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.
I would not have handled it the way OP did and it has nothing to being a doormat. I'm as far from being a doormat as they come but I would've come out appearing poised and perhaps even received a shameful apology from the physician after I owned my part.
This is what my apology thread was about. It wasn't about apologizing when we blatantly screw up, of course we'd apologize then. It was about repairing and building relationships even when we're a little bit wrong and they're the most wrong.
Everyone here has taken the courses and passed NCLEX questions about dealing with difficult personalities but there's this righteous attitude about not letting anyone talk disrespectfully. It's like a pissing contest where no one wins.
I want to win and i want more than to just be right, I want trust, respect and good working relationships and that comes with learning how to work with difficult people. And sometimes the strong but soft approach wins.
PedsRN, your post helped me figure out what annoyed me so much about some responses. The physician, in this case, was held in higher regard over not only the nurse, but also the patient!
Some told the OP she should redirect the pt to listen to the doctor, as if the pt's concerns were insignificant to whatever the doctor was saying. "Oh, no, Ms. Patient...time to be quiet, the doctor is speaking now! I'll answer you later...after he's finished!"
Good lord.
Some told the OP it wasn't about her...she should listen to his yelling, try to understand his viewpoint. Ok, then, it's all about him, his time, his need to dress her down in front of people.
But she pointed her finger at him! *pearl clutch*
This is the situation as I understand it: The physician was discussing some important medical information/plans for discharge with the patient while the OP was present, and the OP told us the patient directed a question to him/her about how they would get to the facility they were being transferred/discharged to, to which the OP replied, which disrupted the physician's conversation with the patient, resulting in the physician becoming angry with the OP for undermining their conversation, which the physician then expressed by shouting at the OP in front of 15 people to tell the OP how displeased he was by the OP undermining them. The OP responded by raising his/her voice over the physician, pointing his/her finger, and delivering a retort to the physician, and was rebuked by the charge nurse.
I don't see the physician being held in higher regard than the patient; I see a physician who is very likely in a hurry, with a lot of information to impart in a short time, who wanted to communicate the necessary information as quickly as possibly. The patient asked the OP a question while the physician was imparting the information, that while valid and important, appeared to be less important than the information the physician was trying to deliver. The OP answered the question, and this further frustrated the physician, who felt his conversation with the patient was undermined. While the patient deserved an answer to their question, and had every right to expect an answer, I can understand that the physician considered that the information they were discussing was more important at that moment for the patient to know. Yes, the situation was imperfect.
As far as the OP, in this situation where the physician was discussing important information with the patient, when asked the question by the patient, I think a better way to have handled it would have been to refer the question to the physician. That way the patient is not ignored, and they receive a response from the physician to their question, which the physician answers to his/her satisfaction.
I really do believe it would have been prudent for the OP to have listened to the physician when he began yelling at them, saying that the OP had undermined him, instead of reacting defensively. Without listening, how is one to understand why the physician is angry. You have to work together for goodness sake, and the physician is in charge of the patient's care. Perhaps if the OP had taken the time to listen, without reacting defensively, and had understood the situation as the physician saw it, the situation could have be de-escalated. Maybe at that point the OP could have explained to the physician why he/she sought to answer the patient's question. I really don't believe that going on the defensive, before even listening, when the physician, while yelling about being undermined, was not yelling threats or obscenities, was the best path to take.
This is the situation as I understand it: The physician was discussing some important medical information/plans for discharge with the patient while the OP was present, and the OP told us the patient directed a question to him/her about how they would get to the facility they were being transferred/discharged to, to which the OP replied, which disrupted the physician's conversation with the patient, resulting in the physician becoming angry with the OP for undermining their conversation, which the physician then expressed by shouting at the OP in front of 15 people to tell the OP how displeased he was by the OP undermining them. The OP responded by raising his/her voice over the physician, pointing his/her finger, and delivering a retort to the physician, and was rebuked by the charge nurse.
I don't see the physician being held in higher regard than the patient; I see a physician who is very likely in a hurry, with a lot of information to impart in a short time, who wanted to communicate the necessary information as quickly as possibly. The patient asked the OP a question while the physician was imparting the information, that while valid and important, appeared to be less important than the information the physician was trying to deliver. The OP answered the question, and this further frustrated the physician, who felt his conversation with the patient was undermined. While the patient deserved an answer to their question, and had every right to expect an answer, I can understand that the physician considered that the information they were discussing was more important at that moment for the patient to know. Yes, the situation was imperfect.
