Should I report doctor who yelled at me?

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I just started a brand new position in the ER. I'm working in 4 different hospitals and up until last week, everything had been great. One of the hospitals pays a "bonus" on each patient that you see - the docs get paid for both their patients and our patients. It's common knowledge that one doc is money hungry and he tries to sign as many charts as possible before leaving, so he'll get paid on them. He even signs off on charts before the midlevel has even seen the patient. I worked with him for the first time the other day and he started flipping out towards the end of the shift, because all the beds were full and there were people in the lobby. He noticed that I had ordered an x-ray on a patient with thoracic pain and he FLIPPED OUT! He started SCREAMING at me and said, "You can't order x-rays on every patient that has pain because we've gotta move patients around here!" I didn't get a chance to speak and I was so unnerved, I couldn't if I had tried. He then started yelling about a patient who had been there for a couple of hours. I had ordered a CT on her and we were still waiting on the results...like it's MY fault we hadn't received the results of the CT yet?? I've NEVER had a doctor yell at me before and I've been a NP for almost 4 years. I've never even had a doctor question anything I've ever done for a patient...EVER! It's not like I'm ordering an x-ray on every person with chronic pain.

This was witnessed by a PA and several nurses. On top of that, the PA and I were discussing treatment for abscesses and I mentioned that an I&D was part of the treatment. The doctor was walking by and said, "NO IT'S NOT!" The PA knew I was brand new and told me to just "blow him off," because he tended to go off every now and then, but he was "harmless."

I've told a couple of my NP friends about what happened and they think I should report him. I hate to report someone, since I've only been around for one week...I don't want to look like a trouble maker. However, I can't work with a doctor who's going to yell at me and berate me. I left a good job for the pay and flexibility of this one. The chances are slim that I will ever have to work with this doctor again, since I was hired to work nights. Although, there is a one hour period that will overlap with his day schedule, if I'm working at that facility. I think I could stay lost for one hour though. What should I do? :confused:

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Specializes in Nephrology, Cardiology, ER, ICU.

I wouldn't report him. However, I would pull him aside privately and tell him that that behavior won't be tolerated.

I'm a mean, crotchety old lady and nowadays few doctors, nurses or anyone else yell at me more than once.

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Definitly say something to the doctor, if he starts acting like a jerk again report him. You have got to teach people how to treat you! If he thinks he can get away with yelling at you then what's next? Stand up for yourself and for all us NPs!

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If you can stay lost for one hour while he is around then do so. Reporting him may cause you more discomfort than putting up with his behavior. Just avoid the man.

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I would do what TraumaRus stated - talk to him 1 on 1 and discuss it quickly and quietly. In high stress situations it happens.... and I don't think the benefits of a 'stand up' in front of everyone outweigh the real benefits of establishing a working relationship in an intense environment with life/death outcomes :)

ps congrats on the new job!!!

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Sometimes, you have to get down on their level. I'd growl at him to knock it the h** off!!!! Get as rabid as he does, even moreso. A lot of times, they will be shocked to get a dose of their own medicine and it will bring them down a peg or two.

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Specializes in ER, Trauma, ICU/CCU/NICU, EMS, Transport.

Hi there!

Sorry about your situation, I know it's probably pretty unnerving.

It would be hard to suggest an answer without more details.

I do know that if your medical staff doesn't already, they will VERY SOON have to adopt a policy about "hostile work environments" and how the individual practitioners are responsible and accountable. You may want to look into this and see what's in place already. You should be able to go to the medical staff office and get some assistance looking it up without having to drop names - this might be a starting point.

The other thing to know is the structure of your physician group and your relation with them.

For example: in my setting, all the ER mid-levels are hospital employees while the MD's are their own group. They have their own group CEO, CFO and a few other admin types ("partners"). They self-regulate with group meetings and bylaws and such and a type of "peer review". Even though we are from different sides of the fence, we (midlevels and MDs) work hand in hand together seeing patients. But for us it gets a little sticky on how to handle something like you describe.

