How to handle rude doctor

Rnfortuna · Feb 24, 2016

Thank you all for taking time out of your busy day to reply/advice. I took my concern to my manager. It's been addressed. There is a plan to add bowel regimen to the Hospitalist's post op order set; even though the surgeon orders the narcs.

canigraduate · Feb 24, 2016

Having worked post-op, I see the surgeon's point of view. He could have handled it better, though. Being civil takes far less energy than does taking offense.

Once the surgery is done and a hospitalist is consulted, the surgeon is done with his part and just follows the patient's surgical status. Medication management is up to the hospitalist. It usually says so right in the consult orders. Now, hospitalists won't change the surgeon's pain med orders, but they will order just about everything else you ask for.

Also, for a previous poster, PCAs and PCEAs are the province of anesthesiology until you have an order that says different. It's anesthesiology who starts them, who is called if there is a problem, and who is called for renewal. It is very rare to get a surgeon that manages PCEAs. Some will manage their PCAs, but I've never seen a surgeon who will touch an epidural order other than to D/C it. The surgeon is responsible for transition med orders.

Now that you know who does what, it will keep you from getting yelled at as much.

Be sure the surgeon is actually being inappropriate before you go and tattle. If someone is angry, raised voices are a given. If they call you names or talk down to you, that's inappropriate.

The best thing to do is tell a surgeon you don't know why they're mad. They'll educate you. They may get a little snarky about it, but you'll know what you did wrong, or if you did anything wrong. Sometimes you'll even get an apology.

I'm not an apologist for docs by any means, but I've seen too many nurses expect docs to be saints, then get an unpleasant surprise when they turn out to have emotions like the rest of us.

danielle2000, MSN, RN · Feb 25, 2016

I had a doctor yell at me on the phone because I was clarifying an order HE wrote. He said to me, "Why are you calling me? Why don't you call the pharmacist? I threw it back at his rude ass and said, WHO WROTE THE ORDER? His rude ass lowered his bass in his voice and talked to me like he had some sense. Never accept rude behavior from anyone.

nurseletDZ · Feb 25, 2016

I took my concern to my manager. It's been addressed. There is a plan to add bowel regimen to the Hospitalist's post op order set; even though the surgeon orders the narcs.

Good work! Even if the surgeon in question is gonna be a d*** at least you resolved the actual patient care issue. Way to take initiative. :)

LessValuableNinja · Feb 26, 2016

"Let's take a moment to understand our roles. I'm here to help achieve good patient outcomes. Would you like me to help with that?" I may be a novice at nursing, but after many years of management and study, I have my Boyscout "dealing with jerks" patch

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

Here.I.Stand, BSN, RN · Feb 26, 2016

" I can understand he doesn't want to deal it"?

I took that to mean that RNperdiem understands OPs frustration at being forced into a middle man position between two treating teams.

npnurse09 · Feb 27, 2016

As a new nurse I used to take the verbal abuse,I watched nurses cry,call in sick etc from rude physicians. Until I realized I am a valuable part of the team and abuse was not in my job description. So depending on how bad the tantrum was determined how I would respond. We had one that liked to throw charts, I would leave the Nursing station and go check my patients, if it was directed at me I asked to speak to the physician in private an tell him how I felt about their actions. And that I would not be tolerating the abuse.

I would always have a nurse I trusted within hearing for a witness, then report it to my supervisor. Eventually I gained their respect and they would find another patsy. Until it became looked down upon by their colleagues for them to act that way and it stopped. Stand tall be assertive but professional, and earn their respect. They actually respect the nurses that stand their ground.

I wish you the best!!

neenrn · Feb 28, 2016

I usually ask if they need a time out.... Like a 3 yr old

NurseCocoBSN, BSN · Feb 28, 2016

I'm a meds surg/surgical step down nurse myself--and at 2 years definitely still consider myself a novice in the field. Im sure I can say that I'm good at my job, and you would have to take me at face value, but I do believe I'm an amazing nurse. As I gain more experience I believe I'm going to be one of the best.

I work in a teaching hospital (with one of the best surgical programs around for new doctors) with a high nurse turnover rate (we're 100% nursing care in a for profit who makes our jobs hell). So, by default, at 2 years in, I'm about #15 in seniority in a staff of 64 nurses. I'm a novice senior nurse which is weird as ****. But I definitely know I have so much to learn.

All that said, surgeons can be a total nightmare. I'm prefacing this with that small story for a reason. It's actually insane. Now, add to that interns and residents who seriously believe they are better than everyone else because evidently surgeons are born with their god complex instead of actually just gaining it over time with experience (which would be a way easier pill to swallow). I've just taken 2 new jobs-one in a surgeon step down at a specialty cancer hospital (one of the best in the US) and a full time job in long term care for the VA (which is not what o want, but I needed to get in and as a disabled vet I believe I should be working with that population). So now that I'm leaving my job, I've lost all ability to maintain tact with surgical residents. This particular new class is horrifically awful, and it takes a screaming match to even get them to go see a patient. I've spotted MANY huge problems early that haven't been addressed until way late because some intern thinks a nurse with 2 years is some bottom feeder who doesn't know what she's talking about. Mind you I spend a quarter of my shift TEACHING these kids how to do their job. When they should be ordering things. Showing them how their orders don't make sense and how to fix that. What subtleties to look for in patients on the service they work that month. I've caught serious medical issues that could have killed patients. They still think they can treat me with little respect.

So all of that....it all depends on how long you're going to be at that job. There are ways of showing these docs how to do the right thing while still being sweet. Then there's me, who's loved by my management and coworkers, who's basically adopted a scorched earth policy when it comes to surgeons. They're going to do the right thing even if that means I'm personally calling attendings and letting them know their interns are hell bent on killing patients. Sure, I have a bunch interns who hate me....but I have a lot of nurses who respect me and a ton of patients who love me. Remember who you're there for. It's not to placate some surgeon who thinks they're never wrong. It's to take care of our patients who deserve the very best care we can provide.