screaming doctors....how can we handle them?

Nurses Relations

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I work on a fast paced med/surg unit in a large hospital. For the most part our surgeons are great caring doctors who are easy to get along with. But we have one especially, who is a peripheral vascular surgeon, that is the most rude, degrading, loud, and angry doctor you could imagine. I mean you should hear the stuff that comes out of his mouth.

We have many good nurses on our floor, we are by no means incompetent. We even have one surgeon that insists his patients come to our floor and our floor only. But this "jerk" doctor will sit in the nurse's station and demand to speak to so and so's nurse and then as soon as they approach him he will lay into them in front of everyone; fellow coworkers, patients, visitors. He usually screams and says what horrible nurses we are and that he should never bring his patients here, and hes just very very degrading and nasty.

For instance tonight one of our nurses had a post-op angioplasty/stent placement patient who was complaining of numbness that just started in his foot and was progressing up to his shin and calf. This was the foot he had just been operated on and he said it had never been numb before and the numbness was spreading. So of course that nurse called the doctor who happened to be the "jerk" doctor. He ended up coming in, assessed the patient, and decided there was no need for concern. Well he came into the nurse's station, plopped down with his feet up, and demanded our unit assistant to get the patient's nurse.

When she didn't appear before him within 30 seconds he demanded to have the nursing supervisor called. In the meantime he is looking around for the patient's chart and sees that the patient's medical doctor is there looking through it. So he leans over, grabs the chart from the other doctor without saying anything, is tearing through it getting what he wants, and then gives it back to the doctor without saying a word.

By this time the nurse had made it to the nurse's station and the first thing he says to her is "have you EVER taken care of a vascular patient before?!" she says yes of course. He then proceeds to rip into her about why would she ever call him when there's nothing even wrong with the patient and that he wants to know how he can have all his patients transferred to another hospital, and so on and so on. I mean he literally yells so you can clearly hear him all the way down the hallway.

Then when he was done with her he demands again where the nursing supervisor is and our unit assistant tells him that she is on the phone but he demands that she come to the floor because he wants to talk to her face to face. our unit assistant tells him that she is doing staffing for the whole hospital and will be there as soon as she can but it wont be right away.

He stands up and slams his pen down and says forget it, let her know i will be speaking with the vice president of nursing tomorrow. make sure you tell her that! and he leaves. It was unbelievable that a human being would act like that....and the sad thing is, this has happened just as bad if not worse many many times with him in the past.

So my question is, has anyone else ever had to deal with this and how did you react? Are we allowed to stick up for ourselves or do we have to sit there and take it? He has never yelled at me but im sure its bound to happen and i really dont know if i would be able to keep my mouth shut. I was just curious on other people's thoughts on this...

Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.

That behavior is not tolerated at my hospital, nor is it tolerated by me.

I think that HR needs to review their policies and enact a workplace violence/harassment one.

Go up the chain of command, see what your options are.

And at but not least, should you decide to go this route, a nurse in TX or was it Tennessee successfully sued a physician for doing exactly this and won a judgment, so there is precedence.

Personally, I wouldn't allow this behavior towards me. It is extremely dysfunctional and says a lot about your employer.

Good luck...and don't allow anyone to have power over your self-worth/esteem by allowing this behavior. It is disgusting.

J

Do as I did at my hospital. I was an internal medicine resident, I got yelled by a young nurse in the nurse station for a couple of seconds and it was so loud that other nurses came out of pt rooms to see what was happening.

I reported her. Next time I had a pt with her she was very polite.

report him. is that simple. If I did it as a resident (lowest person on the hospital pyramid) you can do it too.

Specializes in Med/Surg.

In our hospital we have a reporting system. We fill out a form; send it to human resources, and they follow up and counsel the doctors as needed. If your hospital has something like that I suggest you do that. If he acts like an a** again, be professional, and point out the fact that he's behaving unprofessionally and if he continues to act like that just walk away. He will end up looking like a fool, especially to the patients. Make sure to document, document, document!!!

Two ideas:

Long, long ago, a very wise nursing instructor told us about this same thing happening to her and her coworkers. They fixed it by the following:

1. She had a "comeback" memorized and ready to go if the offending doc got out of hand. Something along the lines of "I will not be hollered at. When we can talk about this rationally, like adults, then I will listen to you." Whatever you decide on, memorize it, so that when it's needed, you don't have to think about what to say.

2. They had their unit clerk call a pre-arranged "code" over their unit's PA system. All the staff knew (officially or unofficially, I'm not sure) to come to the nurses' station when that code was called - they would all stand around the nurse and give her their physical presence as support.

I'm lucky, in 12 years I've never been hollered at. But I work in a smaller institution, and the docs need us as much as we need them, and they know it.

Specializes in Adult ICU (All over), NICU, Education.

