Resident rude to family members after death/vent

[kate1114]

Without getting into details (because you never know who's reading this thing ) I have to share a complaint about a resident's actions following a patient's death.

I had a patient expire the other morning (totally expected). The doc came in to do the pronouncement, and then became argumentative and confrontational with the family when they raised a legitimate question. They reacted with emotion but without raised voice or confrontation. Without details, I can tell you that his actions were a little abrupt and could have been easily seen as disrespectful of the deceased.

Later, when I emerged from the room the resident confronted me asking me what was wrong with them. I told him they had just lost a family member and were grieving :uhoh21:. He didn't like that idea, said that they were being inappropriate and then told me that he should have booted them out of the room and called security. I tried but could not make him see that his actions were not therapeutic ("But I said I was sorry for their loss"). He even told me that he had pronounced someone else earlier in the night and the family was "fine". I told him that different people grieve different ways but he didn't accept this, nor did he accept the fact that the family had been very appropriate all night long. He felt that he had done everything right and that they shouldn't have challenged his authority.

This happened a couple of days ago, and I haven't been at work since, so I haven't been able to access my email or the reporting system. Plus, this happened at the end of my shift, so I didn't have time to discuss with my charge nurse. I will be going to work tonight and I plan an extensive follow up with the notes that I made that morning once I got home. I have been a nurse for almost 11 years, and I've never seen anyone this insensitive to a family.

Thanks for reading my vent. Hopefully doofus isn't on tonight!:monkeydance:

[bargainhound, RN]

I think it has to do with the personality of the doctor.

You cannot control his personality.

All you can do is do what you know is right yourself and appropriate

for the family.

[Antikigirl, ASN, RN]

That would truly upset me to no end! I would have certainly told the family to contact the Board of Physicians and complain! I mean what is next? Telling a newly dx pt with terminal cancer "yep your dying..don't ask questions...just get over it?" OMG!

[jo272wv]

The resident may have not acknowleged that he was in the wrong at that moment but if you were truly honest with him and did not sugar coat his error, I am more then sure that the next time he encounters a similar situation he will be more careful. Residents are learning also, they have to be knocked off their pedastol a few times before they realize they are not God. I respect most the residents I work with and see the many personality changes they go through, most for the better.

Keep being honest with them.

[TrudyRN]

This was so confusing. I thought you were talking about the deceased's roommate resident in a nursing home. Finalloy figured it out, though.

The Resident is probably quite young, was probably tired, not experienced with death, maybe thinks the family was criticizing when all they were really doing was trying to understand and come to grips with losing their loved one presumably.

Lots of professionals are not capable of talking with people. They feel challenged and criticized, even if no challenge or criticism is meant. Try to keep out of it as much as possible.

You are not responsible for the doctor's development and someone will probably try to blame you for the whole mess in the end. Only half joking. Hope all goes well.

[BSNtobe2009]

The doctor may not have heard the last of it.

If that had happened to me, I may not have said anything at the time, but when I got home, the Medical Board and the Hospital Administrator would hear about his conduct.

I don't expect a doctor to cry with me, but when a family member dies if they can't answer questions and be respectful to those that have just lost a family member, he needs work in a locked up office somewhere.

[Daytonite, BSN, RN]

kate1114. . .I've been taking classes in health information management and a recent class in medical staff services. Doctors can be inappropriate too, just like other employees. The problem is that in most places, nurses are never told how to report or deal with this. Just write factually how he behaved in a memo addressed to his current supervisor. He does have one, I guarantee it. You can give the memo to his supervisor or take it to the medical staff services office and they will see that it gets forwarded to the correct doctor supervising this jerk.

Since taking this medical staff services class, I've learned that the medical staff services office of each hospital keeps all the confidential files on the doctor's and their performance. That also includes any residents who are in training programs. When it comes time for staff doctors to have their privileges renewed, which must happen minimally every two years by law, all information on their performance is reviewed. So, when a doc is being a jerk, his behavior should be written up so it makes it to his file in the medical staff services office. Ideally, any complaints should go through the chain of command, but you could also just give these write ups to the staff that work in the medical staff office. They'll make sure it gets to the right person because that's part of their job. For confidentiality reasons, just like with any other employee, medical staff office people and the other supervising doctors aren't supposed to discuss the performance of doctors with others. But, I guarantee you that if this resident is like this and enough people complain about him, he is going to have problems getting staff privileges in hospitals that do care about how their nursing employees are treated when he finishes his residency and is looking to get privileges as an attending staff member.

I wish nurses could learn what I've learned about how doctors are organized and supervised in hospitals. It was always a mystery to me. Taking this class has been a real eye opener. Yes, there is something that can be done about doctors who are inappropriate. It's just that it is not handled through the human resources department, and because of some laws that are in place, doctors have the right to due process (that means they can demand a hearing complete with lawyers to represent them and presentation of evidence) when they are disciplined and feel it was unwarranted. If nurses had organized the way doctors did years ago, we might have many of the same rights and power doctors seem to have, but things just evolved a different way.