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The best behavior/verbal respond to the MD raising his voice

Posted

Specializes in General Medicine.

Hello,

I am a new graduate and just recently got off my orientation. I work on a very busy med/surg floor. I had a full load of 5 pts today: two with psychiatric conditions, 2 complete and 1 transfer. In the middle of the busy day the surgeon came and asked me to assist him with one of my patients. I was helping him to find the equipment needed for a procedure and he was getting mad that "it's impossible to get all the needed supplies in this hospital" etc. I told him we don't have a certain type of dressing at this floor and he just raised his voice and said "Why don't you find out what floor has it and get it for me. I already have enough of this..." I was really shocked because I don't think I have ever been yelled at, especially by a male, so I just looked around and other RNs who work with me and watched us did not say anything either... Then I went to look for a dressing and meanwhile one RN told him smth about him being inappropriate, so later he apologized to me in a patient's room (to make it even "better" :-) for being a jerk before he left but I just did not say anything to him at all...

Ok, I know there are a lot of stories out here about being yelled at, etc and I I am not writing my story here to complain or get some sympathy. My question is really basic. If you had to tell a doctor not to raise his/her voice at you in one/two sentences, how would you do it? I wanted to say smth at that moment, but I had hundred of questions in the back of my mind: should I get him to the side, should I say smth right there at the front station so other RNs are my witnesses in case it gets any further, should a charge RN intervene... So, basically what should I do and say not to get to the level of those MDs and stay professional... I am looking for a best suggestion :-)

Thanks! :redpinkhe

Scrubby

Specializes in Operating Room Nursing. Has 6 years experience.

If your being yelled at then you need to politely but firmly say 'I am not comfortable being spoken to in this manner, you need to lower your voice.' If this doesn't work then just walk away from the situation because no one should have to work in this sort of environment. If they then follow you and keep yelling then maybe go to where there will be other nurses at witnesses to this behaviour. If they then still continue to yell at you despite asked to stop then tell them very firmly that their behaviour is unacceptable, that you feel unsafe and will be calling security. Document the incident and write a complaint to the hospital administration.

Bortaz, MSN, RN

Specializes in CDI Supervisor; Formerly NICU. Has 12 years experience.

One important aspect of dealing with him yelling at you would be to appropriately respond to his apology, rather than 'I just did not say anything to him at all...'

A simple 'I accept your apology, sir, and appreciate that you realize that it's inappropriate to yell at your coworkers" would have gone miles toward developing a decent, professional working relationship with this particular doctor.

iluvivt, BSN, RN

Specializes in Infusion Nursing, Home Health Infusion. Has 32 years experience.

In the case you just described my instant instinct was to say " I do not appreciate their tone you are taking with me. I would be happy to assist you if you can behave in a civil manner". This to me covers all bases. I let them know I will mot accept treatment like this but it also lets them know if they can get their act together I am still there to assist them in any way I can. That way I can never be accused of failing to do my job. I have been screamed at a few to many times on the phone but never have had a repeat offender. Ironically, some of the worst encounters I have had with some MDS have later proven to be some of my best working relationships with the physcians.

Have a few good lines prepared to get you going b/c some people freeze and can not think of anything to say at the moment. Luckily.this kind of behavior is frowned upon in the workplace...for many years we were on oour own and you defended yourself or you would get a repeat offender.

olli975

Specializes in General Medicine.

One important aspect of dealing with him yelling at you would be to appropriately respond to his apology, rather than 'I just did not say anything to him at all...'

A simple 'I accept your apology, sir, and appreciate that you realize that it's inappropriate to yell at your coworkers" would have gone miles toward developing a decent, professional working relationship with this particular doctor.

Thank you for the suggestion. I realize that would be better but we were in front of the patient, therefore I did not want to discuss anything :-)

Scrubby

Specializes in Operating Room Nursing. Has 6 years experience.

I personally believe nurses should still have the right to assert themselves in front of the patient, otherwise patients too will think it's acceptable to yell at nurses and be disrespectful.

Bortaz, MSN, RN

Specializes in CDI Supervisor; Formerly NICU. Has 12 years experience.

I personally believe nurses should still have the right to assert themselves in front of the patient, otherwise patients too will think it's acceptable to yell at nurses and be disrespectful.

Absolutely agreed. And in this case, they physician chose the venue. I'd have used it.

Magsulfate, BSN, RN

Specializes in ICU. Has 13 years experience.

I've only been yelled at twice, and that was when I was a new ICU nurse and I had screwed up. Once it was because I accidently let a pt eat before he was suppose to get a heart cath. (didn't realize he was getting one this am) SO, I let the doc yell for 30 seconds or so, then I softly told him I was sorry and that I would never let that happen again. Let me tell you, that doctor quieted down REAL fast. Just with my reaction to his yelling, he probably realized what he was doing.

