Learning to deal with unpleasant staff at clinical site

Nursing Students Post Graduate

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Specializes in ICU.

This is my second semester of clinicals in a Family Practice office. There are 2 MDs, 1 NP, and 1 PA. So far, the first three have been incredibly helpful, offer plenty of information, and treat me as a professional.

The PA, however, has not. He is arrogant and seems to enjoy humiliating me and the other NP student in front of patients. It has become so unpleasant that everytime he looks for me to introduce me to one of his patients I make an excuse or avoid him entirely. I'm glad to know that the other NP student there avoids him as well for the same reasons.

So how do I deal with this? The Dr. I work with shares the same hallway as the PA so it's not an easy task to hide from this guy. My MD preceptor thinks the world of the PA which makes me uncomfortable letting him know how I feel about the PA. I can't take another moment with the PA in a patient's room being embarrassed by him!

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I would first have a talk with the PA and let him know your concerns. Then, if he continues, the next time he acts out in front of a patient, say something like, "Mrs. Jones, let me apologize for Mr. PA. I don't think he really means to act like he does in front of you." Do it every time and I'll bet the PA will try to avoid you like the plague!

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Specializes in Trauma, Teaching.

I would make notes about specific things he does (note pt., date and time), then ask to meet with the MD and the PA, so that you can confront him but with a neutral party to arbitrate. If the other NP student feels the same way, you can make it a 4 way conference.

Do all the usual confrontation stuff: own your statements, "when you do this, I feel that". "What did you mean by _______- on this day with this patient". Start off with you want this to be a learning experience, not a complaint session. Be the total professional.

If PA denies it, well, which of you presented yourself the best? If he really has a problem with you professionally, this is the chance to find out. If he is just being a jerk, you've hauled him up short on it.

I would not confront him in front of patient, ever.

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Specializes in Nephrology, Cardiology, ER, ICU.

Hi there. I too would not confront the PA in front of a patient. However, when alone, I would certainly tell the PA what I thought. This is ridiculous.

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I would make notes about specific things he does (note pt., date and time), then ask to meet with the MD and the PA, so that you can confront him but with a neutral party to arbitrate. If the other NP student feels the same way, you can make it a 4 way conference.

Do all the usual confrontation stuff: own your statements, "when you do this, I feel that". "What did you mean by _______- on this day with this patient". Start off with you want this to be a learning experience, not a complaint session. Be the total professional.

If PA denies it, well, which of you presented yourself the best? If he really has a problem with you professionally, this is the chance to find out. If he is just being a jerk, you've hauled him up short on it.

I would not confront him in front of patient, ever.

I especially agree with your last sentence - it is unprofessional to "air our dirty laundry" in front of patients. Or even other co-workers. If you have a problem with someone, it needs to be taken care of in private. Then go up the chain if you get no satisfaction.

Good luck . . . we have a new PA orienting here and so far he has been really nice.

steph

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Just for the record, I'm not talking about confronting the PA in front of the patient, but apologizing in front of him. It has worked very well for me. Consider that many patients have already been exposed to this guy's behavior. I have a good idea what he's like and he probably needs some "slap" therapy. How long do you want it to continue? I bet you will have a real problem when you get two buddies together and tell them that you have a problem with one of them. Good luck. But consider also, that I might be able to carry this off and you might not. Patients are usually aware of what's going on and I've had a few laughs with them about it.

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Specializes in Tele, ICU, ER.

Does he treat all the nurses around like that, or just the NP students? I ask, because we've had a few PA students doing clinicals with our docs in the ER, and to a person, they've all hung on the doc's sleeve and completely ignored the nurses. Maybe this is something they're taught? The ER docs rely on us, you'd think the PA students would learn who their friends are gonna be, hmm?

That said, maybe you can find a tactful way to talk to your doc.. something along the lines of "have I offended Mr. PA in any way? He seems ... I don't know... unsure of me, or as if he's afraid I'll so something silly in front of him?" . When doc answers no, ask him again, every day, until the doc maybe notices that star-PA is the jerk.

Just a thought.

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Specializes in ICU.

Thanks to everyone's input so far. I haven't had any bad interactions since starting this thread, but have decided that if the PA asks me to see something in his room I'll kindly decline. My preceptor is giving me a good experience and I feel like I'm learning from him.

To top things off, I met the PA's wife (also a PA) and she was even less pleasant than her husband. She tried to grill me and the other NP student about some things at which point I left the room. What a bizarre couple. :uhoh3:

EmerNurse - it seems that the MAs aren't too thrilled to work with the PA either. He tends to have a bit of a superiority complex around them as well.

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Sigh. Every workplace has one or more unpleasant person or at least the potential for getting one in the future. This man gets some kind of satisfaction from his behavior otherwise he wouldn't be acting this way. Just be glad that your tenure at this place is limited. I think your decision to decline to interact with him is a wise one. If anyone asks about your actions then politely explain. Hopefully, you will be required to provide an end of course evaluation of your experience where you can address this problem in writing.

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Specializes in Nephrology, Cardiology, ER, ICU.

Glad things are going better and that you have some coping strategies in place. Life is too short to be around miserable folks.

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Specializes in ICU.

Lucky me! The PA now has a PA student with him! No more hours in the room with him! :)

Thanks again for all the support!

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He he he! Lucky you indeed!

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