Doctor's attitude towards nurses

[jrsnars2]

Hello fellow nurses. I need opinion from this community on how to handle the situation that transpired today that involves an in-house physician.

I am a RN full-time 7AM-3:30PM shift in a rehab unit of a long-term care

facility for 14 months now. In the nurse station while I was

transcribing an order, I heard a familiar voice (with Indian accent)

and said in a strong tone of voice, "Hey you two, look at me!",

referring to me and a per-diem LPN who was transcribing orders into

the MAR. This lady doctor holding a patient's chart for us to see and

said, "When you see the physician order sheet is full, put a new

one in the chart!." A podiatrist standing in the other side of

nurse station was present and I noticed him with a blank stare

towards the in-house doctor. What bothers me is that I felt treated

like a child the way she addressed me and the LPN and not as

professionals. In addition, the POS is a piece of paper that is

available in the doctor's office where she's currently doing her

work. How hard is it to write the patient's name and put this paper

into the patient's binder? The unit manager of the rehab unit was in

his office which is next to the nurse station and heard about the

doctor's demand. After the incident and the doctor went back to the

office and shut the door, the Unit Manager came to us and said he

felt sorry for us and told us a story of similar situation with

another doctor. I wish this unit manager could have said something to

the doctor.

Nurses in this facility are hesitant to approach this doctor or even ask other nurses about the doctor's mood before approaching her with lab reports or to consult about a patient. Sometimes she puts a "Do Not Disturb" sign on the door of the doctor's office which is located in the rehab unit. Most of the times I receive calls from nurses in the long-term care units inquiring if this doctor is busy or what is her mood like.

I feel this incident and the doctor's attitude towards nurses need to be addressed. Should I talk to the doctor in private about the incident? Or should I bring instead this incident to the attention of the DON and/or Nurse Administrator? Your suggestion and opinion r/t this matter is

appreciated.

[KelRN215, BSN, RN]

Meh, it already happened, I wouldn't bring it up. If a doctor did something like that to me, I'd probably say "oh, the order sheets are right there in the filing cabinet, help yourself." Usually works well. Residents used to do this stuff all the time to us- can you get me a gauze? Can you make me a copy of this? Can you find this patient's nurse for me? No, but I will tell you where the gauze is, where the copy machine is and where to find our who the nurse assigned to this patient is and her phone number so you can call her. Then you can do all those things yourself.

[MunoRN, RN]

I wouldn't worry so much about the individual instances of her attitude as I would about the overall hostile environment she is creating. As you've mentioned, staff are hesitant to approach her with patient issues, which is simply dangerous. As a nurse there really aren't any fixable threats to patient safety and effectiveness of care that should be ignored. If your manager is aware of the problem is just sympathizes then you need a new manager.

[Anna Flaxis, BSN, RN]

I agree with both of the above. I might also add, have you tried going out of your way to be friendly toward her? Like greet her with a cheerful "Hello, Dr. X, how are you today?" when you see her, or if/when people bring treats to share with co-workers that she is also invited to partake? Or have you just been intimidated by her and just avoidant of interacting with her?

Not knowing any more detail that what you've provided, I can honestly say that sometimes the key to breaking the ice and winning someone like this over is to just be friendly to them and charm them and include them, so they feel like part of the team.

[Here.I.Stand, BSN, RN]

I wouldn't mention the incident since at this point it's water under the bridge. If it happens again though, in situations like this I've done similar to KelRN and advised the MD in question how she can solve her own problem.

Now the hostility issue--esp. the Do Not Disturb sign, I would bring up w/ the DON. Of course it may mean in the meantime that the RNs/LPNs need to stiffen their spines and advocate for the residents even if this MD is being nasty. Kind of like having to call a provider in the middle of the noc and s/he demands to know "why you're calling for THIS??" Well, it's because you're the provider on and my pt needs medical orders.

I hope it gets better soon! I know it's rough.

[Pangea Reunited, ASN, RN]

The doctor surely lacks tact, but is there someone responsible for stuffing charts who's not doing their job?

[LTCNS, LPN]

The doctor surely lacks tact, but is there someone responsible for stuffing charts who's not doing their job?

I was wondering the same thing. When I worked for a non-profit rehab/LTC, in addition to being MDS Coordinator, I also did Medical Records and it was my job to make sure there were blank order sheets and blank progress notes on the charts. I also did a 3 month contract Medical Records job for a Veteran's Home. It was drilled into my head that there were to be blank order sheets and blank progress notes on the charts at all times.

[vintage_RN, BSN, RN]

I would have looked up at her and said "the sheets are in your office, help yourself." I don't tolerate doctors taking a power trip on me.

[ausrnurse]

It drives me wild when doctors are incapable of doing their job without having the chart placed in their hands with the patient label already stuck on it.

[HouTx, BSN, MSN, EdD]

If you're working in a JC accredited facility, they MUST have a policy & procedure that addresses "disruptive physicians". If this is the case, follow that process.

Disruptive physicians are a very well-known patient safety/quality issue. A google search will bring up a ton of references for you. Your manager should be handling this situation, particularly since he witnessed the event. If this is not the case, you may need to escalate by using the chain of command.

[Ruby Vee, BSN]

The doctor surely lacks tact, but is there someone responsible for stuffing charts who's not doing their job?

That person would be the one who uses the last line on the page.

[RyanCarolinaBoy, ADN, BSN, MSN]

i'm pretty sure I would have smirked as I said "ummm yeah the sheets are in YOUR office"...

But thats just me...nope, that wouldn't have gone over at all.