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?
Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.
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.
so you're resigning to the fact that the unit won't change because of one person? nah. i can't participate. i'll do exactly what op did, and not return. i can't compromise my integrity, let alone my license.
how can those nurses sleep at night knowing their patients are compromised? i can't. karma will get us in the end. i truly believe that. i'd much rather be blacklisted than know that someone was getting sicker on my watch.
Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.
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.
i have never worked where that would be tolerated, but then i have to say that i believe my self-worth is up there and know legal would have a fit should that have occurred.
i've written up neuro/cardiothoracic surgeons. and should i have been punched by that doctor, he would've been paying my mortgage, college bills, etc., forever.
sorry. abuse is not in my lingo and it shouldn't be in anyone else's either--this is just so that whoever reads it and agrees that their environment is "sucky" and they put up with abuse. i sure as heck hope people don't deal with this kind of crap anymore.
and my current environment is awesome too--very collegial...
It is unfortunate that this behavior continues to be tolerated,but i dont think much will ever be done in these situations because docs generate income and nurses are an expense for the hospital.
I worked at a community hospital over a decade ago with a very emotionally labile surgeon. He would do surgeries late into the night (mn/2am) and get very angry if a nurse called about a change of condition. He would make a point of coming in the early am to complain to the manager about these nurses/calls and got more than a few fired. Once he had a sixteen year old die less than twelve hours after surgery, nurses had called at least three times during the shift without orders, nothing happened.
You know the reason that a complaint was filed against him with the medical board finally?? He made the error of trying to bully another surgeon (like the nurses) over a surgical suite. He went so far as to intentionally contaminate the sterile field to keep this surgeon from using the suite that he thought he was entitled to.
Ever wonder if being mentally unstable is a prerequisite to being a surgeon?? Or is it their brilliance that drives them mad?
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.
That's very unfortunate. If she pursued legal action (assault/battery) against the physician and received no satisfaction, then it is probably time for extra-legal action to have been taken against the assaulter. In other words, have a friend or two explain the situation (up close & personal) to the physician. Unofficially, of course. It's always good to have friends in "low" places.
I think you did the right thing. Too often MD's get away with yelling and intimidation and it's not OK. I complained to my manager once when a neurosurgeon (one who was known you don't call, don't cross) yelled at me for giggling. He apologized after my boss got ahold of him.
There are usually ways around them too- every hospital should have a Patient Safety Officer, incident reporting system and a Rapid Response Team. I'd use them all if some butthead MD wasn't participating in the care of his/her own patient.
Specializes in acute care med/surg, LTC, orthopedics.
so you're resigning to the fact that the unit won't change because of one person? nah. i can't participate. i'll do exactly what op did, and not return. i can't compromise my integrity, let alone my license.
how can those nurses sleep at night knowing their patients are compromised? i can't. karma will get us in the end. i truly believe that. i'd much rather be blacklisted than know that someone was getting sicker on my watch.
can't do it.
i'm not convinced that one outsider can change things, guaranteed it will go ignored. if i read it correctly, she got yelled at once, on one shift. maybe he was having a bad day? i'm not excusing him, but any write up that includes hearsay such as "the others nurses say he yells all the time" is hardly persuasive enough to motivate management to take action.
now if the group of staff nurses banded together, maybe. there's safety in numbers. but from what i understand from my american colleagues, nurses can get fired for anything, unlike nurses in my country whose unions protect them from most idiocies, couple that with your poor economy....and yeah.. i suppose if you're willing to risk losing your home, not having enough food to feed the kiddos and potentially living off welfare, then sure, stir the pot for the sake of integrity and justice, but just make sure you understand the consequences when there's no going back. that's all.
