How do you handle "the unhappy MD"?

[Sunflowers]

My first experience with an "unhappy MD" made me feel worthless. From that moment on I decided to adopt my own "plan of attack"

Case: I call the MD for orders at 3am. Instead, I receive "!@#$$%^&***()&^%#$@"

My response: Calmly repeating the objective data and requesting orders.

MD Response: !@#$%^&*()(*&^%$#@!

My response: Calmly repating the objective data and requesting orders.

MD response: Orders given, !@#$%^&*())*(*^%$#@#!

Case closed, my patient has been advocated for. Outcome +

How do you handle MD's that are mad, rude, grumpy, or whatever?

[fab4fan]

Yes, I've noticed that is seems like you get barked at less in the ED. I usually do one of the following:

1. "Excuse me, I didn't hear you...what did you say?" (Never had anyone repeat himself.)

2. Bark back

3. Some variation of, "I will be happy to talk to you when you can behave professionally."

I have no patience for this kind of behavior; do they perhaps teach docs in med school that they can use nurses as their personal punching bags?

[RN always, BSN, RN]

Originally posted by yannadey

I usually start off charming them "oh I'm so sorry to wake you at 2am doc but as you know its the policy " then i tell him/her what i need & suggest (if its a recurring problem e.g. injuries r/t falls) to make it a standing order they usually agree.

although I agree with starting out by saying "oh I'm so sorry to wake you" or "I'm so sorry to bother you" or whatever, we learned in school to never start out by saying that. The rational is that we are doing our jobs and it is THEIR job too so we shouldnt have to apologize for calling them, even if it is the middle of the night. When they decided to become a doctor they knew they would be getting calls at midnight so what do they expect? Or even calls during the day, they are the docs. They are the ones that need to be called. Oh I get so frustruated with this subject. I just don't understand why docs have to be like that.

[deespoohbear]

Originally posted by RN always

although I agree with starting out by saying "oh I'm so sorry to wake you" or "I'm so sorry to bother you" or whatever, we learned in school to never start out by saying that. The rational is that we are doing our jobs and it is THEIR job too so we shouldnt have to apologize for calling them, even if it is the middle of the night. When they decided to become a doctor they knew they would be getting calls at midnight so what do they expect? Or even calls during the day, they are the docs. They are the ones that need to be called. Oh I get so frustruated with this subject. I just don't understand why docs have to be like that.

Ditto! I refuse to apologize for calling a physician unless I called in error. (Had wrong doc paged or some such thing...that don't go over too well either ). Otherwise, I just say "Dr. So & So, this is Becky from the hospital. I am calling about"...and depending on what the pt needs/wants tell the doc what I need. Most of the time our docs are pretty decent but we are a small facility and know our docs pretty well. I will not tolerate rude behavior from anyone...fellow co-worker, doctor, patient, and visitor. I am a human being and demand to be treated like one. I will be nice to the docs but if they reply with an attitude Ms. Sweetness turns into Ms. Hell-On-Wheels.

[fab4fan]

Yeppers...we were taught the same thing: Don't apologize--you are doing your job, the doc is doing his job.

Depending on the doc, I'm not at all sorry to wake him up at 0300!

[liberalrn]

I agree with the 1st post, but I will admit that I jump to, "This is the problem and I need orders." fairly quickly with some docs. And then I shut up. Usually they just start reeling them off. I once had a doc tell me (in ICU) that he was taking his Dad to church for Father's day and he was not to be paged for the 2 hours the service lasted (he was on call). I waited for him to finish and said, "I'll just document that, and let the chief of staff know, so that ICU has coverage for Sunday morning." He cancelled the order........ some docs I am friends with and have known for forever and so I'll joke a bit with them--but they are not the ones that are swearing etc.!

[Nurse Ratched, RN]

I like to start with something like, "Wouldn't dream of calling you at this hour except I knew you'd want to be aware that (Mrs. Patient's BP is 210/130, O2 sats are 70%, whatever) She's our x-year-old patient admitted Tuesday for (brief rundown just in case this doc has no clue who Mrs. Patient is.) We've already (whatever interventions have been tried) with no luck. I'm sure open for suggestions :)."

