Anyone having a hard time getting over the verbal abuse?

Ruby Vee, BSN · Feb 16, 2018

Call me a pansy, thin-skinned, not cut out for nursing, but hey I'm here, I'm me, and I'm staying as a nurse so just please help!
I worked on a med-surg floor in a top hospital in Florida, Magnet hospital with residency training and all that.
So, like every nurse, I made mistakes, a lot of them my first six months, but astonishingly I received the harshest criticism from actions I made that actually were not mistakes.
For example... An IM doc called me to ask me to call Liver doctor to ask what is plan for patients worsening encephalopathy. I called Liver doc as that was who had last written note, not PA or NP. Anyway, she gives me the scoop and I call the IM Doc back. I thought everything was cool and it was over. Then, a NP from the Liver doc's team comes up to me in the hall later that day and gives me a PRINTED page from a book with the definitions and signs and symptoms of each stage of encephalopathy, and how the patient doesn't have encephalopathy. And do you know what makes me mad? My reaction. I take her piece of paper and say ok and walk away. Then I go and cry in the break room. I didn't tell her "hey why don't you give this to the IM doc who used that word?" or "Unbelievable you have time to go to your library of books and print out this article for me!". Why did I not do those things? Because we were in the middle of the hallway, I was busy (99% of the time we were understaffed, and call lights are always beeping). I did what was quickest. Later in the day I went to my clinician to tell her about it and she started an email to the department right away and said that it was NOT ok. I never found out if anything happened.
Another example is when we had a cardiologist from a private group come see our patient who was unresponsive, i think on a vent (can't remember) and on telemetry. His note was so lousy. There was barely any patient information on it. So she ended up having some weird rhythms, and while he probably knew about it, I couldn't be sure. I have to cover my butt. So, I called him twice that day for two different rhythms. He ended up being really rude to me and telling me to calm down and I don't need to be calling him. Of course, he is telling me this while I'm in a patient room and I just say Ok, sure, Ok, because I don't want my other patient (A&OX4) to hear me in an argument on the phone. I wanted to say "your note has barely any information in it and we have no idea what you know about this patient". But I took it, and I still remember it.
Has anyone gone through these things? Did you ever freeze, out of shock, or business, or inappropriate place/time for convo and not have said what you wanted? How do you get over it?
I know one reason why I'm not over these things, even tho they happened over a year and a half ago, is because I'm not working now. I am staying at home with my infant and I often think about going back to work. I always question myself, "will I be strong enough, quick enough, and skilled enough that I can respond in a way that will defend myself and stay professional?" I have these questions because I haven't had the opportunity to test myself yet. So, in the meantime, here I am. Any words of advice or personal experience would be greatly appreciated. Thank you

Yes, I've frozen out of sheer shock. We all have. But I don't think there was anything particularly shocking in the communications you describe. One of the ways you get over it is to reframe your idea of verbal abuse.

I froze from shock when the world famous neurologist called me a name associated with female anatomy because I asked him his name when he gave me a verbal order. He thought I should have recognized him on the spot even though he rarely visited our CCU. I froze from shock when the pulmonologist hit the NP in the face with a metal chartback and excused it by saying "I was aiming for HIM," indicating the cardiac surgeon. I froze from shock when the former football player turned nurse tackled the thoracic surgeon who had been throwing contaminated sharps at him. In other words, I think you've set the bar too low as far as what constitutes verbal abuse.

I think that what you're characterizing as "verbal abuse" is really just communication that you don't like. I'm not saying it was PLEASANT communication or that you should have liked it -- I wasn't there. But what you're describing here isn't really abusive. So the first step would be to reframe the issue in your own head. Any interaction that you don't like is not necessarily verbal abuse. Any communication that makes you feel stupid isn't necessarily verbal abuse.

Negative interactions with medical staff seems to automatically drop off at the point where you learn to be professional in your interactions. So make sure, before you label something as abusive, that it wasn't just someone responding negatively to a lack of preparation on your part, an unnecessary phone call, a lapse in judgement or whatever. You might also cut someone a break if they've been in surgery for 20 of the last 24 hours, if you've awakened them for something you could have resolved without calling them, if their mother just died or their husband is in the ICU paralyzed from the neck down.

The NP from the liver team went to the trouble of printing out some information that you seemed to be lacking and she sought you out to share it with you. Perhaps she only meant to add to your knowledge base. Instead of accepting the article with good grace, reading it and absorbing the information and then, thanking the NP for her effort on your behalf, you chose to go behind her back and "report her" to your "clinician". (Whatever that means.) If you didn't like the way the NP presented the information, the professional thing to do would have been to talk to her about it. If you couldn't talk to her right in the moment, you could have talked to her the next day or in a few hours after you'd had some time to calm down and possibly reflect on the interaction and your part in it. But you didn't do that. You went nuclear instead. You've damaged your working relationship with this particular NP if not her whole team. Not smart.