Always... always, always, always, no matter what the situation is, start a paper trail. Start the paperwork and keep it coming. Document everything you say and do, regarding everybody you talk to. Make copies of everything you generate and keep them safe. Hospital administrators hate paper trails, and lawyers love them.
it totally repulses me, that these dr's are supported, enabled, and feared.
i mean, it.sickens.me.
this has absolutely nothing to do with "thicker skin", ego, pride, or anything personal.
when we see a pt circling the drain (enough so, to be possibly vented?), of course we should be seeking further orders!!
to back down, put all testing on hold, only serves to: 1. put the pts at critical risk and 2. encourages further breach of duty from those idiots on call.
op, i totally support and applaud you.
your priorities are in the right place.
sadly, doing the right thing, often serves to bite you in your pants.
but at least you can keep your head high, sleep at noc, and know you did everything humanly possible to protect your pts.
I have written a doctor up for yelling at me loud enough that patients complained about hearing it. He did go to administration and he was told to apologize to me but he didn't. He has been nice ever since however.
It is unfortunate that this behavior continues to be tolerated,but i dont think much will ever be done in these situations because docs generate income and nurses are an expense for the hospital.
I worked at a community hospital over a decade ago with a very emotionally labile surgeon. He would do surgeries late into the night (mn/2am) and get very angry if a nurse called about a change of condition. He would make a point of coming in the early am to complain to the manager about these nurses/calls and got more than a few fired. Once he had a sixteen year old die less than twelve hours after surgery, nurses had called at least three times during the shift without orders, nothing happened.
You know the reason that a complaint was filed against him with the medical board finally?? He made the error of trying to bully another surgeon (like the nurses) over a surgical suite. He went so far as to intentionally contaminate the sterile field to keep this surgeon from using the suite that he thought he was entitled to.
Ever wonder if being mentally unstable is a prerequisite to being a surgeon?? Or is it their brilliance that drives them mad?
I have often wondered what percentage of surgeons have narcissistic disorder...
ITA. I thank goodness I'm in a union and my facility doesn't treat nurses like garbage.
That's very unfortunate. If she pursued legal action (assault/battery) against the physician and received no satisfaction, then it is probably time for extra-legal action to have been taken against the assaulter. In other words, have a friend or two explain the situation (up close & personal) to the physician. Unofficially, of course. It's always good to have friends in "low" places.
Specializes in Trauma Surgery, Nursing Management.
Oh my Lord...YES! I have written up a few docs in my time. I have also been used as target practice by a surgeon who was throwing off the end of the light cord/camera during an arthroscopic procedure. I told him the first time he did it that he better not do it again. (Nervous laughter from the staff in the room, including his resident.) The second time I was with him, he did it again (I am sure to test me). I stopped what I was doing without hooking up the equipment and went to pick up the phone to call the director of the department. The offending surgeon said, "What are you DOING? We are starting a CASE here!!!" I just casually told him that I was calling his director to tell him what happened. He begged me to hang up the phone, apologized profusely and got really red in the face. I said to him, "Dude, you think I am kidding about this? You may have been beat up too much as a child and now that you are in a position of power, you want to see what it's like to deliver instead of receive, but I am NOT going to let you do that to me. It makes you look weak." I can't tell you how embarrassed he was.
As far as yelling...hmm...sometimes I feel that they are just venting, and seriously if someone is not paying attention and the surgeon yells at a staff member because they are doing something that will compromise the patient, I think they are justified. If a doc is just being a jackwagon and simply doesn't want to be bothered, I write them up in a skinny minute.
We all have a job to do, and that is to first and foremost take care of the patient. The egos need to be left at the door. Sometimes I will "remind" a doc that his ego is in the room and I ask if someone needs to write a d/c order for it!
PostOpPrincess, BSN, RN
2,211 Posts
so you're resigning to the fact that the unit won't change because of one person? nah. i can't participate. i'll do exactly what op did, and not return. i can't compromise my integrity, let alone my license.
how can those nurses sleep at night knowing their patients are compromised? i can't. karma will get us in the end. i truly believe that. i'd much rather be blacklisted than know that someone was getting sicker on my watch.
can't do it.
j