Little Doctor, Holy Terror

[VickyRN, MSN, DNP, RN]

Most of our cardiologists are respectful/appreciative of the nursing staff, if not a pleasure to work with (we all have our favorites:) ).

[hogan4736, BSN, RN]

you don't work for him, you work for the hospital...give it right back to him

[bestblondRN]

Yep.....been there, dealt with characters like this before. You have a couple of avenues you can pursue. One would be to have your nurse manager facilitate a meeting between the staff and this physician. Rather than having it become a personal attack launched on him, try to present things from the standpoint of how his behavior negatively impacts your ability to care for patients. Try to solicit his input about how this issue can be solved, and come to a mutually agreeable plan. If you make him part of the solution, you can hold him to the agreements you came to while meeting with him. If that doesn't work, there is usually a section chief or staff chief that you could take your concerns to. I think the key is to convey how the behaviors he exhibits make it difficult to administer good care to his patients--most docs won't argue about that--they simply want their orders followed and for the patients to have good outcomes.

One other thing: if part of his frustration is the number of calls he receives while on call, perhaps you could ask him what things he feels are calls that could wait, or be consolidated with other calls. In a critical care area, there probably aren't many issues that can wait, but let him be the one to identify that as a problem.

Good luck!

[RNPD]

If you weren't posting from the "Sunny South" I'd say I know him too! Only he wasn't a cardiologist, but he was Italian!! (again, sorry Mario-but I'm Italian as well!). I think little Italian guys have this Napolean complex (or should I say Mussolini!!)

I work with a little doc now-not Italian, BTW. I have often hung up on him after saying-"When you can speak to me professionally, call me back and I'll tell you about your patient". He learned that I'll hang up each & every time his voice is raised, and so now it works every time!

[bestblondRN]

And another thing......(sorry to sound like Mary Lou Retton!), if you get no where with him after trying to work things out with him, definitely document his outbursts and take them to the Nurse Manager. You could also copy the Chief of Staff on the documentation. If they won't deal with it, then you just have to keep climbing--usually a threat to go to the State Medical Board will suffice. We just did this with one of our CV surgeons who didn't feel that he had to play by the same rules as everyone else, and who publicly demeaned a number of staff nurses as well as his own NP in front of other staff, patients, and visitors. The administration had already spoken with him on several occasions, with no improvement in his outbursts, so the staff wrote the State Medical Board and he was let go from our hospital.

Don't tolerate his abuse, but do try to work this out civilly first.

[mattsmom81]

Short man syndrome is alive in well in our doc population, ain't it??? hehehe... Some of these guys respond well to a 'Hey, get off my back willya?' comment. But they're all different and our facilities are too....talk to your peers and brainstorm...I can give suggestions but you guys know your facility's 'personality' and what will fly there.

Practice your delivery of your phone call and use the right medical buzz words to get his attention---if bully docs hear vague terms they use it against you. If he goes on a rant, redirect him "What are we going to do for our patient?" I HATE when they do this in ICU with a critical patient because they know we won't walk away from them....we know the pt needs a pacer or a swan or some intervention, that's why we called them in., right ......

If he's screaming on the phone, put him on speaker, get witnesses and write professional letters to management. The more who do this the better the results. Send copies to your medical staff director, chief of staff, risk manager. Explain thoroughly how patient care can suffer because of his bad behavior, ie nurses afraid to call him, scenes at the desk, effects on the staff, etc. Consider going from the angle of 'abuse', 'harassment', and 'hostile work environment' as these are buzzwords management understands. Again, the best results are seen if many people take part...try not to do this alone. Good luck! :)

Our jobs are bad enough as it is and then these jerky docss just give us one more headache..... Hang in there!

Oh and involve your manager or she may feel you're jumping rank....and you may have another ego to deal with...hehehe!

[mattsmom81]

Sorry, BestblondeRN, we were typin' at the same time and said a lot of the same things, didn't we?

You're so right..docs don't like 'unprofessional conduct' on their records with the state medical board!

[bestblondRN]

Mattsmom--

When all else fails, the state DOES seem to get their attention, doesn't it? Great minds think alike......

[hogan4736, BSN, RN]

Love the speakerphone idea!

[mattsmom81]

Yes, it may give a tantrum-throwing doc 'cause for pause' when they hear that little 'click' and figure us out...LOL! Love those speakerphones....turned up WAY loud...

Also have heard "Did you put me on speaker? How dare you!!! Take me off speaker this instant...pay attention to me...!"

Then we all have a group eye roll (along with any other docs, etc. listening)..I was lucky enough to have our CEO in the unit one time and I LOVED the look on his face when he heard our 'little man doc' carryin' on....also really embarassed the doc when a colleague or partner picks up the speaker phone after a rude outburst......

We're wicked sometimes but they MAKE us be that way...LOL!

[AnnaBanana]

Having been a nurse for 26 years... been there done that. One incident I remember involved a nephrologist who was known for his quick temper

and tyrannical manner towards nurses in general. The MD came in to make rounds on a step down unit,

I was in charge that weekend and the doctor proceeded to rant and rave, using profanity, he was in effect really "getting in my face so to speak". He was ranting about somnething that had happened on the previous shift, I was not there

and therefore had no control over what had happened. I attempted to calm him down so that we could discuss the issue in an appropiate manner he wouldn't let me get a word in edgewise. I finally stated to him Dr.________ when you are able to calm down and discuss this in a calm professional manner as two adults one to the other I will certainly continue discussion. I then turned around calmly walked out of the nurses station and proceeded to notify the shift director of what i had done. We are not here on this earth to be doctors whipping posts whenever they are having bad days or something is not to their satisfaction. Later on that same doctor came back and apologized to me in a round about way by saying that he was sorry he had yelled, but that he was on call that weekend for the group and was trying to cover 5 hospitals. I told him I expect to be treated in a professional manner which is nothing less that they would expect. Ever since then I have not had a problem with that physician

in fact he makes a point of speaking to me and is always professional in his manner. I feel that if you let the doctors know that you expect nothing less than to be treated in a professional manner they will respect you for that. Of course there are always a few exceptions !!! :)

[RN-PA, RN]

Applause, applause to bestblondeRN and mattsmom81 for your replies here. As someone who has too often been cowered by the attitudes and rude behavior of a few unprofessional doctors, I appreciate your excellent advice and am memorizing a few of your statements and strategies to use in the future.

I've never been good at assertiveness or confrontation, but am learning to care less about the doctors and more about the care my patients deserve. I recently wrote up a doctor for the first time and felt relief and empowerment from the fact that we *DO* have recourse to address this unacceptable and demeaning behavior. I'm also trying to stop saying, "I'm sorry to bother you" when I call and to speak in a strong, no-nonsense, but professional tone with the worst offenders.