Rudeness by physicians!! Anyone else experienced this?

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Specializes in Dialysis.

This is a vent/question for all...I was at clinical yesterday on a tele/med-surg floor. This may seem a little rambling, but I need to set up the situation. My pt had end stage renal disease and receives hemodialysis. He was admitted because of a bad fall that occurred while he was confused (d/t all the toxins in his body). His elbow was badly bruised and swollen and he is sore all over. He especially complained of back pain yesterday, even more than the sore arm. I went to physical therapy with him, and the PT showed him how to use his arm brace and walker for mobility. He will likely stay on the rehab floor to gain strength before he goes home. On the unit, an aide and I walked with him since he is a fall risk. We constantly reminded him to use proper form while walking for safety and needed to keep orienting him to what he was doing. He was a wonderful man and had great stories to share, but when he would stop to share a story, he would forget to walk safely. He was quite confused and forgetful all morning. He had a Foley catheter inserted to accurately check his output.

My clinical instructor (CI) and I assisted him in changing into his clothing for the day. Since he had such limited urinary output, CI and I discussed the possibility of finding him a leg bag for the duration of his stay. CI also recommended that I notify the pt's physician of the amount of urinary output, because this can impact the frequency and duration of dialysis. I agreed, and found the MD in pt's room. As he was leaving the room, I updated the MD on the pt's output. He looked at me in the most condescending manner, and informed me that "he's on dialysis, so he won't have much output". He then turned around and walked away. I said that I was aware the pt was on dialysis, but that I felt he should know.

I didn't take his rudeness personally. I felt good knowing that I kept my patient safe by doing the right thing. However, I am not a stupid person and do not appreciate being spoken to in that manner. I have an advanced degree. I've been working with this patient ALL morning. I saw his old fistula, his new graft, and his dialysis catheter access. I'm a senior nursing student and know how important I/O is, especially for HD patients. I think I'm irritated because he spoke to me as if I was the dirt on the gum on the bottom of his shoe, and not as someone who is concerned about his patient. Now, to be fair, I've experienced great MDs, too. Some have been great teachers, and some welcomed me to assist in procedures. Others didn't say much of anything and just ignored me. There's a real variety of personalities and I know people have bad days. However, there isn't a need to treat students like pond scum! Please help- this is bothering me! Thanks!

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Specializes in Oncology/Haemetology/HIV.

Where to start?

While no one should be rude to you, you will find a certain amount of rudeness from MDs/other nurses/lab people/pharmacy/insurance people/UR/Pt/OT. Not to excuse it but the situation you describe is on the "milder" end of the rude spectrum, relatively speaking. Of course, much depends on tone.

And having an "advanced degree" does not make any difference - no one deserves rudeness, whether they be a housekeeper, nutrition aide, or a CEO.

A couple of questions: As this patient was ESRD, did you and your CI review the prior output records, and discuss this issue with the staff nurse/charge nurse, in conjunction with data on when the HD was done? Did you review the MD notes? If the pt had consistantly low output, especially right after HD, then there was no reason to notify the MD. The staff/charge nurse can also clue you in as to whether this is the norm for the pt. And your CI should have encouraged this commonsense research.

If you were a renal MD, and every single shift, for every ESRD that has poor UOP, called you, you would never being doing anything but answering calls. And you would get a bit peeved, if this as the pts norm.

Now, if this was a major change, then the MD really needed to know, but chances are, in most ESRD cases, this would be the norm. While some renal failure pts still produce plenty of urine, most ESRDs with the symptoms that you report don't void much.

I will warn you that when working with the variety of people working/receiving healthcare, this relatively minor rudeness. To certain extent, you need to let some of this roll off - trust me, there are much more major rudeness issues that you will need to tilt out later on. Sad but true.

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Specializes in Dialysis.

I absolutely agree with you. Degrees or not, all persons should be treated with equal respect. I did not mean in any way to imply that a degree should imply a certain level of respect- or not- and certainly apologize if my statement was interpreted in this manner.

Thank you for your insightful feedback on my situation. My pt had HD the day before I cared for him, and I had not reviewed his previous outputs with his RN or charge RN. I reviewed his meds and other labs, but for patients with his history, this is certainly a prudent approach. I will do this in the future, and it will be helpful in my future practice.

I think I was just irritated because I treat all people respectfully and patiently, but the tone he took with me was just incredibly condescending. I was a student acting with my best intentions. In the future I will do more research before I bother him with irrelevant or redundant details. I will also work on developing that rhinoceros hide. :)

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Rudeness should never be condoned from anyone, but you will find that some physicians have an almighty God complex.

