sbic56

Any time of day or night in OB. I worked with several docs...OB and Peds....who would blow when stressed. I think sometimes they were tired when stretched thin especially when they were on big call and running back and forth to the ED, OR, the hospital across town. And some just had poor dispostions period. I also worked with so many docs where the roof could be caving in and they remained calm and even tempered regardless.

This topic needs to be discussed IMO. Poor treatment by the very people that need you to remain in practice gets very old in itself. I agree we have satisfied the topic as far as Tired MD's piece, but hardly the big picture. I think especially younger nurses benefit greatly by venting and discussing this topic as it impacts the workpace in a very big way. It is getting better though...a lot better. I've wondered if this topic may be addressed in medical school now as I notice younger doctors sren't so prone to this type of behavior. Or am I just getting tougher?

I really like this post! Women are more likely to be intimidated by yelling. Now I see it as more of an annoyance and counter-productive, but when I first entered nursing, I was very affected by the tone a doctor would take with me. I was doing my best and could not see why this man of supposed authority was losing control of his emotions. I certainly knew his outburst was not teaching me anything constructive. Sure, I had to grow a thicker skin and adapt, but why be rude & unpleasant in the first place? Is this healtcare or boot camp? It's also about knowing your audience. A worker yelling on a construction crew may not offend many (though I'd still say it is unnecessary), but there is no place for it in a hospital where the effect on patients, milieu and co-workers can be destructive. Agree that a sincere apology is one of the most gracious offers a human can make. One can often walk away with a better understanding of the situation and perhaps even a renewed respect for the offender.

Of course I've yelled at people when frustrated, but in retrospect I know it was not an effective way to communicate. It was a mistake in judgement during a time of my own stress.

I can remember one doc I used to work with...very smart, great surgeon and a total perfectionist with a tendency to yell loudly no matter where he was when he was frustrated. One super busy day he was upset at a nurse for not having his patient ready when he came to do rounds...the patient was in the bathroom *sigh* He hollared at her so loudly that the entire unit could hear. She was mortified. You could clearly feel the tension on the unit from his outburst for a long time afterward. Later on, when he came back and was OK, I asked him to come into the office so I could speak with him. I asked him if he realized that when he yelled like that it was actually harder to understand what he wanted...I told him when he yelled like that, ironically, it's really hard to really hear him. He understood that and apologized and went on to tell me about problems in the OR that day. So, yeah, doctors are painfully human, but need to hear that what we need from them is commuication, not tirades and tantrums. I was glad I confronted and discussed his behavior with him. I wish the nurse he had targeted would have done it, but she was too freaked out to try. I've dealt with a few docs in this same way. Wait til the heat of the moment is over, then confront. It just may help.

"There's a tendency on this board to equate yelling with some kind of hideous assault that leaves people emotionally scarred. I've never understood that, and personally I'm grateful I've never worked in a place where people shared that attitude. There are times when it is perfectly appropriate to raise your voice, and I have employed it (effectively) on numerous occassions. It's not illegal, it's not unprofessional when done at the correct time, and I see nothing wrong with it. " This is just plain nuts. Yelling is never effective and is always counterproductive in any instance, except perhaps getting someone's attention if they are about to be hit by a bus or something. If you think you are getting your point across better by yelling, Tired MD, you are not only a poor communicator, but an irresponsible practitioner. This type of aggressive behavior in the workplace only causes undue stress, distraction and the potential for creating an environment where errors are more likely to occur. Temper yourself and stop kidding yourself. I can guarantee you are misreading your co-workers if you think yelling at them does not bother them and is actually helping any situation.

OOOPPPS..sorry wrong thread!!

That appears to be so... http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1548515

Tainted Love is the perfect work song!!!

All great suggestions MIZZ...the problem with hospital policies and campaigns like these is they never seem to ask the people who could truly help put an effective policy in place...the nurses!

I used to think nurses were more dysfunctional that the general population, but have reconsidered that stance. I think when you are with nurses day in day out, you get to know them and start thinking we must all come from messed up places. But, since I have been doing nurse consultant work and out of the mix, so to speak, I find everyone is equally vulnerable, no matter their profession.

Thank you for all you are doing...and for those links. I know it is personal to you, but you are helping many with your efforts. I sent you a PM...I look forward to reading your proposal.

I am sorry to hear of your tragic loss. This is especially pertinent to me as I am in Maine. I work in the community mental health field and am always looking for the most current recommendations and find standards to be sorely lacking Thus I hesitant when admitting clients with MRSA or hx of to units always erring on the side of caution in order to protect the other clients. I think the reason for the lack of standard is because the medical community really does not have a lot of the answers to this quickly evolving threat. It's frightening, really. Is there a site which one can go to to see what legislative mandates that are being proposed in Maine?

The doctor is saying the patient can have 15mg/Q3h. I like these orders. This allows the patient to take only what they need. If they ask for a portion of the Q3h dosage and find more is needed before the 3 hour period is up, they can take up to 15mg in that time period...something like using a PCA w/o the pump. More work for the nurse, better pain control for the patient.

It's a clear order. You may give up to 15 mg/3h depending on the patients response. Think about how PCA works; the patient can deliver as much med as is needed over time, so long as it is within a certain range for safety. This is a good order, IMO, as the patient can be involved in deciding what he needs for pain control.