Hi. I'm a brand new RN working nights on a telemetry med-surg unit. Just started off on my own. I know there are a handful of topics on this particular subject. But I just wanted to share a particular experience I had last night calling a doctor regarding a patient, and wanted to hear how some of you would've handled this. If there is anything I need to work on, it is my assertive skills.
So I called the doctor. And it went like this...
Me: Hi Dr _____. This is ____ from _____. I'm calling in regards to a patient, _____ from room ______ who came in w/ _______. Are you familiar with him??
Dr: If you ask me that question again, I will beat your head!!! Are you stupid? Didn't you see my name on the board!? Don't you dare ask me that. Just get straight to the #^#/ point.
Of course, I apologized. Then continued and so forth, just trying to get to the point while he still rambled on. I suppose it was a dumb question. I mean, I'm still figuring all the things in the hospital and Doctor names, who is on call/who covers who, who is private - just still figuring how everything works and so forth. But still, I felt that was just a bit overboard. Yes he is a private doctor; and maybe it was a dumb thing I asked (I always ask "are you familiar with this patient" with every greeting to determine the familiarity and how much background history to provide - maybe I shouldn't ask that).
Well, at least I got orders... and I got to finally make the patient comfortable (he was ETOH withdrawal) I know that some angry or irritated doctors will just hang up or say whatever and leave you like "Huh?"
I don't know. Afterward, and even still now, I feel kind of bad. Even feel intimidated if I have to to speak to him again. I asked some of my coworkers their opinion, and apparently they weren't too surprised and told me he usually bickers about petty things such as so. What do you guys think? How do you handle angry or rude doctors or coworkers? Any advice to someone too soft like me. Thanks :)
This made me so mad to read that I started an account so I could reply. I am an ICU RN and have been for about 10 years. I precept nurses, train new grads, and am relief charge. What you did was exactly what I would have done however if I would have gotten a reply like that I would have reminded the Dr. that I am caring for "our" patient and doing what you are supposed to do as a patient advocate. So what if you asked if he was familiar with that patient what inconvenience did that cause him. All he had to do is simply say yes and leave it at that. You are a professional and he is supposed to be too. That response was completely unacceptable and if it had been me I would have written a Confidential Occurrence Report. He needs to treat the nurses with the respect they deserve. I work nights to and he knew getting into being a Dr. he was going to get called in the middle of the night and he should expect it. If you were constantly calling with questions that could wait until the AM that would be different but this sounds like it was completely appropriate. If he treats you and other nurses that way your guys's management needs to have a talk with him. Our hospital required one of our Dr.s to go to anger management, now he is one of my favorite Dr.s it really changed him. If you can't call a Dr. regarding your patient in the middle of the night without getting threatened, because he did verbally threaten you, then how can you appropriately take care of that patient. It is unacceptable for him to say things like he is going to beat your head in even if you knew it was said in anger and he would never really do that. Dr.s do not have the right to treat nurses like crap.
I am an NP now, so have been on both sides of the phone! (Worked nights for years as RN and now take call as NP) Your approach sounds professional and appropriate. The only piece of advise I could offer, which I don't even believe would have helped in this instance, is just be as prepared as possible when calling MD/PA/NP. Have most recent VS, med list, allergies, hx, labs in front of you when pick up phone. This will make encounter as quick and painless as possible on both ends..and if you can answer any questions asked will increase your confidence. Doctors will come to respect you if you are a prepared caller.
Try also to not take it so personally. Even despite my best efforts..I can be occasionally irritable on phone..if I have been woken up several times. Patients always come first.
If you try to consolidate calls with peers as well that is always appreciated. Can't always work out that way..but easier to be patient with one or two calls than 3 or 4. :) Good luck...:)
While I agree this doc is over the top, and something needs to be done about it, I disagree with telling this new nurse to report his "I'll beat your head" comment. I'm sure he'll deny it, and that could make for an uncomfortable situation for the new nurse. I'd suggest that, whenever she has to call this doc again, she asks another nurse, unit manager, supervisor, etc. to listen in on the call with her. Reporting his threats and inappropriate responses, with a witness, is more likely to get the right attention. As far as calling docs, in general, I think it would also be wise to make a point of knowing whether or not you're calling the doc that is the patients attending, a covering or on call doc, and skip the question "are you familiar with this patient?" Have your pertinent facts ready, i.e. the reason for the call, v/s, allergies, current meds and effectiveness, etc. Even docs who are familiar can't remember everything about every single patient.
