse. This is NOT the 1900's or 1960's for that matter.

    Agree with the other responses; this doctor needs to be put on notice her behaviour was inappropriate and out of line.
  7. 0
    Quote from DoGoodThenGo
    If a physican has a *problem* with how you practice nursing, that is one thing and she/he is perfectly within rights to question. However under no circumstances should you tolerate being "yelled at" or any other sort of verbal abuse. This is NOT the 1900's or 1960's for that matter.

    Agree with the other responses; this doctor needs to be put on notice her behaviour was inappropriate and out of line.
    She needs that check up from the neck up.
    Or She might need changing or
    a swift kick to her nether regions


Nursing Jobs in every specialty and state. Visit today and Create Job Alerts, Manage Your Resume, and Apply for Jobs.

A Big Thank You To Our Sponsors
Top