Awful Doctors

Nurses Relations

Published

As a newly graduated nurse, I am still in the midst of trying to grow in self confidence and improve my critical thinking skills. I have only been working as a nurse for four months now and there is this horrible doctor that works on my floor. This is not the first time this same particular doctor has chewed me out but this time, this was by far the worst.

Early in my shift, I received a critical potassium level of 2.8 and reported it to this doctor. She ordered me to start an IV 60meQ of potassium and to draw a potassium level stat after the IV was completed. To start off complications, the patient's IV site was infiltrated and I wasn't able to take the time to start a new IV until three hours later. She complained that the site was burning too much so I started it off at 50ml/hr instead of the prescribed 88ml/hr.

Later in the day, this doctor comes up to the floor and demands why the potassium level hadn't been drawn yet. I explained to her the situation and it was just horrible. This doctor raises her voice at me in front of the whole nursing station and says, "Then you should have called me and I could have easily written an order for KCl po! That her potassium was this low and that it's taking this long to get her potassium is ridiculous. This is just unacceptable!!" Silence fell from the whole audience and I just nodded my head and walked away. It took all the strength I had to not burst into tears.

Quite a few of my coworkers came up to me to hug me afterwards and it's well known that this doctor has a tendency to be this rude. I understand my mistake and it was a learning experience. If she had a problem that needed to be addressed, she could have easily taken me aside and I would never make the same mistake twice.

My day just went downhill from there. I had a new admit and a million new orders for my other patients. As soon as I clocked out for the night, I burst into tears. I dread going back into work tomorrow.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

It is obvious that the OP made some major mistakes. Who among us, especialy as new nurses, didn't? That has NOTHING to do with the physicians decision to bully her. I would also like to know how much support this new nurse had. With less than a year of experience under her belt did she have an assinged mentor she could go to with any questions or when she needed help? Obviously her orientation was severly lacking as well. I would like to ask the hospital why they ignored evidenced based practice in their training an orientation program.

Up Vote Up Vote ×
Specializes in Emergency, Telemetry, Transplant.
Dear first semester nursing student,

...before anything else?

I'm glad you've learned a few things, but I'm not sure you're in a position to scold the nurses who've graduated ahead of you. Some humility might be in order.

I think we should all be grateful that a first semester nursing student is here to learn and that they want to participate in the discussion (and I also hope that responses like this don't discourage such participation). However, I do agree that you (jbumgardner) need to be careful when addressing other nurses, especially new grad nurses who are also trying to improve themselves. I am not trying to be mean to you, but think about how you would feel if, right after you start your first job as an RN, you were told by a new student how you 'screwed up' on the job. Again, I appreciate you coming here to learn and I applaud you for participating in the discussion. Just be careful of what you say and how you word it. :up:

Up Vote Up Vote ×
Specializes in Emergency, Telemetry, Transplant.
If a patient can take PO, I would much rather give it that route than IV.

This was my though too, especially since the MD made a comment about how she could have written for PO KCl. Unless the could not take PO, I have almost always seen Ks of 2.8 treated PO. This comes with experience, but perhaps the OP could have suggested to the doc (in a carefully worded statement) that they should go with PO? This doctor may dig her heels in and go with IV anyway, but PO is probably the way to go.

Up Vote Up Vote ×
Specializes in Emergency, Telemetry, Transplant.

Of course the doctor was wrong. It is not her place to YELL or SHOUT at nurses. While she may well have had a legitimate concern about the care (or lack of) provided by the nurse to YELL or SHOUT at nurses is not only unprofessional but degrading and is a hostile act of bullying.

In my mind, the doc was 100% correct in her message, 100% wrong in how she delivered it.

Up Vote Up Vote ×
Specializes in Med-Surg, Emergency, CEN.
This was my though too, especially since the MD made a comment about how she could have written for PO KCl. Unless the could not take PO, I have almost always seen Ks of 2.8 treated PO. This comes with experience, but perhaps the OP could have suggested to the doc (in a carefully worded statement) that they should go with PO? This doctor may dig her heels in and go with IV anyway, but PO is probably the way to go.

