Is it ever okay to speak up for yourself...

allnurses Guide · Jan 8, 2008

The patient comes first, not my ego. So, I handle situations like this in private and definitely away from the patient.

I've had calm but firm talks with people who are disrespectful to me - most of the docs I've worked with are great. I have had to have some talks with a few co-workers (nurses).

I'm my patient's advocate before all else. They don't need to see drama. They're sick.

steph

nursesam2 · Jan 8, 2008

I have been in those situations and frankly I have walked away leaving a physician acting like a fool. He says his peace but I dont have to listen!

jessi1106, BSN, RN · Jan 8, 2008

Doctors are human beings. I feel that when anyone becomes hostile with you, it is appropriate to speak up. This can be done in a very professional mannor (not "flipping out"). After all, for the pts sake we should strive to communicate and work as a team.

I am fortunate to work in a teaching hospital, where I rarely feel belittled, my nursing judgement is respected and where (new) docs ask my advise.

Verbal abuse is not only demeaning and negative, but also illegal.

BTW there are many threads related to this that you may want to read.

nursedudeforchrist · Jan 8, 2008

Doctors are human beings. I feel that when anyone becomes hostile with you, it is appropriate to speak up. This can be done in a very professional mannor (not "flipping out"). After all, for the pts sake we should strive to communicate and work as a team.
I am fortunate to work in a teaching hospital, where I rarely feel belittled, my nursing judgement is respected and where (new) docs ask my advise.
Verbal abuse is not only demeaning and negative, but also illegal.
BTW there are many threads related to this that you may want to read.

It's illegal? Really?

nyapa, RN · Jan 8, 2008

I do believe you should speak up for yourself. But it should be done in an assertive and professional manner. I agree that it should be done calmly, and if possibly privately. Nurses do not have to put up with abuse.

I had a doctor tell me I went against his wishes when doing a dressing. True, but at the time I had no documentation to follow, and noone had told me verbally. I told him this. He didn't accept it, but I still had the right to do so. And I documented big time afterwards, and told my clinical nurse manager the next day.

There are times when patients do things that can affect us personally, for example aggressive incidents. We do not have to put up with this in the street, and we shouldn't have to put up with it in the workplace. But you let them know appropriately. I have often said to such ppl that I am willing to care for them, but only when they treat me with the same respect I treat them with. I am talking about ppl who throw things, touch inappropriately, hit ppl. You have the right to call security. Again document big time!

And there are patients who do things against recommended care. I had one who used to give his own long acting insulin whenever he felt like it. I said to him that I would like to check each time he gave it, as my registration was on the line. OK, he still gave it, but he had been told, the doctors were informed, and again it was documented. Eventually the doctors were convinced to take it off him. But even that is hard to do, as it is his property...

Other staff can tell you to go against what you believe is right, based on evidence. You have to stand up, explaining your concerns based on evidence. If this person still insists you do it, even if they are senior, then you can either just document - or, as I have done a couple of times, tell them to do it themselves, for evidence based reasons. Document...

If other staff are personally rude or abusive, then you have the right to pull them aside, tell them that what they are doing upsets you, and that you don't think their behaviour is appropriate. And you have the right to ask for mediation if you still don't receive satisfaction.

Speaking up for oneself can be a form of advocacy for your patients, as well as protection for your self. But it has to be done correctly and respectfully

psalm, RN · Jan 8, 2008

I once said to a doc "oh, someone got out of the wrong side of the bed this morning!" when he came in early morning and proceeded to verbally assault me, a night nurse. It stopped him enuff to realize there were other people around the nurses' station and he became more subdued.

Not for my ego but just to diffuse his temper. As steph says, the pts. don't need the drama and neither do our co-workers. I didn't get an apology but this doc is civil nowadays...

BookwormRN · Jan 8, 2008

Yes, it IS ok to speak up for yourself...Done properly, of course.

Also, it helps if your fellow nurses are around to stick up for you. I've never seen it done, but have heard of a "Code White." When a doc is heard/seen to be verbally abusing a nurse, another nurse on the floor intervenes by asking if there is something wrong. Usually diffuses the situation.

locolorenzo22, BSN, RN · Jan 8, 2008

Most of our docs are pretty good...one or two "old-schoolers" have the idea that nurses should be following on their coattails....However, one time a nurse tried to read me the riot act after I'd be on shift all of 10 minutes....IN front of patient(who was confused, had Benedryl, talking strangely), patient's family, and roommate in next bed....I had a funny bp so I wanted her to double check it...she said, "His BPs x/x..it's fine...what's wrong with you? Do you even know how to take a BP?" I promptly replied, "who, me? Oh, I've done only...what...maybe 7000 BPs a year for 3 years now....I'm glad it's ok, and you got a good number...." Then told her "DON'T EVER DO THAT TO ME IN FRONT OF A PATIENT AGAIN! He does not need to hear I am incapable of handling a task as simple as BP, we all need a extra set of ears once in a while, and I felt the patient needed someone to double check my number before we went all the way down the hill to the doctor....thanks, and good night!"

You just have to stand for something...or you'll fall for anything...

ebear, BSN, RN · Jan 8, 2008

ABSOLUTELY it is OK to speak up for yourself, fellow nurses, and your department.

I once walked up to an orthopaedic floor with a fellow supervisor (from PACU) to check on an O.R. patient situation. Upon rounding a corner, I found a surgeon berating the O.R. dept. and staff. I stood there listening to him rant until he was finished and he didn't realize that I was right behind him. When he got done and turned around, to say he was shocked would be putting it mildly. I said "Dr. X, will you come with me please?" I asked the PACU nurse to accompany me (her eyes were as big as saucers). We went in an empty pt. room and shut the door. I said, "Sir, don't you EVER stand in front of a nurses station and complain about the O.R. in ANY form again. If you have an issue, I will be happy to discuss whatever it is with you at the appropriate time and place. What you just did was very unnecessary, inappropriate, and unprofessional and besides that, you are very ill informed". Let's just say he left the room with his tail tucked between his legs....

llg, PhD, RN · Jan 8, 2008

I agree with the general tone of the posts here. It's good to speak up for yourself and we should all not allow ourselves to be abused. However, there is an art to knowing HOW to assert yourself appropriately that we all need to learn. "Flipping out" or otherwise behaving in ways equally inapproriate do more harm than good.

Pearlgirl · Feb 28, 2011

I once said to a doc "oh, someone got out of the wrong side of the bed this morning!" when he came in early morning and proceeded to verbally assault me, a night nurse. It stopped him enuff to realize there were other people around the nurses' station and he became more subdued.
Not for my ego but just to diffuse his temper. As steph says, the pts. don't need the drama and neither do our co-workers. I didn't get an apology but this doc is civil nowadays...

Psalm and others who mentioned that patients don't need to hear this:

I once knew of a hospital secretary that would harass the floor staff and in fact picked a fight with one of them at her desk when the person quietly let her know the harassment needed to stop. She only elevated the situation by raising her voice and pointing in the person's face, acting almighty and powerful "behind the desk." Unfortunately, the staff heard a patient nearby had acute hearing and was very upset by it. Guess who got written up? It wasn't the secretary. Yes it was okay for that person to speak up. Was it handled right by the institution? NO. Lesson learned: refuse to speak with the person unless in a private room, preferably with a witness or two. This secretary was putting on a show at the patient's expense. I pity her coworkers. Don't know how she manages to convince their manager she is "all that." And we worry about Doctors?!? Oh my word! :eek: Love the "wrong-side-of-the-bed joke!