Do doctors really yell at you, and get away with it?

[copyandpaste]

I was asked in my interview for nursing school to rank the level of importance of the following things from 1-10. And they asked things like "your patient isnt eating", "your classmate takes money from a patient during clinicals", and one of them said "the doctor yells at you". I ranked it the lowest because I figured he'd get over it.

But the thing is: I began to wonder how often that happens, why did they ask me if it isnt something Im certain to run into more than once?

Cant you just report the doc? I mean, do they get away with that sort of thing??

I can see if you work in their family practice clinic maybe, but what about a hospital setting?

Thanks for your responses.

[groanup]

It doesn't happen often, but when it does I can choose one of three responses:

1-- Ignore the person as he or she couldn't possibly be addressing me

in such an unprofessional manner

2-- Shout back as that must be this person's normal form of communication

3-- The most sarcastic comment I can come up with at the moment,

hidden in a calm, professional- sounding statement

~~Real life example:

A GI bleeder spent most of the night in the ICU trying to die.

He was finally somewhat stable-- lines & tubes in every known orifice,

plus some new ones we created for him, multiple drips, etc.

At 7:30 AM, the RN finally got out of the room to give report to

the next shift. I know this doesn't happen anywhere else, but the

day people wouldn't get up from the desk until report was given on each

patient, then they work out assignments, go for breakfast, then go see

their patients. OK, I won't go down that road-- back to the story:

A bombastic GI doc showed up unannounced at 7:32 AM to do a bedside EGD

"WHERE IS THE NURSE FOR THIS PATIENT?!?!!!!!

Giving report to the next shift so she can go home

"WHY ISN'T SHE HERE?!?!!!! SHE SHOULD BE IN THIS ROOM AT ALL TIMES!!!!"

(Obviously he either ignored my reply or forgot it immediately)

Thank you, doctor, for explaining our job description to me

================ ~ : ^ /' =========================

* * * *

[Work in Progress]

When I was looking into moving to Colorado, it seemed like more nurses there had stories about getting yelled at. My sister-in-law works there and before I started nursing school, I asked her what surprised her the most about the profession, what she had encountered that she hadn't expected. She paused for a moment and said, "I didn't expect to get yelled at so much." She said it was by the doctors, by the families, and by the administrators. I was shocked! Maybe Colorado (and other) posters can shed some light.

I live in Colorado, and although I am just a student (graduating in a month) I have also worked as a nurse intern. I have never witnessed any yelling at a nurse by a doctor. Families, yes, I have seen that. The docs are pretty respectful in the hospitals that I have been at. Even when I could tell that they were a bit irritated with being called, they have always been respectful of me and the nurses on the floor. There is conflict, but it is pretty professional. I should note that each hospital I have worked at or been a student at had a zero tolerance policy for "workplace violence" (which includes yelling and bullying).

Do doctor's get away with it? Only if you let them. I am a firm believer in calling people on their nonsense. I have even been known to tell a perfect stranger that they are being inappropriate when yelling at their barista/waitress/cashier in a public place. Nobody should be allowed to think that this kind of tantrum is okay for an adult. And they certainly shouldn't be rewarded for it.

[supernatural]

We have one doc that curses at you on the phone and one night he told our charge nurse "your the third call I've gotten I'm trying to shave". She said you just keep talking and let him know your documenting you contacted him with regards to the situation.

He's well know for, if you call him he'll have your head.

[annaRNC]

I have a pretty good relationship with the doctors that I work with and I think that it works because it's a two-way street. On my end when I do have to call them off hours for something I make sure I have all of my stuff together as well as what I'd like an order for prior to picking up the phone. Nothing is worse than the nurse that rambles on and there is no surer way to **** someone off. I keep current on what's in the journals for the more complex patients I take care off (lots of seizure kids, hemo/oncology) so I have a basic idea of what's being discussed. I listen whenever I can and go on rounds. I feel like my suggestions and questions are treated with respect and I get really good feedback from doctors in terms of the care I provide including taking the time t explain why something may not be right to me. I've never felt talked down to and I actually really feel valued which is one of the main reasons I've continued to be really passionate and advocate for students coming up. Sadly I'm only one that seems to really take advantage of this which I don't understand at all. If you're busy with your patients that's understandable but facebooking/myspacing/texting does nothing but waste time. If you aren't learning or at least trying than it's impossible that nurses get the recognition they deserve.

