Difficult Doctors:  Tips for Students and New Nurses

I’m a new nurse, and one more piece of advice from my experience is: Form your own opinion about each doctor (and each nurse for that matter!). Sometimes, all the experienced RNs will tell you “Dr Smith is awful, so watch out” and “Dr Jones is great” but you may find that you get along better with Dr Smith. If you listen to a bunch of gossip before you even meet the doctor, you may walk into a conversation defensive and expecting a battle before the other person has even opened their mouth.

I'm not a new RN, but new every 13 weeks, and dealing with EXTREMELY condescending and rude docs and a PA on this contract. I just CANNOT believe what these nurses put up with! Multiple times in only 7 shifts, I have been the recipient of eye rolls, horrid condescension, outright dismissal when presenting legit concerns (NO, this patient cannot go home, he can't walk, or even crawl, he's still in active withdrawal!) And (I've asked 4 times now for a DNR order for this pt who has a clear advanced directive...Nope.)

Admin is aware of the problem, and apparently this team has been "spoken to" by HR multiple times about their (collective and individual) behavior.

It's unreal how quickly, with the doc I've worked with most, (again, only 7 shifts) the attitude has shifted. I've looked him straight in the eye on multiple occasions, and said something to the effect of, "I'm not sure what you meant by that comment, but I'm telling you from my experience that X is what's going to happen if we do Y without Q. I don't really care, since neither one of us will be here when he (pulls out the NG, has a seizure, has to be exposed to more radiation d/t another CT...) but in the interest of his (health/comfort, whatever) can you just hear me and do what I'm asking?"

He has started to actually come to me and (not ask for advice, that would be too much...) hint subtly that suggestions would be considered. He actually commented the other day that I was to be commended for "using my own judgement" and not feeling the need to "bother him" by "getting confirmation" on a patient concern.

Um, thanks, jackass, but I don't need your approval to educate my patient. That said, it really was validating, and the charge and two other nurses heard him, and were like, "How the hell did you do that??!! Actually get him to talk to you like a person, instead of a peon??"

Honestly, I know my ***. And I'm not afraid to tell you what I know, and what I DON'T know.

Now, if I could only get the PA to stop thinking she is God's gift to Neurosurgery...

ETA: Maybe mine's not the most helpful post for a new nurse...more of a rant, but I will say, confirm your feelings/suspicions with a more experienced nurse, Unit Director, even House Supervisor. If warranted, stand your ground! Docs, NPs and PAs will dismiss your concerns if you are emotional or seem unsure of yourself. Once you have confirmed that your concerns and recommendations are legit, be calm, firm and direct. Don't let anyone dismiss you.

You do not have the power to transform a reasonable, sensible person into a jackass. If the person you are dealing with is acting like a jackass, it is not because of something you did. It is because he or she is a jackass.

1. Know your patient in and out.

2. Know the disease process in and out.

3. Know nursing interventions and considerations in and out.

With all that said when you consult with a dr. Do it in a place of confidence. They are more inclined to answer professionally than not. No matter how they answer, stand your ground with shoulders up and use direct eye contact....kinda with anything in life. Confidence!

However there are situations that would need to happen. I have two known Drs here that are so rude to nurses that whenever you mention their names its like a Lord Voldermort situation out of harry potter. Both drs i made in a point to put them in their place publicly in front of the nursing station. ? funny how i think i'm one of the few nurses they say good morning(or whatever the time is) to now.

On 4/18/2019 at 8:45 PM, hherrn said:

You do not have the power to transform a reasonable, sensible person into a jackass. If the person you are dealing with is acting like a jackass, it is not because of something you did. It is because he or she is a jackass.

The only problem I have with this post is that I cannot like it a few hundred times.

I was probably 20 years into my career when computerized charting came out. I had already developed the habit of writing pertinent information down on my "brain sheet" and calling the doctor without entering into the electronic chart. Entering the information was, at first, an ordeal, and sometimes the patient need was too urgent for me to waste time figuring out how to chart it before calling the doctor. Besides -- I already had all of the information right in front of me before I picked up the phone.

I learned quickly (and the hard way) to chart the information before calling the doctor. The second day we had our electronic medical records up and running, I had to call a surgeon about a bleeding issue. I called his cell and started to fill him in on the situation when he interrupted me with, "None of this is in the chart. I can't SEE it." Turns out he was in San Francisco at a medical conference, and when I called he was sitting in front of his laptop, perusing the patient chart on the firewire connection at the hotel. (Yes, before WiFi, too.) That's when I learned first, how useful the electronic charts could be, and second, that I needed to keep it updated at all times.

When you're new, it can be really intimidating to call a provider; especially one with a reputation for being a bit of a jerk. Years ago, I worked in a CCU where the medical director was more than a bit of a jerk. I was used to seeing nurses go back and forth about calling him. "You call him, you're the charge nurse." "No, you call him; it's your patient." "Maybe we don't need to call him. Is there someone else we can call?" "Nope. Nobody else. Let's wait an hour and see what happens." That kind of thing isn't in anyone's best interest.

I learned quite by accident that even the most sarcastic and intimidating provider is still just a human being like you and me. I discovered a scuba diving journal with Dr. Imaflamindonkeybutt's name on the address level just lying in the nurse's station and, being a diver, picked it up and flipped through it. The next time I saw him, I walked over to him, screwing up all of my courage, and said "I hear you're a scuba diver. Have you ever been to the underwater state park?" He had, it turns out, and he'd love to tell me about it. In the future, for as long as I worked on that unit, he'd come looking for me when he first walked on the unit. We'd chat briefly about scuba diving, and then he'd make his rounds. He was never rude to me again, and he was a lot nicer to my colleagues as well.

It takes only 1 or 2 minutes to greet someone, acknowledging them as a person and asking about themselves or their interests and it makes all the difference in the world when you have to call them at 3am because their patient self-extubated.

Pro tip? Give them back exactly what they give you. Nobody in the hospital is more important than anyone else. If the doctor doesn’t show up tomorrow, we’ll get by, but what if environmental services or food services don’t show up? It isn’t a hierarchy, it’s a level field. I always approach everyone with kindness and respect. I get attitude? You’re getting it right back. Too many people, from bully nurses to arrogant doctors, have gotten away with their BS for far too long. Not around me. Stand up for yourselves. It makes everything better.

Just now, traumaRUs said:

Hmmm...doubt this will work for you in the long term. It might be better to try to defuse the situation and try to get along. Just because someone gives you attitude doesn't necessarily mean you need to react in kind. Someone in the situation should remain calm so that you can both move forward with pt care.

It's worked for 27 years, so I think it's ok. You never let a conflict interfere with patient care. I'm talking more about personality conflicts with difficult people. They continue to be difficult because other people allow it. Anyone can have a bad day, and everyone gets a second chance. Getting along is the first option, and is why I always approach with positivity. Other than that, stand up or enjoy being run down. It's everyone's own personal choice.