How to handle rude doctor

Here.I.Stand, BSN, RN · Feb 22, 2016

"I'm going to step away for a moment so you can collect yourself."

thenightnurse456 · Feb 22, 2016

It's the surgeon God complex. If you have genuine assessment questions that regard patient care and he yells/intimidates you- escalate it. Fill out a report. Go to your manager.

allnurses Guide · Feb 22, 2016

If he is the one ordering narcotics, it is absolutely his problem; if the hospitalist wrote the med orders, he is the appropriate one to ask for it. Some docs are just jerks, and others bend over backwards to make patients comfortable.

You didn't say what order didn't get followed, sometimes not getting the right follow up undoes all the surgery so I can see being upset about a serious breach. Best thing is to stay calm yourself, don't try to explain or justify, go with "I wasn't here then, but what can I do today to get it fixed?"

RNperdiem, RN · Feb 22, 2016

I understand the frustration of having different doctors ordering different things and getting caught in the middle.

I also make a distinction between a doctor being a little short or snappish and keeping to the topic of patient care and one going off the rails and making personal insults. I shrug off the first one and have never had to deal with the second.

~PedsRN~, BSN, RN · Feb 22, 2016

I would have absolutely replied to that with you're the one that ordered the narcs....

We have fancy "care plans" essentially, that now put everything that should be ordered in a nifty little package for the docs. It has definitely made life easier. Less chasing them around for orders (although some of them get click happy.... do we really need that daily weight on the healthy kid with a femur we just nailed back together? Not going to be very accurate with his new hardware... lol....

I had a surgeon get pissy with me once because I needed an order for a PCEA pump to be continued. It has expired and had to be renewed. When I called him about it, he told me off and said ALL QUESTIONS REGARDING PCEAs ARE TO BE DIRECTED TO ANESTHESIA. Umm, what? I very politely told him that this was his patient and he had ordered this particular pain medication for in the first place, so all I really needed from him was a verbal order to CONTINUE it or new orders for other pain meds. Why is anesthesia going to come fix your orders on your patient? It's not like this guy was going numb up to his eyeballs. I just needed the order renewed. A mere CLICK of the button.

Make me CRAZY!

You remember the chapter on Assertiveness we all sat through in Nursing School? It's for real. You don't have to be rude, but don't stand for their rudeness either. I can't stand that. We do not work for doctors, we work WITH doctors. Some of them needed to be reminded of that sometimes.

mmc51264, BSN, MSN, RN · Feb 22, 2016

that's part of the order set for ortho pts: narcotics = bowel regimen. Karma usually takes care of most if it. When the pt is not allowed in a rehab facility because they have not had a bowel movement and you have documented that you/pt documented a request for bowel regimen, and they have to stay at the hospital until they have one-doc will figure it out.

I work weekends and most of our ortho pts that are waiting until Mon for placement, need to have a BM on the weekend. I call it Sh** storm Sundays because starting Sat morning, we usually have to get aggressive with bowel meds. Most pts are on Senakot and Miralax as a protocol, but we add dulcolax and a supp if need be.

I used to work in a rehab unit and have been on the receiving end of a pt that has not had a BM in 4-5 days. Disimpaction is not fun for nurse or pt and it is considered a sentinel event in a SNF

TheCommuter, BSN, RN · Feb 23, 2016

I think it's important to remember that we cannot control anyone's behavior, nor are we responsible for how people act.

However, we have total control over our reactions to 'difficult' people, and the most professional reaction involves assertiveness. In other words, maintain your composure, do not allow people to rent your valuable head space, and never let them see you sweat. Good luck to you.

Horseshoe, BSN, RN · Feb 23, 2016

"Okay, I'm documenting that you are refusing to address a known side effect of the medication you have ordered."

Lol.

Been there,done that, ASN, RN · Feb 23, 2016

" I can understand he doesn't want to deal it"? The surgeon HAS to deal with it. The patient is not just about the procedure. how many of the surgeon's patients develop post-op ileus?

God the surgeon , and hospital protocols ...should have bowel management protocols.

That is your first battle, get the protocol instituted.

As far as dealing with the surgeon, look them straight in the eye" I am advocating for my patient, what are your orders for this issue?" This is about the patient, not the nurse.

Been there,done that, ASN, RN · Feb 23, 2016

"Okay, I'm documenting that you are refusing to address a known side effect of the medication you have ordered."
Lol.

No LOL here. Patients DIE from post-op ileus.

Horseshoe, BSN, RN · Feb 24, 2016

No LOL here. Patients DIE from post-op ileus.

My LOL was actually for the image the doc bursting a blood vessel and mentally cursing my soul to hell WHILE giving in and begrudgingly writing my order.

I've had post op narcotic related issues, and I totally believe you and recognize what an important issue it is.