On the doctors' side I've only had two episodes where someone crossed the line. The first the doctor immediately apologized without me even saying anything--he was having a off day and I think he felt awful b/c he's actually a really nice guy. The second involved a oncology doctor that I was discussing a patient with. I wasn't familiar with the patient so I said that it was difficult to assess where he was at since there wasn't much documented regarding his baseline status prior to diagnosis. This was a kid with behavioral problems compounded by a brain tumor as background. He said to me that the difficult patient had a difficult nurse to which I replied that he (as a doctor--slightly ****** of me) should know the difference between a smart nurse and a difficult one. Never had another episode after that. Doctors are just people and people will yell if you allow them to get away with it. Call them on it without getting emotional and I can almost guarantee the behavior will stop. If you're going to be a nurse be in there and be willing to learn because I think that's made a huge difference between where I'm at with my professional happiness versus those that started around the same time. If you aren't willing to learn in whatever way whether it be reading, attending conferences, talking shop with your peers, or rounding than get out of the way of those that want it. Off the soapbox now!

[netglow, ASN, RN]

Yeah, boy.

Now let me preface this by saying I once worked exclusively for a doc and I have since learned to keep myself in check with my "comebacks" when faced with the obviously ridiculous from those I do not personally know. Once, when I was a student, I could not get this cardiologist to give me parameters for meds for a patient who had an "incident" in the early a.m. it took me asking three times as he sat there in a snit, arms crossed and scowled at me incurring long uncomfortable silences. Now, my RN pointed him out and told me I had to learn to deal with real PITAs and to go for it. So... on my third attempt, having received no answer I gave him this big sigh, looked down at his name/specialty on his lab coat, and muttered about going and finding the NP, that she'd be able to figure it out. As I turned to head towards her, he hopped out of his chair, and said, "that won't be necessary." To which I said, "are you sure?"

[cb_rn]

Sad but true...

First week off orientation, green as a blade of grass on a Cardiothoracic surgery stepdown unit at a very well known teaching hospital. The patient is a 87 year old lady, tele shows her HR is dropping to 40s when she ambulates with PT. I text page the resident for EP. EP doesn't usually work on this floor BTW, they traditionally keep those pts up on the cardio floor. Nobody answers but pt is asymptomatic, beautiful SR in the 60s when not ambulating. I assume they are rounding. Fast forward a few minutes. Attending doc has a group of about 8 around him talking about the pt's HR and "She's controlled right now but who's to say she isn't shooting up with activity?" I say - in a lil mouse voice- something like, "Excuse me, I paged earlier to let the resident know she's having some bradycardia while walking." They all turn and look at me.

"Who the hell asked you?" Did an attending REALLY just say that to me?

Wow. I wanted to melt into the floor.

He continues..."That's impossible, blah blah humiliate, degrade, blah." Well at that time my 2nd patient starts alarming with an O2 sat in the low 80s and the CNA is squawking at me from down the hall to get in there.

And in a blinding glimpse of the nurse I would one day become, I say "I'm just the nurse with the patient 12 hours a day. Here are your tele strips." I drop the strips on the chart and take off down the hall to check on the other patient.

Later...the fellow comes up to me and tells me that's just the doctor's sense of humor and he was really just kidding. The clinical nurse specialist from the cardiac floor comes down to find me and brings me a basket of candy and says that the doctors on that floor just have a brutal sense of humor and that the attending was sorry that I took it badly because he didn't intend it that way. Sometime later my manager hears about it and brings me in his office to ask if I'm ok being off orientation. My charge nurse is absolutely inflammed. Even the attending finds me later in the afternoon and tells me that he's sorry, he was really just joking and says that he's not sure what was up with the tele strips but it was impossible that she was truly bradycardic when walking.

I didn't mention this incident to anyone to get all these people to come apologize. It was witnessed by several family members and a couple of other nurses to add to my humiliation but I didn't cry and I didn't say anything about it so someone else must have taken offense for me. Of course, I have no doubt in my mind that attending was just a jerk and someone complained about him to the right person.

I've seen a prominent neurosurgeon dress down another doctor right at the nurse's station and ask if he got his degree off the internet. Heard people called liars, idiots, retards, seen surgical instruments fly and gigantic fits of rage be thrown for no reason and also for big medical mistakes. It all depends on the hospital culture. The big hospital I worked for encouraged you to be a ___hole right back to the resident or fellow that was giving you a hard time and, as demonstrated, would expect an attending to do something to "make amends" but I've worked at several smaller hospitals that treat the docs like gold. One of the docs wasn't even made to use the computer!! He would come on the unit and you better have printed all his labs and test results out and written down the VS, TMAX, and i/o from the last 24 hours or he would spazz out. But that was the culture of that hospital. He was allowed to get away with it so it became habit.

Its not right but its the way it is in some places. My advice is to develop a tough skin, to remain professional, but to also develop your own system for telling someone that is crossing the line in how they are addressing you. My own personal policy is to apologize if I am wrong, speak up if it gets snarky, and to let it go when it doesn't matter. There are a few times that I've engaged in snarkiness right back and it can be satisfying at the time but is ultimately not the professional I'd *like* to be. I try to be understanding at the random incidents, I've snapped at people when I'm in a bad mood too and I hope they don't walk around afraid to ask me things.

