A resident swore at me!

[pumpkin]

I am a new grad of 6 months on a Surgical/Ortho/Trauma floor. When I first started here, I was miserable. I'm very shy and it's hard for me to talk to new people. But in the past 2 months things have gotten so much better - I feel more comfortable, I know most of the interns and attendings, and I'm actually happy. Being a new nurse, I sometimes question what I need to page the intern about, and what I don't. Sometimes I call over things that seem important to me, but apparently aren't to the team. Up until this point the interns have been really nice and humored me, explaining gently when I ask that it was probably something that could have waited. But on Thursday all of that was ruined and now I am angry and upset and I'm not sure what I should do. So I'm just going to rant in a long post here, and hopefully feel better after getting this all out.

This past week I was working 7a-7:30p. Near the end of my day on Wednesday, one of my patients was complaining of increasing pain. She had just been started on percocets that morning, and they really weren't helping her. Her daughter was there and for obvious reasons, quite concerned. I told her I'd call the intern on call to see if he could change her pain meds to something else. I started paging him at 6pm and still had received no call back by 7pm. By this time, the daughter was furious, stating this was unacceptable and she wanted something done NOW. So I looked for the person who made the last order, who happened to be the chief resident for that team, and I paged him. Several times. After another half hour, he called back and I explained my patient's pain issue. He said to give her IV Dilaudid and he'd have the intern change her pain meds to po dilaudid. I did so, the patient and daughter were happy, and I went home.

Thursday morning I came in and was told by the night nurse that the same patient was doing wonderfully on the po dilaudid. She also told me that another daughter had called that night complaining that nobody gave her mother pain meds on Wednesday (which the night nurse assured her that I did). I went in to see my patient at 8:00 am- and she told me her pain was excrutiating and would not be able to do anything if the pain stayed that way. She wasn't due for more dilaudid for another hour and rather than have the same thing happen again (and have the daughter yell again) I decided to page the on call intern right away. It was the same intern on as Wednesday, and once again he did not call me back. After another hour of paging and no response, I spoke to my resource nurse to ask her advice. I wasn't sure if I should page the chief resident again, or if there was someone else on the team I should page instead. We looked at my patient's orders, and once again the chief had written the last order, so she suggested I call him. So I paged him several times with no call back. After 20 minutes, I happened to see the chief resident walking onto the floor, so I hurried over to him. Our conversation went something like this, all the while me trying to keep up with him as he continued walking away:

Me:"Oh I just paged you. I'm sorry, but Mrs. so and so is having more pain issues just like she did yesterday-

MD: "This is the first I've heard of this."

Me: "well I've been paging the intern for an hour-"

MD: "He's in the OR."

Me: "Well, he never called me back to tell me that. Anyway, Mrs. so and so-"

MD: "There's a third year resident you should have called."

Me: "Well, I didn't know that."

MD: "Next time call the third year." and he stormed off muttering.

At this point I just stood there with my mouth open. Luckily, my nurse manager was walking right around the corner and she grabbed me and pulled me into her office right away as I began to cry hysterically. Apparently, the MD had been swearing at me as he walked away. Whether it was "f you", or "f off" I don't know, but my nurse manager heard him and he didn't abbreviate. She told me she immediately turned to this resident and told him that they needed to talk. He told her he was busy and kept walking. I explained to her the whole issue and what had happened. She assured me that I did nothing wrong and that there was no excuse for his behavior. I'm supposed to be the patient advocate, yadda yadda yadda. While I felt better when she spoke with me, the rest of the day I obviously felt like crap. I kept questioning everything I did. It's hard to stand up for yourself when you're new and you're not convinced that what you did was right. And being shy doesn't help. Anyways, my manager said she'd definitely speak to this resident and his attending. I've been off since that day, and I'm so nervous to go back in on Wednesday. I'm so scared that I'm going to have another patient on that team. And what if my nurse manager doesn't do anything - should I do something? Part of me wants to stand up for myself. He really made me feel like I was worth nothing, a lowly nurse. But part of me just wants to pretend it didn't happen and not cause any tension. I'm just so angry, I wish I could have yelled right back at this guy.

Any advice??

~Jaime

[lilhippy007]

This blokie obviously has some issues if he has to take that sort of attitude with a student nurse who is obviously trying her best.

I can sympathise with you completely as I'm quite shy myself, especially when it comes to taking action. I always feel that I should check in case I do something wrong. I guess it all comes down to selfconfidence in the end, which I must admit I'm not brimming with!

In your case I would carry on as usual, always being very polite to this guy and then he can have nothing bad to say of you. That way if he opens his mouth in that way again you can report him and he won't have a leg to stand on!

You sound as if you are a really good student. It takes a lot to ask for help or double check something and I think you should feel pleased that you are one of those who obviously takes real pride in their work and is safe while doing so! Keep doing what you're doing and believe in yourself! Email me if you need to talk, I have a listening ear! [email protected] is my address.

I'm a student midwife as of last tuesday so I know what you're going through and I have worked in hospitals before that with people just as antagonistic!! Chin up!

