Physician called my manager and said I was "unprofessional".

[Smellnell]

Hi all! I thought I would get a little input from the community because I'm not sure if this doctor has a legitimate complaint about me or if he just can't take criticism.

I work in outpatient OBGYN. I generally work under one physician but will help out with triage calls for other nurses when time allows. I took the call of a patient's husband for whom we had done some genetic screening on. Turns out his pregnant wife is a carrier for alpha thal and her physician had offered to test her husband. Her husband called for the results and I happened to notice that the hemoglobin electrophoresis wasn't complete and was missing some elements (it was sent to a lab that we don't normally use). When I brought it to the attention of the physician, he responded that he had "reviewed the result of his hemoglobin electrophoresis. Test results are normal.". I spoke to him later in the day and explained why I didn't think his testing was complete. He again said that everything looked normal to him but that he would look into it. An entire day had passed and I still had this patient's call up on my desktop. I asked his nurse if they had discussed it and she said "no". I wanted to leave for the day but also wanted to make sure that the gentleman received a call so I emailed the physician and his nurse apologizing for giving the call back to them but noted that I didn't feel comfortable telling the gentleman that his results were normal because his results didn't reflect the testing I had been taught was needed. Later that night he wrote a scathing email to both me and my manager calling me "totally unprofessional" and saying that if I ever needed clarification on something I needed to come to him. I guess he was upset that he told me that he would "look into it" and I dismissed that when I tossed the call back to the team and said I didn't want to call the patient. My feeling is that it's not my job to stroke his ego. I know the testing was wrong. If he and his nurse want to figure it out and he wants to take the time to look things up in an untimely manner before calling the patient, then the problem needs to be theirs. I didn't want it on my plate anymore. Perhaps I could have been more diplomatic? He ended up ordering the test I had suggested, by the way.

[EllaBella1, BSN]

I don't think you were being unprofessional at all. If anything he was unprofessional. Our job as nurses is to act as a patient advocate- you did that. You advocated for the correct test, and when you did not get what you needed you simply notified the patient that you weren't able to answer his concerns without the information that you needed. I would think it was unethical/unprofessional if you told the patient everything was fine, knowing that testing was incomplete.

[caliotter3]

ITA with EllaBella1.

[NuGuyNurse2b]

I don't think you were unprofessional, either. But your approach would not have been the way I would've done it. I go with the 1 strike you're out rule. If a physician isn't receptive to my concerns and I feel that it would affect my license, I then take it up with management to handle.

[llg, PhD, RN]

I agree with NuGuy. While you were not "unprofessional," you didn't handle it in the politically best way. I am not sure exactly how I would have handled it -- as that would depend on my assessment of the specific individuals involved, my previous experiences with this particular physician, etc. But whenever I am going to step on a doc's toes, I get very careful -- and make sure I am handling the politics wisely.

I definitely would have alerted my supervisor to a potentially risky, sensitive situation -- and sought his/her advice for how I was going to handle it.

[HouTx, BSN, MSN, EdD]

Good grief. Hopefully, OP has some written standards to rely on when it comes to genetic testing. If not, this should be the next step. But, I certainly don't believe that it is unprofessional to expect our physician colleagues to enforce the expected standards of practice. Are we supposed to give them a pass because they just aren't feeling it?

[lemonstolemonade]

Your actions sound very reasonable and professional. That physician is the one who should be ashamed of his behavior. Hopefully your manager understands.

[klone, MSN, RN]

Luckily, you have your example of "unprofessionalism" in writing in the form of that email you sent to the OB and his nurse. If your manager has questions about whether or not you were out of line, you can just show her that email.

[Smellnell]

Lo and behold, who's patient has abnormal results and has been referred to hematology? No thanks needed...but that's mostly because I didn't get any. LOL.

[cleback]

You did well. Good job. Whether you should've been more diplomatic or approached the manager kind of depends on the work culture and personalities. If you don't regularly work with that doctor, it's hard to gauge how much to push or when to involve others. But you weren't rude and you got it done, so congrats. Glass of wine now?

[WestCoastSunRN, MSN, CNS]

Good catch! Sometimes we have to escalate things. It's never fun, but part of the job.

[Meriwhen, ASN, BSN, MSN, RN]

Lo and behold, who's patient has abnormal results and has been referred to hematology? No thanks needed...but that's mostly because I didn't get any. LOL.

And hell will probably freeze over before that MD thanks you and/or even admits that you were right. Because that's how a lot of MDs are.

Though I hope your manager knows that you were spot on :)