Rude docs - not letting it get to you

My comeback is always this: "I can't hear you when you are yelling. When you want to talk calmly, I am ready". And after the next tirade, or the blank look or my walking out the door, I usually get an apololgy of sorts and a professional discussion. When they hang up or go ballistic, they get a contact with my supervisor.

My favorite;

"Oh wait...let me take you off speakerphone...I'm here with the patient's family......"

(Of course....I don't actually have the doc on speakerphone)

Don't allow them to run you over! If someone is yelling at you, tell them plain as day that just because you sought a different degree doesn't mean you are uneducated, unintelligent, or unworthy of being treated with dignity and respect like all humans.

If you are walking into a room for the first time and getting yelled at about not putting a patient on precautions for a disease you didn't know they had, kill the doc with kindness in front of the patient so the patient doesn't doubt your competence. Kindly explain that it's your first time in the patient's room, but you just reviewed the notes in the chart and didn't see any mention of said disease. Would he mind showing you where he documented it so that you'd be able to pass it along to the oncoming team later? Then when he realizes it's not documented, you can't be held accountable and deserve an apology.

I used to be pretty passive too, but a few years on the job helped me to realize I don't work for the doctors. I work for the patients. The only two options are to treat me as an equal or to save their rants for someone who cares. I'm there to do a job that I'm pretty good at, not to be mistreated.

I feel like all the disrespect is finally getting to me and I'm so afraid that I'm going to take it out on my coworkers, aides or patients. How do you not let it get to you when the pressure is on and tempers are running high? I'm considering a change in career.

I am of the mind that you answer the doctor calmly and directly. "...why the patient's not on precautions for a disease," would be, in front of the patient (politely), "Because no physician informed us of the disease."

""I DO NOT want any more pages about this patient!" For me the response would be, again very politely, "Then you need to send me proper instructions for handling a bp of x/x, or you will hear from me again, as well as from my manager."

I know some of them can be very intimidating, but they are not your boss.

You can't take charge of the physician, but you can take control of you. You can do it! :)

DC, ED NOC RN ADN

Abbreviations R Us :)

Get some guidance from your NM first. It is a learned skill to be able to handle nasty docs, and she probably knows most of them. When I was new to my current unit, there was a nasty doc that was constantly saying things just to be inflammatory. I would stand my ground, but another more seasoned nurse told me to just listen, let him rant and then go about my business. It worked like a charm. I found that it didn't matter who he was speaking to...he was halfway down the road to the nuthouse and I would be climbing a never ending hill if I chose to lock horns with him. Having that knowledge made it so much easier to deal with him. Now I just imagine him as a 5 year old in a 60 year old body and I feel kinda sorry for him.

Seek out the advice of your NM and go from there. Hang in there! You have sacrificed too much and have gone through too many years of school to throw it all away on jackwagon docs.

My favorite;

"Oh wait...let me take you off speakerphone...I'm here with the patient's family......"

(Of course....I don't actually have the doc on speakerphone)

LOVE IT!!!!!!

I am of the mind that you answer the doctor calmly and directly. "...why the patient's not on precautions for a disease," would be, in front of the patient (politely), "Because no physician informed us of the disease."

Haha yes actually this is what I did - but my voice I think displayed my annoyance instead of my usual "kill 'em with kindness" politeness. The MD was like "err... yes, umm, they definitely should have communicated that..." and ever since he acts different around me, like he's annoyed to see me and still hasn't let the whole thing go. Even so I said my piece, it still affected my attitude for the rest of the day because I was so disappointed by the rudeness. And that's the part I don't like, about how I let it get to me.

I had a similar problem with a physician at the hospital where I work. In my case I am a Nurse Extern on a med/surg floor and one of the physicians walked into a patients room who was on contact isolation for MRSA without gowning up or gloving and did not wash her hands when she exited the patient's room. I was told if I see the physician do this to contact one of the nurses, so I did. The nurse approached the physician and she denied it at first and when the nurse told her that I saw her do it the physician approached me and told me angrily that if I have a problem with what she does to approach her and went on and on about how long she has been a doctor and that she knows what she is doing. I simply explained to her that I have to look out for every patients best interest at all cost and that she of all people should understand that. She shook her head, called me "impossible" and walked away. She hasn't spoken to me since but who cares. She has however started wearing gowns and gloves into isolation rooms. So I feel like I have done my part.

This is a good thread! I've already copied and pasted some ideas posted.

I'll add one. Depending on the situation, you can figuratively push the MD out of the way if they show a failure to launch. They don't like that.

As a student (maybe I've posted this somewhere already in the past?) I was told to get parameters from a nasty card. My preceptor had already told me he was a PITA and sure enuf there he was at the nurses station slumped down in MY CHAIR (lol) with his arms crossed, smirking. I went to him and asked once, twice, three times. The parameters were for new orders for betablocker on a MI pt who had had a hypotensive episode early a.m. He just sat there silent and smirked at me. So, I mumbled something about how I was going to find the group NP, that she'd know what to order ...and I spun on my heel and off I went over to her at the far nurses station. Well, he hopped up out of his chair and called out to me, "That won't be necessary!!!!!" I got my orders, but I made sure to wipe my smirk off of my face before I turned around to meet him.

"so I'm writing the order that you've stated you will not be taking anymore phone calls about your patients condition, whom should I call instead".

doctor.."no don't write that, I'm just telling you..."... nurse... "so I'm taking a verbal order that you won't be taking anymore calls about this patient...

another scenerio... doctor gives a crappy order say's don't call him again and hangs up... I call the service right bace to that same doc.... "I apologize, we were disconnected you were saying never to call you again... hang on.. I'm charting this... would you like anything else?"

I'll not make excuses for them, but please at least look at your docs and how many calls they get for crap... "can I start another IV?" you know the overworked docs vrs the orifices.

I dare one to hang up on me... I'll blow up his fricken pager for 29cc's of urine instead of 30 per hour, a headache, a sleeping pill...and every time I page them it's documented... sir I've paged you for three hours, be aware that this looks bad in your patients chart....all said with a smile and a happy voice.

The docs I work with, we leave our names in the call systems, They don't mess with me. It takes a bit to break some in.. but I keep calling and I sure as hell keep charting.. it's all about my patient.....

When they yell, and finally stop, waiting for a response.. I ask them to hold for a second.. then tell them that I've written them up, as I will after the call, get the orders I need and remind them, that I will call again and I am charting their response time as well as informing the patient and family as to their response.

I'd lie if I said this process doesn't upset me, because I'm a patient advocate and I do get very mad. But I follow the protocol and write them up, document to cover me, let the family see how they fail and give the family the resources to kick their behinds. It's what being an advocate is all about... it's never easy.

But I do take pleasure in giving the pager numbers of the doc's out to family, as well as ratting those few dogs out.

Cover your butt, do what is right and give family the resources to fight with you. And then, your burden won't be so heavy.

When someone snaps at me, all I hear is, "La de da de da..." and I keep on track until my mission is complete. Dreaming up passive aggressive strategies or witty comebacks is a waste of my valuable time.

Even so I said my piece, it still affected my attitude for the rest of the day because I was so disappointed by the rudeness. And that's the part I don't like, about how I let it get to me.

Yeah, I hear you. It would likely mess with my day too.