Upset about being yelled at by MD (long)

Nurses General Nursing

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for the first time yesterday i was yelled at by a doc. i have been "waiting" for this day because i was really worried about how i would end up responding, but i am so proud of myself for not losing it. i am, however, so upset about the situation...

i had a pt being d/c'd to home, 88y/o, confused at times, difficult to communicate with. she was on bedrest for 1 wk, could not even turn on her own. when her daughter got to the unit i asked if pt had been ambulatory prior to hospitalization. yes, with a cane. i asked about her home/care...(stairs, does daughter have help, etc...). anyway, myself and pct get pt oob w/ walker to a chair. obviously very difficult for pt to even walk 2 feet. daughter looks nervous. :uhoh21: i ask if she thinks she would be able to care for her mom at home. no. tell daughter i can call md and ask for mom to transfered to snf for pt/ot. daughter wants that. well, md happens to be on the unit d/c'ing another of my pts. i go to md and barely start to explain situation...and she flips out!!

"why are you telling me this last minute when pt is supposed to be d/c'd?"

"you don't think the pt is appropriate for d/c...then hold d/c!"

"i came here in-between pts at my clinic to only see this other pt and you harass me...you have been harassing me all day...you called my office 4 times."

(me) "no, i did not, i called once." (her) "you called 4 times." (me) "no, i didn't, i called once." that went back and forth about 4 times. i had called her office once b/c the other pt was going to go ama and she called me 4 times to ask if pt was still there and to update me on when she would get to the unit.

anyway, she grabs my id and says she is going to write me up and blah, blah, blah. she leaves the unit, charge rn comes to ask me what happened and as i am telling her md starts coming down hallway again...yells at me to hold d/c, walks up to charge and yells at her to hold d/c and leaves again. now, case manager is telling me pt has to be d/c'd and i need to call and get order for transfer to snf as a rep is on the unit saying they can take pt today. also, for other pt, md wrote no rx after writing to continue new meds. charge rn pages md x2 with no return call. i call her office and receptionist says she is with pts, is it ok if other md calls me back...yes...please!! :yeah:

so, other md calls back, i explain about the pt and how deconditioned she is and that daughter (although for the last wk has been saying she wants mom home) states she cannot care for mom at home and she would like for her to go to rehab first. md (who is obviously not aware of what had happened) is happy daughter decided that and says, "of course, that is perfect."

fast forward 2 hrs..... "mean md" calls me to yell at me some more. :angryfire she is saying that she should have been aware long before d/c that pt is deconditioned (duh...you are the md) and that it is my responsibility as a nurse to make her aware...which i respond that i had only had this pt this 1 day and until i talked to daughter did not know her pre-hospital condition. she then says that pt has been ordered the first day pt arrived, and why had i not done my job and followed though on the orders. i flip through chart and tell her there is no order for pt for pt and again, if there had been i only had this pt this 1 day! she keeps telling me how wrong i was and keeps asking, "do you see why i am so upset?" to which i respond, "no, i do not. i am sorry you perceive this situation the way you do, however, i feel like i was a great advocate for my pt, was being proactive and i do not understand how you do not see that." she tells me what a nice doc she is and how i am the only nurse she has ever yelled at (this is where i realize not only is she a *itch, but a delusional one at that)and she is so upset at me for causing her to get so upset and how unprofessional i am..... i tell her i am done speaking about it, i know i did nothing wrong, if she has anything else, call my manager as she is already aware of the situation. to which she replies she absolutely will.

:angryfire:angryfire:angryfire i am just sooo annoyed/mad/disappointed. there are things i wish i would've said, but am so proud of myself for remaining calm and professional, as i have a tendancy to say what i think w/out thinking about what i'm saying!! :lol2: i know i did nothing wrong and only made sure my pt was safe. i feel really good about the outcome for the pt/family. i just do not understand why something so simple had to be such so stressful and upsetting. :o

thanks for "listening" :D

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Specializes in Education, Acute, Med/Surg, Tele, etc.

Oh man what a familiar tune! Been there too!

I have learned to be professional but to the point of things with MD's...takes time and thankfully I work with the same MD's and know them/they know me well enough I can frankly say...

Better now then when they go home and fall, or do you want to see this patient again with a pending lawsuit in your direction? I am doing this in the best interest of your patient and you which IS MY JOB. Can't help the time of this, I am just seeing this information. Please refrain from discussing this further till my official documentation and yours reaches the administration desk and mediated if this is the course this is going to go...".

