Yelling Doctors, How do you handle them?????

[Danielle7]

The other night at work (I work 7PM shift), I admitted a new patient. She was seen at her doctors office a couple days before and was started on PO antibiotics TID. She did not take her antibiotic all day. At my hospital we are to clarify meds upon admission and she could not remember the dose perscribed. So I had to page her doctor, which has a reputation of being mean at 11PM (not that late). He interrupted my question by yelling/screaming at me, asking me how he would know the dose (he prescribed it), demanding I answer why it couldn't wait till morning while huffing and puffing on the phone!!! I know if I didn't address it, the charge nurse or someone would of had my neck due to policy...Can't win!!

I've only been a nurse for 8 months and I haven't had much experience with this.

My question is... How do you respond to a doctor who talks to you this way- I mean screams at you this way?

[diane227, LPN, RN]

That is so funny. I think I will take her approach.

[payitforward]

I would have called the Doc as a LAST resort, only because many of them are grouchy,and love to sink their teeth into nurses at that time of night. I would first ahve asked the patient, as stated before, asked a significant other, or someone who lives with her. It wasn't that pressing because she hadn't started taking them. In no way should anyone be yelled at. Again as said before, I would have apologised for the late hour, speak in good tone and keep it moving. Keep in mind there will always be doctors who thrive on ANY reason to yell at a nurse- it doesn't mean it's right, but it's all the way you handle it. Good Luck!

[TomCCRN1991]

Screw 'em! Thats why they make the big bucks. If they didn't want to get woken up at night they should not have gone to medical school. You just do your job, and let them yell if it makes them feel better.

[Cajun Nurse]

first the call to the doc is a requirement under the conditions of participation, the joint commission and plain old provision of quality care.

the behavior is unacceptable and is addressed in the joint commission standards, any quality rules and regulations of the medical staff and in alaska is cited as unprofessional conduct in the alaska medical board statues and regulations. the ama policies at their web site prohibit this behavior.

you are not dealing with a professional but rather a bully. this needs to be report to your medical executive committee.

i must admit that i really enjoyed miko 014's strategy for addressing this behavior.

[Jiminocala]

Your facility should have a policy for dealing with irate physicians, some kind of a QA group that addresses these issues. A lot of places went to that after some employees sued for a hostile workplace, so JCAHCO require some kind of policy. Report him through the prescribed channels and document each step. As a guy, this kind of thing is hard to take laying down and frankly, there have been times when I would have preferred to handle things "out back," but professional standards being as they are...

[Jiminocala]

Ever see the movie "Hoffa" starring Jack Nicholson as Teamster President Jimmy Hoffa? I would be for unions if they could just send out some goons to deal with the docs who yell, throw things, etc. And it to the contract negotiations. Administration will be officially against having union goons doling out a shellacking to misbehaving physicians, but in their hearts, you know they will want to watch.

[Code_VSA]

I have had doctor's raise their voice or "yell"....but it has not been directed at anyone personally.

When it does take a personal turn, then I say, "Watch out." These physicians are bullies. Verbal abuse is not acceptable.

For five years I worked in a little country hospital. It had a 4 bed ER and 22 med-surg beds. There was one doctor for five years I never made rounds with. He had the reputation for belittling nurses and making them cry in front of patients and families. He would have nurses written up for the stupidest things. I would not even speak with him on the phone, but hand it over to another nurse. I would offer to pay my co-worker's lunch if she would make rounds with him.

One day, I got caught. I received a call from his office nurse. She said, "Dr. Evil wants Mr. Soandso to come to the ER for a portable CXR." I said, "Okaaay". Definetly confused because portable meant for the machine to come to the bedside. Right after that call I received another from Mr. Soandso's nurse. She told me that Mr. Soandso was a DNR, being moved from the med-psych unit and admitted to the Med-Surg unit. I said "Okay, I wonder why he has to make a stop in the ER first? Just for a portable CXR? She said she didn't know. I said, "Well, it would be faster for the x-ray machine to come to him and take the CXR, then move him to his new bed."

She said, "Okay." Patient received his CXR and when they started moving him to his new room he died.

A little while later, here comes Dr. Evil to the Nurse's Station. With his voice raised, he said, "why is my G...D... pt. not in the ER? I thougth to myself, "well here it is, you finally came under Dr. Evil's wrath". I calmly explained to him the CXR was done and I made a decision for the portable CXR to go to the patient to save time." This time, he was yelling "My f......g patient is lying down there dead, and if you would get of your a(double)s it wouldn't of happend!!!!! I was standing at the time, but thought better not to correct him. I tried again to explain it. He came around the desk, put both hands on the security television monitor, looked to the right at my chest, and threw it. It knocked me to the side and the television crashed to the floor. I heard gasps from the other nurses,and even four of the student nurses that were there, patient's and families came out of their rooms to see what the commotion was about. All I could think of is that the job I loved dearly and high hopes of furthering my career in.......were gone. The secretary next to me looked at me and said, "Do you want me to call the sherriff?" "Yes, please."

I then got called to the ER about a patient arriving by EMS. The whole time, trying not to cry.

Thirty minutes later here comes Dr. Evil and the Director of Nursing. He mumbled, "Sorry for the incident, not make out an incident report." I just stared, thinking "Oh he wants to write me up, because that's what he does with the nurses." Then, I realized, "He's not wanting ME to write HIM up!" I turned around an walked off. They left the ER.

A while later the phone wrings. It's the DON. She said, "You didn't here this from me, but he kept asking why you won't talk to him. He says if you try anything you won't get away with it." The light bulb went on over my head. He wasn't sorry that he hurt and humilated me, he was sorry for himself!

