:angryfire I have been in ICU for 4 years now, in 3 different hospitals. Never, have i EVER experienced or witnessed as much verbal abuse as I have since coming to this last hospital. I am a recent transplant from a much larger ICU where physicians truly respected the nurses' opinions....maybe 1 percent who didn't. now what i seem to be dealing with are dr's who don't respect me and who i don't respect in return. i hear other nurses getting screamed at over the phone and THEY TAKE IT!!! today was my first horrible experience, where the dr actually told me to "never bother him again". (the order was for him to place a CVC in a septic patient, he placed an 18gauge IV and wrote in his note "this will be sufficient". never attempted a CVP. I questioned him)
the nurses around me just said "oh, that's HIM." and i had the incident report in my hand ready to write him up.
i'm just venting. but any advice for how to deal with these docs would be appreciated. just please understand that it truly is the majority in this place. not just writing this because i had one bad experience. many of you would fall over if you saw this stuff these nurses take. i'm upset because you know how closely physicians and nurses have to work in the ICU setting.
Actually, in the hospital I work at, this used to be a major problem. With our last CEO, this was changed drastically and continues with our current (who is also a nurse). There seems to be a real team approach. If I doctor ever does become abusive, there is a system in place in which we can contact one of the MDs in a committee, you will personally call them on it. Those unruly MDs will know immediately they are going to be reprimanded when they receive a phone call.
:angryfire I have been in ICU for 4 years now, in 3 different hospitals. Never, have i EVER experienced or witnessed as much verbal abuse as I have since coming to this last hospital. I am a recent transplant from a much larger ICU where physicians truly respected the nurses' opinions....maybe 1 percent who didn't. now what i seem to be dealing with are dr's who don't respect me and who i don't respect in return. i hear other nurses getting screamed at over the phone and THEY TAKE IT!!! today was my first horrible experience, where the dr actually told me to "never bother him again". (the order was for him to place a CVC in a septic patient, he placed an 18gauge IV and wrote in his note "this will be sufficient". never attempted a CVP. I questioned him)
the nurses around me just said "oh, that's HIM." and i had the incident report in my hand ready to write him up.
i'm just venting. but any advice for how to deal with these docs would be appreciated. just please understand that it truly is the majority in this place. not just writing this because i had one bad experience. many of you would fall over if you saw this stuff these nurses take. i'm upset because you know how closely physicians and nurses have to work in the ICU setting.
A medical license doesn't give anyone the right to bully and abuse people? Yes, it is abuse, and I'm surprised that so many nurses who've experienced it just accept it as a part of the job and keep on taking it every day. Most physicians I've worked with so far are pleasant, respectable people. But I've seen a few miserable and nasty ones, too.
I'm the type of guy who's always calm, professional, and treats everybody with respect. And, if any doctor ever tries to throw temper attacks on me I will very calmly and very respectfully put him or her in their place. I don't have to be rude, but they will definitely know that their unprofessional anger antics will not cause this nurse to bat an eye. I would also document everything they say, even if it is a curt remark because legally it is an order. Of course, if I feel that what they are telling me to do will harm the patient then I would follow the protocol for that. Doctors are not gods. They are just as accountable to the patient as every other member of the healthcare team. The ones who refuse to accept this should not be surprised when the lawyers come knocking.
Just a few tricks I have found that knocks bullying physicians off their game:
1. I am normally a soft-spoken person to begin with, but when one of these idiots is yelling, I reply with an even quieter tone, almost inaudible. It usually makes the other person stop yelling because he/she can't hear me.
2. Perfect the art of staring...also a good way of unnerving someone who is on a tirade.
3. Pull out a piece of paper and start writing word for word what the person is saying. Usually, he/she will ask what you're writing, and then you can say that you are documenting word for word what is being said.
4. If all else fails, simply walk away without saying a word.
Of course, make sure you fill out an incident report if someone is being abusive. I can give people the benefit of the doubt for having a bad day, and we all say things we regret, but abuse should never be tolerated. It compromises patient care, and if abusers are allowed to get away with it, they'll just keep it up.
I know lots of nurses who ignore physicians on a tirade. Their reasons for doing so?
They are focused on their patient and self actualized enough not to take the doc's berhavior personally.
They know that reporting or documenting goes nowhere. Administration doesn't CARE.
I admit that it gets very tiresome dealing with these 'little boy with important title' egos. It erodes the enjoyment of the job over decades.
I follow Fab 4Fan's rules...but unless I have the support of coworkers, managers, and above I think twice about documenting. It tends to backfire in some facilities, where we learn to choose our battles.
I'm glad 'hostile work environment' is getting more attention...but some hospitals haven't gotten the message yet. My experience is coming from the at will nonunion South; and I'm sure other areas are less tolerant of megalomaniac docs.
I last worked in a hospital, except for staff relief, in 1980. And a physician was the reason I resigned and refused to work in a hospital. I had moved to Florida, from NYC, after working in a major teaching hospital. I had a patient, in ICU, who was going into sceptic shock. She was seen on consult, orders written and I cared them out. To make a long story short, her attending despite repeated calls refused to come in. I finally threaten him with a report to administration, when he revealed he had his small son. i told him to bring him in and we would find someone to watch him. He did and gave me a verbal order. The medication was not available and I had to run to the pharmacy to get it. I gave it without checking his order, which he had changed. He threaten to turn me into the BON. I was lucky, two other physicians heard him give the verbal order. I turned in my resignation the next day. After six months of no support from the DON and abuse from some of the physicians, I had had it.
