I am a new nurse trying to figure out how to get a doctor to stop bullying me at work.

[Mississippideer]

I've been a nurse for just under a year. I'm being bullied at work by a doctor. I work in a cardiac ICU so we work collaboratively with our doctors toward the goal of good, safe patient care. There is one doctor who has begun to target me with his bully behavior. He yells and is disrespectful in the way he speaks to me both in private and in front of patients and coworkers. He makes comments to others that insinuate I am incompetent and don't do my job. I've had nothing but praise from other doctors, coworkers, even the house supervisor about my performance, knowledge, and professionalism. What can I do to stop this doctor from treating me this way. He has a reputation for doing this to most of the staff but I refuse to spend my career, which I love, being treated this way. Help!! All insight appreciated.

[Khaan]

Tell him to stop, and be serious. Tell him why he should stop. If he doesn't, escalate to his and your superiors.

[CrunchRN, ADN, RN]

You need to tell him to stop. If he has a beef with Anesthesia doc he needs to man up and discuss it doc to doc.

[NicuGal, MSN, RN]

If you are in a patient room you need to just look at him and state "We can continue this conversation at (insert place) after I call my charge nurse/nurse manager to sit in."

If you are on the phone just state " I really don't think it is necessary to speak to me this way, let me page anesthesia to call you back and you can speak to them about a plan"

Document all confrontations, but sometimes the key is to cut them off and walk away. If it continues then management and HR need to become involved.

[FolksBtrippin, BSN, RN]

I recommend that you write him up. Describe what happened objectively, exactly as you did in your second post (not the first one).

Do not threaten to write him up, just do it.

In the meantime, I recommend that you keep your communication with him minimal, and to the point. I don't recommend that you communicate with him about his behavior or your feelings ie; your behavior is unacceptable, I will not be treated this way, I will not be your pawn, There is no need to speak to me that way,etc. These tactics are not effective. Methods for dealing with bullies have been tested. I'm not saying you should be a pawn. But simply don't be the pawn. Don't talk to him about it. Don't talk to him about how he ought to speak to you, he already knows how he ought to speak to you. Simply write him up when he chooses not to speak to you in a respectful manner.

Only talk to him about the patient. If he starts nonsense like; You should know better, etc. take the conversation back to what you want for the patient. "I want you to order pain meds." Do not mince your words. Be firm and direct with what you want from him.

If he does it again, write him up again. No threats, no drama, just a factual report.

If he asks you if you wrote him up, tell him yes. If he asks why, tell him your reasons are in the write up and you will not discuss it unless management decides discussion is part of a formal intervention.

Be extremely matter of fact and do not worry about him calling your boss. Just go through the proper channels. It will be resolved. Be willing to take the high road, which is absolutely not the same as tolerating abuse.

[ssn2000]

Perhaps an incident report with witness signatures can be addressed in the QA meeting in the presence of the medical director and the rest of the team. Perhaps including another doctor will make him tone down because some doctors are at a place where nursing management cannot question them.

[imenid37]

Your manager needs to report him to whoever babysits doctors in your institution. When it happens, tell the charge nurses, write it up, and make sure the charge RN and manager are kept in the loop. This is ridiculous. I admire your tenacity in wanting to stick with this specialty. He and the anesthesiology group need to agree who handles what and communicate it to the nurses. When I graduated from school, I worked in a tele unit with post-OHS patients. We had clear guidelines about what was a call to the surgeon and what was a call to the cardiologist.

The bottom line is that this is a threat to patient safety. If he wants something for a patient who is not breathing, he needs not to delay care with his game playing. Perhaps if anesthesia would also write him up and elevate it to administration, the matter might get more attention. It is you who is a target now, but this is a far-reaching problem. This behaviour has worked for him in the past, so he persists. You should consider filling out an incident report when this type of thing happens. That way someone in the patient safety/legal realm will see this. They may not be as blinded by the $ of the cases he brings to the facility. Your charge nurse on the shift also needs to have your back on this one. Sometimes those of us with experience need to be brave and stand behind the newbies. Some nurse are just glad that it is no longer their turn to be targeted. That's fine, but t is a lot better for the new nurse and ultimately the patient if the behaviour is actively not tolerated, rather than just ignored.