Above all, you can't be afraid of the docs because you can't write orders yourself and if you hold off on notifying them because you're nervous, your patient will suffer.

[PMFB-RN, RN]

One time, many years ago, I was struck in the head by a telephone that had been thrown by a cardiologist. He ripped it off the desk and threw it at the wall just as I walked out of a patient room and I got hit pretty hard. Raised quite a goose egg on the side of my head. The doc quickly left the unit as I think he realized I had every intention of kicking his butt. I called the cops and pressed charges. He was charged with battery. Our local DA was very interested in prosecuting the case. The docs lawyer made me a great offer that included a public apology (what I really wanted) and some other stuff and I dropped the charges.

IMO the correct response to violence is first to defend yourself and second to call the police and press charges.

[Zookeeper3]

Luckily our culture has changed and it is done by doc's but not tolerated... they just never learn:D

We have an internet "physician behavior form" that goes directly to the med ex. It is fairly often when a doc might get snippy... catch him/herself and say to me.... "oops sorry, you aren't going to fill out one of those forms again?".

To be a fly on the wall when these docs get the business from the head boss. OUr culture and nurse retention is improving, and those docs that haven't learned have been suspended from admission priveleges.

[DogCrazy]

I haven't seen a doctor go off yet. I'm a new grad at my hospital, but I worked there for a couple of years as a student nurse tech, then as a nurse extern and now as a new grad. I spent a month on the new grad unit, and all the docs were telling me their pet peeves about night nurses, which I've taken to heart. Most of the doctors here are great, and pleasant enough. I think being an older new grad also helps me.

[suanna]

Yep - it happens every now and then. You get over it and try not to take it as personal. Health care is a stressful field. Litigation, diminished compensation, long hours on short sleep and dealing with over worked nurses can make even a saint of a doctor a bit cranky at times. My wife gets cranky from time to time but I'm not reporting her to the local law inforcement for spousal abuse. If a doc gets really abusive, or ANY physical threat- sure call in your supervisor or whatever policy your facillity has in place to deal with workplace violence. A few short words or a testy brush off- get over it and move on. If you are still upset after the heat of the moment is passed, the next chance you get to pull the doc into a private conversation- ask what they would have preferred you do in the circumstances that caused the altercation. If the doc sees you are comming from a place of patient safety you are less likely to catch the wrong end of a yelling match again soon. Please keep in mind, despite frequent advise in this forum- calling a doc in the middle of the night or in O.R. or even frequently just to C.Y.A. is a great way to teach the doc that your phone calls are less about patient care and more about placing (or displacing) blame. You are going to get a testy doctor a lot once you are known for this behavior.

[nursel56]

CalmEnurse[/b];4271282]p.s. this is my first post after lurking for about a year, so you really know this issue is a big deal to me!!

. . .but you still deserve your :hrns&wlcm: to allnurses!

I've been yelled at twice. The first was when a full of himself p1ssant intern didn't appreciate my attempt to clarify his screwball order. Being new, I was upset by that, but it turned out OK when my nurse manager got up in his face did this, and said, "Listen, Harvey. You will not be treating the nurses that way on my floor. Do you understand?"

That happens more often in a teaching hospital, because some of them didn't get the memo that being a jackass to the nurses who will likely save their butt on many occasions is not part of the program. The other was an endocrinologist who told me I had screwed up his fancy q void urine deblahblah 24 hr test on the 3 year old who's parent's had taken him to the cafeteria.

That one, in retrospect, could have been avoided. I had 6 patients, 4 two-year olds, a 10 year old fresh post-op kid and the endocrine test kid. I should have asked for help, but I didn't. I assumed at the time the person who made the assignments must also know how to make assignments. Big mistake!

By far my best jerk doctor story didn't involve me getting yelled at, it was an OB in our clinic. I worked next door to the Chief of Staff, heard someone tell him to come upstairs real quick because Dr. K----- is throwing all his office furniture out into the hallway!! This I had to see. You mean, like all his furniture?? Yes! I think we arrived just as he was throwing his last bookshelf onto his creation, which appeared to be something a small mountain consisting of chairs, side tables, bookshelves and lamps. You almost want to give an award to somebody who has the cujones to that, lol !!

[netglow, ASN, RN]

nursel56,

:hpygrp:

You seem a bit like me in that when I see supposed in-control professionals spaz, I find it slightly, I mean VERY entertaining. The more they spin-out, the funnier it is to me. If I was with you at that moment, I would have brought the popcorn and the two of us would be crying from holding back the laughter.