Yelling Doctors, How do you handle them?????

rngolfer53 · Mar 6, 2009

We have to do that at our hospital when we get an new admit who can't remember a med as a part of med reconciliation. Yes, I think it could wait, but no, my bosses don't think it can. And it's the idiots down the hall who keep me on the payroll, not the PO'd doc on the other end of the phone.
I do make a point of saying, "Sorry, Dr. X, but my manager requires that I call you and clarify....."

A little politeness often goes a long way.

I call docs at night a lot, and most are quite civil. I try to keep them that way by always starting off by thanking them for calling back or saying sorry for the late hour.

Yes, it's their job, but they're human as well, and we all like a little recognition for the hardships we put up with......and being awakened in the middle of the night is a hardship. Sometimes you can't get back to sleep, sometimes the call wakes the kids, spouse, etc.

lolalolacherrycola · Mar 6, 2009

The other night at work (I work 7PM shift), I admitted a new patient. She was seen at her doctors office a couple days before and was started on PO antibiotics TID. She did not take her antibiotic all day. At my hospital we are to clarify meds upon admission and she could not remember the dose perscribed. So I had to page her doctor, which has a reputation of being mean at 11PM (not that late). He interrupted my question by yelling/screaming at me, asking me how he would know the dose (he prescribed it), demanding I answer why it couldn't wait till morning while huffing and puffing on the phone!!! I know if I didn't address it, the charge nurse or someone would of had my neck due to policy...Can't win!!
I've only been a nurse for 8 months and I haven't had much experience with this.
My question is... How do you respond to a doctor who talks to you this way- I mean screams at you this way?

I don't take it well, I would refuse to speak to them and hang up after telling them so. Perhaps in the future ask the patient where she filled the RX and call the pharmacy or a family member so they can look at the bottle.

rngolfer53 · Mar 6, 2009

Bingo. If this wasn't the admitting physician, there was no reason to call that late. It's just completely inappropriate. This isn't a case of a "rude doctor", it's a rude nurse. Would the OP have called a family member that late to ask the same question? And I wonder, if a telemarketer had called the OP that late, if maybe they wouldn't have done a little yelling too?

Yes, but the OP indicated that it was hospital policy that the call be made. The policy may be coocoo, but you still have to follow it, especially if you're new.

Valerie Salva, BSN, RN · Mar 6, 2009

When I was a new nurse, I would crumble. Now, I yell back.

cardiacRN2006, ADN, RN · Mar 6, 2009

If it's in person, I walk away. They can yell to themselves.

If it's on the phone, I remain silent. When they are through yelling, and I mean, totally through (I remain quite for a few seconds after they yell) then I say, "are you done?"

I'm so sick of Drs thinking that I'm there for them to yell at.

Too bad. That's why you picked medicine. To be called when we need it. I picked nursing so I could leave my job at work.

It may not be the most appropriate reason to call a Dr but oh well. Do your job and get over it.

Boo hoo.

Valerie Salva, BSN, RN · Mar 6, 2009

you could have called the pharmacy where the med was filled. why would the md know off hand what he prescribed?

This is true, if the pharm was still open that late.

When prudent, I always try to figure things out on my own and use other available resources before calling a doc.

Scrubby · Mar 6, 2009

Bingo. If this wasn't the admitting physician, there was no reason to call that late. It's just completely inappropriate. This isn't a case of a "rude doctor", it's a rude nurse. Would the OP have called a family member that late to ask the same question? And I wonder, if a telemarketer had called the OP that late, if maybe they wouldn't have done a little yelling too?

I completely disagree with your comments TiredMD.

For starters your comparing a nurse who is concerned about a patient's medication to a telemarketer. Do I need to explain the difference to you?

And the OP wasn't being rude. They wanted to do the right thing by their patient and they were following the hospital policy.

This is a case of a rude doctor. Yelling and screaming at someone is rude behaviour, or at least it is where I come from.

The OP is a new nurse and will learn when to call a doctor late and when it can wait until morning. Bad behaviour by doctors is hardly a great way to go about retaining graduate nurses.

Oh and as for yelling doctors well I either turn my back on them, hang up the phone, sometimes I even laugh in their face. But I never apologise or act submissive...EVER.

caroladybelle, BSN, RN · Mar 6, 2009

Bingo. If this wasn't the admitting physician, there was no reason to call that late. It's just completely inappropriate. This isn't a case of a "rude doctor", it's a rude nurse. Would the OP have called a family member that late to ask the same question? And I wonder, if a telemarketer had called the OP that late, if maybe they wouldn't have done a little yelling too?

There is a significant difference between the the OP and a telemarketer. The MD was on call and therefore should reasonably expect some calls. The OP is not obligated "on call" to a telemarketer.

For that matter, even if I am not on-call, I still get called at very inconvenient times from coworkers or staffing, some of which are for rather inappropriate issues. That does not give me license to yell at them...no matter how tempting.

For that matter, I expect that many nurses and MDs have gotten phone calls when trying to sleep. It does not give us permit to be rude and yell.

There are many ridiculous requirements by facilities that nurses have to enforce/abide by, that MDs may not approve of or even be aware of. If they have a difficulty with such policies, they may address via chain of command. Thus an inappropriate policy of calling on certain issues can be clarified or addressed, and it may be resolved that the MD need not be unduly disturbed. Or it may be resolved that it is appropriate to immediately notify the MD and MD may be made aware of that. No yelling, which is unprofessional and rude is necessary.

The MD does not have the right to yell at anyone.

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As an aside, I would have never called the MD at that time of the night regarding that issue. It was not an immediate issue and could easily wait. And it is ridiculous to expect that even if the MD wrote a script, that they may instantaneously recall it several days later, for a specific patient, at 1100 PM.