Being that new and having little self confidence would probably reinforce the shy "can't talk back to the doctor" feeling. For a revised order or for being yelled at.

Up Vote Up Vote ×
I'm sorry the doctor yelled at you but at the same time, she wasn't wrong.

*** It is embarrasing to me as an RN that a fellow nurse would feel this way. Of course the doctor was wrong. It is not her place to YELL or SHOUT at nurses. While she may well have had a legitimate concern about the care (or lack of) provided by the nurse to YELL or SHOUT at nurses is not only unprofessional but degrading and is a hostile act of bullying. That physician is lucky she didn't get slapped upside the head since bullying often begets bullying.

This whole discussion has depressed me. Not only that the physician made a choice to bully a nurse, but that neither the nurse, nor her cowardly co-workers stood up to her. Even worse than all of that is the enabeling comments made by many here.

Sounds like we need some more laywers involved. I bet a properly worded letter to the hospital from a laywer about the hostile work enviroment they encourage (by failing to address the physicians behavior) and the bullying they choose to allow at their work site would get some attention.

I am taking note of the screen names of those nurses here who have provided enabeling-of-bullying comments here. I better never read any of those people complain of being bullied or i will be happy to remind them of when they refused to support their bullied fellow nurse.

I don't condone bullying of anyone by anyone, but when I re-read the OP I don't see that the doctor was bullying the OP. The doctor raised his/her voice at the OP when the OP failed to take timely action to address a severely low potassium value, which could have had severe consequences for the patient. Why wouldn't the doctor be upset? Yes, everyone makes mistakes, but regardless, if my family member had waited three hours for their severely low potassium value to be treated by the nurse, I would be upset and angry and I would hope the doctor would have some strong words to say to the nurse. If I was the nurse in the OP's situation, I would feel it was reasonable that the doctor said some strong words to me and raised their voice at me, and I would expect it. I wouldn't think it reasonable for the doctor to throw a chart, but strong words and a raised voice, yes.

I also don't see the enabling of bullying that you are speaking of on this thread. And I am a small woman, not a large man (as I believe you are from your other posts on AN), and I am thus much more likely to experience bullying/intimidation attempts than you are, that I am physically much less able to counter than you are.

Up Vote Up Vote ×
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
I don't condone bullying of anyone by anyone, but when I re-read the OP I don't see that the doctor was bullying the OP. The doctor raised his/her voice at the OP when the OP failed to take timely action to address a severely low potassium value, which could have had severe consequences for the patient. Why wouldn't the doctor be upset? Yes, everyone makes mistakes, but regardless, if my family member had waited three hours for their severely low potassium value to be treated by the nurse, I would be upset and angry and I would hope the doctor would have some strong words to say to the nurse. If I was the nurse in the OP's situation, I would feel it was reasonable that the doctor said some strong words to me and raised their voice at me, and I would expect it.

*** Yes as I said I have taken note of those who have made enabeling comments.

I wouldn't think it reasonable for the doctor to throw a chart, but strong words and a raised voice, yes.

*** A I already said it is highly embarrasing to me that some of my fellow nurses feel they are fair game for bullying and bad treatment. Being shouted at by a person in an unequal ower relationship IS being bullied. The physician is NOT the nurses mommy, nor her boss or supervisor. The physician is in NO position to disipline any nurse in any way. Nurses have their own chain of command and have people who are responsible for disipline and the nurses practice. Typicaly a hospital nurse would have a charge nurse as her immediate supervisor and a nurse manager or nursing supervisor above that who IS in a position to disipline (though not shout at) a nurse. If the physician had issues with a nurse she should have brought it up to the charge and or nursing manager/supervisor to deal with.

I also don't see the enabling of bullying that you are speaking of on this thread.

*** No I am sure you don't.

And I am a small woman, not a large man (as I believe you are from your other posts on AN), and I am thus much more likely to experience bullying/intimidation attempts than you are, that I am physically much less able to counter than you are.

