Dr.s throwing their weight around...............

[LSRNgrad2008]

Well I know older Docs hate the idea that the days of a nurse standing up to salute them, making their coffee and lighting their cigarettes are over.......but......they are! How do you guys handle being disciplined by a Dr in front of a patient or other colleagues? Can they even do this.....or do you ask that they bring their concerns to your manager who holds the responsibility of disciplining you. Correcting someone tactfully and reprimanding them are two very different things. When you sense that you are being reprimanded by another coworker (Dr.s included in that, because they are peers whether they like it or not) how do you handle that? I can take a lot of crap from patients, or otherwise....but the bully mentality I don't deal well with at all.

Scenario: This Dr. (Infection Control Doc) is a nazi.....and I understand this is his job, he has been known to take the time to gown up, mask etc when called to a Code, he has even gone into an isolation room ungowned just to tell the people in the room that they should be gowned! (?????......er nothing like setting an example)

Anyway I had a pt on isolation precautions the other night and he desated into the high 70's so of course I ran into the room to sit him up quick and put his 02 back on. I didn't gown (good, bad, or indifferent decision....that's not the point) My point is that the Infection Control Doc from the pt doorway yells out you should be gowned gloved mask.....not only in front of my pt, but another nurse......I at this point was walking toward the doorway and said back (just as abruptly) he was in respiratory distress and I ran in here......he then repeated himself......I repeated myself back....I could see it escalating so I stopped walked away and washed up. End of story right? No, he later comes back and asks another nurse for my name.....funny, this guy doesn't know me from a whole in the wall, didn't assess the situation at all, but wants to file a complaint. Wants to file a complaint because I bruised his ego? Anyhoo, thoughts, opinions? I think it was inappropriate; not his concerns, but he should have taken me aside.

[barbyann]

Just reply......"Your not a people person are you?" and go about your business. I agree with the above poster....I answer to who signs my paycheck and the BON.

Be a duck and let the rain roll right off your back!

[meadow85]

He obviously takes his job seriously. I agree that people should get into the habit of gowning and gloving though for our own and for the pts safety. If my radiation pt was in distress I would need to wear on the lead apron. You could have possibly contaminated yourself (clothes, body) and go on to caring for other sick/vulnerable (immuno-compromised, children, elderly) pts and expose them as well. Pts can/do die from hospital acquired MRSA.

Either way I think the situation was blown out of proportion. Things got heated. You yelled, he yelled and it just escalated the whole situation. It could have been handled differently. Whats done is done. Let it go.

[platon20]

The reason docs are rude is because of residency and the mean-spirited nature of hospital-based training.

Residency really changes these guys. When you are cross covering 80 patients and expected to admit 10 people a night, then you are overwhelmed, stressed, and you react to situations differently. When nurses page you, instead of being polite and willing to help, you view it as a burden and just want everybody to leave you alone so you can finish your work. Calls by nurses, even if they are very appropriate/legit on a 36 hour shift

Its the same reason why OR nurses are generally more rude than floor nurses. Its because the OR is a very hectic environment and they are constantly getting yelled at by the surgeons. The OR nurses in turn take it out on the medical students, who in turn take it out on the OR nurses later when they are done with training.

You take "rude" OR nurses out of that environment and put them in a floor unit taking care of only 1-2 patients at a time, and the entire attitude changes. Its the work environment, stupid.

We need a change in institution. Nurses should only be taking care of a few patients at a time. Doctors should not be expected to cross cover 80 patients at a time, thats just ridiculous and way too much for one person to handle. Medical training has this built in sense of "you need to be tough enough to handle 36 hours of on-call" but its a crock of BS. Change the culture and you will see drastic improvement in doctor-nurse relationships.