The other time, I Didn't call the doc to get abx after I recieved a CXR and the pt had pneumonia. I just wasn't thinking and didn't even look at the MAR to see if the pt had abx.....

Other than that, I've never been yelled at, but I think the best way to approach it is to tell them something like ""if you want to talk to me,, stop yelling." Or like another poster said previously..

sissiesmama, ASN, RN

Specializes in ER, TRAUMA, MED-SURG. Has 22 years experience.

Hey - First, congrats on finishing nursing school and joining our profession. I have been an RN since 1991 and have worked various facilities, and different specialties. They have physicians that can be sweet, polite, and appreciative of what you do. this type of MD makes you enjoy your job.

Unfortunately, there is also another breed. The type that will curse you, yell, and yes, even throw heavy objects at you. I have had nurses station phones ripped from the outlet and hurled at me, all at the nurses station in front of witnesses.

I have had a physician scream at me that he would find out where I lived and kill my dog.

I have had a heavy door slammed in my face while he was spewing obsenities at me, still in front of the patient and family.

I actually had one MD who we found out later that they were working under the influence pick up a copy machine at the nurses station and throw it at my feet because they were trying to get a paper jam out and couldn't. Apparently mama never taught them how to say please and thank you.

When a MD is angry at something and he begins to raise his voice at me for something, I attempt to diffuse the situation, and try to stay calm because I don't want to sink to his (or her) level. I try to get away from patients and families, but after having some of the above objects hurled at me, I do try to have a staff member as a witness. Doesn't have to be right there in our faces, but within earshot and in sight of everything going on. If things begin to escalate, I do get our manager or the nursing supervisor, because I am not having luck in dealing with that particular situation.

When I charge, I can usually calm them down and try to figure out the problem and find out what I can do to calm them. The majority of the ones that act stupid are relatively new and the ones that know me I can usually calm down pretty quickly.

Oh, the MD that threw the copy machine down at my feet was a female! Go figure!

Anne, RNC :banghead::banghead:

olli975

Specializes in General Medicine.

I think I came up with a good line myself. I would just say: "Dr, in order for me to assist you with this procedure, I would like you to change the tone of your voice. I do not appreciate you raising your voice at me. This is a hospital setting and we need to remain professional in front of other health care workers, patients and families"

I am not going to let an MD raise his voice at me, I am not. I promised to myself that was the first and last time I let it slide. :redpinkhe

olli975

Specializes in General Medicine.

Hey - First, congrats on finishing nursing school and joining our profession. I have been an RN since 1991 and have worked various facilities, and different specialties. They have physicians that can be sweet, polite, and appreciative of what you do. this type of MD makes you enjoy your job.

Unfortunately, there is also another breed. The type that will curse you, yell, and yes, even throw heavy objects at you. I have had nurses station phones ripped from the outlet and hurled at me, all at the nurses station in front of witnesses.

I have had a physician scream at me that he would find out where I lived and kill my dog.

I have had a heavy door slammed in my face while he was spewing obsenities at me, still in front of the patient and family.

I actually had one MD who we found out later that they were working under the influence pick up a copy machine at the nurses station and throw it at my feet because they were trying to get a paper jam out and couldn't. Apparently mama never taught them how to say please and thank you.

When a MD is angry at something and he begins to raise his voice at me for something, I attempt to diffuse the situation, and try to stay calm because I don't want to sink to his (or her) level. I try to get away from patients and families, but after having some of the above objects hurled at me, I do try to have a staff member as a witness. Doesn't have to be right there in our faces, but within earshot and in sight of everything going on. If things begin to escalate, I do get our manager or the nursing supervisor, because I am not having luck in dealing with that particular situation.

When I charge, I can usually calm them down and try to figure out the problem and find out what I can do to calm them. The majority of the ones that act stupid are relatively new and the ones that know me I can usually calm down pretty quickly.

Oh, the MD that threw the copy machine down at my feet was a female! Go figure!

Anne, RNC :banghead::banghead:

Are you serious about throwing instruments and a copy machine? Wow, did you report them?

sharona97, BSN, RN

Specializes in IM/Critical Care/Cardiology.

I've had charts thrown at me. Female doctors are either the best or the worst. Don't know why.

I've had a female doctor try to destroy my career....hmmm right after I turned down her invitation to become "her" nurse. The board din't buy it.

As far as male MD's, I've never seen such a childish tantrum in some and I'm a mom!

What do I do?