AND then I would be writing things up, talking to my manager and administration, and doing everything in my hospitals rules to protect myself from something that was RIGHT in the first place!

Pain in the toosh...but I have only had to do this on one occassion that was very bad (Doc was out of his mind cussing over the fact this was disturbing his chances to leave early!)....

I actually have it contracted to not have to work with this doctor or his patients again!!!!!

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Specializes in Med-Surg.

I'm sorry you experienced this. It's tough when the doc gets in their God Complex states. Sounds like you handled it good. Expect for the argueing about how many times you called. I can picture in my mind too kids "No you did" "Yes I did"...Besides, even if you called 4 times, that's what she gets paid the big bucks for. Doc sounds like she was out of line. Way outta line

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Well, all I can say is whatever man. lol. That MD obviously has a little somethin somethin she doesn't like about you and certainly isn't able to take the stand for something she is equally responsible for: the patient.

There are so many doctors like that it seems. They look at us as "just nurses" but then they turn around and say that it's OUR responsibility for our care. Hello! YOU direct the care, NOT us!

I'm sorry to hear that you had to deal with that though. I'd just brush it off and hit work again with all you got. Don't let it bother you.

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Specializes in Med-Surg, , Home health, Education.

Sounds like you did a great job to me. If she had ordered P.T. for the patient on admission and she was doing so poorly with mobility it seems like the therapist should have passed this info on to a staff member or the doc prior to the day of discharge. I think the fact the doc was trying to get you to understand was probably because she realized she was wrong. You did the right thing by getting the Charge nurse involved. I've had my hind end chewed on so many times over the years that it should be microscopic but it's not! :) Blow it off- we all have bad days and maybe you'll get an apology....eventually.

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There was probably something else going bad in her life. I always tell new nurses when a Doctor is yelling at you just imagine that his wife probably just got through kicking him out of bed and telling him he wasn't doing it right so he's mad. It gives you a secret little chuckle and makes it not so upsetting for you. I always tell yelling Doctors that I am not going to allow them to talk to me that way and either walk away or hang up on them. But I've been a nurse for a long time and most of them won't yell at me anyway. They seem to like to pick on new nurses.

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Specializes in ICU, OR.
I'm sorry you experienced this. It's tough when the doc gets in their God Complex states. Sounds like you handled it good. Expect for the argueing about how many times you called. I can picture in my mind too kids "No you did" "Yes I did"...Besides, even if you called 4 times, that's what she gets paid the big bucks for. Doc sounds like she was out of line. Way outta line

Despite the delusional state this doc was in, you have every right to repeat the information until this thick skulled fool got the message. One would think that a candidate for medical school education would require at least average intelligence. It is in no way acceptable to allow someone to pin their own obvious shortcomings on anyone else. One must own their behaviors and shortcomings. As you may have guessed, making someone a scapegoat is a MAJOR pet peeve of mine.

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for the first time yesterday i was yelled at by a doc. i have been "waiting" for this day because i was really worried about how i would end up responding, but i am so proud of myself for not losing it. i am, however, so upset about the situation...

i had a pt being d/c'd to home, 88y/o, confused at times, difficult to communicate with. she was on bedrest for 1 wk, could not even turn on her own. when her daughter got to the unit i asked if pt had been ambulatory prior to hospitalization. yes, with a cane. i asked about her home/care...(stairs, does daughter have help, etc...). anyway, myself and pct get pt oob w/ walker to a chair. obviously very difficult for pt to even walk 2 feet. daughter looks nervous. :uhoh21: i ask if she thinks she would be able to care for her mom at home. no. tell daughter i can call md and ask for mom to transfered to snf for pt/ot. daughter wants that. well, md happens to be on the unit d/c'ing another of my pts. i go to md and barely start to explain situation...and she flips out!!

"why are you telling me this last minute when pt is supposed to be d/c'd?"

"you don't think the pt is appropriate for d/c...then hold d/c!"

"i came here in-between pts at my clinic to only see this other pt and you harass me...you have been harassing me all day...you called my office 4 times."