Have the nurse and anyone that witnessed the incident fill out an incident report. Where I work the risk management department sends the report to the responsible party/department and they have to address it....fill out enough of these reports and hopefully his provileges will be revoked.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
wouldn't you just love to tell him something like....

"i am certain that you won't have a problem with having any of your patients in this hospital once you lose your privileges here for your increasingly unprofessional behavior, both in your apparent attempts to avoid patient care through bullying and in exposing this hospital and it's staff to unwarranted risk of lawsuits due to your careless and unfounded allegations.

if you can't follow up on your own work when there is an apparent change in condition, and answer your patient's concerns about said changes in a professional manner, then perhaps we can find another md for the patient who can.

with all your education, you should be aware that nurses are not allowed to diagnose, but must be an advocate for the patient and report any changes in condition. if you can't be bothered to do your job, don't try and blame me for not doing your job."

it's perfectly legitimate to tell him that, if you think you can pull it off.

i've also had good luck with rolling my eyes and saying with an absolutely straight face, "yes, i'm sure dr. smith ordered this consult just to ruin both our days." i hadn't planned to say that -- it just popped out. but it worked. dr. jekyll thought about it for a minute or two, and then started to laugh. i never had another instant's problem with him for as long as i worked there.

"let's talk in here," as you're leading the way to a private area works. and then feel free to tell him he's behaving worse than your two year old, but you'll be happy to discuss the issue when he calms down.

and if nothing else works, i've had extremely good luck with the "wall of white." when he starts carrying on like a jackass, every nurse on the unit comes and stands shoulder to shoulder with the one he's addressing. no one says a word. they just stand there. usually it works right away -- they kind of sputter to a stop and only one such treatment cures them. even the hard cases respond to two or three. there was one cardiac surgeon, however, who didn't respond even when every nurse, usc, cna, pt, social worker and pharmacist on the floor stood with the nurse he was verbally abusing. but our medical director happened to be on the unit one day when this was going on, and got every physician in the house to come and stand with the nurse. word must have gotten around, because that was the last time we ever had to use the "wall of white" in that hospital!

I have had multiple docs get mouthy with me on the phone. I pick my battles... I am the type of person that will take so much and then I burst my top and tell them they need to stop ... most of the time in a nice way, but sometimes not as nice as I *could* be.

You need to stand up for yourself. You and others need to tell these docs that this is NOT acceptable behavior. If they continue to be verbally abusive, the only thing you can do is tell them that the current conversation is over, get the chart for him and set it in his reach, and tell him "If you wish to write additional orders, GO AHEAD, but you will not get anything else out of me until you can act like a civilized adult."

Specializes in Psych.

I have dealt with this type of behaviour on a few occasions. First of all, he will only continue to behave this way as long as he thinks he can get away with it...

I got into a yelling match with a surgeon once -- waste of time as I was in the gutter with him. The next altercation I had was with an attending and by this time I had learned not to get involved. I just restated my business concerning the patient and said "this conversation is over -- you are not going to talk to me like that" and walked away. It was all in front of my co-workers and one of his residents and he apologised the next day without any prompting.

In my mind, this behaviour is worth of an incident report. It is no different than physical violence. Times, dates, direct quotes should be kept. Note the stress this caused and how it affected the work environment. If your place of employment does not support you, report him to the medical board or seek the advice of someone from the labor department. Do you have a union? How about employee assistance?

Specializes in NICU, PICU, educator.

First off, people need to stand up to him. When he starts, someone needs to get on the phone to the nursing supervisor and any higher ups if it is during the day when they are there and make them come down and witness this. JCHAO (or how over you spell that lol) has a mandate on bullying in the workplace...this guy can lose his job if he is written up and taken to HR so many times. You ALL have to write him up ever single time he does this. Also, I agree...you need to just say to him, as he is ranting "I cannot stand here and allow you to speak to me like this...if you want to continue this conversation in a better setting and in a more civilized manner I will be in the conference room."

We had an attending that used to do this in the unit in front of patients...he was turned in, HR sent him to anger management classes, he was suspended from the unit for 6 months. Pretty much they told him one more time and he is fired.

a surgeon is taught be feel superior and his belief that he is the God factor. The bad boys are encouraged to fight for their opinions among their peers. I once had a surgeon to insist that I be written up when I had passed on the info in report that I had not been able to do. They are a fussy sort. I agree with NBMom1225, call a code gray. Verbal abuse among peers is detrimental to all.

The incident OP described? I'd have probably broken into hysterics of laughter. That's just so over-the-top pompous, I'd have gone past the point of being overwhelmingly angry with him that I'd be laughing.

But for those that wouldn't be laughing with me, as was said above, he does it because he gets away with it. Pick your choice of ways to stand up to him, and don't back down.

There is a proper way to stand up, and a protocol. Document incedent and the go the the Nsg Big Dawg. It really takes higher nursing mgmt to deal with these things. Nursing standards are followed and documented. This may be something that Department Heads may have to address.

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