As far as the OP, in this situation where the physician was discussing important information with the patient, when asked the question by the patient, I think a better way to have handled it would have been to refer the question to the physician. That way the patient is not ignored, and they receive a response from the physician to their question, which the physician answers to his/her satisfaction.
I really do believe it would have been prudent for the OP to have listened to the physician when he began yelling at them, saying that the OP had undermined him, instead of reacting defensively. Without listening, how is one to understand why the physician is angry. You have to work together for goodness sake, and the physician is in charge of the patient's care. Perhaps if the OP had taken the time to listen, without reacting defensively, and had understood the situation as the physician saw it, the situation could have be de-escalated. Maybe at that point the OP could have explained to the physician why he/she sought to answer the patient's question. I really don't believe that going on the defensive, before even listening, when the physician, while yelling about being undermined, was not yelling threats or obscenities, was the best path to take.
So let's reverse the roles.
Let's say it was the nurse was giving out very important discharge education, and the patient interrupts and asks the physician an unrelated question. The doctor answers her.
Should the doctor then be obligated to listen to the nurse yell at him in the hallway for undermining her education? Disregarding her time?
Doubtful.
And like I said, it's happened to me more times than I can count.
Newbie nurse. You have a good couple of decades ahead of you of dealing with doctors who will act like this.
If you pop and get defensive every single solitary time it happens, you will burn out of this career in a few short years.
Honestly? Keep your trap shut when they're around unless you need to provide input that ABSOLUTELY needs to be heard AT THAT MOMENT or it threatens the patient's SAFETY. Keep Maslow in mind.
And just get used to managers NEVER being on your side. It's nursing. It's reality.
Dogen, I cannot quote on my phone, but here was my understand based on the OP, the physician started screaming at her because she tried to answer a patients question, which I'm sure made her defensive and angry. In her anger, she raised her voice above that of the physician, who was screaming at her. Essentially, they both were screaming. During this confrontation, she started pointing her finger, which made him angrier, and his voice I'm sure went up in volume. The charge nurse witnessed and reprimanded nurse for yelling and pointing her finger.
As I have been to many hole-in-the wall bars in my life, many physical altercations occur, when two people start screaming and one starts putting their finger in the others face. This usually is because the have entered someone's personal space with that finger. Then if they don't start brawling right there, they say, Let's take this outside. Where they either start fighting or a gun gets drawn.
But it all start innocently enough, by someone doing what someone else perceives as offensive. The other person gets angry and defensive and many time the finger starts wagging.
I honestly just see it as if she would have handled it differently, he would look like the complete jerk and bully that he is to everyone around them. Now, this doctor is smearing her name around colleagues, and she got a scolding from her charge nurse.
And there are much better, eviler, ways to deal with this doctor where she comes out smelling like a rose. I've been known to lose my cool every once in a while, and yes at work. But that was in my youngin days in my early twenties. í ½í¸›í ½í¸›
Specializes in ED, Cardiac-step down, tele, med surg.
It's over now and the person did the best they could in the moment and can reflect on the situation and learn from the experience. At least the person didn't just shut up and take the public humiliation. Sorry, but that's wrong. The physician was capable of directing his own conversation with the patient, right? Yeah, the physician is supposed to guide care, then do so. They can do that while at the same time being respectful and professional. I've learned a lot from physicians and learn better from the ones who are respectful of me and view my input as valuable to the patient's care.
I think the OP was disappointed the charge nurse didn't stand up for her. I've had a really awesome charge nurse tell a physician who was yelling at a nurse with 35 years experience in front of everyone to stop it. She said don't yell at her, there's a better way to get your point across! It's not professional to yell at people or berate them in public. It creates distrust of the health care team. In a way it's throwing your coworker under the bus. I think if someone has an issue, it's far more effective to tell them in private and they will command way more respect in doing so.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
As if yelling at a nurse in front of 15 people over answering a patient's question with a doctor in the room is a way to forge good working relationships.
Docs walk in, don't say a peep to the nurse, interrupt patient teaching, med pass, etc., and don't bother apologizing.
teamwork in healthcare is so dysfunctional, and this just perpetuates it.
I am not saying the doctor was right. But he didn't ask for my advice. The nurse was wrong. Raising your voice, pointing and failing to listen to valid criticism is wrong.
When the doctor asks for my advice, I'll tell HIM he was wrong.
Let's say it was the nurse was giving out very important discharge education, and the patient interrupts and asks the physician an unrelated question. The doctor answers her.
Should the doctor then be obligated to listen to the nurse yell at him in the hallway for undermining her education? Disregarding her time?
Doubtful.