If your event happened here it could be approached in a few different ways...

1) Approach the ER medical director who IS a hospital employee, BUT has great influence in the contracted physician group

2) Approach my ER nurse manager (my chain of command as we come under nursing); she would then probably consult with the ER Medical director

3) Discuss with my "supervising" MD; who I have carefully selected as a "peer" and an advocate for my advanced nursing practice. While right now my "supervising" MD is not a "partner" of the physcian group he is an associate and he would go to bat for me in the most politically correct way

4) Recruit other sympathetic "group" MD's to my cause that they might collegially approach the "rotten apple"

5) Finally, look into the medical staff oversight on this as I mentioned before.

I do believe you should not let this slide whatever path you choose.

Also remember support from your fellow mid-levels is essential also.

AND remember the ENA (Emergency Nurses Association) STRONGLY supports a conducive workplace environment for ALL ER nurses (staff level or advanced practice too!!).

I'd love to hear what you work out on this.

Good luck.

-Mark

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Specializes in Nephrology, Cardiology, ER, ICU.

Mark - you bring up some excellent points. I too am an ER midlevel in a small community hospital where the ER physicians (and me) are a separate business. I work for the physician company, not the hospital.

I'm very new to the ER and two of the physicians have made it glaringly clear they don't see a need for mid-levels. It is always very important to remain unfailingly polite and to the point with them. Acknowledge the anger, but don't feed it. Offer solutions but don't talk yourself into a corner.

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Hi there!

Sorry about your situation, I know it's probably pretty unnerving.

It would be hard to suggest an answer without more details.

I do know that if your medical staff doesn't already, they will VERY SOON have to adopt a policy about "hostile work environments" and how the individual practitioners are responsible and accountable. You may want to look into this and see what's in place already. You should be able to go to the medical staff office and get some assistance looking it up without having to drop names - this might be a starting point.

The other thing to know is the structure of your physician group and your relation with them.

For example: in my setting, all the ER mid-levels are hospital employees while the MD's are their own group. They have their own group CEO, CFO and a few other admin types ("partners"). They self-regulate with group meetings and bylaws and such and a type of "peer review". Even though we are from different sides of the fence, we (midlevels and MDs) work hand in hand together seeing patients. But for us it gets a little sticky on how to handle something like you describe.

If your event happened here it could be approached in a few different ways...

1) Approach the ER medical director who IS a hospital employee, BUT has great influence in the contracted physician group

2) Approach my ER nurse manager (my chain of command as we come under nursing); she would then probably consult with the ER Medical director

3) Discuss with my "supervising" MD; who I have carefully selected as a "peer" and an advocate for my advanced nursing practice. While right now my "supervising" MD is not a "partner" of the physcian group he is an associate and he would go to bat for me in the most politically correct way

4) Recruit other sympathetic "group" MD's to my cause that they might collegially approach the "rotten apple"

5) Finally, look into the medical staff oversight on this as I mentioned before.

I do believe you should not let this slide whatever path you choose.

Also remember support from your fellow mid-levels is essential also.

AND remember the ENA (Emergency Nurses Association) STRONGLY supports a conducive workplace environment for ALL ER nurses (staff level or advanced practice too!!).

I'd love to hear what you work out on this.

Good luck.

-Mark

I work for a ER staffing company and so does the doctor. I just found out that another NP is no longer allowed to work at that facility, because she "got into it" with this doctor. This company requires that all their docs who work in urban areas are ABMS certified in ER medicine. Unfortunately, this doctor is BC in ER medicine and it's supposed to be pretty tough to find docs who are.

I'm definitely keeping everything documented and fortunately I'll be able to schedule my shifts so I won't have to work with him for over 1 hour. I talked to a few of my peers who work for this company and they all advised me to just avoid him - so much for their support! The ER nurses work for the hospital and I know they don't appreciate being yelled at! I've only worked with this company for a little over a week, so it's not like I have connections or anything. Unfortunately, I DID give up my day job for this one!

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