While I agree this doc is over the top, and something needs to be done about it, I disagree with telling this new nurse to report his "I'll beat your head" comment. I'm sure he'll deny it, and that could make for an uncomfortable situation for the new nurse. I'd suggest that, whenever she has to call this doc again, she asks another nurse, unit manager, supervisor, etc. to listen in on the call with her. Reporting his threats and inappropriate responses, with a witness, is more likely to get the right attention. As far as calling docs, in general, I think it would also be wise to make a point of knowing whether or not you're calling the doc that is the patients attending, a covering or on call doc, and skip the question "are you familiar with this patient?" Have your pertinent facts ready, i.e. the reason for the call, v/s, allergies, current meds and effectiveness, etc. Even docs who are familiar can't remember everything about every single patient.
No way should she skip the threat when she reports it. That is probably what is going to get her complaint taken seriously! I would document the conversation in its entirety including quotes from what he said and the tone of voice he used.
I agree with having the pertinent facts ready when calling the doctor but that still does not excuse his behavior if she didn't have an answer to his question that very second. I always make sure that I am calling the right doctor but sometimes it is not clear who is actually covering if there are multiple doctors assigned and sometimes the specialist should be called instead of the primary, but all of these things will very greatly depending on the patients needs and the facility.
Here is what I do with angry, belligerent doctors. When they pause their tirade long enough to take a breath, I very politely state, "Dr. when you calmed down enough to speak to me in a civil tone of voice and as one professional to another, please feel free to call me back at 212-555-1212", and then I very calmly hang up the phone.
It usually takes about 5 minutes for them to call back and apologize, because by doing that, they can't turn you in without looking like the complete ass that they are, and you have very effectively let them know that you will not be treated like a second class citizen who can be belittled for doing your job.
I would absolutely report the physician. He had no right to talk to you the way he did. You handled yourself professionally. The only thing I would do different is have all pertinent information that you may need to give the physician, especially if you're calling in the middle of the night.
I was a charge nurse at the largest nursing home in my state. I was often the only nurse responsible for 52 patients with four CNAs and one Med Aide. I rarely spent any time at the nurse's station. As soon as I made the call to the answering service, I made sure the chart was open to current labs, had the med list, VS, and SBAR. That way when I had to run down the hall to answer the phone I was prepared.
Also before calling the physician, make sure you have done all you can for that patient so that when you get the doc on the phone they aren't saying things like "did you try this...or this" Another tip is make a recommendation to the doctor, or tell the doctor what you want. That way you are better prepared. Also talk with your fellow nurses. When I was a new nurse, I found talking to the other nurses before making a phone call, I was able resolve issues without having to wake up a doctor in the middle of the night.
You do not have to take this abuse. Just remember you are the voice of the patient and their care always comes first. You don't need a physician with a God-complex making you scared to make a call in the middle of the night.
I am an ER nurse and once was asked if I ever took an assertiveness course, I asked if I needed one. " No" was the answer; my point is that there should be no problem letting this so called professional know that you will not tolerate being threatened and that you meant ...... Then go on to explain what you originally for. *** I would always inform the night supervisor. *** I have also asked a doc basically the same thing and got yelled at but I just laughed and said of course you do and what I meant was..... Doctors are just people and should get the respect that earn.
First of all, 99% of the doctors have got so much pride in themselves. Asking the Dr whether he is familiar with his own patient is a huge blow to his ego. Questions like this will only make the Dr more defensive and angry. You should've never phrased ur sentence in this way. Anyways, now u know. When it comes to patients' urgent safety and health issue, I always call the Dr, even if it is 3 o clock in the morning. I don't care if he is grumpy or sleepy. But I make it very short and sweet and straight to the point, like, "Hello Dr__, this is calling from__ from__ regarding your patient__ from room__. He is having blah blah blah and blah blah blah." And that's it. I wait for the Dr to make up his mind and tell me what he wanna do for the patient. If the Dr is still in his sleepy head, I would then say, "Is there any orders I can carry out for u?". And that keeps me from the yellings and naggings from all these nasty Drs all this while
I don't agree with this in regards to the affront to their egos by asking whether they are familiar with their patient. Many times doctors are not, they are on call, not the primary as the Patient's doc doesn't have privileges, the patient hasn't seen the doctor for years, etc, etc. It's a legitimate, important question that instantly ascertains whether the doctor needs more or less information from you - helps you help him as a matter of fact. He had no call to talk to you like that. He was totally wrong. I've said that many times myself and if that had happened to me I would've said - excuse me? Please don't talk to me like that. I expect you to be professional and I will as well.
My my personal opinion is that doctors get mad because they can't bill for individual phone calls (unless that's changed - they don't where I work now at least.) Regardless, it comes with the territory and they should not take it out on us. What we have to say matters. Mistakes can easily be made because of miscommunication.
