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Discussion

Why is it inappropriate to stand up for yourself?

So, about two weeks ago I had a very unpleasant interaction with my patients primary provider. I was in the patients room with him and they were talking about the care plan, when the patient directly asked me a question. It was nothing medical related, and not anything relevant to what they had been talking about, but I answered the question. I then went to the nursing station to chart while they continued. The doctor came raging out and started to yell at me for undermining him in there. This is in front of about 15 people. According to him, I should not even talk when he is in with a patient. In the middle of his rant. I interrupted him and frankly said, " There is no reason for you to be so disrespectful towards me, and if there is anything else you need to let me know, feel free once you decide to behave like a professional." and left. I was later pulled aside by my charge (who witnessed the entire thing) and told that it was unprofessional for me to "point" and raise my voice in front of everyone.

I just cannot believe that I was pretty much being told not to stand up for myself.

Did i do anything wrong here?

Featured Replies

If it actually went down the way you describe, then no, you did not do anything wrong.

  • Author

That is exactly what I said to him, no more, no less. And yes, that was what occurred before our interaction. He did not like that I answered a patients question with him in the room.

Some providers are special snowflakes with God complexes. It doesn't sound like you did anything wrong.

Edit: Oh, if he was talking, and you raised your voice to talk over him, that's a little impolite. I would say at least wait until he is done talking to answer a question.

did you point and raise your voice?

  • Author

I did point, I raised my voice to speak over him. I did not yell, and stayed calm the entire time.

From your post history you are a new nurse. Without knowing what you said in reply to the patient's question, it is not possible to conclude that your answer, although not apparently directly related to the conversation the physician was having with the patient, did support his/her discussion with the patient. In my opinion, in these kinds of situations, one needs to tread very carefully. When the physician approached you angrily afterwards, stating that you had undermined his/her discussion with the patient, in my opinion it would have been appropriate to hold your tongue, and listen to the physician's objections, and try to understand the physician's point of view, instead of launching into defense mode. You say that you raised your voice to speak over him, and pointed; I suggest that in future you try listening first. The physician, not you, is in charge of the patient's care, and he apparently had specific reasons for objecting to what you said to the patient. The patient's needs are the most important here, not your need to stand up for yourself. From the limited information you provided, I cannot support your behavior.

Whether you undermined him or not, he has no right to yell at you in front of 15 other people. I understand the point some of the PPs make about hearing him out and seeing it from his perspective, but if he indeed came raging out and yelling at you, I see no reason why you need to extend him an ounce of respect by "seeing his POV".

You wouldn't let anyone else talk to you like that. A doctor is no different.

  • Expert
From your post history you are a new nurse. Without knowing what you said in reply to the patient's question, it is not possible to conclude that your answer, although not apparently directly related to the conversation the physician was having with the patient, did support his/her discussion with the patient. In my opinion, in these kinds of situations, one needs to tread very carefully. When the physician approached you angrily afterwards, stating that you had undermined his/her discussion with the patient, in my opinion it would have been appropriate to hold your tongue, and listen to the physician's objections, and try to understand the physician's point of view, instead of launching into defense mode. You say that you raised your voice to speak over him, and pointed; I suggest that in future you try listening first. The physician, not you, is in charge of the patient's care, and he apparently had specific reasons for objecting to what you said to the patient. The patient's needs are the most important here, not your need to stand up for yourself. From the limited information you provided, I cannot support your behavior.

I tend to agree and am curious why the OP didn't add exactly what the patient asked and what her reply was so we might have a better understanding of both sides. If it was nothing medical, did he think she was derailing his post op instructions with chatter? etc. In my experience nurse managers are often supportive when a Doc behaves badly so that also makes me wonder what happened.

Physicias are always in a hurry,they want to get in and get out of those discussions as quickly as possible.They also have a lot of information to impart in that short time.The patients question clearly demonstrated he or she had tuned out of the conversation.Quickly and kindly refocusing their attention towards the doctor would have been a better way to handle this..."We"ll talk about that when the doc is done,let's listen to what he has to say"........That said,I would not tolerate being yelled out and berated in front of a group of people.A better way to handle that is to take the power back and walk away....Raising your voice and pointing your finger is not professional or appropriate.A calm,quiet"We can talk about this when you speak to me in a civil manner" and walking away would do.....I love to almost whisper at people who are screaming at me-they just don't know what to do......

When the patient and physician were talking about the care plan, what did the patient ask you and what was your response?

We don't have enough information to make any sort of judgment on this situation. Not only are you leaving out what actually was said, but tone of voice. We can't give you any validation or advise based on this incomplete, one-sided account.

  • Author

The patient asked me about how he was going to be transferred to the long term facility he was going to be transferred to. I explained to him that ems will come and prepare him for transport and he will be transferred in an ambulance. The doctor was literally mad because I talked while he was in the room. Me talking was undermining him. I guess he wanted to explain that maybe?? I don't know.

If that was the case fine. If the doctor really doesn't want me to talk while he is in the room I won't, but there is no reason for him to embarrass me in front of so many people. This same doctor did something similar a couple of days before to another new nurse and she ended up crying for 20 min after he yelled at her. This is not okay. And if I am wrong for not "biting my tongue" maybe nursing is not the field for me. I don't tolerate bullying.

While I totally understand that me pointing at him was rude, I really did not realize that I was doing it, and accept that it was wrong of me to do that.

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