Little Doctor, Holy Terror

[VickyRN]

Most of our cardiologists are respectful/appreciative of the nursing staff, if not a pleasure to work with (we all have our favorites:) ).

[rncountry]

All of the prior suggestions are all good and workable. I have also written up a doc with an incident report. Not once but twice. This was shortly before Christmas. Not a short man by any means, 6'6" or thereabouts. But with the tendency to be horrid. I have never put up with bullies well but after 11 years of nursing I tolerate it even less.

I had gone to my nursing coordinator, as well as my CEO about this doc with no real results. The day before I wrote out an incident report he had made a couple of the nurses I work with so upset that they were in tears. He verbally attacked me at the elevator one morning as I was getting off it, had not even punched in yet. I can't even express how angry I was, had no problem giving it right back to him, but what a way to start my day. I wrote up the incident because I was so angry and because communicating with the head of nursing and the CEO had not gotten me anyway. Two days later this doc swapped wound vacs between two patients because he didn't think one was working and wanted to check. I also do infection control. I about had a cow, first that it was done, and second that the nurses on the floor at the time were so afraid to upset this man that they did it. For goodness sake there is an 800 number right on the wound vac for problems. Anyway I wrote that up too. Since then this doc has been always courteous and decent to me. Creating a hostile work environment is against the law, sometimes it is a good thing to remind others of that.

[l-andrée]

I agree, don't let it all fall on your shoulder alone, and discuss a plan before it happens again. But then, when it does happen, it's you on the phone with him. Do you think another doc would let him talk to him that way without responding? We are all professionnals, aren't we?

I too once said to a doc "My reason for calling you in the middle of the night is the patient's condition, so call me back when you can speak to me without yelling". He called back and I never had trouble again. Did it work for you Mattsmom? I believe putting things in perspective is a winner!

[mattsmom81]

I can't advocate hanging up on a physician--you're only giving him ammunition because you really mustn't have much of an emergency if you have time to hang up and await a call back, right? We're talking ICU situations here :)

We're calling for orders/interventions we cannot do, and our patient needs the doctor to intervene. I have done all that I can legally do without practicing medicine without a license..... I stay with that idea and feel that's how I get the best results. :)

[l-andrée]

Mattsmom, unfortunatly, it was an ICU situation, with a trauma patient that has just been admitted with a tiny tiny little paragraph of prescription from ER. He was 21, had multiple fractures, was unconscious, was bleeding, well, you get the picture. This doc didn't think it needed his immediate bedside consultation, he would see the patient in the morning. That still left me for a couple of hours with a young patient in pain, with a low Hb, no prescibed labs, no respirator parameters, etc... (and a devastated family) so I insisted, and he actually blasted me for weaking him up for so little!!!!! I was to call the anaestesist for back up if he didn't called back. I had done that too before!

I think we sometimes have to stand up for our patients, that's part of our job. That doctor is still not answering our calls lots of times, or insulting us because we call him at night, but that time, somehow he realized he wouldn't get away with it. I didn't feel I gave him ammunition, exactly because it is ICU. I don't know what he tought when he called back but he must have felt something else would be done. No doctors like to be summonned by another one because he didn't do his job......

[mattsmom81]

OK, I see what you're gettin' at now Andree'...and yes they call back fast if they think you may be 'going over their head' and calling chief of staff or something....definitely!

Maybe if we said "If you won't help me I can always call chief of staff" faster (on the grounds that we needed to get MD assistance stat, weren't getting a response, and were following appropriate chain of command) these jerky docs would stop their little games with us.

Good point! :)

And yes, I agree, we must be advocates for our patients...our nurse practice acts expect no less of us.

[hoolahan, ASN, RN]

I Have worked with this guy...in NJ!