I will say it's a good idea to be prepared ahead of time for what a doc might ask - something as simple as a look at their labs, vital signs - helps out and reduces impatient doc responses. But wouldn't have helped in this case. Hang in there - we've all been there. Hugs
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Wow. That doctor was Rude and Inappropriate. I would have reported him. He demeaned and threatened to do you harm. You may not think it does any good, but the more nurses continue to report the jerk, the more the Dr. realizes the nurses aren't going to tolerate that way of being spoken to. The only thing you did wrong was apologize to that rude behavior. He doesn't deserve it, but you stayed professional throughout the entire conversation.
There are better ways to handle rude and inappropriate interactions that reporting him. I don't think he literally threatened harm, but was expressing frustration.
The best way to handle rude behavior is to not tolerate. Your demeanor, body language, tone of voice and general manner show people how to treat you. It's hard to put that all together in a confident package when you're new and NOT confident. Apologizing -- even when you don't mean it and the other person is being a jerk -- is "social grease." It mollifies them, and allows them to stop their rant and get down to business.
Everyone's time is valuable. When you call a doctor, get straight to the point. "I'm sorry to bother you, doctor. This is Ruby in the CCU and Mr. CHF has (list issues that prompted the call) and I'm wondering if you'd like to (list interventions that Crusty Old Bat nurse has suggest might be elicited by the phone call). Even if they don't like your suggestions, it at least gets them started thinking and informs them that you can think too. If they're rude and obnoxious, say "I'll call you back in a few moments when you've had a chance to calm down." Then hang up. And call back. Or ask the charge nurse to call back and take notes on how she handles it.
If you don't tolerate inappropriate behavior, you'll notice that you stop GETTING inappropriate behavior.
You did EXACTLY what you should have done. You were professional and informative. I frequently ask the same question. You should file an incident report and meet with someone in HR. Don't just tell your manager who may also be bullied by the same physician. Don't just let it go. Start now, early in your career standing up for what is right. There is nothing wrong with expecting a safe, bully-free environment where you are not harassed. DO NOT be intimidated by his unprofessional behavior. Next time he tries something like that, just make sure you have witnesses and tell him calmly and professionally that when he communicates with you he needs to do so in a professional manner.
I am so sorry you had to endure this. You sound very kind hearted in your post and I'm sure you are such a sweet bedside nurse. Keep your head up. You did the right thing. Just don't allow that behavior to continue.
As a new nurse, taking to doctors can be intimidating. The best advice I have is to keep your call short and to the point. I probably would have said, "hi dr xyz, this is nurse xyz, calling about the patient in room xyz, named xyz. The patient seems to be experiencing etoh withdrawal, would you like to order xyz." If the doctor is unaware of the patient, he or she will ask you additional questions. Drs seen to like when we make a suggestion... the way this doctor responded to you, regardless of how you phrased your questions, was completely inappropriate. I had a similar situation happen to me. Immediately after, I emailed our CMO and also my unit manager. I also filled an incident report so this would be on the drs permanent record. This kind of conduct will only be addressed if you speak out.
It's not your fault at all- no need to even apologize. In fact, I would see if there is a system at your hospital where you can report this doctor for his inappropriate behavior and threats towards you. You should NEVER have to apologize for being an advocate for your patient!
Unfortunately things like this continue to happen and you will quickly learn which doctors are notorious for this behavior. Despite them being rude, don't ever let that get in the way of you calling them in the middle of the night for something that your patient needs. Patient care comes first
Kelli2u
2 Posts
This made me so mad to read that I started an account so I could reply. I am an ICU RN and have been for about 10 years. I precept nurses, train new grads, and am relief charge. What you did was exactly what I would have done however if I would have gotten a reply like that I would have reminded the Dr. that I am caring for "our" patient and doing what you are supposed to do as a patient advocate. So what if you asked if he was familiar with that patient what inconvenience did that cause him. All he had to do is simply say yes and leave it at that. You are a professional and he is supposed to be too. That response was completely unacceptable and if it had been me I would have written a Confidential Occurrence Report. He needs to treat the nurses with the respect they deserve. I work nights to and he knew getting into being a Dr. he was going to get called in the middle of the night and he should expect it. If you were constantly calling with questions that could wait until the AM that would be different but this sounds like it was completely appropriate. If he treats you and other nurses that way your guys's management needs to have a talk with him. Our hospital required one of our Dr.s to go to anger management, now he is one of my favorite Dr.s it really changed him. If you can't call a Dr. regarding your patient in the middle of the night without getting threatened, because he did verbally threaten you, then how can you appropriately take care of that patient. It is unacceptable for him to say things like he is going to beat your head in even if you knew it was said in anger and he would never really do that. Dr.s do not have the right to treat nurses like crap.