Should I do anything about being yelled at?

allnurses Guide · Feb 27, 2012

Take it to your manager, let her confront the doc or his supervisor.

Yelling is not conducive to teamwork, and patients DO have the right to refuse things.

You didn't say what the kidney issues are: a catheter isn't going to "fix" them, only let you watch I/O, and prevent retention.

llg, PhD, RN · Feb 27, 2012

I agree. Talk to your manager. But I would also write up the incident and get statements from the witnesses. (Have them sign the summary of events.)

If the doctor is usually a nice person and this was an unusual outburst, I would simply give a copy of the documentation to my manager for his/her files (and keep one for myself) -- but not make a huge issue out of it. I would let the manager address it. If it is a pattern of bad behavior -- or becomes a pattern of bad behavior, then having that documentation available will be helpful to deal with that pattern. If it is or becomes a pattern of behavior, then I would definitely file whatever official complaint is possible at your hospital. The Joint Commission requires that facilities not tolerate such behavior and I would ask that your facility deal with this.

Seas · Feb 28, 2012

I would write her up.

A doctor recently got a little mean with me on the phone. It wasn't half as big as this issue, but still not nice. When I told this to my charge nurse, she encouraged me to write this up. A few days later, the house manager told me he got my complaint, and also told that doctors are employees at the hospital just like us and it is my right to write it up if needed to. And nobody is entitled to be rude like this no mater what their title is.

MN-Nurse, ASN, RN · Feb 28, 2012

I would want a little more information than just the family saying, "I don't want a catheter."

I had a similar situation the other day. A patient came in with a SBO and had orders for an NG tube and a foley. 80 years old, had a history of BPH, but was AOx3, good renal labs, up independent and often, voiding OK amounts, compliant with urinal use, clear, yellow.

I got the NG tube in near the end of my shift and told him the foley was ordered but I would let him rest a little before I shoved something in the opposite end. He didn't want the catheter and I couldn't see any reason he really needed one.

When the next nurse came on, I gave her the situation. She was thrilled I had placed the NG tube and said she'd be happy to take care of the foley. I mentioned I didn't see why he needed a foley but didn't press the issue at all.

Not surprisingly the foley insertion was painful, the pain never went away and they d/c'd it before my next shift with the patient. I told him as long as he kept voiding ok and his bladder scans were fine, I wouldn't come after him with any more tubes.

He loved and appreciated my care and his SBO resolved a few days later with conservative management. However, I really owed him an apology for not calling the admitting MD myself and getting that foley order d/c'd instead of passing that decision to the next RN.

If an MD would have yelled at me for that, I would have taken it on the chin with no regrets whatsoever.

As it was, I screwed up by not advocating for my patient. That's worth getting yelled at by some goofball MD.

Col. Hans Landa: "You'll be shot for this!"

Lt. Aldo Raine: "Nah, I don't think so. - More like chewed out. I've been chewed out before."

Altra, BSN, RN · Feb 28, 2012

I'm sorry this happened to you.

I have to say, however, that I would have made it my business to know what the rationale was for the catheter and attempted to redirect the patient's daughter by educating her on that rationale. Yes, she has the right to refuse but she needs to be made aware of what she is refusing: the ability for I/O to be strictly monitored, etc.

As for the conversation with the daylight hospitalist ... I would have cut him/her off mid-sentence with, "the patient's daughter refused the intervention - end of story" and walked away.

TheCommuter, BSN, RN · Feb 28, 2012

I suppose I am the voice of dissent here, but I feel that it is more effective to put an end to the yelling at the moment it is happening. Confront difficult people at the very moment they are being difficult. Be assertive.

My favorite phrase to yellers is, "This conversation is over." After hearing this, most of them usually get the point and lower their voices if they wish to continue talking to me because I will not acknowledge a disrespectful screamer.

Other helpful redirects:

"Please stop yelling at me."

"This discussion needs to happen behind closed doors."

"Your behavior is not very professional today."

allnurses Guide · Feb 28, 2012

Ditto what The Commuter said. It is a bullying tactic that usually goes away immediately when calmly met with professional boundaries.

Perpetual Student · Feb 28, 2012

I agree with TheCommuter, better to address poor behavior at the time. Health care workers are like dogs--no sense smearing their noses in it a week later. All of this writing stuff and complaining to management business seems pretty petty and weak. Honestly, I can understand why that doc was annoyed, though she clearly handled it wrong by yelling at you.

If the reason for the admission was "blood loss and heart related issues" can't you imagine why monitoring urine output closely might be very important? I love the doc's line that this isn't Burger King.

dudette10, MSN, RN · Feb 28, 2012

All of this writing stuff and complaining to management business seems pretty petty and weak.

Agreed. A good nurse I work with and who is my mentor has been on the receiving end of "running to mommy" and twisting the truth, and it just reeks of 2nd grade-level skills in interpersonal communication.

I'm not saying the OP is twisting the truth, but the "running to mommy" part certainly applies. As for the situation the OP speaks of, you don't mention a pattern of behavior, and I'm sure you would if she did indeed exhibit a pattern. Let it go.

If it continues, have a "Come to Jesus" talk in a private place. That's always worked for me.

Guttercat, ASN, RN · Feb 28, 2012

I've only snapped at a doc once.

Needed to call a covering doc that was not familiar with renal patients. I'd never interracted with her before as she was from out of town. She was kind of "dumped" on by nephrology, actually. As tactfully as I could said, "I'm sorry to bug you with this issue as I know renal is not your specialty but here's what's going on..."

She interrupted and went balistic on the other end of the phone: "Do you have any idea who I am? I'll have you know I graduated from such and such doctor school with a Magna cum Superior Super Skill Superpower and who do you think you @^5* are!!!"

I paused briefly, and said, "You know. I don't need this sh&t. I'm just trying to look out for my patient." Coulda heard a pin drop on the unit. Everything went silent :)

Poor MD later apologized. She'd been having a hell of a day before I called. I actually liked her spunk. Sometimes people just lash out because of a whole lot going on we don't know about. Doesn't make it right, but sometimes it happens.

As to the OP's conundrum. That doc went WAY overboard in chewing you out in that manner. I'd be torqued. In our hospital, the hospitalists report off to eachother on the patients they're covering. I would've asked this doc why the hell the night shift hospitalist covering her patient had no idea what was going on, and perhaps they should start communicating with eachother when picking up eachothers' patients.

Art_Vandelay · Feb 28, 2012

I really like a combination of The Commuter's and Altra's answer. Cutting the doctor off mid-sentence with the phrase "this conversation is over" combined with walking away maintains your professionalism but doesn't allow the behavior to continue or affect you. In retrospect, my original response was anger in return. Yes, there are better ways of dealing with poor behavior. I'm just suprised The Commuter could offer "Please" stop yelling at me. I'm not there yet.