How does one become assertive in the nursing field?

anurseuk · Apr 22, 2008

It's a real shame you feel like this; most of the docs on my unit I'm more than hapy to talk to and they generally speak to us the way we speak to them. Scratching each others backs so to speak.

Have you thought about working in a different area prehaps? In accident and emergency, theatre and critical care you find you have more one to one conversations with the docs so may make you feel more comfortable talking to them?

At the end of the day I think to myself, they are only human like us and we each have different experiences etc and thoughts to offer. And also we (as nurses) outnumber them!!! :specs:

Hope this gets better for you, let us know how you get on :specs:

RNperdiem, RN · Apr 22, 2008

Become a parent. You will become a master of assertiveness for your own survival and sanity. When phrases like "what part of 'no' do you not understand" become part of you vocabulary, assertiveness gets easier.

I do understand some of you difficulties dealing with doctors. I have learned to think a little about exactly why I am calling and what I need to say before making the call. I have also become a fan of text paging for important but nonurgent concerns.

Wendy_RN · Apr 22, 2008

It is difficult, but don't let the physicians know they intimidate you. They may be a "doctor", but they are absolutely no better than you are. I have been fortunate in not dealing with many physicians that acted in the manner. I had one physician that insisted I did not know what I was talking about when I told him my patient was going into flash pulmonary edema. He laughed and made a comment to another doc at the nurses station. I pulled Lasix from the pixis and told him to follow me. When he got back to the nurses station he had a different attitude. He told the other doc that I knew what I was talking about. He treated me with respect after that. I don't know what makes them think we are idiots sometimes. I don't care to diagnose patients, but I expect the doctors to listen to me when I tell them there is a problem. Just take a deep breath and stand up for yourself and your patients. You are their advocate so don't feel a bit bad about doing it.

YellowFinchFan · Apr 22, 2008

I have been a RN for 4 years now. You would think by now I would be comfortable with speaking with physicians. But I am not. I hate speaking to physicians because they are so disrespectful. They talk to nurses like we are scum. It bothers me so much that I get nervous before I call them and most of the time I don't say everything that I intended on saying. I have thought about leaving nursing over this issue. Can anyone offer any advice?

I feel for you .... I actually woke up this morning thinking about a rude nasty 'burnt out' MD who was his usual rude self this wknd - I dislike him intensely and he treats most of patients and families horribly .... I told him his patient had some issues - he gave me is usual rude "SO????"

I walked away from him - I did my job, documented it-a few minutes later he came up to me trying to make small talk - I have had it with him and his ilk. They (the rude ones) make our jobs worse and they get no respect from me if they treat me this way. Many nurses feel this way on my unit....its a busy critical care area - and most of the doctors are decent and professional.

Try talking to other nurses who seem to handle the nasty ones - pick up some tips from them.... I also agree with the other poster who suggested maybe a change in areas...not all doctors are jerks.:typing:twocents:

crb613, BSN, RN · Apr 22, 2008

I have been a RN for 4 years now. You would think by now I would be comfortable with speaking with physicians. But I am not. I hate speaking to physicians because they are so disrespectful. They talk to nurses like we are scum. It bothers me so much that I get nervous before I call them and most of the time I don't say everything that I intended on saying. I have thought about leaving nursing over this issue. Can anyone offer any advice?

This is something that just burns me up! :angryfire I am sorry you are having to deal with jerks. This is just an example to help you.......

I know it might be hard but decide what is acceptable for you.....state the reason for your call (write it down if that helps) when & if they start what is unacceptable to you......stop them right there ( EXCUSE ME! Dr so & so.....I am calling you about your pt, not because I was bored & thought now what doctor can I call!.... Do not ever speak to me like this again. Now do you wish to continue as professionals? If they continue unacceptable behavior....hang up!)

Stick to your guns! So what if they get mad....better them than me. I would also relay what took place to my charge. Good Luck

BlueRidgeHomeRN · Apr 22, 2008

i sympathize with your discomfort, but to some extent we teach people how to treat us by what we allow them to say and do. i have always found a few well placed "excuse me, doctor, what did you just say?" to be effective. :nmbrn:

i also agree that you should write down your concerns before you call, and be direct aobut your the problem and what you'd like to see done next. don't apologize for calling--if they wanted to sleep all night, they should have become dermatologists or cpa's.:hehe:

SDS_RN, RN · Apr 22, 2008

I hear you. :banghead: I have a similar problem. I let them treat me like crap and don't stand up for myself. If I deserved the chewing that's fine but if I'm doing my job then back off.

Just yesterday I had an order that totally looked like something other than diet/preop meds so I called to get a diet order, had the board nurse ask b/c he was scrubbing in so I got the order. Then the sarcastic jerk comes over after his case to see this pt and says to me "HMM D/C IV, HMMM Diet & pre-op meds. Since you wrote the order again now I don't have room to fit the D/C order in." :madface:There was a whole new page of physician orders that was blank that he could have wrote on but he managed to find a place to put it on the FULL page of orders.

What did I do? :confused:I like a beaten down dog apologized told him I was unable to read the order and let him make me feel like an ass because I called to clarify an order that I could not read. :no:

It's really disgusting to me that we have to kiss their you know what just so they can kick us around because we are just nurses and we don't know anything. This doc is like this w/ all nurses and it just makes me mad. Even if you were to stand up to him he would not change his behavior. I'm just hoping he will retire in the very near future.

spider11 · Apr 22, 2008

There's only one Dr. on our unit that is really horrible. I think it's a cultural difference. He is foreign and that's how women are treated where he is from. The few male nurses we have don't have ANY issue with him, but God forbid a woman nurse call him. He treats us all like idiots. I usually just ignore his nastiness. lol Everyone knows he's an a** anyway.

I do have to agree with the poster who said that once you become a parent that some of the uneasiness goes away. I have 3 kids, 2 with chronic medical/school issues. I have NO problem being assertive anymore. Be confident..you are the advocate for your patient. :)

imanedrn · Apr 22, 2008

I have 2 completely different pieces of advice: (1) find a co-worker who does this well and ask for their assistance, or (2) JUST DO IT!

This was VERY difficult for me when I precepted during my last semester of school. My preceptor would force me to do it though -- in a kind-hearted way, though -- basically option #2. She reminded me that they weren't vampires (though some may seem like it!), so what's to be afraid of?

Now that I'm an RN, this is actually the one thing that bothers me the least which is completely bass ackwards because I take almost EVERYTHING personally! I think I just realized that there's nothing they can do to hurt me. (I'm sure that my preceptor pushing me helped a LOT!) I don't work WITH them so much as I take (& evaluate) orders from them. If they're jerks, mean, rude, whatever, I just shrug it off. "Ok, Dr. so-and-so. Thank you!" I find that being EXTRA nice when they're EXTRA mean is the best! They always seem a little dismayed when they realize I'm not shaking in my shoes!

Assertiveness is something I've been working on for years. I have severe anxiety issues. When medication doesn't/can't help, I just force myself to get over that hump. I realize that's easier said than done, but - once I've actually gotten over the hump - I feel so great about myself!

Whatever you do, good luck!

gr8rnpjt, RN · Apr 22, 2008

Remember that doctors are just people like us. they go home and deal with family and home issues and they go to the bathroom just like us.

Picture them in their jammies. :bugeyes:

GizmosMom · Apr 22, 2008

Picture them in their jammies.

I was just going to suggest the old advice of picturing them in their underwear :yeah: I've worked with/for lawyers most of my (previous) career and lawyers = doctors in this situation and the old underwear thing worked for me.