I have though occasionally worked with a few Charge "pit viper" nurses, and the Chief "cobra" residents that have a sonic meltdown if every little space on the Med Rec is not documented fully by the time that they show and thus can understand the pressure on the new nurse.

I have also dealt with many (MANY!!!!!!!!!!!) MDs that despise Med Recs and will not do them or sign them, or finish them at DC. There have been several hospitals that have gotten so sick of the passive aggressive behavior that many MDs/HCWs display toward the med rec issue, that they cracking down on that IT WILL BE COMPLETED, SIGNED AND FILLED OUT in a timely manner, or else....even if it means hassling the MD. Which, in turn puts the nurse in the position of hassling the MD, when it should be adminstration hassling the MD.

RedhairedNurse, BSN, RN · Mar 6, 2009

Just a thought, but I don't get these doctors that yell like this. Seems to me that when they yell, it get's them all worked up and probably makes it hard to go back to sleep. It seems as though it would be much easier for them to just answer the call politely, calmly and easily fall back to sleep.

Valerie Salva, BSN, RN · Mar 6, 2009

There is a significant difference between the the OP and a telemarketer. The MD was on call and therefore should reasonably expect some calls. The OP is not obligated "on call" to a telemarketer.
For that matter, even if I am not on-call, I still get called at very inconvenient times from coworkers or staffing, some of which are for rather inappropriate issues. That does not give me license to yell at them...no matter how tempting.
For that matter, I expect that many nurses and MDs have gotten phone calls when trying to sleep. It does not give us permit to be rude and yell.
There are many ridiculous requirements by facilities that nurses have to enforce/abide by, that MDs may not approve of or even be aware of. If they have a difficulty with such policies, they may address via chain of command. Thus an inappropriate policy of calling on certain issues can be clarified or addressed, and it may be resolved that the MD need not be unduly disturbed. Or it may be resolved that it is appropriate to immediately notify the MD and MD may be made aware of that. No yelling, which is unprofessional and rude is necessary.
The MD does not have the right to yell at anyone.
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As an aside, I would have never called the MD at that time of the night regarding that issue. It was not an immediate issue and could easily wait. And it is ridiculous to expect that even if the MD wrote a script, that they may instantaneously recall it several days later, for a specific patient, at 1100 PM.
I have though occasionally worked with a few Charge "pit viper" nurses, and the Chief "cobra" residents that have a sonic meltdown if every little space on the Med Rec is not documented fully by the time that they show and thus can understand the pressure on the new nurse.
I have also dealt with many (MANY!!!!!!!!!!!) MDs that despise Med Recs and will not do them or sign them, or finish them at DC. There have been several hospitals that have gotten so sick of the passive aggressive behavior that many MDs/HCWs display toward the med rec issue, that they cracking down on that IT WILL BE COMPLETED, SIGNED AND FILLED OUT in a timely manner, or else....even if it means hassling the MD. Which, in turn puts the nurse in the position of hassling the MD, when it should be adminstration hassling the MD.

Excellent post- right on the money all the way around.

TiredMD · Mar 7, 2009

There is a significant difference between the the OP and a telemarketer. The MD was on call and therefore should reasonably expect some calls. The OP is not obligated "on call" to a telemarketer.

I think you and I are reading this differently. I read it as the patient's primary care physician, who was not the admitting physician, was called at 11pm to answer a relatively insignificant question. Was he really on-call? I must have missed that part of the story. If so, then sure, he has an obligation. But if he's like most Primary Care docs these days, who do not admit their own patients, then he wasn't on-call for this patient, and it was a nuisance call. If that's the case, you really can't understand why someone might get hot under the collar?

For that matter, even if I am not on-call, I still get called at very inconvenient times from coworkers or staffing, some of which are for rather inappropriate issues. That does not give me license to yell at them...no matter how tempting.

Personally, I disagree. It gives you every right to yell at them. Someone who wakes you up in the middle of the night for something that is not only unimportant, but also that you have no responsibility for, absolutely deserves to get yelled at.

There are many ridiculous requirements by facilities that nurses have to enforce/abide by, that MDs may not approve of or even be aware of. If they have a difficulty with such policies, they may address via chain of command. Thus an inappropriate policy of calling on certain issues can be clarified or addressed, and it may be resolved that the MD need not be unduly disturbed. Or it may be resolved that it is appropriate to immediately notify the MD and MD may be made aware of that. No yelling, which is unprofessional and rude is necessary.

The fact that it is "hospital policy" does not trump the requirement to act with basic human courtesy. You do not wake up a person who is not on-call and not caring for a patient to ask some nonsense question. Anyone with half an ounce of common sense realizes this. Hiding behind hospital policy, or worse, making the physician responsible for changing an idiotic policy, is simply inappropriate. And I know you realize this, because you wouldn't have done it.

The MD does not have the right to yell at anyone.

There's a tendency on this board to equate yelling with some kind of hideous assault that leaves people emotionally scarred. I've never understood that, and personally I'm grateful I've never worked in a place where people shared that attitude. There are times when it is perfectly appropriate to raise your voice, and I have employed it (effectively) on numerous occassions. It's not illegal, it's not unprofessional when done at the correct time, and I see nothing wrong with it.

Virgo_RN, BSN, RN · Mar 7, 2009

I think you and I are reading this differently. I read it as the patient's primary care physician, who was not the admitting physician, was called at 11pm to answer a relatively insignificant question. Was he really on-call? I must have missed that part of the story. If so, then sure, he has an obligation. But if he's like most Primary Care docs these days, who do not admit their own patients, then he wasn't on-call for this patient, and it was a nuisance call. If that's the case, you really can't understand why someone might get hot under the collar?

That's how I read it too.