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Difficult Doctors:  Tips for Students and New Nurses

Nurses Article   (2,578 Views 39 Replies 846 Words)
by J.Adderton J.Adderton, MSN (Member) Writer Verified

J.Adderton has 20 years experience as a MSN .

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It is a common scenario- a student or new nurse attempts to communicate to a difficult physician.  The nurse’s response- blank stare, red face or maybe a defensive response. This article will provide tips for dealing with difficult physicians to ease the transition from novice to confident and competent. You are reading page 3 of Difficult Doctors:  Tips for Students and New Nurses. If you want to start from the beginning Go to First Page.

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2 hours ago, JinnSchlajfertig said:

I am glad this is being discussed but I can't help but laugh. As I was reading the tips for dealing with doctors it reminded me of wildlife safety tips to help you survive a bear or puma encounter. 

😄 Always approach slowly, never turn your back, and carry a food item that can be thrown as a distraction if the situation gets tense. 

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ThePsychWhisperer has 6 years experience as a BSN, MSN, APRN, NP and works as a Psychiatric-Mental Health Nurse Practitioner.

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3 hours ago, CommunityRNBSN said:

😄 Always approach slowly, never turn your back, and carry a food item that can be thrown as a distraction if the situation gets tense. 

So very true, especially the food part. Whenever I'm having a bad day, the staff nurses have learned to just throw candy in my general direction. I guess the Snickers commercials are right... I'm not myself when I'm hungry 🤣🤣

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NightNerd has 5 years experience as a ASN, BSN, RN and works as a Med-psych nurse.

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10,000% agree with forming your own opinions on providers! There's one that I was warned about repeatedly whom I've never had a bad encounter with after three years. Sometimes, things just click unexpectedly.

I'm always torn on the advice of, "It's all in how you TALK to them." Sometimes it makes a difference, other times you're just dealing with a certain kind of personality. Regardless of how they act, conduct yourself in a way you're proud of, advocate for your patients, strike a balance between confidence and appropriate humility. Communicating with providers is an art, not a science, and one size doesn't necessarily fit all.

My best advice is to know what YOU'RE good at and know what THEY'RE good at, and use it well. I had a rocky start with a certain PA (she basically treats everyone like an idiot at first), but we get along great now. In part I think she's loosened up in general, but we have a particularly good relationship now. I don't pretend to be an expert on everything, so while I know my patients' information inside and out and will contribute my ideas, I ask questions and try to learn from her when possible; she's extremely thorough and really has a lot of knowledge to share. She has also started to see me as a resource in my area of expertise, as I will (not unkindly) assert what I know when it's needed. Now she will call me when she has certain questions. We still have the occasional moment, but there's an undertone of respect there that I think is facilitated by respecting each other's intelligence.

Also, unless something is actually my bad, I really try not to apologize. If I have to call you five times in one night because a patient's condition is all over the place, that's what needs to happen. Instead of, "OMG I'm SOOOOO sorry to call again," I sincerely thank them for their continued help. We're all here trying to take care of people, so my efforts to keep them informed really shouldn't be seen as an inconvenience.

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Elizabelibby has 40 years experience as a BSN, MSN and works as a Consultant.

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I've got a long career of dealing with difficult physicians (well). The caveat I always remembered was "it is easier to catch flies with honey than with vinegar". I agree to develop your own impressions of physicians than necessarily take what others say as gospel. I got along well with all of the "ugly" ones, partly because I knew my stuff and partly because I knew how to finesse to get what I felt was needed for my patient. What I wish someone had told me was how to have the fortitude as a new nurse to get passed the Charge nurse when I felt something was wrong and wanted to inform the doctor. That happened maybe 35 years ago and it still haunts me.

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May I ask why, in this day and age, we are researching, writing and reading articles on this topic? 

I get it, it still exists, but less so and I think instead of focusing on how we can learn to better deal with “difficult doctors”, we are not focusing on changing the culture on why this is still considered acceptable behavior!

There are a few “difficult” physicians where I work, but I have found that if you don’t cower to them, and make it clear you will not tolerate being treated as such they tend to be less difficult.

That being said, as a student or new grad that can be very intimidating, so the best advice is be prepared with all patient info and to answer their questions before reaching out to them. Then, give it time, with experience comes confidence and never feel bad for standing up for yourself! I promise there are respectful ways of doing so!

Edited by kldepp08

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On 4/20/2019 at 12:31 PM, Ruby Vee said:

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.

Agree with a lot of this. I learned early on that if you ask the doctors about their kiddos they are much nicer to you. You learn that he has a kid playing t-ball, or that her daughter is good at soccer, and you're good to go. They love talking about their children, and someone giving them permission to brag about them or to tell cute stories about them just makes their day. 

