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.
My point was that by referring the question to the physician, the physician can choose to answer the question as he sees fit, or to defer the question. No-one is necessarily made to look silly.
We're just going to have to agree to disagree on this. When I have the answer to the question it makes no sense to refer the patient to someone I know doesn't have it. That's just wasting time, and seems a lot like stroking the MD's plumage. I don't see how it could benefit the patient in any way, but much like Heathermaizey above I feel like no one (including me) is interested in being convinced, rather than doing the convincing.
Use the dictionary. Look up the word "peer." You used it incorrectly. What I said was not "semantics." Also look up "semantics."
Semantics is the study of the meanings and usage of words. You're being semantic when you tell someone to look up a definition or correct someone's usage of a word or phrase.
Semantics is the study of the meanings and usage of words. You're being semantic when you tell someone to look up a definition or correct someone's usage of a word or phrase.
Go back to PedsRN's post where he/she said that nurses and physicians are peers. I disagreed, as nurses and physicians are not peers (peers means equivalency in, for example, education, training, and so forth). PedsRN said in his/her next post that I was using semantics. While semantics is indeed the study of words and word usage, PedsRN was using the word "peer" incorrectly, which I pointed out. The issue was not one of semantics.
I actually found your posts useful. I started off completely disagreeing with you but some of your posts and others really helped explain the other side of the story. I hope you will continue posting on topics.
I started off completely on the side that the OP was ok to blast the physician as I have a bit of a quick temper, and the situation described would make me pretty ticked. But after reading all of the responses I hope when something similar happens to me I can hold my tongue and address it more professionally.
I did have a physician really go off on me once, and I was so startled that I didn't respond. Then a few days later I pulled him aside and told him I felt he owed me an apology. He did apologize, and I looked like the bigger person (although I really was not since it was just surprise that rendered me speechless).
Love this!! Kudos to you for keeping an open mind and allowing yourself to grow. To me this is the best outcome from all the hours I spend goofing off here.
Go back to PedsRN's post where he/she said that nurses and physicians are peers. I disagreed, as nurses and physicians are not peers (peers means equivalency in, for example, education, training, and so forth). PedsRN said in his/her next post that I was using semantics. While semantics is indeed the study of words and word usage, PedsRN was using the word "peer" incorrectly, which I pointed out. The issue was not one of semantics.
Semantics is the study of the meanings and usage of words. You're being semantic when you tell someone to look up a definition or correct someone's usage of a word or phrase.
It's not necessarily a bad thing to be semantic (sometimes the meaning of words is very important). I don't know that this qualifies, but c'est la vie.
dudette10, please show me where in this thread I have said that anyone yelling at anyone is acceptable.
When presented with the role reversal, you answered with info about the MD's education and training being much more than a nurse's. In my opinion, that has no bearing on the question you were asked, and it implies that the MD should be given more leeway in uncivil behavior to others just because of his education and training. Can I have that too because I have much more education than any of the other staff I listed.
In nearly every response you've given, there is a definite overtone of deferment and subordination to physicians in interpersonal relations. I defer to them in medical POC, and I call them doctor when they call me by my first name (although there is a new trend of interns being uncomfortable with the "Dr." title which puzzles me), but I'm hard-pressed to remember any time that I treat them differently than I do other colleagues. I don't see the point in it except to stroke egos, which leads to LESS teamwork, not more.
If MDs truly saw us as colleagues rather than handmaidens, they would NOT interrupt my med pass or patient teaching. Most other things--aside from hygiene care--can and should be interrupted to allow for the provider's round. (Honestly, if every time I was in the room, the MD had to defer a round, rounds would never be done!)
When presented with the role reversal, you answered with info about the MD's education and training being much more than a nurse's. In my opinion, that has no bearing on the question you were asked, and it implies that the MD should be given more leeway in uncivil behavior to others just because of his education and training. Can I have that too because I have much more education than any of the other staff I listed.
In nearly every response you've given, there is a definite overtone of deferment and subordination to physicians in interpersonal relations. I defer to them in medical POC, and I call them doctor when they call me by my first name (although there is a new trend of interns being uncomfortable with the "Dr." title which puzzles me), but I'm hard-pressed to remember any time that I treat them differently than I do other colleagues. I don't see the point in it except to stroke egos, which leads to LESS teamwork, not more.
If MDs truly saw us as colleagues rather than handmaidens, they would NOT interrupt my med pass or patient teaching. Most other things--aside from hygiene care--can and should be interrupted to allow for the provider's round. (Honestly, if every time I was in the room, the MD had to defer a round, rounds would never be done!)
dudette10, I have already expressed what I have to say on this topic. It is fine with me if you interpret what I have said in whatever way you wish to, and it is fine with me if you disagree with me.
