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?
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?
with this patient having already missed x3 doses of antibiotics, basically the damage was already done. it's probably best all around to wait and notify the doc of the missed doses. he could make a determination as to how to proceed.
if i know the reason that the patient is on antibiotics and know that it needs to be continued, such as for critical-pneumonia, not only do i need an order but also since x 3 doses were missed, but i need to know how to proceed. for me, it's a matter of the standard of care. i call the doc. to be social, i apologize for the late call and explain why i need the info. if he yells and curses, so be it, as long as i get the information i need. i'm the person there and the patient is in my care. as much as possible, i go with continuity of care.
if the doc is a real a**, and i'm not able to get the info and new orders, i notify the charge nurse, chart it and move on with the goal of the day shift continuing the process. the reality is "sticks and stones...." again, i go for standards and continuity of care.
i always try to follow up with him if i see him, i smile and speak to him, like hi dr. whoever, i hold out my hand to shake and introduce myself, i'm blah, blah, the nurse you yelled at when i called you about so and so. they've been 100% sheepish and usually apologize profusely. i think they feel pretty stupid and i feel like the adult in the room.
I agree that it is not something I would have called about either. Unless she is his only pt, how can he be expected(and at 11pm) to remember every script he writes?? Maybe you need to deal with an issue closer to home, that is the behavior of your charge nurse!! She is, among other things, the one person that is to have your back..if your behavior is appropriate..just a thought.
Specializes in OR 35 years; crosstrained ER/ICU/PACU.
I think I agree with the other nurses who would've waited on making that call to the MD. Again, he can't pull up a patient's office chart & check things out quickly at 11 pm. And, as mentioned, the pt. hadn't been taking it anyway, so let the admitting MD decide what antiobiotic to use. After many years in Nursing, you do get a feel for what to call docs about in the middle of the night, & what not to call them about. Now, as for docs that yell at you, one thing I've learned over the years is to quietly & calmly let them go on for a few minutes. They eventually stop when they hear nothing back. Then, again...quietly & calmly, say "are you done yet? Feel better now?..." Usually they settle down. If not, ask them who they'd like you to call instead!! If you have a valid concern/question regarding your patient, remember your first responsiblity is to that patient! Be the advocate for him/her, & remind the doctor we're all on the same team. You'll find also that once you've been a nurse somewhere for ages, the docs do realize you have a good head on your shoulders, and will respect your input on the care of their patients. Hang in there.....some day you'll be giving advice to a new nurse too to give them a boost!
Realize that most doctors have about 70 patients in the hospital at any one time. No telling how many patients they see-------probably close to that many each day. For this doctor to know exactly what he prescribed for this patient would be unlikely. I usually ask the patient what pharmacy they use. If it is a national chain like Walgreens, there is usually a 24 hour facility open and they can look up any prescription. The other option: is there a family member for friend that can look at the prescription at home? Otherwise, who ever is taking care of this patient when the patient's pharmacy opens or the physician office opens gets to handle this. There are policies, but then there is common sense.
Now, for yelling Drs. Used to be that there were 1 or 2 that would yell. Now, seems like more and more of them. Drs seem to have lost that loving feeling for their patients, their job, the hospitals, the nurses, the system, the insurance companies and the pay---or lack of.
Most of these docs will try and avoid you after such a scene. They know they are out of line, but they learn it in medical school and then as interns and residents. Doesn't make it okay or right and I am quick to write them up now that JCAHO has a new policy that there can be NO verbal or physical abuse towards nurses. I would not have written this doc up. Next time you see him, let him know that you are a new nurse and still learning and you are very sorry for the call. Better to handle this one with honey and not vinegar.
Specializes in Ortho, Neuro, Surgical, Renal, Oncology.
Dear Debra,
My first week of nursing I had a patient who could not pee. 3 nurses(including supervisor) were unable to cath him and only blood was returning. So, I called the doc. He yelled at me and may have said some curse words and then he hung up on me. Before he hung up on my he said, "is the patient dying?," then don't bother me.
I had no idea how to handle that, luckily my charge nurse was right there when he was yelling and she sent an email to the director of off the doctors(don't know title) and that was that. Thru my nursing career I've realized that doctors can always be written up but I've found that if I can deal with them (on the phone or in person) rather than writing up it's better for me and my working relationships with them. Another doctor decided to yell at me in front of my other workers and patients because I did not implement his order(it was illegible) so I threatened to write him up for this. From that time on he has written his name legibly next to his signature. It is considered a medical error to write illegibly. I usually listen to the doc rant and when he takes a breath I calmly reply with whatever the reason was I called for in the first place. Doctors can sense a nurse's insecurity and I hate to say this but, I believe they feed on it. Do not ever be ashamed for having to do your job and that is protect the patient; that should be the doctors priority too.
