I recently became the victim of harassment in the workplace, only to watch my nurse manager cater to the physician as he belittled me and used profanity towards me in her presence.
Backstory: Two weeks ago, a surgeon asked me how his patient was doing. I reported to him that she was very weepy during the day and had mentioned being upset with him because she came out of surgery with 3 JP drains and she had not been expecting that. He marched into her room and began yelling at her. He told her she had better change her attitude because he saved her life and he would stop making rounds on her completely if she didn't start thanking him every time she saw him. I was present during this interaction and said This needs to stop. NOW†and walked out of the room. He told me Don't you ever walk out while I am speaking†and walked off. I did report him to my supervisor, but did not make an occurrence report to human resources, which I am now deeply regretting.
Yesterday, this same surgeon told me he was writing up a discharge order for one of the patients. I told him her blood pressure had been running high and rattled off her morning vital signs from my report sheet. I was waiting in line to pull medications from the Pyxis and he asked me when the patient had received PRN medications last. I replied I'm not sure because I'm not in front of the computer, but I've been here since 7am and I haven't given her anything and it's now 8:15am.†He was sitting at the computer and replied me Well log on and tell meâ€. I knew he was trying to throw his weight around, so I replied I am about to pull medications so I can't do that right nowâ€. He became angry and demanded to speak to my supervisor.
While we were speaking to her, he insulted me, called me names, and used profanity towards me. To my absolute surprise, my nursing supervisor kept making comments like Yes, sir. I agree with you sir.†and She will be spoken toâ€. She not once interjected or disagreed with him. I feel that her very attitude serves to only inflate the ego of this physician and makes his behavior acceptable. He literally made me go to my supervisors office and his argument was she didn't do what I told her to do when I told her to do it!â€. After noting that she was just agreeing with everything he said, I said I'm done with this conversation, I have to go take care of my patients†and began to walk out. The physician replied You're a nurse, you don't get to decide when we're doneâ€.
I may be a nurse, but I am also a very real person with very real feelings. His commentary serves to explain his treatment of me. To him, I am beneath him and am even unable to decide when I no longer want to participate in a hostile exchange. I was upset at how he was treating me, but even more upset that my nurse manager did not intervene. The message she sent across is that I may be important, but he is MORE IMPORTANT to the facility because he is a surgeon. My nurse manager was practically agreeing with him that I needed to wait until he ended the conversation.
This lack of support for nurses should be highly frowned upon and should not be tolerated. I may not have gone to school for 8 years, but I do have an education, a mouth, and a brain and I can make my own decisions! I am more than JUST A NURSE. As nurses, we get caught up in patient care to the point that small interactions such as my original encounter with him go unreported. We must stand up for ourselves and our profession and report incidences such as this one to protect ourselves. We can no longer tolerate doctors making us feel inferior or demanding that we stop performing our responsibilities to cater to their needs.
I am now left with only a few witnesses of our original encounter as my ‘proof' and have been ‘fired' from taking care of any of this surgeons patients in the future. I did nothing wrong, but all of his request were fulfilled and I am left waiting the response of human resources, from which I hear, will do nothing. We need to change this and demand to work in environments in which we are valued and supported instead of freely belittled and harassed. Report all of these incidences to protect yourself!
so, you would prefer a lie? is he that childish that he can not cope with the truth?
No but making a doctor mad at a patient right before he goes to see the patient is crazy. Let her tell him that's she mad at him. Tell the doctor that she is upset and leave it at that.
So this is a bit of an aside... This may not be the most popular point of view but here it is: While Doctors are not our bosses (we are governed by our own regulatory body), we do literally take orders from them. A hierarchy does exist, whether we like to admit it or not. We can advocate for care and treatments for our patients. We can relate assessment findings and help paint a clinical picture. We can guide doctors when they write (or should write) orders. The list goes on and on. But at the end of the day, we have chosen to work in a field where we are not 100% autonomous (at least in most specialties and APNs aside). However, although a hierarchy is present, we are in a symbiotic relationship with doctors. We are highly dependent on each other and optimal patient care tends to occur when we work in unison as a team, recognizing each others strengths, knowledge, and skills but also our own limitations.