1. I've seen physicians scream loudly at staff in front of families, patients, and visitors

2. I've seen surgeons pound their fists because the surgery was not going smoothly

3. I've had physicians curse, swear, and holler because the nurse had the nerve to call and report a change in condition regarding a patient

There are many more instances, but I will agree that what you've experienced is on the milder end of rudeness from doctors.

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I agree with all the previous posts; there is no excuse for rudeness. But, welcome to nursing . . . you will be able to write a collection of rude comments for your memoirs . . . doesn't make it right but it will occur. You will find that some physicians are just rude jackasses and there are some that realize that we are their "eyes and ears" and they appreciate our work.

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get use to it, you've got more to come. just think about it and how you treat and will treat the rn's, lpn's, cna's and so forth that are under you.

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Specializes in Nephrology, Cardiology, ER, ICU.

Hi and I do apologize that this physican was rude to you. In the grand scheme of things, this is a minor amt of rudeness.

Now as to the HD pt:

1. Few to none of them need a foley catheter. This only predisposes them to urosepsis or at the very least a UTI.

2. Intake and output - intake is the important thing. Dialysis pts should have no more than 32 oz/day. This can be increased by the amt of urine they produce if its more than 1 cup. However, after a pt is on dialysis for awhile (it varies from pt to pt), they will produce less urine and finally will become anuric.

I hope that you will cont to ask questions. Some things people say are better left ignored.

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Specializes in Cardiac Telemetry, Emergency, SAFE.

Heres a similar story for you:

AS I student, I was in my ICU rotation, My pt was to have a bedside bronch done and I was going to observe. SO, high and mighty doc walks in there.....turns straight to me and says "What pain meds is this pt on?". My response "Nothing.". Well, he scoffs in disbelief, and basically questions my intellect under his breath and calls for the pt's "real nurse". She enters, he turns to her and asks "What pain meds is this pt on?". Her response: "Nothing." If looks could kill. :p

Lol. I dont know what answer he was going for, but he made such a big stink about my answer that i took great pleasure in the RN giving him the same one.

Dont give up. Some people (doctors and others) are just jerks. Nothing you do will satisfy them, just dont take it personally. Or take the time and try and turn it into a learning moment. Possibly pose the information in the form of a question. Some docs so have a soft spot for teaching and will soften up and share that way.

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Specializes in OB/GYN, Peds, School Nurse, DD.

I think I was just irritated because I treat all people respectfully and patiently, but the tone he took with me was just incredibly condescending. I was a student acting with my best intentions. In the future I will do more research before I bother him with irrelevant or redundant details. I will also work on developing that rhinoceros hide. :)

I have never met a specialist that wasn't a complete pompous @$$. Get used to it. You can't control how other people act. You can only manage your own reaction. You can get put out with them or you can choose to rise above it. They can be condesending all day long, but if you refuse to take the bait and continue to be respectful *others* will notice and respect you for it. Just don't expect doctors to "get it."

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Specializes in Operating Room Nursing.

I used to get really upset by those sorts of comments but now I just don't care. If someone wants to be rude and make condescending remarks I just ignore it or make an equally sarcastic comment back to them. I can be pretty darn rude too when I want to be.

Screaming, swearing and throwing things is different. That's when I stand up and tell them to back off cos they're out of line.

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Specializes in Peds/outpatient FP,derm,allergy/private duty.
Rudeness should never be condoned from anyone, but you will find that some physicians have an almighty God complex.

1. I've seen physicians scream loudly at staff in front of families, patients, and visitors

2. I've seen surgeons pound their fists because the surgery was not going smoothly

3. I've had physicians curse, swear, and holler because the nurse had the nerve to call and report a change in condition regarding a patient

There are many more instances, but I will agree that what you've experienced is on the milder end of rudeness from doctors.

All of the above, plus one who threw every stick of furniture in his office out into the hallway. It ended up in a pile one might expect to see in preparation for a bonfire. Maybe he was actually planning to light it, but I'm not sure. The Chief of Staff showed up right about then. :uhoh21:

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People in general are ruder today than a couple decades ago.....you see it on the roads, in stores, theaters, etc.

MDs, or nurses for that matter, are subject to the same trends as the larger world.

Not to excuse it, but life is easier after you develop a thick skin.

If simple rudeness escalates into abuse, then some action should be taken, just learn to choose the ground you fight on.

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