[FurBabyMom, MSN, RN]

Does your facility use a specific model for communication? Many facilities are using SBAR to organize communication, but is there a framework for communication? We use TeamSTEPPS and I find it helpful when dealing with surgeons and anesthesiologists. I will say though, the overall culture of a facility can certainly help or hurt interprofessional relationships.

I think others have provided plenty of good suggestions. Involving your manager or charge is great. If it's an off shift hour and your manager is not physically present you can certainly page/call them, and if the situation is something happening physically at work, you/your charge might look at getting the nursing house sup involved.

I might try a conversation with your manager about the situation and what *YOU* can change. Obviously, let your manager know about the physician's behavior. It's going to be 99% easier to change you than it is anyone else, and there may be a way to "handle" this physician (way of discussing things with them, ways of leading them to what you'd like done) that others know and you do not yet know. I am in *no* way excusing their behavior, but saying that for some people, sometimes there are tricks to getting them to do what you want or need. The other thing I would look at, for your own professional growth, is your own communication. There's some really good books and strategies outside of SBAR and things like TeamSTEPPs that can be instrumental in effective communication. There are some really awesome techniques to de-escalate situations and get everyone back on the same page.

I think the other thing is, as time goes on, you learn what people's preferences are. The next time you have a similar situation, when you call that physician you can ask about bipap ("I know previously your preference was...") based on that being what they wanted in this situation. Something as simple as that might nip this in the bud the next time. Not that they shouldn't be held accountable for being a nice coworker, because they should, but sometimes this helps avoid it altogether.

[Harveyslake]

In my, going on 20 years, of critical care nursing, I've only been yelled at once by a physician. I'm a guy and I'm lucky, I guess. I had a patient that was made comfort care. I started a morphine drip and extubated. I was to titrate the drip for comfort. I was a brand new nurse, just off orientation. I consulted the experienced nurses as to how high I should titrate the drip. Believe it or not, I got advice to titrate up 1mg per hour to "just 999 it" I had the drip running at 15 mg/HR the trauma surgeon came in and saw that the patient was still tachypnic. He yelled at me that "does this patient look comfortable??? Increase the drip!" I said he is already at 15 mg/HR. He disappeared and a short time later a resident appeared and asked if the patient was really at that rate. I said yes and the resident said to drop the rate to 10mg/HR. The surgeon later apologized for yelling at me.

[AlwaysLearning247, BSN]

I would let him know kindly that you need to work together for the patient and it's not appropriate to keep targeting you. It was very unprofessional of him to make you call anesthesia, why couldn't he just order the bipap? What is this doctor trying to prove? He seems like he has real issues and like he is very immature. I'm sorry you're going through this. I would honestly pull him aside and say we need to talk. Ask him what his issues are with you exactly and tell him your concerns. Remind him that instead of mocking you, he should be there to encourage and help. If that doesn't work, report him. Good luck!

[compassionresearcher]

There are situations where admin will never backup a nurse vs. a doctor, especially if he/she is bringing in big money. Only a mass exodus of staff will get their attention.

[HouTx, BSN, MSN, EdD]

PPs have offered great advice and suggestions.

Just wanted to add - check your organization's policy on Disruptive Physicians. They have to have one if they are JC accredited. Then, follow the procedures outlined in the policy. This type of behavior is a widely-acknowledged threat to patient safety (that's why the policy is required). Chances are, once formal action is taken, the Medical Staff Leaders will be forced to act. They can't just wish it away with a "that's just the way he is" and chuckle.

[Ruby Vee, BSN]

I've read the whole thread, and saw a lot of advice that basically recommended going nuclear (writing him up, lodging a formal complaint) as a FIRST step. If you like your job and wish to continue working there, that's unwise. The FIRST step is to talk to the physician and tell him you don't like being talked to in that manner, especially in front of patients because that makes patients afraid to trust you. Stand up straight, look him right in the eye and tell him you won't tolerate that nonsense.

If talking to the physician doesn't solve the problem, THEN involve your manager and write him up (or not) as she recommends.

What has always worked for me -- although I'm not actually recommending this -- is snapping back some sarcastic comment that I didn't know I was going to make until I'd already made it. About the time I'm wishing the floor would open up and swallow me, Dr. Imaflamingdonkeybutt apologizes. It's happened twice -- the two times I've had problems with physicians. (Which doesn't include the times I've had issues with residents, which is a whole 'nother thread.)