Actually, there was a psycho of a ped cardiac surgeon in the place I used to work. Before I left, staff were discussing calling a Code White when this doc came on the unit. If he was observed "starting" in on a nurse, every available nurse, manager, supervisor, etc, would report to the area to be witness to the harrassment. When a pt finally reported the behavior, when he observed the doc blow his cool, and wail a cup of hot coffee against the wall, admin paid more attention. Up until that time, they were just as non-supportive. Our DON even had the nerve to tell these nurses "Don't be such babies, stand up for yourselves!" Honestly, this man was so evil, it was like every nurse in that pedi-ICU, who happened to all be female, were like battered women, they did not recognize how demeaned they had become. Several nurses reported going on antidepressants, and many left the hospital.

At another hospital, another cardiac surgeon was so abusive, many of the staff left, including myself. They never admitted it, but I think the hospital made him go for counseling, when one nurse claimed she had to go out on disability d/t the fact that he reamed her out in front of pt's and staff one day, and she had a nervous breakdown. Was sent home, and couldn't come back.

I eventually worked w him again, and he was very much calmer. In fact, I left him a voice mail the other day about one of my HH pt's of his, I said nothing personal like "Hope everything is going well," etc, just left the facts and my voice mail. I was SHOCKED to hear a very nice message back, wishing me a Happy Easter, and he even said, "Good to know you're still out there taking good care of my patients!" I nearly fainted. I didn't erase it, I listen to it once a week for kicks! I think they are desperate for staff in the CT ICU, and I have gotten called about q 2 months asking if I want to come back. Nah!!!

[willie2001]

We have a doc with "short man syndrome" but ours is an orthopedic surgeon .

[Jenny P]

We have a "Little Napolean" CV surgeon who would reset drip rates on IV drips without informing the nurse and then leave the unit, back when he first came here. He did that to me once, and as my pt. was going down the tubes, I paged him, then went back and checked everything again so I could give the info in a hurry. When I saw my drips were changed, I nearly fainted! He had already gained a bad reputation at that point; so when he answered my page, I was furious and lit into him about messing with MY patient! Boy, was HE shocked! He had really never realized that the nurse might consider the patient as "theirs", and I doubt if anyone had ever talked to him quite like that before. He has treated us so much better since then.

[P_RN, ADN, RN]

Also remember that "little man syndrome" also applies to the ones who are 7 feet tall, just "little" in mind and big in attitude. I've had them throw, tantrums, coats, charts, pens and even a hemostat once in OR but they never got away with it.

That's ONE advantage in working in a teaching facility. Someone's BOSS is ALWAYS available. I'd call a chief or an attending or even an administrator before I'd let one of those pipsqueaks get away with ignoring MY patient!!!

[judy ann]

Obstetricians are usually pretty mellow, but I worked with one that was not. You haven't had anything thrown at you till you are the target of I) obststrical forceps, 2) placenta! Yuk! This guy also thought he was the worlds greatest OB/GYN (wrong) and he was God's gift to all women, and was full of verbal and physical sexual harrasment. He was reported regularly, and there was never anything done until there was a new Chief of Staff. The new guy called each nurse who was still on the staff that had voiced a complaint, and asked if they were willing to stand behind their complaint. Many of them backed down, because they were afraid of wonder boy, but some of us agreed. Unfortunately, that is as far as it ever went. BTW this guy is short, but he is a New York ****** . (I'm not sure about that spelling but I think you get my point)

[thisnurse]

i have found that stating the situation usually works best...

excuse me dr. ..i dont like calling you in the middle of the night any more than you like being called. however, this patient needs the attention of a physician.

im a nurse, you are a doctor and this is what we do. ..so now, what how would you like me to proceed with care....

when he is finished and has hung up just say dummass ...that always helps..

another thing you can do is to keep asking him to repeat his orders ....what? what did you say? was that 2 mg? did you say you wanted a cbc or cardiac enzymes? can you hold for a minute doctor? (docs LOVE being put on hold)

[leeriza]

Report this to your superiors, document, and stay cool. He might just be as anxious as anybody else during crisis and this is just one of his defenses. Or, he is just like someone I know who "eats and barks" at people if his sleep is interupted.:roll