Abusive Doctors!

annmariern · Feb 23, 2010

"Wait until your facility gets electronic medical records and the docs can look up everything themselves!! It will save alot of aggravation"

Sorry to say, we have docs who refuse to use the computer to look up labs, VS, if they are not on the chart one doesn't review them at all but writes in the chart that no information was available to him! I don't know why he thinks that will absolve him from neglience charges when he misses something about his pt.

imintrouble, BSN, RN · Feb 23, 2010

I prefer to see myself as a realist. You are right, I need to grow me some backbone. I assume I'm going to lose cause it's easier not to fight. That's a real unattractive quality. You know, whenever I get back to work.....I've taken call the last 3 nights cause i'm too scared to go in.....I'm taking all of you with me. :yeah:

GadgetRN71, ASN, RN · Feb 23, 2010

I have found that the male doctors that are really pushy and obnoxious at work are often the types whose wives wear the pants at home. The only place they can assert any kind of authority is at the hospital, so they run with it. The good thing is, once you stand up to these guys, they fall into line.

PMFB-RN, RN · Feb 23, 2010

The thing you guys have to remember about doctors is that when they where in high school and college they where the nerds. While the rest of us where chasing girls (or boys as the case may be), hanging out with friends, doing things with other people and learning social skills they had their heads buried in a science book. Finally after all that work and study they get the big pay off, they are physicians, about and high in the social ladder as one can get in our society. However their experiences as younger people didn't prepare them for such a position.

tewdles, RN · Feb 23, 2010

You have received a great deal of good guidance here...

With a couple of years experience it is time for you to take the next step in your nursing career...step into the "professional" role of the nurse. Embrace the fact that you provide a service to the patients and the doctors both. Put on your professional face and tone of voice when dealing with these physicians. Make no apologies for doing your job rather than jumping up and down for the MDs' convenience. Egocentric physicians are a dime a dozen and typically back down and change their tune when professional staff refuse to be bullied. They are not necessarily bad people, or bad docs, they just have poor interpersonal skills in the work place. We also work with nurses and other disciplines who share this shortcoming, they just are often not as "coddled" by hospital administration.

Sometimes you just have to call a spade a spade when working with the bad apples. The important thing is to confront these people in a fashion which does not embarrass them professionally while reminding them that you share their goals for the patients but are not willing to be abused in the process. Pay attention to how the bad actors interact with their physician peers and then use that knowledge to shape your encounters with them. Some MDs will respond to a very straight forward approach, while others will require intervention from further up the food chain.

For example...I worked with a young pediatric intensivist who was rude and demeaning to the nursing staff. He was often argumentative with the RNs about their interactions initially and then later would come back and provide orders or whatever which reflected the nurse's findings and recommendations. I pulled him aside one evening and said directly "Jim I think you are a fine physician and provide good care for our patients, but it is really hard for us to work together when you come into the unit with a chip on your shoulder acting like an A$$". Yes I used the cuss word directly cuz that was his style. He didn't apologize, but that did not matter much. What mattered was that he began to change his approach, not only with me, but with the other nurses as well. And yes, I used his first name intentionally to level the playing field...we were not within earshot of any patient or family. Some docs do not respond well to this approach and when that is apparent you must seek the assist of the administration. As a nurse manager, I visited the office of the chief medical officer on behalf of unit nurses a few times. They were never fun or enjoyable visits, but we have to occasionally remind the docs that we have to play nicely together in the sandbox if we want our patients to do well. In my experience, hospital administrators are supportive of improving these relationships when the nurses can credibly demonstrate that the behavior is counterproductive to effective care. Evidence of patterns of behavior which adversely affect the ability of professional disciplines to collaborate can be a powerful tool...so talk to your supervisor EVERY time bad behavior interferes with your ability to care for patients. Encourage your co-workers to do the same. Most CMOs are willing to overlook occasional bad behavior by docs but grow weary of docs who burden them with repeated reports of unprofessional conduct.

Keep your head up...you are still a pretty new nurse and it takes time to discover who you are as a professional. Good luck.

new_oldRN · Feb 23, 2010

Thanks to everyone who has responded to this post. You have given me lots of great advise that I can use to reformat my nursing attitude and become a better nurse. Tewdles, your post was very eloquent and I agree with your statement that I need to "step into the professional role of a nurse". I have the skill base and need to reflect that in my attitude.