Even though I had worked there for 5 years.....in the next few weeks I learned so much about Dr. Evil. My director told me to keep my car doors locked, that he wasn't beyond having someone plant "something" in it, or have someone run me off the road. She had known him for over 20 years, grew up with him in the same town. One nurse gave me a card to the Drug Enforcement Agency with the agent's name and number on it. She told me they were using her place for surveylance, that when the good doctor landed his plane the lights would be turned off and cars would drive up.

I filed complaint with the Medical Board and filed criminal charges with the law. The Medical Board investigator was my knight in shining armor. I submitted pictures of my bruises. Told him Dr. Evil said he would pay for all my medical expenses and I was offered a check in the administrator's office to "forget the whole" thing.

It being such a small town, things would get back to me. That a judge had been called at home. He declined to take the case. When it went to the grand jury 11 jurors voted to indite. The one juror that did not, was Dr. Evil's office secretary. The second time it went to the grand jury, there was a man whose son was related by marriage to the grandmother of the office nurse (who I had taken the order from, and since then Dr. Evil married). Something about a relative to the sixth degree. I only had one more chance at the grand jury. But paper work began to disappear. At first, even the District Attorney was against me. At our first meeting he said, "What I heard, was that you might as well put a gun to that patient's head." I told him I never saw the patient, didn't even know what bed he was in, and he died 10 minutes after receiving his portable CXR, and how could I be responsible for his death??" When I went to court the first time, the judge was to determine whether is should go to trial/grand jury. I am surprised he said yes, because he too, was a patient of Dr. Evil. When Dr. Evil hear that the case was going to go on, he stood up fast, grabbed his coat, knocking his chair over and stormed out. The District Attorney met me outside and simpley said, "Stay away from that man."

A few weeks later, another doctor told me to get the pt. Mr. Soandso's chart and look at it. I said, "No, I don't need to. I had nothing to do with him." He kept saying I needed to get the chart to look at it. Finally, he gave up and said, "The lawyers from the city were here. The other nurse gave him too much Ativan, but you are going to be blamed for it."

Dr. Evil got the family to sue me for negligence, but it was dropped after 6 weeks. Thank God for malpractice insurance! I had an attorney from Chicago call me, one from Texas, and my home state. They all said the same thing, that the lawsuit was a form of intimidation on Dr. Evil's part. Not to worry.

I started having nightmares, blackouts where I would be driving and then realise I didn't know where I was. There was some other stuff too that is very painful to recall. And yes, I did see a psychiatrist and psychologist....in another state. I didn't want Dr. Evil to get ahold of my records or know anything. The story of what happened was even being told as far away as a hundred miles, "in the big city". One story goes, that I got in his face and was yelling at him...another story was there was a cart and he pushed and it "bumped" into me.

This was all in 1996. Here we are in 2009. My hands are shaking while I type. But at least I don't cry when I tell the story. The nightmares are gone unless I feel threatened by a male authority figure. To be completly truthful, I really didn't feel safe until I moved out of the country. I didn't give my home state a change of address. I got some flak over it, but I think subconsciously I didn't want Dr. Evil to know where I went. The whole mess was a major factor in destroying my 25 year marriage and alienating my children.

So a couple of years ago, in my new country, my new job, I have only had one doctor raise his voice....not bad, I could handle it. But when he took the chart and threw it down on the desk, it rattled me. I wasn't aware how much until I got home and couldn't sleep after the night shift, my hands were shaking and when my husband came home I burst into tears.

It never went to trial because of missing paper work. My personal attorney who was going to file for damages dropped it because the medical board hearing found the doctor not guilty of unprofessional conduct and another charge. Can't remember. But, that hurt the worse. To me, this state I lived in was saying it was okay for a doctor to hit a nurse and get away with it.

I have only told this to a few nurses close to me over the years. I apologise for it being so long. I can't go back and correct spelling, or punctuation. I don't think I can handle going over it again in my mind.

If there are any physicians out there that read this....please think twice before you yell, scream, curse, or belittle someone. If you can't control that, the next step is throwing things. And the next step is.....well, reread my post.

[payitforward]

Whoa....

[NeoPediRN]

Bingo. If this wasn't the admitting physician, there was no reason to call that late. It's just completely inappropriate. This isn't a case of a "rude doctor", it's a rude nurse. Would the OP have called a family member that late to ask the same question? And I wonder, if a telemarketer had called the OP that late, if maybe they wouldn't have done a little yelling too?

You sound a little burnt......we all have to work together in this field. We took an oath to provide excellence in patient care and sometimes that means taking a late phone call and a few minutes to go over a medication. A call from a nurse does not equate to a call from a telemarketer in any way, shape, or form. A telemarketer is soliciting a product while a nurse is calling to help care for your patient. His/her license is still active even if you are sleeping.

[nurseforlife]

I know that sometimes we feel pressured to carry out every detail of our shift. In this case if the exact dosage could have waited till the morning, then I would have reported to the oncoming nurse to follow-through. I don't agree with the doctors behavior, but why can't we remember that certain things really aren't that urgent. Relax, let's start using some plain common sense and remember you are doing something when you report off to the next shift and chart it. Just my opinion.

[luv2canoe]

So when he started to yell at me I said if you going to yell we need to go to the parking lot. He took off and when the Nursing supervisor came to talk to me and wanted to know why I threatened the MD, I said " I told him if he was going to yell at me we needed to go to the parking lot, don't you think that is a more appropriate place to have that type of conversation? She agreed with me and went and spoke with him, he never yelled at me again.

[nurseforlife]

Once I had to call a doctor in the middle of the night (0300hrs) for a patient who's heart rate was dropping. He wanted to order a medication that would lower it even more. When I questionned his order he got upset, hung up on me, and then called back a few minutes later denying he ever ordered the med.

The next day, He called me at home at noon, because he wanted me to know what it felt like to woken up from my sleep!!!WOW SHOCKING!!!