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

Nurses Relations

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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?

Specializes in Operating Room Nursing.
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?

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.

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.

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.

Yelling at someone over the phone as described by the OP is definitely bullying behaviour and unprofessional:

http://www.hr.unsw.edu.au/employee/workbully.html

While I don't consider it to be a hideous assault, it's still bullying and should not be tolerated.

Yes I agree there are times when it's acceptable to raise your voice, in emergencies, when doctors don't come and help when your patients is thrashing and about to fall off the OR table or injure someone. But because you've been woken up? All I can say is dry your eyes princess!

The OP is a NEW nurse. They have a lot to learn, it's not an easy transition going from student to RN. It can be emotional, frustrating and it certainly does nothing for their self esteem to be yelled at because they are trying to do the best by their patient.

It doesn't surprise me at all to see doctor justifying this sort of behaviour at all. I'm beginning to wonder if doctors take a special course at university Bullying101

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My first question would be if the patient has a record at the facility that could have been looking up because 9 times out of 10 people will not know what they prescribed every single patient at the top of their head.

However, the yelling should NEVER be tolerated and I'm sorry to hear you went through that from an idiot doctor!

I would definitely not yell back so that they could feel even more stupid! You shouldn't tolerate that. You are not 'a doctor's nurse', but a Registered Nurse who is a professional caregiver just as anyone else is who is giving care in the facility.

You need to tell the charge nurse, or DON as soon as possible. That should NOT be tolerated and nurses are in demand so to where I would be surprised if it was!!

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Specializes in LTC.
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?

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.

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.

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.

Wow are you kidding me ??? I will never condone YELLING. Being confident, stern, and persistant yes but not ever yelling. If you are smart, educated, and intelligent why should you need to yell to get your point across.

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Specializes in Cardiac.
. 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..

The fact that it is "hospital policy" does not trump the requirement to act with basic human courtesy. .

(Bold emphasis my own)

As you can see, Dr, you contradict yourself.

I'm sorry, but feeling that someone 'deserves' to get yelled and-and better yet, it's your right to yell at them does not constitute an act of basic human courtesy.

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Specializes in Cardiac Telemetry, ED.

The PCP probably thought he was being paged in the middle of the night for some urgent emergency, only to find out that it was a small thing that could easily have waited until morning. I can understand his being upset. It wasn't very nice of him to yell, and I don't condone it, but I can understand his POV. Yet another reason the docs hate the med recs.

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TiredMD - can you explain why if someone makes an *honest mistake* (eg for the first time as they were following policy as a newbie) that they *deserve* to be yelled at? While I can understand someone initial response to be anger and that they might lash out verbally without forethought, I'd also think that they could later reflect upon the situation and realize that they could have made their point without yelling.

Do some people think that a person won't really learn from their mistake unless they are verbally dressed down? I know I learn BETTER when things are calmly explained to me. But people respond differently and learn differently so maybe raising one's voice is an effective way for some to receive feedback.

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Specializes in Cardiac.
So I had to page her doctor, which has a reputation of being mean at 11PM (not that late).

Actually, if this was the PCP, why would he have a reputation for being mean at night?

This sounds like it was the Doc on call.

I mean, I dont' even have pager numbers for PCPs...

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Specializes in ICU, nutrition.

My experience is that the answering service or hospital operator (I've used both depending on which hospital it is) will not page a doctor who is not on call. If the patient was admitted at night by this doctor, you would think he would be on call. Me personally, I would not have called for a med reconciliation issue, but when I was a new nurse, I dunno. But I digress...

I've handled yelling physicians in different ways. In person, I've yelled back, stood there and looked at them like they were speaking a foreign language, and walked away. On the phone I've yelled back, sat there silent and when they stopped asked if they were finished and then started over with the call, hung up on them, or, my favorite, told them I was going to put them on speakerphone so all of us could enjoy her tirade. (Yep I said HER. I used to work with a neurosurgeon who was notorious for yelling at anyone who called her at night. Even at 8PM!) Usually the word "speakerphone" toned it down quickly, although I did have to actually do it the first time. She was furious, but what could she do?

It's been years since I've had a doctor yell at me. I can still remember the last time...me and Dr. R standing in front of bed 2 disagreeing over a patient's right to withdraw from life support. The day before was Sunday and the patient's daughter asked me some questions about taking her dad off the vent (he'd been on for about 6 weeks and not getting better, only developing more complications...) I talked to her some, tried to put her mind to ease, but I didn't blow her off and tell her to talk to Dr. R the next time she saw him. When he saw me the next day he started yelling because he thought I was trying to talk them into withdrawing...not the case at all. I tried to explain myself, he kept yelling. Then I started yelling at him too...it just kept escalating...finally I said "We are just going to have to agree to disagree," and I turned around and walked away.

I dunno...maybe I carry myself in such a way no one dares yell at me anymore. :icon_roll

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Specializes in Rescue+Medic+ER ER ER ER.

Can someone PLEASE write standing orders RE:

Things "unimportant" per the MD.

Per the Nurse.

Per the Patient.

Per the time of day.

Or, OMG! Take 2 seconds to tell someone "Thanks for your question but I'll take care of that later. Click." Then chart that. Then go on. Geez.

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Specializes in CTICU.

I'd let em yell and then say "thanks, I'll chart that verbatim, shall I?"

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Specializes in Psych, ER, Resp/Med, LTC, Education.

As I sit here and read all the replies I have to say that I am unclear here.........

So this patient came in.....did the PCP do the actual admitting earlier that eve then leave and go home without ordering the ABX? Or does that doc not practice there and the patient's admitting doc is another doc? Is the policy to call the PCP who prescribed a med prior to admission? -- I work in an ED, Psych ED and we do the med rec's as well as part of everyone we see admitted or not. I have found that if I were to call a PCP to get a med dose after hours when he is at home....he/she is not going to have that one (of what like 300 they have?) patients med records there at home with the dose--yes some docs are doing things electronically and MIGHT have access that way, but I have never had luck with this. I Generally try, like other nurses have mentioned, all other avenues. the pharmacy can work even at that hour-- if the med was filled at a chain pharmacy, even if the one they use is not a 24 hour location often one or two locations in that chain in your city are 24 hour and the bigger ones are usually able to access the info on all patients meds on their computers.....this is handy. And then like mentioned calling family.

So I guess you might want to see if the policy specifically says a PCP who is NOT the admitting doc--did NOT leave without writing an order-- needs to be called 24/7....or if getting the DOSE, however you do that, is the POLICY.

I am thinking that if the ADMITTING DOC left the building and FORGOT to order something....they are the primary doc and the doc who did the forgetting--I can see THIS DOC needing to be called. It seems like there is some confusion as to the policy-- what is the goal of mandating this call? To get the dose or notify the doc...and what are you notifying him of? To say he neglected something...if the non-admitting PCP, he didn't forget anything and as long as the DOSE is obtained it should be unimportant where the info came from....

Does this make sense..........and yes the doc should not have yelled...period. regardless of if the call was really needed. or not. Yes 11 is not 7 but its not 3AM either! lol Yelling is never professional. period.....hope this helps to maybe take back to look at the policy and see if it makes sense..... if not why not bring it up to the manager???

Good luck.

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Specializes in Med surg, Critical Care, LTC.

I've been in this situation more than once in 17 years. I usually handle it by holding up my hand and calmly stating, "When you calm down and can behave like an adult, come find me" then I walk away. Works for me.

Blessings

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