Sometimes I have noticed that the power struggles that tend to occur between doctors and nurses happen when this hierarchy is perceived to be threatened, especially if one of the parties has a fragile ego (ahem, the surgeon in your post OP). Generalization: surgeons especially, seem to have a low threshold for "insubordination." They are making split-second life or death decisions on a daily basis and have to competently and confidently direct a team to carry out their plan of care. Surgeons tend to be a certain personality type because, well, they kind of have to be. This is not an excuse for this doctor's behaviour. It's just a context. Personally, keeping this context in mind helps me to better understand some of the different personalities I work with.
My perception of your situation is the doctor had to make one of these life-saving decisions (hence the unexpected drains) and was upset that the patient didn't appreciate his efforts. Not only were you the bearer of this bad news, you called him out on his inappropriate interaction with the patient in front of the patient. Double eep! You became his new target. I think that you did well to stand up for yourself, OP. It's never ok to be verbally abused and belittled. It's also never okay to verbally abuse and belittle a patient.
That being said, it was a two-way interaction. It sounds like you have reflected on the ways in which your own statements and actions contributed to the situation. Did you stand up for the surgeon when the patient complained about the drains? It's obviously upsetting to wake up with something unexpected after a surgery but the drains are serving a purpose. If a patient complains about nursing care to a doctor (i.e. it took so long for me to get a glass of water this morning!), I appreciate it if the doctor is on my side (well, you're not in a hotel!). Phew! Long post :) Hope you have a good outcome from this!
The patient's needs come before your personal vendetta with the doctor. You are not the most important person here; the patient is. Yes, it would have been appropriate for you to help the doctor in caring for his patient, as you were the patient's nurse.
Can't the doctor log in and see when the last PRN was? If not, yeah, I guess I would have done it for him when he asked.
I also would have not said pt was upset by 3 drains.
This doctor sounds like he's under some serious stress to talk to a pt the way he did. He was seriously rude and unethical - threatening to abandon her, demanding that she grovel and worship him. Is he known to have treated other patients like this? This is simply not acceptable behavior, especially if he is an employee like so many doctors are these days.
Did this happened recently? If so then you should be able to file a grievance with your institution. THe policy should be available from the HR department. They may ask that you speak directly with your manager or their manager because the grievance process can be lengthly. Everyone would like to avoid it but in this situation your manager needs to be held responsible. They are supposed to be your advocate, not the physician's. If it cannot be resolved at that level then I would file a grievance against your manager and the physician.Also, if someone is cursing or using profanity at you that is called assault. Call security immediately if it happens again.
I would also report this to your Medical Staff Chief; the physician's behavior is against their code of ethics behavior and should be part of his/her recredentialling file. When staff don't report adverse physician behavior, patient safety can become an issue due to avoidance of interaction. Include dates, patient information regarding the original poor behavior.
Specializes in Med Surg, ICU, Infection, Home Health, and LTC.
Even if the write up and documentation is late I would write both incidents up. The two combined show a pattern of behavior on his part. If you have a physician peer review I would certainly use the forms they provide as well. If your hospital has an Ethics and Compliance hotline call them.
You are 100% right and I commend you. Doctors are not gods and they are not entitled to be buttholes even if they may act like that at home. We do not lose our rights to be treated with respect and have the same right at work as we would in town. No one has the right to verbally harass and belittle another licensed person.
I would absolutely report his interaction with the patient that is flat out abuse. He should be chastised. I think you are one of my new heros and in my 30 years of nursing I have seen very few worth supporting sadly.
p.s. I would also write up that manager. No one in the trenches needs a manager that throws them under the bus. I think you may be a manager in the making, back bone and all one day!
I might have done what you did and only reported to my unit manager in the HOPES (expectation) s/he could handle the matter to everybody's satisfaction. So, you did what I probably would have done. Your manager should have had your back. She didn't (AT ALL) and I think it's pretty obvious she has no business leading other nurses. So... maybe my first reaction would've been incorrect... maybe this is something for HR to handle.
springchick1, ADN, RN
1 Article; 1,769 Posts
No but making a doctor mad at a patient right before he goes to see the patient is crazy. Let her tell him that's she mad at him. Tell the doctor that she is upset and leave it at that.