You handled the interaction with the cardiologist poorly as well. The FIRST time you called him, you should have clarified what rhythms to expect from that patient vs. what to get alarmed about. Some people (me for one) can have lots and lots of ventricular ectopy on a normal day. I can see why the cardiologist would be irritated with you if you called for ventricular ectopy a second time after he'd already reassured you that it was normal for that patient. If you called without knowing what the rhythm actually WAS, did you attempt to figure it out first? Or discuss it with your clinician? Did you note how the patient was tolerating the rhythm and discuss that with the cardiologist? Even with another alert and oriented patient in the room, there would have been nothing wrong with clarifying with the cardiologist the parameters for calling.

I'm not going to call you names. I'm just trying to help.

Pepper The Cat, BSN, RN · Feb 16, 2018

I agree with Ruby. I am not seeing verbal abuse here.

The NP might have been a little abrupt, but not enough to cause you to have to run away and cry.

And with the MD if you don't know what to be looking for, ask.

Docs are busy people and don't want to be called repeatedly about minor things.

Wuzzie · Feb 16, 2018

None of the retorts you wished you would have said are professional or beneficial in the situations you described. Had you actually said them I'm pretty sure the verbal onslaught you were likely to have received would have out you in the fetal position. Even then that wouldn't have risen to the definition of verbal abuse. You do not have to act stupid but always, always word things in a non-confrontational manner. Otherwise you risk an uncomfortable tongue-lashing, a reputation and even worse you risk not getting the information you need or the orders you desire. This can and will affect patient care and will make your tenure in that job mighty uncomfortable. You need to learn to be smart and proactive with your questions. Think ahead. Gather as much information as you can. If you're new admit that to them and tell them you're open to and excited about learning. Of course there will always be a butthead or two but you need to let that roll off your back.

brownbook · Feb 16, 2018

I agree with all the posters, it was not egregious verbal abuse.

BUT I am just like you. I tend to take some responses as "verbal abuse" when the person probably did not mean it that way. And re-play what happened over and over in my head.

There is no magic answer for us "thin skinned pansies", I also like the term "snowflake". Sometimes I can mentally think to myself STOP IT! And think..."okay they meant to say the right thing....they were not intending to be rude". Take a deep breath and maybe not escalate it...maybe let it go, maybe they were just having a bad day.

If you REALLY think you are not being a thin skinned pansy, it really was a rude comment, say some kind of "I" statement., which I usually can never think of in the moment.

Google How to Respond to Rude Statements and you will get a lot of ideas.

It is hard to change, think of yourself as being a future role model for your infant.

Emergent, RN · Feb 17, 2018

Try to let this stuff roll off your back. You sound inexperienced. I used to take stuff like this to heart years ago. The passage of time will give you the knowledge and experience to be more assertive in the moment.

If someone gives you information, simply thank them for it. Don't make a mountain out of a molehill. If a doctor gets impatient, you can say you're sorry they are upset, can you please clarify what rhythms you want to be notified of. Stay calm, the world isn't coming to an end.

Because you're a newbie you're amplifying everything in your head. Train yourself to quickly let go and move on. Nobody will remember it tomorrow, unless you go off on someone foolishly.

**canoehead, BSN, RN** · Feb 17, 2018

I want to add, if one doc wants clarification from another doc about the treatment plan, they should really talk to each other. The nurse is not a go between.

37changes, ASN, RN · Feb 17, 2018

I want to add, if one doc wants clarification from another doc about the treatment plan, they should really talk to each other. The nurse is not a go between.

I wondered about that. Thanks for commenting.

Wuzzie · Feb 17, 2018

I wondered about that. Thanks for commenting.

Yeah that seemed a little shady to me. I've never known a doc who appreciated a nurse as a go-between. Also I am not a personal secretary.

HelloWish, ADN, BSN · Feb 17, 2018

I agree that the events described are not characterized as verbal abuse or any abuse. It doesn't mean you won't feel bad about it because someone is trying to correct you. I think being a patient advocate is your number one job as a nurse and so yes you have to be willing to take on physicians and NPs and advocate. They won't always agree with you and you won't always agree with them.

idialyze, BSN, RN · Feb 17, 2018

I had a Cardiac surgeon throw a metal chart at me in the early 90's. I threw it back at him.

Julius Seizure · Feb 17, 2018

OP, I recently had a doc refuse to sign some patient-related paperwork that required an attending MDs signature. In general, that practice group all signs for any patients seen by their group, regardless of which MD actually physically saw them. So I was told to just go ask her to sign, since she was on service that day. Instead, she first said "Can this wait until later?", and then after I said yes, she asked which patient it was for, and I told her. Then she said, "I can't sign that, I didn't see that patient. You'll have to find the person who discharged them." (A person who wouldn't be back on service for over two weeks.)

Unhelpful, frustrating, and a little awkward, since I am new and this happened in front of a lot of people.

Eh, I am over it.

All that to say, it will get better for you as you get more experience. I used to be much more sensitive about feeling silly/dumb/embarrassed at work. Now I am just jaded and tired. So....yay?