I felt belittled by a Dr.

martymoose, BSN, RN · May 23, 2014

Very simple- he has to blame SOMEONE , and you were the lucky one today. Noc person isnt there. So You're IT.

It really sucks. It's a no win situation. I've been made IT many times. Seriously, I had this DR the other day INSIST that his orders were in the EMR. They were not, and I even had my charge nd a PA look through to make sure I wasn't blind or something. It was as if he was sayin the sky is brown, when we all know its blue.

These guys don't want to hear ANY excuse you might have, such as you changing pts, etc.

I don't feel belittled by the doc, as much as p'd off .

I also got to hear an earful from a doc once on the phone just because I picked up- it wasn't even my patient. He was in a general rant.

These guys know they can do this. They like the power. And they know if they wanted to pursue things further , they could.

We are, after all, a dime a dozen.

martymoose, BSN, RN · May 23, 2014

Btw , who ordered the ativan anyway?

Makes you just want to put it over the PA system and say Dr SO and SO Ordered the darn ATIVAN!!!!

:)

Anna Flaxis, BSN, RN · May 23, 2014

Tag, you're it!

It'll be someone else's turn tomorrow.

Edited to add, I've been there. Read on:

https://allnurses.com/emergency-nursing/when-hospitalists-attack-897793.html

jadelpn, LPN, EMT-B · May 23, 2014

Do not internalize or personalize this. That the MD is not familiar with the orders that he or a colleuge wrote is not you issue either. That "what kind of report did you get" is rude and inappropriate--but apparently no one including him got an ideal report.

Going forward you could only say: "This patient has Ativan ordered PRN for agitation. Assessment after the dose was such that the Ativan worked well for this patient. If this is not something you would like for your patient, please discontinue the order, however, please consider a PRN medication for agitation." (and I would also ask for a geri psych consult, if he wants a urine to check for a UTI, temps q4 to make sure this patient is not becoming feverish and delusional).

I would focus on your professionalism as opposed to his lack of same. Bring the conversation back on task--meaning non-defensively state what you need (patient is combative. Please give something PRN for agitation if ativan is not an option) what you suggest (check for other causes of agitation) and leave it at that. If the MD declines to give something, then I would have a low threshold for phoning said MD when patient gets out of control as to what interventions the MD wants. (interestingly, the "Ativan is bad for the elderly" tune changes when in fact the out of control patient acts out at 2am).

And use your resources. Your charge RN should be party to this conversation, so that he/she can direct the care nurses going forward as to how to manage this patient's behavior.

Here's the thing--someone had to order the Ativan--and if this MD took over care for this patient, then it is up to the MD to decide what he/she wants and doesn't want going forward.

martymoose, BSN, RN · May 23, 2014

Just move on knowing some drs are pompous donkey behinds , and not take it personally.

I will say though, MD i dealt with won't even let you explain. He usually ( if on phone) just hangs up on you anyway mid sentence.

gcupid · May 23, 2014

What type of report are you getting? me..." If there's something that I don't know, I usually go to the chart or learn from my own assessment. I haven't had the time to do neither, I just walked by the room to see if the patient was still breathing. In ICU they get two patients, I have ______."

Why is he on Ativan? me..."The night nurse said that the patient was combative towards staff so the on call doctor ordered ativan for agitation. Would you like to discontinue the order?"

After him lecturing me 5min.."Thanks for that info. I will keep that in mind when caring for elderly patients but there's not a staff nurse on this floor today or ever in the past that has had prescriptive authority."

yoga pants · May 23, 2014

Uhh I didn't realize that the purpose of nurse-to-nurse handoff was to make the oncoming nurse an expert on the pt. I don't know about you, but even if I receive what I consider to be a "good" report, I still don't know a lot about the pt, and I'm probably not able to answer a bunch of random questions from the doc. I've had the provider stop by and ask questions right after receiving report, and none of them have berated me for saying, "I just received report and have not had a chance to look over the chart or assess the pt, but if you give me a minute I'll look in the chart and see if I can find out for you," if I wasn't able to answer one of their questions. Our docs are pretty gracious about it.

You definitely didn't do anything wrong! His behavior was inappropriate. The only thing you can do about his lack of professionalism is to maintain YOUR OWN professionalism. The way people treat you is a reflection of them and not you. I wouldn't have felt belittled, I would have been p'd off! Don't let things like that get to you. You aren't stupid, he's a d-bag.

Been there,done that, ASN, RN · May 23, 2014

Don't let anyone make you a punching bag.

Apparently " God", (also know as the surgeon) was consulted on the patient.

God wanted to evaluate the patient and he was too lethargic to do so.

God needed to be cut off from the lecture with" Speak to the doctor that ORDERED the Ativan... this is a doctor issue"

Practice in front of a mirror until your get it down.

It gets easier, I promise.

Esme12, ASN, BSN, RN · May 23, 2014

((HUGS))

All of the answers here. He wanted to vent on someone...today it was you. What kind of report did you get? I got a report that the patient is confused and combative...I haven't looked at the chart lets look at it together so we can both learn about the patient. Who ordered the Ativan? A physician so I would discuss the appropriateness of the order with them...nurses don't have prescriptive authority. Why was it given? From what I understand they have a nasty right hook and was throwing punches.

Don't let them know they are under your skin...some physicians like to know they dominate. I never give them that satisfaction.

suanna · May 23, 2014

I've pointed to my ID badge and shared with a number of doctors that I do not have a medical license and am not capable of ordering Ativan- please take it up with the ordering physician. Feel free to come in and take the kicks and punches the next time the patient goes off the deep end. Ativan isn't ideal, but what drug is when a patient in endangering staff and himself? Haldol? Seroquel?- Since he is the expert he should order whichever PRN he would prefer. The patient is alive and not beating the stuffing out of the staff. Sounds like the immediate problem was handled- now what does he want to do to solve the issue in the future?

Btw , who ordered the ativan anyway?
Makes you just want to put it over the PA system and say Dr SO and SO Ordered the darn ATIVAN!!!!
:)

telealli · May 24, 2014

Thank you everyone for your comments! It is a pleasure to know that there are nurses out there that are supportive of each other. I really wish I had that support when that MD was embarrassing me in front of everyone. I mean those nurses (even the charge nurse) was just sitting there listening to the MD give me that lecture, I mean don't you think the CN could've backed me up a bit?? I really wish I had more support on the floor like I do here on allnurses. It is such a relief to know that I can always get support, even if I do not get in on the floor!

I am a new nurse on my 2 month by myself and I still need to learn to be more assertive.