Go back to PedsRN's post where he/she said that nurses and physicians are peers. I disagreed, as nurses and physicians are not peers (peers means equivalency in, for example, education, training, and so forth). PedsRN said in his/her next post that I was using semantics. While semantics is indeed the study of words and word usage, PedsRN was using the word "peer" incorrectly, which I pointed out. The issue was not one of semantics.
I think you knew what I was trying to say. At least, I hope you did.
Or perhaps you think you are educating me.... after all this time, I had no idea that Doctors had more education than I do! Thank you for your service. :)
Anyway, my point is lost in this silly argument. The point being that that doc's time is no more important than mine. We are both there to take care of the same patient, and it's our job to work together to achieve that goal. I'm lucky in that the physicians I work with share these ideals. I have great working relationships with all of them.
... 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.
...
Exactly this. OP asked for feedback about her behavior. Comments on the physician's behavior are not relevant.
Believe me, I understand how difficult it is to hear feedback about where one's own behavior fell short after someone else has been a douche... but that's where we can change and that's where the gold is.
Thanks to all the experienced nurses who provided different points of view and feedback about how to handle a tough situation like the OP's with skill and grace. I know I am taking notes!
I didn't read that the dr interrupted the OP, I didn't think she specified who got there first or if the dr being present was an interruption, did I miss something?
For all we know from the description the OP might have been hanging an IV or something and didn't need the patient's attention.
First of all, it was rude for this patient to interrupt the physician while he was giving discharge instructions.
The Op said "it was nothing medical related." The mode of transportation to a facility is a medical decision and the nurse should know that.
An ambulance transfer requires a physician certificate of medical necessity for Medicare reimbursement.
If this patient could safely go to rehab by privately owned vehicle, then this physician was justified in feeling undermined. I can see how the whole scenario could be a huge source a frustration for a physician.
However, he was not justified in publicly lashing out at the OP.
Thank you LaneyB. I have been known to lose my cool with people before, even a boss or two, on the job. I can't exactly remember why now, but it was in my early twenties, when I worked in retail management.
One day it hit me, that it wasn't getting me anywhere but in trouble and I would make myself look bad in the process. Not only to my co-workers, but to any customers in the store at that time.
Then, I went to interview for a big box homestore, that I loved to shop. It was in the flagship store for our region. I was meeting with the district manager for my interview. He was in the office with the door shut. He started screaming and yelling obscenities at various store managers. I was thinking run, away,now. I should have listened to that voice, but I wanted to give him the benefit of the doubt. The customers on the sales floor could hear him,
i got got hired and started my six weeks of training. The DM's office was in my store. Every Monday he would scream at his store managers, come down to the sales floor and criticize and insult the floor managers. The morale was very low. I got ripped apart one day because he stopped a group of thieves for trying to steal $1500 worth of sheets. I was mortified and I could feel the rage coming.
I bit my tongue and walked away seeing the looks on my coworker's faces and looks of sympathy from customers. I spent my next two days off fuming and obsessing.
After that, I acted completely indifferent to this man. I worked my butt off, would nod my head if he was in my dept, and never spoke unless he directly asked me a question. Then it was generally one word answers. I was completely professional but I wasn't all bubbly anymore either.
Then I was forced to quit due to having seizures while pregnant. Lack of sleep triggers my seizures and I was working 14-15 hours a day. My last week there he came down to the floor to see if there was anything he could do to keep me. He would modify my schedule, give me more employees to make my job easier, and more money. I told him no, that I was staying home with my son. He wished me luck and told me he was sorry to see me go. He looked me in the eyes, smiled and shook my hand. I was floored. I had earned his respect by the way I dealt with him. There is much more to this, obviously it wasn't over a single incident, just grew over time. It was a lesson that took me too many years to learn. I was a no nonsense person, who got the job done.
Many people misunderstand what this is about. It's not a doctor vs. nurses type thing. It's how to deal with conflict when it arises.
Dogen
897 Posts
We're just going to have to agree to disagree on this. When I have the answer to the question it makes no sense to refer the patient to someone I know doesn't have it. That's just wasting time, and seems a lot like stroking the MD's plumage. I don't see how it could benefit the patient in any way, but much like Heathermaizey above I feel like no one (including me) is interested in being convinced, rather than doing the convincing.
Semantics is the study of the meanings and usage of words. You're being semantic when you tell someone to look up a definition or correct someone's usage of a word or phrase.