[leslie :-D]

explain to your nm that you intend to speak with the resident and/or his superior, and that you intend to document in your nurse's notes, that dr. so and so refused to adequately treat pt. x's pain as evidenced by conversation.

put in quotes how doctor responded to you.

do NOT take his verbal abuse. this is totally unacceptable. period.

now, as a new nurse, i don't expect you to know all of the political b.s.

nor do i expect you to know how to approach doctors and their maniac egos.

if the nm doesn't do anything, go above her head.

what i'm trying to say is this resident's behavior was bullying and hostile.

he needs to be reported and needs to know that no one is going to accept his behaviors.

and please, don't be nervous.....be outraged!!! how DARE HE!!!

much luck to you.

leslie xo

[Dplear]

Tell him that he can take his head out of his *** and that you will NOT tolerate being swore at or treated that way by ANYBODY!! Then tell him you will be taking uit up with his chief...all the way up to the chief of staff for the hospital if need be. NEVER accept this behavior from a doctor.

Dave

[Tweety, BSN, RN]

Jamie, I'm sorry he treated you like this. You've bumped it up the chain of command so I would just let it go for now. But be sure to ask the manager what her followup was and that you are interested in not letting this doctor get away with treating you as such. Let her know you're willing to put it in writing. Let the manager do her job with it and continue to be the patient advocate and the profressional that you are.

You'll grow stronger and the next time maybe you won't cry hysterically. Working in an surgical/ortho/trauma is tough. I work in a similar unit so I know how it can be. You have to grow tough skin and big brassy balls, without loosing that compassionate edge and patient advocacy. But that doesn't happen right away. Hang in there.

[teeituptom, BSN, RN]

I remember at Parkland years ago. This nasty little 2nd year resident started yelling at me in front of patients families and coworkers. I punched in the face and broke his nose. No resident ever yelled at me again.

[traumaRUs, MSN, APRN]

As you've been around the block a few more times, you will develop more self-confidence in your abilty to discern who and when to call. That does not excuse this resident at all. Does your hospital have a practice council that resolves issues between the nursing and medical staff. It is NEVER acceptable to swear at people.

[laurasc]

When I was a new grad I had one of the residents berate me in front of my patient because her NG tube kept blocking. It was really humiliating for me and I was both angry and close to tears. When I finally saw that guy in the nurses station about 1/2 hour later, I took him aside and very quitely and calmly told him that I am a fellow medical professional and did not deserve to be told off like that, especially in front of the patient. I told him that I had spent my entire shift working on that NG tube and that it was because of me that it was still patent for that long. I also said that the next time he had a complaint about my work, he was to take me aside and talk to me in private and that I would no longer tolerate that kind of treatment.

He appologized. :rotfl:

That may be what you may have to do if your NM doesn't talk to him first. I know I was shaking in my boots when I confronted him, but ultimately it worked out for the best.

That doc and the one that cursed at you were both out of line. If you don't do something about it, it won't stop there.

Good Luck!

[leslie :-D]

I remember at Parkland years ago. This nasty little 2nd year resident started yelling at me in front of patients families and coworkers. I punched in the face and broke his nose. No resident ever yelled at me again.

tom, i didn't know you were a patient at parkland.....

and how many mg of haldol did you receive?

[nursemary9, BSN, RN]

Hi

I'm so sorry this had to happen t o you!!

I have been nursing for a long time and personally, I just don't put up with this kind of stuff any more.

Number one: Your patient was not getting pain relief. You were paging people and they weren't answering you. I document each and every page now--the time I page, and when I re-page them. If that amount of time goes by, I ultimately write them up. I do go up the chain of command & do try to get

orders from someone.

If someone, intern, resident or attending or anyone uses inappropriate language or treats me inappropriately, I write them up. These days people can't get away with that.

As you say, we are the advocates of the patient; you did right to try to get help for your patient. I know you say you are shy, but you did a good job. Feel good about yourself.

I know you feel bad about the situation, but you held your own. I'm glad your manager supported you.

Each time something like this happens, you;ll grow & get tougher. Don't worry--I started out the same way, even afraid to page a doctor. Now 38 yrs, later--I still get a bit nervous, but believe me--I'll do anything for that patient!! Also, It felt really good one day when I heard a 2nd year resident say to a first year resident--"If that nurse pages you, You know it's important" !!!

So you cried hysterically this time--it's OK. You'll get tougher as time goes by. Unfortunately, there are always Doctors like this around.

I hope it gets easier for you.

Mary Ann

[teeituptom, BSN, RN]

tom, i didn't know you were a patient at parkland.....

and how many mg of haldol did you receive?

Obviously not enough, but wait Haldol hadnt been invented then. Would have to of been Thorazine back then.

:rotfl: :rotfl: :rotfl:

[Katnip, RN]

Each and every time you page a doc, chart it. Make sure you note how many times you've tried to page them and received no answer. The resident who was in OR should have set his pager to forward to the person who was taking his calls for him.

The Chief should be reported to his superiors immediately. That kind of language and behavior is extrememly unprofessional.

I had a resident yell at me in front of patients and other staff one day. The day before, he went off on the charge nurse. He was a chief also. I pulled him into the med room, told him how very unprofessional he looked in front of not only the staff but the patient and their family, and that he probably shook their confidence in him because he could not control himself.

He apologized and never bothered me again.