It acknowledges the suckiness of having to call him/her at that hour (and I know they're being paid a lot of money and they knew what they were getting into in med school, but they're human and any human deserves a little courtesy at that hour :).) Also gives them a second to wake up. And I always thank them, again out of common courtesy.

[nursesrthebest]

ROTFL :roll

[joyflnoyz, LPN]

Oh Gosh...I just got this hilarious vision of nurses actually barking (woof, arf, yip) into the phone at the docs LOL

[Anaclaire]

I like Nurse Ratched's post very much.

Without apologizing for calling in the middle of the night, she allows them a moment to wake up as she concisely describes the situation, interventions made, and asks for the doctor's input in a way which lets him/her know the ball is appropriately placed in their court.

From my experience, doctors generally are not into chit-chat or up to playing the question-and-answer game at 3am. Being concise and having your ducks in a row before making the phone call (and having an idea in your mind of what you want/expect the doctor's orders to be) goes a long way for a positive outcome for a middle of the night phone call.

I agree that although these physicians know they will be called at all hours when they chose to be doctors is true, however they are still humans. The physicians I would call at night were mainly OB-GYNs and Pediatricians who were on-call for their group of physicians... doctors who spent their days seeing patients all day in an office or doing scheduled surgeries and then after making evening rounds, had a short evening with their family while fielding questions from their answering service from patients, and often coming to the hospital to attend deliveries or admit patients. I was not the only one calling the doctor at 3am because they were getting calls from other nurses at other hospitals, in other departments at our hospital, and from patients. When one of us needed to call doctor so-and-so we'd check with all the other nurses before calling so we could each speak with him/her all in one phone call. Our doctors seemed to appreciated that.

With all this said, there were always a couple who would be grumpy no matter what you did. I remember one who would sounded like she was sleeping through the phone call every time... we knew to tell her what we wanted and she'd say "ok" and then you'd hear the phone rocking in the cradle as she tried to hang it up in the dark. Hilarious and scary at the same time...

I've never had a doctor curse at me. Once had one who liked to make smart a$$ comments which I ignored completely. I have always thought if anyone cursed or screamed at me I'd firmly, and with conviction, reply, "My own parents never spoke to me that way and I'll be darned if you're going to do it right now." Thankfully I've never had to see how that one would go over.

[Stargazer]

I liked Ratched's post too. It costs me nothing to say "Sorry to have to wake you" before swinging into my schpiel, it gives the doc a moment to collect his/her thoughts, and it starts the conversation off on a pleasant note. I do it as a courtesy, not as a groveling, abject apology.

[altomga, ADN, BSN, MSN, DNP, RN, APRN]

I would have to agree with every post here. The doctors have a job to do and so do we. Like we really want to call the MD; that just means that are A$$es are busy trying to stabalize a pt one way or another. I work at a large teaching facility so I have to interact with many different interns, residents, consulted docs, private physicians, etc. Luckily I've been here so long that the privates and second year and up residents know me and also know that if I CALL I NEED SOMETHING. With the newbies, they get one or two chances to show me what "type" of doc they are, the god complex or the we are all here for the pt attitude. The god complex ones get three fold the amount of calls. "oh Mr. soand so has gas, oh, MR soandso had a increase in his hr by 10 beats; just wanted you to know, and so on" you get the picture. They learn to treat me with respect b/c I can make their life a living hell!:) (which I don't mind doing HE HE HE)

All in all, with the docs I know well, I give them the benefit of the doubt when they are grumpy....I mean we ALL have rotten days here and there>>>

Just remember....KILL them with kindness........If that doesn't work, report them to the medical director or their supervisor.

We can write docs up don't forget.

[LaVorneRN]

I agree with Scoob(RNAlways-hey sister!) I wouldn't apologize because it would only start a trend and ruin it for everyone else. It's not what you say but how you say it and depends on who you're talking to. I know some docs who are pleasant no matter what time, issue, patient problem. Those I wouldn't mind apologizing to cause...well...you know...you just like em. But the other buttmunchers would get the 411 and that's usually what they want. For you to get to the point. It IS crucial to have all your info together before calling.