I am so sorry this md yelled at you!! He should have not yelled at all, but we all know that some mds just don't know how to act. Thank God that we do :wink2:
Anyway, take it from someone working the night shift......some things can actually wait until the morning. That was one of them. Next time, you can ask your charge nurse if she thinks it can wait, or if she thinks you should call the md. They should know.
Keep your head up though and know that all mds are not like that and do not take it personally.
Once the OP clarified that this physician was on-call, obviously the yelling was inappropriate. Hell, the anger at being called was inappropriate.
But I continue to insist that not only is yelling not a particularly big deal, but it can also be incredibly effective if used infrequently and only when absolutely necessary.
Seriously, if you haven't yelled at someone lately, give it a try. You might be shocked how well it works.
Specializes in OR 35 years; crosstrained ER/ICU/PACU.
Excellent point, Mudwoman, especially the last sentence, and common sense issue. This will all come with experience and growing in your career. Good luck!
In this, my point was that a nurse cannot approach the doc directly, she must suggest as opposed to outright telling the doc what to do. She must be respectful and polite at all times.
Never in my wildest dreams, no matter what I was thinking, would I spout off sarcastically, "The guy's in CHF, doctor. He's dying. You didn't order the lasix that he usually takes at home! What're you trying to do, KILL the guy???!!"
See the difference? Yet had the tables been turned and I made a mistake like that....would you all be justifying that behavior? Because after all, I was right, the doc did make a huge mistake and you could see where I was coming from.
How many of you prevent docs from making errors that could kill the patient? Do you call the doc up and yell at him?
Am I making any sense here at all?
I think we all have saved many a doctor's butt. do we blow our horns about it? Or remind the doctor of it? No.
Do doctors take credit for our saves? Yes. Do they maybe privately thank us? Sometimes, but NEVER will you hear them credit us in public. Too weak in their egos to give credit where it's really due. I have quit saving them. Let the students go to their residents, the res to the attending, the attending can sink or swim. I just do my nursing thing.
Specializes in pediatrics, geriatrics, med-surg, ccu,.
It can be a tough situation sometimes. I have been yelled at numerous times after calling the doc during the night. My first reactions were shock, disbelief, anger, and retaliation. As a new nurse, I was definitely intimidated after hearing stories about some of the doctors yelling at the nurses.
Our facility also requires that the medication req be completed. Initially, it was the same way, we had no options to not call. After repeated episodes of doctors complaining, our facility now requires it completed within 8 hours. Which is reasonable.
I personally would approach this doc and let him/her know that their behavior was not appreciated, nor appropriate when you called him/her in regards to a patient, and if it continued, you would have not choice but to file a report in regards to it. And then walk away. He/She will get your point.
All it takes is to be polite, firm and matter of fact. Not always easy to do, but necessary or it will continue simply because they got away with the first time. (The first time I did this, I had a stomach full of butterflies, rubbery legs, and the whole idea scared me to death but believe me, I sure felt better after doing it, and it got alot easier after the first time!)
Secondly, talk to your immediate manager and let him/her know of the situation. If enough staff members report the problems, the policy can be changed within your facility. Upper management can't change what they don't know.
dotherightthing
94 Posts
with this patient having already missed x3 doses of antibiotics, basically the damage was already done. it's probably best all around to wait and notify the doc of the missed doses. he could make a determination as to how to proceed.
if i know the reason that the patient is on antibiotics and know that it needs to be continued, such as for critical-pneumonia, not only do i need an order but also since x 3 doses were missed, but i need to know how to proceed. for me, it's a matter of the standard of care. i call the doc. to be social, i apologize for the late call and explain why i need the info. if he yells and curses, so be it, as long as i get the information i need. i'm the person there and the patient is in my care. as much as possible, i go with continuity of care.
if the doc is a real a**, and i'm not able to get the info and new orders, i notify the charge nurse, chart it and move on with the goal of the day shift continuing the process. the reality is "sticks and stones...." again, i go for standards and continuity of care.
i always try to follow up with him if i see him, i smile and speak to him, like hi dr. whoever, i hold out my hand to shake and introduce myself, i'm blah, blah, the nurse you yelled at when i called you about so and so. they've been 100% sheepish and usually apologize profusely. i think they feel pretty stupid and i feel like the adult in the room.