Difficult doc

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I have been a RN, BSN for 11 years and worked LTC, management, staff development, nursing instructor, Med Surg, and ICU. I have always had a decent working relationship with doctors, never any real issues...until now. I recently accepted a position in LTC at a small SNF as the staff developer, but also fill in as charge nurse a few days a month to allow charge nurses PTO and cover if a charge nurse calls off. I have discovered that the medical director is nothing short of an arrogant jerk. Very rude to nurses, not very nice period. He has on several occasions made condescending remarks about nursing staff, the residents and family members. I have experienced issues with him in the past week that I covered for the charge nurse. She told me I needed to call him about ALL orders because he will say he did not give an order if he is in " a mood", so assuming she knows this first hand, I took her advice. Long story short, I do not know this doc as I do previous docs that would tell me not to call for Tylenol, just put in a phone order and they will sign. Not all docs are OK with that so not knowing this doc, I called him to report that a resident had a stage 3 decub because the other nurse told me he wants to decide the tx orders. Now some docs want the nursing staff to handle this but she said he reprimanded her before so I called him and asked him what would he like to order. He yelled at me not to ever call him about " stupid things that are protocol" ever again. The thing is, there is NO written protocol...would he not need to write and sign a protocol in order for it to be legal? I was merely calling to ask a question and got my head bit off. He told one of the other nurses I must be new or just stupid. Apparently all of the nurses are treated this way. I went to my boss and discussed it, she did say she would talk to him but I don't know what to expect. I have no intention of working with a doctor who is THAT disrespectful and I sure won't be intimidated or afraid to call to report a concern I have regarding a resident. What else can I do? I don't intend to work in a hostile work environment but apparently this doc has been allowed to act this way for quite some time so I am not sure it is a battle I can win. Right now we all need to be supporting each other. I have approached the doctor with respect but nothing has changed regarding his behavior. I hate to quit the job but I don't want to deal with him acting like this either. I will say I have a lot of personal issues at home too....raising 3 grandkids and a mother who is not well and refusing to go to a SNF that I am trying to take care of. Maybe I am just oversensitive and overwhelmed. Thanks for any advice.

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How bad do you need this position?

Is he THE doctor for the facility, or is he a part of a group? Have you tried finding who is this doctor's superior/employer? Doctors like this tend to cave real quick, or even get fired, once their superiors get involved.

How much sway do you have there? Enough to convince other nurses and staff to write down detailed, objective complaints about this doctor? (Warning: Going this route would make you a target - would not recommend unless you are prepared to become a martyr.)

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I guess you have to think of it this way: Even if this doc was one of five docs on the payroll, let's say, do you really want to be on edge every time you show up to work and he might be the doctor for that shift?

A leopard does not change its spots. I would start looking around for another job just because, for me, it's not worth going into a job and being on edge. Why not put your resume out there and see what comes your way? Maybe you get a better job offer?

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Specializes in SCRN.

Please, use paragraphs.

In 11 years, this is the first time you see and arrogant MD? I say, that's pretty darn good.

Anyways, he is this way because of HIMSELF, nothing to do with you. Tell him you are concerned with patient safety, and tell him that again and again. Nothing to stress about.

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On 4/8/2020 at 5:54 PM, missourinurse2b said:

I have been a RN, BSN for 11 years and worked LTC, management, staff development, nursing instructor, Med Surg, and ICU. I have always had a decent working relationship with doctors, never any real issues...until now. I recently accepted a position in LTC at a small SNF as the staff developer, but also fill in as charge nurse a few days a month to allow charge nurses PTO and cover if a charge nurse calls off. I have discovered that the medical director is nothing short of an arrogant jerk. Very rude to nurses, not very nice period. He has on several occasions made condescending remarks about nursing staff, the residents and family members. I have experienced issues with him in the past week that I covered for the charge nurse. She told me I needed to call him about ALL orders because he will say he did not give an order if he is in " a mood", so assuming she knows this first hand, I took her advice. Long story short, I do not know this doc as I do previous docs that would tell me not to call for Tylenol, just put in a phone order and they will sign. Not all docs are OK with that so not knowing this doc, I called him to report that a resident had a stage 3 decub because the other nurse told me he wants to decide the tx orders. Now some docs want the nursing staff to handle this but she said he reprimanded her before so I called him and asked him what would he like to order. He yelled at me not to ever call him about " stupid things that are protocol" ever again. The thing is, there is NO written protocol...would he not need to write and sign a protocol in order for it to be legal? I was merely calling to ask a question and got my head bit off. He told one of the other nurses I must be new or just stupid. Apparently all of the nurses are treated this way. I went to my boss and discussed it, she did say she would talk to him but I don't know what to expect. I have no intention of working with a doctor who is THAT disrespectful and I sure won't be intimidated or afraid to call to report a concern I have regarding a resident. What else can I do? I don't intend to work in a hostile work environment but apparently this doc has been allowed to act this way for quite some time so I am not sure it is a battle I can win. Right now we all need to be supporting each other. I have approached the doctor with respect but nothing has changed regarding his behavior. I hate to quit the job but I don't want to deal with him acting like this either. I will say I have a lot of personal issues at home too....raising 3 grandkids and a mother who is not well and refusing to go to a SNF that I am trying to take care of. Maybe I am just oversensitive and overwhelmed. Thanks for any advice.

"There is no written protocol" ought to shut him up real quick, along with a firm "also, I don't appreciate being spoken to this way."

Does he pay you or make decisions on your employment status? No? Then he can go kick rocks. I've had to work for plenty of arrogant jerks, and the best way to handle these people is to give it right back to them. If you're not doing something stupid, then make them feel stupid for getting upset. It also makes them feel like they are psychos, which they are.

"Why would a phone call upset you so much?"

"Why are you getting so upset? You're literally shaking." I've said this to a guy who just exploded on me in a highly inappropriate way.

Not being able to control yourself is a weakness; these types of personalities are weak. Remember that. They compensate by being assholes.

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Specializes in ED, Family Practice, Home Health.

It's time to fight fire with fire. A lot of these types of arrogant assholes simply will not respect you until you ramp the dialog up a notch. I recall a memorable conversation with a doc where I ended up saying "Hey! ***! You DO NOT speak to me in that tone of voice and you better do the job you are being paid for. Grow up and act like a professional adult!" I literally never had a problem with him again.

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I actually took this advice and confronted him about his behavior and also talked to my manager....so far he has simmered down. For now at least. I have a feeling he won't play nice too long though.

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Specializes in Psych, Corrections, Med-Surg, Ambulatory.
On 5/13/2020 at 5:00 AM, missourinurse2b said:

I actually took this advice and confronted him about his behavior and also talked to my manager....so far he has simmered down. For now at least. I have a feeling he won't play nice too long though.

That's okay. Rinse, repeat. He's probably a slow learner. He'll eventually figure out you're not a very satisfying target for his crap.

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Specializes in Critical Care; Cardiac; Professional Development.

Most bullies back down when you point out they are being a bunghole and that it is not okay. Call him on it every. single. time. If he is an abusive type, he will straighten up for a while and then try it again. However, by my experience, most doctors like this figure out who is going to put up with it, behave better with those who open don't tolerate their nonsense and actually have greater respect for them and a more trusting work relationship due to their backbone.

Good luck!

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