Tell then it's unacceptable to their face.

In regard to the woman who went to the board, I kept a one week diary of events. Such as telling me to take O2 off a patient who came in with chemical burns and on our way to xray. The 02 was ordered by the triage assessment doctor who I was with when we met the patients at the door.

After one week of pulling stunts like this, I knew my license is my license and I wasn't about to take the fall for stupid behaviour on their part. I met with the administrator and wrote a follow up letter to start a paper trail. Not fun but nec.

Sometimes I just had a wet back and realized maybe they are having an aweful day and are completely stressed.

I guess I am a believer of my own fate. If I am really trying to help an MD ( which I am ) the best I can, I know it. Maybe they can't see that at the moment. Or maybe they are as superficial towards co-workers as you can get and will never see the light.

I keep my standards high and work through the differnt situations as they present.

Not always easy. Some surgeons have been the worst to work with in my experience. It's weird when you try to figure them out, I just try to go with the flow and smile sweetly, waiting for the next barking order.

Another day in paradise! You learn as you go.

Good luck and best wishes in your career!

Sharona

classicdame, MSN, EdD

Specializes in Hospital Education Coordinator.

Ask "Are you hard of hearing?" When he says no, reply "Neither am I". If it continues, tell him you will listen when he lowers his voice.

MaryAnn_RN

Specializes in ICU. Has 15 years experience.

Snotty doctors come in all shapes and sizes. There is a new female doctor at work, very sharp with all concerned. Then the theatre matron had words with her and she - the doctor - came crying to the ICU nurses. She has been soooo much more polite with us ever since.

HappyPediRN

Specializes in Pediatric Psychiatry, Home Health VNA.

Truthfully I would have told him "Go find your own supplies and then come find me when you're ready to speak to me like a professional."

Flare, ASN, BSN

Specializes in school nursing, ortho, trauma.

I agree that you should have accepted his apology. Even though you were trying not to discuss it infront of the patient, you still should have made some sort of acknowledgement to him.

I have had my fair share of snotty, bratty doctors and while i haven't had a copy machine thrown at me, i did have a chart thrown at me, hitting me in the face. My offense in the doc's eyes was not being able to read his handwriting. To which I was met with a face full of the chart and him screaming "How about now! Can you read it!". I calmly picked up the chart and simply said "How professional." He realized that he made a terrible mistake and was apologetic beyond words. We had a long discussion about decorum - i felt like a mom berating a 7 year old. I was tempted to offer him the choice of me reporting it to my manager or me getting even by throwing a chart at his face - but in the end i just ended up reporting him.

Not_A_Hat_Person, RN

Specializes in Geriatrics, Home Health. Has 10 years experience.

The problem with "I" statements is that you assume the other person cares about your feelings, or how their behavior affects you. That's a huge assumption.

I've had experiences like this in my current job. I never raise my voice to them; as Dear Abby said, you can't shame the shameless. I usually respond with "I'm right here, You don't have to shout." or "If you ask me like that, I'm not doing anything." If they start swearing, I say "If you're you're going to use that language, I'm going to have to end this conversation"

With the doctor who yelled about supplies, I'd probably say

sissiesmama, ASN, RN

Specializes in ER, TRAUMA, MED-SURG. Has 22 years experience.

olli975- Yes, unfortunately, those things happened to me, and others that worked with me. I'm all for giving them respect, but once they do something like that, I don't feel like I should have to respect them while at the same time dodging heavy objects. That sounds rude, I guess, but please...

When I was in school, we were taught the common courtesies, for lack of a better word. It's still ingrained in my head. When a MD comes into the station, I automatically stand up and give them my chair, even if I'm at the computer charting or whatever. The dh is a nursing sup. and he does the same thing. Some like you to walk a step behind when you are rounding with them and sometimes even want you to write their orders on the chart when they give them orally to you on rounds. Sometimes I know I just really don't have time for that, on a medical unit where I used to work, we would have between 10 and 12 patients. That doesn't leave a whole lot of time for bull, so I do what I can.

But anyway, the MD that threw the copy machine got turned in - thank God I did have a witness- and sent to a month of anger mgmt classes then to inpatient rehab. They don't practice medicine any more. The one that ripped the phone out of the wall and threw it got written up and eventually left the area where we live, not sure why, but it was his second offense using the phone as a personal weapon. Figures!

So, the ones that showed their tails did get written up, most of the guilty parties are newer MDs, the older ones I knew since 88 or 89 when I was a ward clerk. I guess the younger ones think they need to get a reputation, but who would want that kind of reputation?!

I never go to a MD if they act like that to staff members, I ask my parents to either.

Anne, RNC

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