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

[zenman]

wow, you're old.

and i guess it would have to be thorazine since the lobotomy didn't work.

I just can't believe that a moderator has not jumped on you guys for humor such as this! It could be harmful and cause you to seek therapy.

As for the resident, write him up. A fellow supervisor where I work wrote up a cardiovascular surgeon for a fit he throw in front of a family, including accusing a nurse of killing the patient that he had to redo twice that day!

He was forced to apologize.

[Katnip, RN]

I don't know if it was my post you were referring to when you said don't chart that they refused. If it is, that's not how I meant it to sound.

I meant, just how Earle said it: just keep on charting every time you tried to reach the doc, PA, NP, whoever. Kind of speaks for itself. You don't know if they are refusing, are in OR with beepers off, out of the hospital and off duty, and forgot to forward their pages.

[Celia M, ASN, RN]

Pumpkin,

1. Most importantly, good luck with and enjoy your wedding, DO NOT let this **** MD spoil it.

2. it sounds like you are a great patient advocate, just chart when the MDs do not return calls or do not give you orders.

3. No one should ever be spoken to like you were. 21 years ago as a new grad I would have let the NM handle it. 19 years ago to present day I would confront the MD myself.

4. May be you could make a cheat sheet with some help from the floor staff on which resident/intern to call for what, coz it all sounds confusing to me.

[Tweety, BSN, RN]

As for the resident, write him up. A fellow supervisor where I work wrote up a cardiovascular surgeon for a fit he throw in front of a family, including accusing a nurse of killing the patient that he had to redo twice that day!

He was forced to apologize.

What do you mean "write them up". We can do an incident report where I work. And believe you me I've written a few incident reports on MD behavior. But fortunately only a few, maybe two are three times in 15 years. Usually I can handle things myself. Usually if an MD is acting up it's because she/he is angry at something we've done and I get past that to the core of the problem. But I don't have the authority to write anyone up (especially now that I'm no longer a charge nurse).

Also MDs don't have the power to write me up, my manager or my charge nurse are the only ones who can "write me up".

Incident reports aren't the same as "writing someone up".

[zenman]

What do you mean "write them up". We can do an incident report where I work. And believe you me I've written a few incident reports on MD behavior. But fortunately only a few, maybe two are three times in 15 years. Usually I can handle things myself. Usually if an MD is acting up it's because she/he is angry at something we've done and I get past that to the core of the problem. But I don't have the authority to write anyone up (especially now that I'm no longer a charge nurse).

Also MDs don't have the power to write me up, my manager or my charge nurse are the only ones who can "write me up".

Incident reports aren't the same as "writing someone up".

What do you mean you don't have the "authority" to write someone up. A CNA can write up a surgeon if needed on whatever form you call it in your hospital. If your hospital has a policy that only certain people can do the writing, you do have a problem!

[leslie :-D]

What do you mean you don't have the "authority" to write someone up. A CNA can write up a surgeon if needed on whatever form you call it in your hospital. If your hospital has a policy that only certain people can do the writing, you do have a problem!

A student says " I am very discouraged, what should I do?"

The Master replies "Write them up."

Leslie Proverb

[SoldierMedic]

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.

Holy cows! did you get fired for that?

I threatened to beat up this MD at my former hospital for belittling me for almost 2 years. He kept calling me this "pet name" as he called it and I finally confronted him and told him I was just gooing to flat out send him to the Emergency department stat!

Okay, not in these words...but close enough.

That doctor's suffering from delusions of grandeur I tell you.

Edited by trauma4Us: obscenity

[SoldierMedic]

I've been in situations where I wanted to start acting as childish as the doctor, one of these days I will get up the nerve...but I'm surprised this doc didn't get you for assault.

When I was rotating through the OR in nursing school one of the RN scrub nurses was prepping a patient for a c-section. She was being very careful and thorough, had the whole woman's belly slathered with betadine...here comes the doctor and apparently he wasn't impressed. He jumped all over this poor woman for making a mess and called one of the other nurses to come clean it up and do it the right way. This little nurse ran out of the OR and a later (after I saw the c-section I was sent out) I saw her coming out of the changing room with her eyes red and swollen in her street clothes and was on her way home. I felt so sorry for her. Like it or not, doctors attitudes and bad days are something nurses (most always female nurses, I have never seen a doctor degrade a male nurse the way he has a female)will have to put up with. I'm somewhat hardened to it, but it isn't ever easy to take.

Don't OBGYN doctors get sued alot?

Sounds like this doctor was sued many times.

[SoldierMedic]

For the OP- Congratulations! You've had your first drive-by swearing!

:rotfl:

[SoldierMedic]

Someone mentioned charting the resident's refusal to call back. Do not do that. That is what occurence/incident reports are for. You open up yourself and the hospital even MORE to ligitation by putting it on the chart. You do chart "Dr. S paged at 0200 for new orders"....."Dr. S. repeat-paged at 0215, awaiting new orders, patient condition-----". "Dr. O, Chief of residents paged at 0230 for new orders". Etc......Make it factual, but do NOT chart "Dr S refuses to return pages" on the patient chart.

Wow...words to practice by.

I'll keep your advice in mind with my new Med Surg job as an LVN next month :uhoh21:

In fact, I should print this and keep in my scrub breast pocket :)

[SoldierMedic]

Hello,

Sorry about the preaching I just hate MD's that think they are better than other people but when it all comes down to it when they are sick the same nurses they treated like s**t are the same ones that end up wiping their butts now where is the irony in that.

You got that right. I remember this one time when I was a CNA, I had this 30 + years of practice doctor to take care of and he constantly yelled at me (everybody including the interns) for being a lowly CNA while bragging about being "God".

Actually, I was told he was a good doctor, but his sickness brought out the Mr. Hyde out of him.

[Tweety, BSN, RN]

What do you mean you don't have the "authority" to write someone up. A CNA can write up a surgeon if needed on whatever form you call it in your hospital. If your hospital has a policy that only certain people can do the writing, you do have a problem!

I would rather leave the writing up to those in authority. I don't want just anyone other than my manager writing me up and counseling me and having it go in my record thank you very much. So I don't think it a problem. But if your institution allows you to write each other up, have at it.

Again, let me say an incident report is not a "write up". Our incident reports allow us to report physician incidents, but we are not "writing up" the MD. Only the chief of staff can "write up" can counsel MDs.