My advice. resign and go to some place where you are appreciated.
After all, he would write YOU up if he thought you had done something wrong. It's about damn time nurses stop taking crap from physicians. Every time we take their sh**, it just encourages them and their colleagues to continue the unacceptable behavior.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
i worked in a private hospital (usually it's not the big teaching hospitals) where physician abuse of nurses was part of the culture. i tolerated it for years, but one morning i just snapped. patient had stopped making urine, and primary doc had called in a renal consult. the nephrologist came in at 0745, surly, and wanted to know why a,b,c, & d hadn't been done. no one had ordered it, i'd just received report and while i had anticipated that some of those things would be needed, i hadn't had time (in between titrating epi, pushing lidocaine and hanging kcl) to get to them yet. so he went on a tirade. as he started to wind down, i looked him straight in the eye and said, "yeah, i'm sure dr. s_______ ordered this consult just to piss us both off." and immediately thought, "that's it. i'll lose my job." to my very great surprise, he stepped back a step, shut up, and then said "you're right. i'm very sorry." and he never yelled at me again. ever.
the following week, a pulmonologist started to rip me a new one about why there were no 8 am blood gas results in the chart. (it was 10 am and i and the entire respiratory therapy department had been trying to stick the patient since about 7:45). i don't remember what my exact comment was, but it was in the same vein as above. i got an apology from him, also. and a few months later, an anesthesiologist wanted me to turn and hold a 250 pound patient for him to listen to breath sounds. i said, "he's to heavy for me to turn by myself, but if you help me turn him, i'll stick a pillow behind his butt and then i can hold him while you listen." the anesthesiologist hit the roof, the gist of his tirade being that "you wouldn't ask dr. b (the pulmonologist) to help you turn a patient. he's the medical director of your unit. so why would you ask me?" before i could even respond that i'd ask anyone in that situation to help, dr. b slipped into the room behind me and said, "ruby, what do you need help with?" i told him, and he helped me turn and hold the patient for the anesthesiologist. the look on that guy's face was priceless! after that, no one messed with me. and if i was in charge, no one messed with any of the staff! you just gotta find it somewhere inside you to stand up for yourself, because if you don't, no one else will.
I love your stories above, Ruby, and agree with you...in the RIGHT ENVIRONMENT standing up to them can work. I've just seen too many nurses ruined in facilities where the environment and culture would not permit any backtalk /confrontation at all. I've seen docs go on smear campaigns against nurses shamelessly, demanding they be fired, etc...even badmouthing her to other docs, even other facilities in the area if she leaves and seeks a job away from the abusive, vindictive physician. In these facilities if a doc has it in for you, you soon find you have no friends...
Yeah its wrong but in many places its reality; sad as it is. It happened to me once and I soon found nobody would dare be a witness for me, thus I couldn't prove anything. They agreed with me in private, but wouldn't speak up. Too scared of being the next victim.
ive come across with some docs who are really very arrogant and usually i let it slide because i know that i can take care of that patient and i know what's going on with that patient, but when i hear them treating other nurses like crap that's when i stand up and say something, i've argued with fellows and residents before because they're so mean to other nurses, and usually i take the newer nurses afterwards and talk to them as well, telling them that no one should talk to them as such. fostering nurses thru learning and self appreciation are some of the things we can do as seasoned nurses to help them love their careers. usually though after u have that one on one match with the resident and they know ur pretty competent they tend to be very very very nice afterwards
No way in hell would I take that!! When I got started in nursing, I felt that as long as I had my stuff straight and was agreeable everything would be ok. However I have since learned that bad behaviour ignored is bad behaviour encouraged. I would'nt take that kind of abuse from someone I know and love so theres no damn way I'll take it from a stranger. If he or she is unwilling or INCAPABLE of performing a needed and ordered task then they should be BOLD enough to defer. It is not a sign of weakness to ask for help. Grow up Dr jerk off.!
I used the #1 before, it works with combative/aggressive pts too
(1. I am normally a soft-spoken person to begin with, but when one of these idiots is yelling, I reply with an even quieter tone, almost inaudible. It usually makes the other person stop yelling because he/she can't hear me.)
I will try #3
(3. Pull out a piece of paper and start writing word for word what the person is saying. Usually, he/she will ask what you're writing, and then you can say that you are documenting word for word what is being said.)
Something that I say to the abusive would be: "Your mother would be ashamed if she would see you acting like that ":uhoh3:
Very important: Stay straight, head up, don't break down and stand up for yourself. Make yourself respected, respectable. You are as important as anybody else.
SarasotaRN2b
1,164 Posts
Actually, in the hospital I work at, this used to be a major problem. With our last CEO, this was changed drastically and continues with our current (who is also a nurse). There seems to be a real team approach. If I doctor ever does become abusive, there is a system in place in which we can contact one of the MDs in a committee, you will personally call them on it. Those unruly MDs will know immediately they are going to be reprimanded when they receive a phone call.