Ever write up an attending for yelling?

[mskate]

So, I am not staff in this particular hospital and was just there helping out as extra staff when I had to call a physician with a change in patient status with correlating lab values - bad enough that I felt the patient was going to need to be intubated... and I got screamed at and hung up on - with no orders. Was actually told that this MD did not care what the values were, that he did not want to be called before 0800, despite the fact that he was indeed the MD on call for the patient.

After discussing it with the staff, they all agreed that this MD should not be called with anything before 0800 just because he does not like it, regardless of anything and then made decisions to not draw labs on other patients until after 0800 because they did not want to find out critical values that would need to be called in.

Well, I flipped out. I wrote a very detailed note and then decided to use that hospital's system for writing up doctors. I felt that this MD's response would put my license at risk if anything happened to the patient, if this MD later denied being notified at all, and it certainly put the patient at risk AND the other patients in the unit who were not getting their tests done for another 3 hours because people did not want to anger this doctor!

The nurses I was working with were equally horrified that I wrote up the MD for this... but #1 - screaming at people is never OK. #2 - intimidating nurses so that they are afraid as a whole unit to call with problems is also not ok! #3 - by backing down and not calling or doing tests, you are enabling this behavior! #4 - patient safety first, right?! and #5 - if the order is there to do the test, DO THE TEST! regardless of if they want to be bothered or not, its their job!!

I generally only work in teaching hospitals and have NEVER worked in an area where this was not only happening, but was widely accepted! I was beside myself with anger that I was yelled at for doing my job and that this patient was not being treated appropriately for no other reason than the physician did not want to be bothered. But the other nurses just tried to console me that I shouldn't feel badly for being yelled at. I certainly did not feel badly for getting yelled at - I was enraged that this happened in the first place!!

Anyone else have these types of experiences? What did you do?

[OCNRN63, RN]

More than once, but it was only in extreme cases.

[Kuryakyn]

I will never allow a physician to yell at me or anyone else in the vicinity. I have had better success with getting up in their faces and letting them know this isnt acceptable. Has happend to me once in 15yrs.

[OttawaRPN]

Oh what a treacherous road you're treading.... you said you're not staff, but you wrote up a Dr. who IS staff, over one unfortunate incident. In the eyes of management, it makes you look like the instigator.

If it's the fact that he yelled at you that's bothering you most, then you need to grow a thicker skin, my friend.

As for the CYA part, that's what documenting is for. "Dr. XX notifed at XX re: XX." You can't make a doctor DO anything, you can only do your part: relaying critical labs, which it appears you did.

I realize you meant well but... chances are nothing will change, and you will simply be blacklisted from this unit.

[casi, ASN, RN]

If you take a job where you are on-call you better expect to be woken up before 8am. Honestly if I got hung up on I would have called right back, "I'm sorry we must have got disconnected. So reguarding Jane Does labs, would you like to have her intubated?

[linearthinker, DNP, RN]

I've been in both big teaching and small community hospitals, and the cultures are very different. The worst behavior I saw was at a large renowned teaching hospital. A neurosurgeon punched a nurse in the face, she fell to the ground, bloody lip, the works. Over a dozen witnesses. She filed charges, was suspended whle it was under investigation, and he went about his business. And his business was bringing in millions in billables to the hospital. Guess who won that fight? He's still there, still abusing nursing staff; she got fired-allegedly for something else. but we all knew. Same place had a surgeon that got off on making nurses cry. He was heard to say to med students, PAs, etc "let me show you how to make a nurse cry, pick one you don't like the looks of." And he would, w/o fail. Anyone who complained was told they didn't have the chops to work in that unit and would be transferred out. At another teaching hospital I worked in, there was a cardiothoracic surgeon who is somewhat famous. NO ONE was permitted to speak to him unless he spoke to you first. Nor was anyone allowed to ride in the elevator with him. If he got on after you, you had to get off. Mustn't disturb the delicate genius. If it is this kind of environment you were in, no I wouldn't bother with the write-up, I just wouldn't work there.

If you are working in a more reasonable place and you think someone would actually listen, care and take appropriate action, then I might. Now I work in a small community hospital, and none of this kind of thing ever happens. Last night a doc hopped up out of my chair and apologized, AND made me coffee, lol. He called me sweetie once a few years ago, and I put a stop to that immediately, by asking him not to. Just a different environment.

The thing with "writing up" physicians is this: is it worth your time and the headache that is sure to follow if you are relatively certain the outcome isn't going to be in your favor? Me, I just prefer to forget those idiots and get on with my happy life and leave them to their obvious misery. I'm not inclined to spend my free time looking for grief. YMMV.

In the instance you described, I'd just ignore it unless a patients safety was actually and immediately compromised, in which case I'd go over his head to the chief of staff. And this I have done, a number of times. Believe me the chief is going to follow up on the unnecessary 3am phone call. Let those guys police themselves.

[General E. Speaking, RN, RN]

We have a cardiologist that is notorious for acting up when called. If the patient has a 18 beat run of V tach during the night and you call, he goes balistic. "Why are you calling me about this????" He won't even let you get a word in about your concerns, labs, s/s, etc... I swear he doesn't want to be called unless you are actively pumping on a chest (and then sometimes I even wonder about that). I still call and I have written him up several times.

The bottom line is: protect your license. Doctors like this are a liability and I do not know why hospital administrators put up with it. We are at the bedside to report patient changes. Unfortunately, you always have to think litigously. I always think " "What would a reasonable prudent nurse do?" I imagine myself in court being peppered with questions.

I find it sad that these doctors intimidate some nurses into NOT calling, therefore, putting their license at risk. "He yelled at me last time and told me not to call" will NOT hold up in court.

Protect your license- and call.

As far as the OP situation. I would have discussed with the manager of the deptartment and gone from there. Like the other poster said, let the Chief get a phone call.

[headinsandRN]

never had this to happen to me.

hope your actions make an impact that allows nurses to stop their involvement in this dr's less than wise demand to not be notified before he gets his beauty sleep.

[merlee]

This used to happen years ago, I had hoped that younger docs were raised better. Shame on them.

[Up2nogood RN, RN]

Our nurse manager would not allow this behavior from an MD.

[CrunchRN, ADN, RN]

Thank you! Your type of action is the only way to ever change things.

It is RIDICULOUS that the MD or any other staff member would get away with that inappropriate behavior.

The nurses that allow this to go on and affect patient care should be ashamed of themselves.

[PostOpPrincess, BSN, RN]

I would do exactly what you did.

And should he decide to pursue it, he can speak with my SIL, the lawyer.

Thank you very much.

J