[Ruby Vee, BSN]

maybe i'm just lucky, but i work with a great bunch of physicians who are friendly and interesting. in my youth, i dealt with a number of physicians who were nasty, rude and difficult to get along with -- but either times have changed or i have, because i rarely encounter anyone who behaves that way anymore. when i do, it's always a complete shock to me because nice physicians are so much the norm!

years ago, when i was working in the ccu of a western town, an anesthesiologist came around to do his pre-op assessment. the patient weighed close to 400 pounds -- a rarity in those days. the anesthesiologist (hereafter referred to as "ah" for reasons that are hopefully quite obvious) abruptly ordered me to "sit him up so i can listen to his lungs."

the patient was huge, comatose and had an iabp inserted into a femoral artery. not only was he not going upright under his own steam, but sitting up is pretty much contraindicated in someone with a huge freaking catheter in his femoral artery!

"i can't sit him up," i said. "but i'll help you roll him on his side so you can listen."

ah went ballistic! he got up into my face and started bellowing at me! i don't remember exactly what he said, but the gist of it was that i was stupid and hopelessly incompetent and that i had insulted his manhood, his years of education and his status as a physician by indicating that he should in any way do any of the manual labor involved in positioning this man so he could listen to his lungs. he finished up by screaming "you wouldn't ask dr. b (the medical director of our unit, who also had a reputation for being a gigantic, rude, pain in the nether regions at that time) to turn a patient, so why in he!! would you think you should ask me?"

it just so happens that dr. b was on our unit at the time, and had heard ah's entire tirade. before ah could even catch his breath to continue his loud and spontaneous assessment of my character, intelligence and work ethic, dr. b stepped into the room. "what do you need, ruby?" he asked. "i'll help you."

and so dr. b., the rude, obnoxious medical director of our unit helped me turn the patient so the loud, obnoxious anesthesiologist could listen to his lungs. i never again had any sort of negative interaction with either of them! dr. b. went out of his way to be nice and pleasant to me from that moment on, and i never saw ah again.

in the years since, i've learned to treat physicians as people. if i encounter someone who's rude and obnoxious, i'll make the effort to find out if they're just having a bad day, or if they're always that way. if they're having a bad day, i cut them some slack. i have bad days, too. if they're always rude and obnoxious, i set them straight as pleasantly as possible. but i rarely encounter the second type these days. i wish everyone were so lucky!

[ShifraPuah]

I find it perplexing that behavior that would elicit a private chat w/your supervisor is tolerated in pts and just smiled at terms of doctors.

MDs who are reading this: Treat us w/respect. Period. If we don't know something that you think we need to know, TELL US!! We cannot read your mind.

We are also not responsible if pts get worse in the night or the middle of your date or whatever, but since you're the pt's doctor, yes, we DO have to bother you whenever we have to. We don't have a choice in the matter, see? If we don't call you, the pt could die and not only would we be answerable to the BON, we also could lose our jobs (not to mention our conscience would be on us, day and night).

If we disagree w/you, we are thinking of two things: the pt and our license. You can go to h*** screaming and yelling but we WILL NEVER compromise on those two ever.

I didn't go into nursing to save your sorry a$$. I went into nursing for my fellow human beings, and there are many days when you, the MD, only meet that by the broadest definition.

[chenoaspirit, ASN, RN]

I had a doc once look at me and say "MOVE!". I was standing in the hallway around the cart of which a nurse was administering flu shots to us staff members. I was not in his way. I thought he was joking and kinda laughed and moved to the side more. Little did I know that he was NOT joking. I wish I had that moment to do over. I dont know how I would have handled it, but I can guarantee he would have regretted being so rude to me...with no reason for it. Some docs are stressed and dont mean to be rude, but most of them have an ego that makes them feel they have the right to treat us that way because they "know more than we do" and we are less educated than they are. I dont like working with doctors like that because it causes stress on me when it shouldnt. I dread taking care of their patients. I truely enjoy working with doctors who value me as I value them and are able to work as a team. After all it does take both a doctor AND a nurse to care for these patients. How stressed would they be if there were NO nurses to care for these patients and they had to do the dressing changes and NG placement, etc, THEMSELVES. They should be glad we are there to work WITH them, not UNDER them.