Edited by Horseshoe

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I remember this PA who was a wanna be physician and he liked to ask increasingly difficult questions to the point where the nurses couldn't answer. He loved to play mind chess with me because I always gave him a run for his money. I remedied that by calling his physician directly. When I am on the job, I don't have time to play games. Otherwise, I liked to engage this jerk. When the doc asked me why I bypassed his PA, I told him that the man was a jerk. Well I used stronger adjectives but will not repeat them here. The doc seemed to understand and must have talked to his PA, because he got real friendly and didn't play the wear you down mind game. He still does with others, but not with me. I have a bigger problem with legibility issues. Before some of these doctors can practice medicine, they ought to be made to pass a legibility test. It doesn't take that much effort to use clear and legible handwriting as opposed to Egyptian hieroglyphics, and they get an attitude when you call them for clarification. After awhile I can decipher the chicken scratch, but I am thinking so many potential med errors could be averted if they took the time to write legibly. 

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Leader25 has 35 years experience.

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I do not have a perfect answer but one thing for sure they can smell fear.Know your  stuff,I used to go home and study/review for several hours any new item/illness that was new to be.

Do not call for nonesense like waking  the on call doc to state the routine chem was normal.[unless he requested that follow up for some reason].

Do not cry,cower,stay calm and firm and report them to administration and your union if needed.

Most will usually come around and apologize for behaving like an ***.

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I don’t understand the introduction to this article. Doesn’t the writer mean the DOCTOR - not the NURSE - has a response of a blank stare, red face or is defensive? 

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mizfradd has 11 years experience and works as a CNA II.

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23 hours ago, LPN With An Attitude said:

I remember this PA who was a wanna be physician and he liked to ask increasingly difficult questions to the point where the nurses couldn't answer. He loved to play mind chess with me because I always gave him a run for his money. I remedied that by calling his physician directly. When I am on the job, I don't have time to play games. Otherwise, I liked to engage this jerk. When the doc asked me why I bypassed his PA, I told him that the man was a jerk. Well I used stronger adjectives but will not repeat them here. The doc seemed to understand and must have talked to his PA, because he got real friendly and didn't play the wear you down mind game. He still does with others, but not with me. I have a bigger problem with legibility issues. Before some of these doctors can practice medicine, they ought to be made to pass a legibility test. It doesn't take that much effort to use clear and legible handwriting as opposed to Egyptian hieroglyphics, and they get an attitude when you call them for clarification. After awhile I can decipher the chicken scratch, but I am thinking so many potential med errors could be averted if they took the time to write legibly. 

AMEN!!!

It's 2019 and this is still happening!🤬

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canoehead has 30 years experience as a BSN, RN and works as a RN ER.

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On ‎4‎/‎21‎/‎2019 at 12:09 AM, NightNerd said:

Also, unless something is actually my bad, I really try not to apologize. If I have to call you five times in one night because a patient's condition is all over the place, that's what needs to happen. Instead of, "OMG I'm SOOOOO sorry to call again," I sincerely thank them for their continued help. We're all here trying to take care of people, so my efforts to keep them informed really shouldn't be seen as an inconvenience.

Good point.

Often the docs that have a difficult reputation have gotten it because they are being difficult FOR the patient. Make sure you have fresh vitals, have the chart in front of you, and take about ten seconds to reflect on what might be causing the problem, and what you might need. Then you've thought of getting the extra fingerstick BEFORE you call, and you sound prepared.

Docs that are ignoring the patient or our concerns should be reported up channels. BUT talk to your coworkers and charge nurse before you do it, just bounce the situation off them. There night be reasons behind the issues, pathophysiology that's been discussed before, new policies, whatever. Then talk to the doc, respectfully, saying, "Can you tell me how that works " or " what are the goals, do you have parameters you want me to shoot for?" or " I don't understand xxx can you give me a good reference to look up?" Usually they will be happy to explain if you admit it just doesn't make sense to you.

I recall a doc that had a raging tantrum over something very very small, but as we spoke to the supervisor an hour later, they had just lost a child in the PICU. Instantly forgiven.

One of our type A docs gets snippy when shes hungry...we give her snacks. The ICU has been known to call ahead and FYI the ER that they've had a rotten shift, and the doc needs some TLC. I think we should support our docs in that way when we can.

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On 4/21/2019 at 4:11 PM, LPN With An Attitude said:

I remember this PA who was a wanna be physician and he liked to ask increasingly difficult questions to the point where the nurses couldn't answer. He loved to play mind chess with me because I always gave him a run for his money. I remedied that by calling his physician directly. When I am on the job, I don't have time to play games. Otherwise, I liked to engage this jerk. When the doc asked me why I bypassed his PA, I told him that the man was a jerk. Well I used stronger adjectives but will not repeat them here. The doc seemed to understand and must have talked to his PA, because he got real friendly and didn't play the wear you down mind game. He still does with others, but not with me. I have a bigger problem with legibility issues. Before some of these doctors can practice medicine, they ought to be made to pass a legibility test. It doesn't take that much effort to use clear and legible handwriting as opposed to Egyptian hieroglyphics, and they get an attitude when you call them for clarification. After awhile I can decipher the chicken scratch, but I am thinking so many potential med errors could be averted if they took the time to write legibly. 

Been there, done that. I was told that we had certain providers that didn't EVER want to hear "I don't know." I made sure I told them that on the regular. I have multiple patients to care for, and you are capable of reading the chart. Need pertinent info or an update? Ask away. Want a 20-day recap or to test my knowledge of BS? No time. 

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