Verbal abuse by physicians in ICU

[erinnRN]

: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.

thanks,

erinnRN

[Gennaver, MSN]

We nurses MUST stick up for ourselves AND each other! I don't care who you are or what hospital you work in, if you are a nurse or a physician, you are an ADULT LICENSED PROFESSIONAL. period. Do whatever it takes to bring change to this behavior, do not tolerate it. Let management know FACTS, in writing, and keep a copy for yourself. Support your co-workers! If I witness a physician badgering a co-worker--I grab a few other nurses and physically stand behind her. It has worked every single time. I think Dr. Jerk got the hint that we outnumbered him, 4 to 1. :) He shut right up. I also had a doc tell me on the phone "I don't care what happens, don't call me again." Of course, I wrote that as an official verbal order on the bottom of a half-full order sheet. He came in, saw the orders, and went to tear the page out but couldn't because it had other orders on it. He's been a peach since.

Hello,

What a great show of support, physically positioning for emotional support. Good! I am glad you shared this becuase now it is forever in my mind and it seems like such an appropriate display support.

Gennaver

[MamaTheNurse, BSN, RN]

in our ICU, we have some awesome docs - there are a few that are questionable but nothing a calm cool attitude can't handle.....

in the last few years, our old Chief Medical Officer retired and our new one has made some incredible changes - physicians are required to sign off that they have been educated on the "zero tolerance" policy for physicians regarding staff - if a physician is abusive in any way, they are in violation of the policy and, depending on what the situation was and how wild it got, may have to appear before a board for disciplinary action.........

we have crack ICU nurses here and anytime someone has to write up a physician for anything regarding a patient, the administration takes it very seriously and our Medical Executive Committee will review the situation and address it appropriately...........

peer review is big here and the docs are on each other like flies on brown stuff - there is a Peer Review Committee (actually chaired by an RN) and it is a busy committee, let me tell you.........

this is not to say I work in Utopia - docs house-wide still freak out sometimes but oddly enough, it makes it a little easier to survive the tirade because you know that you have resources and while administration might not always see your side and sometimes the matter is not resolved to your liking, there is an honest attempt to make sure the guilty parties get punished and that the rest learn from it and mind their own P's & Q's...........

[daisybaby, LPN]

I also had a doc tell me on the phone "I don't care what happens, don't call me again." Of course, I wrote that as an official verbal order on the bottom of a half-full order sheet. He came in, saw the orders, and went to tear the page out but couldn't because it had other orders on it. He's been a peach since.

This may be a silly question, but would the powers that be have a field day with a nurse who wrote that as a verbal order if it went to chart review? I love the idea of writing something like that, and am considering it as it's happned to me several times- but who would come under fire for it more- the MD for making such a stupid remark, or the nurse for putting it in the permanent record?

Good suggstions, especially the showing of force for an RN who's being berated.

[justmanda]

This may be a silly question, but would the powers that be have a field day with a nurse who wrote that as a verbal order if it went to chart review? I love the idea of writing something like that, and am considering it as it's happned to me several times- but who would come under fire for it more- the MD for making such a stupid remark, or the nurse for putting it in the permanent record?

Good suggstions, especially the showing of force for an RN who's being berated.

If a nurse wrote that, I think TPTB would realize it was THE DOCTOR who needed to come under fire, not the nurse. The nurse was just doing her job, being a patient advocate, while the doctor was doing anything but. However, if the nurse did what the doctor ordered and DID NOT call him when the patient's condition changed, she would and should be held accountable for following such a stupid order.

[Mirai Kangofu]

Don't med students nowadays have to take medical ethics/etiquette courses nowadays? One of my friends said something about it...