*** First it's the size of the fight in the dog, not the size of the dog in the fight. I understand you and that is why I would have expected her fellow RNs to jumpt to support her and confront the physician as a group as some nurses are taught to do. In anyevent one doesn't need to be a large man to take action. This incident of bullying behavior needs to be documented and reported and appropiate action taken by that doctors supervisor.

Up Vote Up Vote ×
Specializes in Medical Surgical.

I hope that I am not only speaking for myself that it is shameful to "reprimand" me for noting that a critical potassium level was addressed so casually and then the blame was placed on the doctor for being so "awful". I know that when I am a nurse I will make mistakes but I will learn from them not make excuses for them. It is sad to see the prioritization that so many nurses on this sight have. Also I show respect to everyone around me but my point was that if you don't think you did something wrong as a nurse go back to those fundamental skills and knowledge that you learned as a student and ask yourself should you have done something differently.

Up Vote Up Vote ×
I hope that I am not only speaking for myself that it is shameful to "reprimand" me for noting that a critical potassium level was addressed so casually and then the blame was placed on the doctor for being so "awful". I know that when I am a nurse I will make mistakes but I will learn from them not make excuses for them. It is sad to see the prioritization that so many nurses on this sight have. Also I show respect to everyone around me but my point was that if you don't think you did something wrong as a nurse go back to those fundamental skills and knowledge that you learned as a student and ask yourself should you have done something differently.

No one reprimanded you for anything other than giving advice without having any basis on which to do so. When you have a license, THEN you can refer your colleagues back to fundamental skills and the basics of nursing, but until then, (and as a wise instructor told us), you're a student, not a peer, and I for one will treat you as nothing more and nothing less.

Up Vote Up Vote ×

Ok. I am just a nursing student, but I also have experience as a medic in the military, so while I realize I don't have the floor experience others here do I still feel comfortable throwing my opinion in here anyway. First off, I am still stuck on why it would take three hours to start a new IV? Or why you didn't ask for help if you were that swamped? But, lesson learned right? So as long as you keep your chin up and learn from your mistakes then you will be fine. As far as being yelled at, you shouldn't be embarrassed or upset. We've all been there. If a doctor gets really out of line by all means tell them, I don't appreciate being talked to this way. Stand up for yourself because no one else is going to do it for you. But it sounds like you have some really supportive coworkers, so focus on that.

As far as the bullying, really? In the military we got yelled at all the time. When I became an NCO I yelled at my soldiers all the time. The reason? We were training them to deal with the stress of life or death situations. If they did something wrong that could get someone killed, they got yelled at. And you can be sure they didn't forget or ever make that same mistake again. I don't see raising your voice at someone to be bullying. Now if they are literally screaming at you or using abusive language, then yeah, that needs to be addressed. Otherwise, rub some dirt on it and drive on.

Obviously, the hospital is not the military. People should not be yelling in the hospital. But it is a stressful place, and stressed people sometimes yell. It doesn't mean you have to run off and report them. You should just tell them their behavior is inappropriate.

Up Vote Up Vote ×
Specializes in Pain, critical care, administration, med.

There are 2 issues here. First the nurse was wrong for not calling the physician about the problem with the patients IV. It is every nurses responsibility to understand the seriousness of the patients condition and report the problems. I agree as a new nurse someone should just be checking with you when you work and offer guidance and assistance.

As for the physician unacceptable approach. I understand the MDs view but it is these types of intimidating behaviors that nurses avoid calling them because they never know how they will respond. These behaviors can result in a poor outcome for the patient. Even joint commission wants these behaviors addressed.

If I was you I would approach the physician and discuss the situation. Don't make excuses but apologize for not following up but tell her that the way she spoke to you on front of your peers was embarrassing.

Your facility should be addressing her behavior and for you a plan to help you handle this type of situation.

Up Vote Up Vote ×

Yeah I get it ... I was fired because DR, is a woman too, did not "trust" me, she thought I was arrogant, and let me tell that is far from reality, I am one of those that if you need help I am right there for you. Keep trying, do not loose your confidence, you can do it. Maybe not at this job, maybe somewhere else, or in a different specialty. Good luck.

Up Vote Up Vote ×
+ Add a Comment