And like I said, it's happened to me more times than I can count.
We are peers.
We work together.
End of story.
The physician is in charge of the patient's care, not the nurse. The physician has spent years in medical school, internships, residencies and specialty training. We are not peers, because we are not equals in our education and training. We are colleagues, as in we work together.
The physician is in charge of the patient's care, not the nurse. The physician has spent years in medical school, internships, residencies and specialty training. We are not peers, because we are not equals in our education and training. We are colleagues, as in we work together.
Going by your logic, the CNAs, unit secretaries, transporters, phlebotomists, and housekeepers should defer to my precious time with the patient. Can I yell at them all for calling me SEVEN times while I'm doing patient teaching? After all, I'm in charge of the patient's nursing care.
This is the situation as I understand it: The physician was discussing some important medical information/plans for discharge with the patient while the OP was present, and the OP told us the patient directed a question to him/her about how they would get to the facility they were being transferred/discharged to, to which the OP replied, which disrupted the physician's conversation with the patient, resulting in the physician becoming angry with the OP for undermining their conversation, which the physician then expressed by shouting at the OP in front of 15 people to tell the OP how displeased he was by the OP undermining them. The OP responded by raising his/her voice over the physician, pointing his/her finger, and delivering a retort to the physician, and was rebuked by the charge nurse.
I don't see the physician being held in higher regard than the patient; I see a physician who is very likely in a hurry, with a lot of information to impart in a short time, who wanted to communicate the necessary information as quickly as possibly. The patient asked the OP a question while the physician was imparting the information, that while valid and important, appeared to be less important than the information the physician was trying to deliver. The OP answered the question, and this further frustrated the physician, who felt his conversation with the patient was undermined. While the patient deserved an answer to their question, and had every right to expect an answer, I can understand that the physician considered that the information they were discussing was more important at that moment for the patient to know. Yes, the situation was imperfect.
As far as the OP, in this situation where the physician was discussing important information with the patient, when asked the question by the patient, I think a better way to have handled it would have been to refer the question to the physician. That way the patient is not ignored, and they receive a response from the physician to their question, which the physician answers to his/her satisfaction.
I'd like to meet the MD who's involved in D/C planning and has any idea whether the patient will be transported by EMS, medical transport, shuttle, or cab. Referring that question to an MD in my hospital would make you and the MD both look silly, because they'd have to admit they had no idea, and then you'd have to decide whether to answer the question the MD didn't know or pretend you also have no idea.
I guess my only point is that, from the perspective of the patient, I can imagine a variety of scenarios where they weren't hearing what the MD was saying anyway. Interrupting may be a sign that their mind is elsewhere. If that's the case, and they're worried about transport for some reason, then answering the question might make all that super important doctor stuff sink in better. But it's not like I have a hard and fast rule that I'll answer any question a patient asks me, regardless of who or what is happening. There are a lot of scenarios where I'd redirect and come back to it later, and there are a lot of scenarios where I'd answer the question and then redirect. What the MD is explaining would be part of that calculus, but so would my interpretation of what the patient needed in that moment.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Some charge nurses are old school, where the doctor is always right , good luck, if you have union , call your union rep.
In the event that a physician or surgeon was being verbally abusive to one of the nursing staff, I, as a charge nurse would back the nurse. Provided that the nurse's behavior was above reproach. If the nurse was yelling, pointing fingers and acting without manners or professionalism, I wouldn't back the nurse. In that case, I'd explain to the nurse where her behavior was unprofessional and rude. It's not my place as charge nurse to explain to the physician how he could improve HIS behavior . . . unless, again, the nurse's behavior was thoroughly professional.
In the original post, the nurse admitted to raising her voice and pointing her finger. Unprofessional. THAT is my business as charge nurse. As far as the physician's behavior -- I can always refer that to HIS boss.
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Libby1987
3,726 Posts
I would not have handled it the way OP did and it has nothing to being a doormat. I'm as far from being a doormat as they come but I would've come out appearing poised and perhaps even received a shameful apology from the physician after I owned my part.
This is what my apology thread was about. It wasn't about apologizing when we blatantly screw up, of course we'd apologize then. It was about repairing and building relationships even when we're a little bit wrong and they're the most wrong.
Everyone here has taken the courses and passed NCLEX questions about dealing with difficult personalities but there's this righteous attitude about not letting anyone talk disrespectfully. It's like a pissing contest where no one wins.
I want to win and i want more than to just be right, I want trust, respect and good working relationships and that comes with learning how to work with difficult people. And sometimes the strong but soft approach wins.
Works well for me anyway.