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?
I just walk away or hang up until the doctor can speak to me with respect. I do not put up with it. Those nurses should be ashamed of themselves for allowing their patients to be compromised because they're too gutless to stand up to him.
I agree that the OP did the right thing by documenting this problem. It may not be dealt with at all but at least it's a record of what's going on. I would probably do an incident report as well because of the potential risk for patient harm.
Specializes in Med/Surg, Neuro, ICU, travel RN, Psych.
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.
It only takes one or two to get the ball rolling sometimes though. Who's to say that he hadn't been wrote up before, that she or the nurses she was working with didn't know?
You just become part of the problem if you just sit back and complain, yet do nothing to try and fix it. If what you do has no effect, then atleast you tried. But you never know until you do. To do nothing, because you are sure it will be ignored though...
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.
What you read is that he yelled, hung up, refused to give orders for a critical patient. Meanwhile, the other nurses, intimidated by his diva behavior refused to get labs for fear of having to call again. So writing him up is wrong, why?
Specializes in acute care med/surg, LTC, orthopedics.
What you read is that he yelled, hung up, refused to give orders for a critical patient. Meanwhile, the other nurses, intimidated by his diva behavior refused to get labs for fear of having to call again. So writing him up is wrong, why?
Not wrong, futile. The OP is not staff at the hospital and wants to write up a staff md over ONE incident. How seriously do you think management will take this complaint, if the choice is b/t an "asset" md and a "liability" nurse?
If she's prepared to not be allowed to return to this facility again, then sure... other than time and energy, there's nothing to lose. But I sure as heck wouldn't hold my breath waiting for a congratulatory phone call.
Oh, my dear fellow nurse. I have just been in that kind of situation. See my post, should I stay or should I go?
It is truely a no- win situation. Writing up a doctor will NEVER have a good outcome. I have worked in MANY different hospitals, as a traveler and agency.
The hospital will ALWAYS protect the physician. They generate income for facilities, they view nurses wages as negative income for their bottom line.
I had to leave THAT environment, as I did not have the autonomy or physician support to provide safe patient care.
Yell at me, I dont care, just give me the orders that I need legally, to save my patient.
Specializes in ICU of all kinds, CVICU, Cath Lab, ER..
The female intensivist I wrote up for unprofessional behaviour was basically forced to apologize in front of the members in the "meeting" held to investigate the write up. She continues to hold a grudge and I believe she is at the background of a concerted effort to remove me from my work.
My direct supervisor was terminated recently; her "cohort" told my friend that they had been working for two years to cure me of my "habit of sleeping on the job".....I never slept on duty and they know it; I challenged these two poor excuses for managers to prove their charges...ultimately the termination of my boss came after NO records of any write ups or verbal warnings were found in her computer.
So now the hospital knows who the liar is...meanwhile, I am out of a job. The other supervisor had enough pull to get herself moved into a supervisory position in administration.....she continues to tell her lies ....I am sure when things are checked, it will come out that I only had two meetings with her in two years; both meetings were to demonstrate that I knew how to complete the QA and fulfill the needed certification.
It will take tme but at some point this scurilous physician will be charged with her vindictive attempt to heap enough crap on me to bury me. I am a survivor and would I do it again = YOU BET!!
Not wrong, futile. The OP is not staff at the hospital and wants to write up a staff md over ONE incident. How seriously do you think management will take this complaint, if the choice is b/t an "asset" md and a "liability" nurse?
If she's prepared to not be allowed to return to this facility again, then sure... other than time and energy, there's nothing to lose. But I sure as heck wouldn't hold my breath waiting for a congratulatory phone call.
Sure, nothing may happen. But that's not necessarily the point. It is the 'ONE incidences' that get people killed, that get people fired, that end up in the news. Staff position or not, I don't think that just standing aside and allowing unsafe behavior to go unrecognized is responsible or prudent.
Yep, in a one-horse hospital in the middle of Podunk-Junction- 35 miles from anywhere. I thought I wanted a small, intimate facillity where I could learn to work within a team. What I found out is that in smaller centers, there is a greater potential for the medical staff to rule the floor like little Napoleons. Nurses don't count, doctors bring in the patients. When you only have one or two docs admitting to any one area- it is much easier to replace the nurse than offend the doctor. I wish it could have worked out the way I hoped, but I left and have worked for a different hospital for many years. Yes, here too I have been abused by over aggressive medical staff. The difference is the behavior isn't accepted here, and the doc not only is going to spend a few hours of his precious time explaining his behavior, he(or she) is cutting his political throat for advancement in the institution. If the hospital accepts that behavior I'm afraid you are faced with two choices: bend over and take it or get out. If the people that can insist on different behavior are not willing to back you I wouldn't want to put my licence on the line to satisfy the moods of a physician-demi-god. You can bet if that patient had crashed and burned you would have taken the fall. "Doctor so-and-so dosen't like to be called too earily in the morning" dosen't cut much slack with most BONs.
See, my experience is the opposite. In large research centers powerful physicians have gotten away with murder. In little podunk places, they are held to stricter standards and nurses have more support in advocating for themselves. The assault I described earlier took place in about 1990, at a top research institution associated with an ivy league med school. The administration actively participated in a a cover up to prevent the victim nurse from getting any traction with criminal or civil sanctions. He got away with it, she lost her job. Writting up docs for being turdwinkles in such an environment would be pointless, not to mention self-defeating. In other words, I wouldn't recommend picking a fight you know from the outset you cannot win. And even if you "win," what do you get?
In the end, it is my responsibility to keep my patient safe. If I felt labs needed to be called at 3am, and the doc in question was a turdwinkle who didn't want 3am calls and abused me for trying, I'd just bypass him and call his chief. I wouldn't put myself through the angst of a) either engaging the dolt in the first place, or b) proceeding with a write-up that is only going to cause additional grief.
Specializes in Hospice, ONC, Tele, Med Surg, Endo/Output.
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.
Ottowa is absolutely right. You aren't even staff. You've been a nurse for 8 years -- you should know better. No wonder why the staff there were so shocked. There's no way this Doc is going to modify his behavior for you. Next time ask the staff what their opinions are before you write up an MD. Unfortunately, due to this the facility probably has already decided you are a loose cannon and won't want you there as much as before this incident. You cannot beat a doctor, even if you feel justified. The MD is a customer and you are not.
I've written up MDs before, for inappropriate behavior, inappropriate care etc. The difference is-I was a regular staff member at that hospital.
Sounds like the nurses on that unit need to "man up" and stop this behavior. You as an agency nurse aren't going to affect the change that needs to take place. CYA in your charting and go on with life.
to save my patient.
Scrubby
1,313 Posts
I just walk away or hang up until the doctor can speak to me with respect. I do not put up with it. Those nurses should be ashamed of themselves for allowing their patients to be compromised because they're too gutless to stand up to him.
I agree that the OP did the right thing by documenting this problem. It may not be dealt with at all but at least it's a record of what's going on. I would probably do an incident report as well because of the potential risk for patient harm.