(me) "no, i did not, i called once." (her) "you called 4 times." (me) "no, i didn't, i called once." that went back and forth about 4 times. i had called her office once b/c the other pt was going to go ama and she called me 4 times to ask if pt was still there and to update me on when she would get to the unit.

anyway, she grabs my id and says she is going to write me up and blah, blah, blah. she leaves the unit, charge rn comes to ask me what happened and as i am telling her md starts coming down hallway again...yells at me to hold d/c, walks up to charge and yells at her to hold d/c and leaves again. now, case manager is telling me pt has to be d/c'd and i need to call and get order for transfer to snf as a rep is on the unit saying they can take pt today. also, for other pt, md wrote no rx after writing to continue new meds. charge rn pages md x2 with no return call. i call her office and receptionist says she is with pts, is it ok if other md calls me back...yes...please!! :yeah:

so, other md calls back, i explain about the pt and how deconditioned she is and that daughter (although for the last wk has been saying she wants mom home) states she cannot care for mom at home and she would like for her to go to rehab first. md (who is obviously not aware of what had happened) is happy daughter decided that and says, "of course, that is perfect."

fast forward 2 hrs..... "mean md" calls me to yell at me some more. :angryfire she is saying that she should have been aware long before d/c that pt is deconditioned (duh...you are the md) and that it is my responsibility as a nurse to make her aware...which i respond that i had only had this pt this 1 day and until i talked to daughter did not know her pre-hospital condition. she then says that pt has been ordered the first day pt arrived, and why had i not done my job and followed though on the orders. i flip through chart and tell her there is no order for pt for pt and again, if there had been i only had this pt this 1 day! she keeps telling me how wrong i was and keeps asking, "do you see why i am so upset?" to which i respond, "no, i do not. i am sorry you perceive this situation the way you do, however, i feel like i was a great advocate for my pt, was being proactive and i do not understand how you do not see that." she tells me what a nice doc she is and how i am the only nurse she has ever yelled at (this is where i realize not only is she a *itch, but a delusional one at that)and she is so upset at me for causing her to get so upset and how unprofessional i am..... i tell her i am done speaking about it, i know i did nothing wrong, if she has anything else, call my manager as she is already aware of the situation. to which she replies she absolutely will.

:angryfire:angryfire:angryfire i am just sooo annoyed/mad/disappointed. there are things i wish i would've said, but am so proud of myself for remaining calm and professional, as i have a tendancy to say what i think w/out thinking about what i'm saying!! :lol2: i know i did nothing wrong and only made sure my pt was safe. i feel really good about the outcome for the pt/family. i just do not understand why something so simple had to be such so stressful and upsetting. :o

thanks for "listening" :D

just wondering....when this patient was admitted, why was she not evaluated by pt/ot to start therapy at that time??? sorry about your experience, you were only doing your job and you handled it well.:nurse:

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deb, it sounds like you handled the situation quite well.

good job!

if someone yells at me, i interrupt them and quietly tell them i will talk with them when they're done yelling.

then i walk away, and update the boss.

sounds like this doctor has issues.

don't let her drag you down.

you showed her who the bigger person was.

leslie

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Specializes in Nurse Manager, Med-Surg, Instructor.

Did she (the doctor) actually grab your ID card? That's assault and battery in my opinion. I'd have called security stat. In addition, I would have told her that if she didn't calm down, I'd have to call the Medical Director to write orders for this patient because I would have to take care of the patient if she wouldn't. That would have stopped her immediately. Docs don't like to have to answer to the Medical Director. It's good that you called your nurse manager, too.

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Specializes in LTC, Med/Surg, Peds, ICU, Tele.

Deb, you did a fine job. Who knows what caused this person to fly off the handle like this. It sounds like she is having a personal meltdown that probably had nothing to do with you, but you just were in the wrong place at the wrong time. You were a good advocate for the patient!

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Specializes in Education, Acute, Med/Surg, Tele, etc.

Yeah, at the point of touching (IE grabbing your badge) I would have walked straight down to Nursing Administration after alerting my charge nurse that they need to cover me and a brief comment on why I am going IMMEDIATELY to the Administration office), and file a formal complaint and have proper interventions done immediately (like security and what not).

That is physical harrassment, and although I find it just as important as verbal...it seems to hold more weight when you come to dealing with administration! And yes, I will use the terms harrassment to goat them into action...because that is a federal and state law protection and needs immediate action!

No, no one touches me unless they have gotten permission in any sort of threatening way! I quit being a "nurse" when that occurs and become a human being defending myself against attack! The buck stops THERE! (and yes, I have actually proceeded with charges on patients who have intentially done physical harm to me!).

Deb, you did fine...sorry that it seems doing the right thing leads to feeling so frustrated...but keep up the good job!

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