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?
I think 2300 hrs is late. The physician may have ordered the abx but if he's seeing a large number of pts per day, it may be asking a lot to ask for his total recall at that hour. No, he shouldn't have yelled at you but I think the med reconciliation could have waited until morning.
I've grown a thick hide over the years. Nothing much bothers me these days. Many years ago a doc swore at me "the f word" when I had to call him for an emergency c-section. He had been up all night.... had probably just gotten into bed, when I called him back. I happened to see a card soon after that incident that said "50 ways to use the f word". I bought it and gave it to the doc who swore at me. I told him he should keep handy it incase he ran out of ideas in the middle of the night.
My co-worker was being yelled at on the phone. In the middle of the ranting, she say "Dr Paul.... I love you". It got the doc to shut up and listen to her. I laughed so hard, my belly hurt.
Last week I had to call a doc about taking on a pt who was going to a LTC facility and that I needed him to complete the forms. He whined and complained for about 5 minutes. I didn't argue but listened to him and then asked if he felt better, and told him I wish I could get him a cup of tea or coffee if he was having a rough day in the clinic. Then he say "thanks so much for letting me whine. Fax the forms, and I'll look over them later".
Different situations require different methods. If he calls me and starts yelling I tell him once to stop screaming if he doesn't I hang up when he calls back its a repeat show. One Doc kept calling 9-10 times before he stopped The funny thing is that every nurse on our unit started doing it. He finally stopped. One I had a bad bad patient with death hot on his heels. I paged the doc and then I had to run into the room. the phone rang about 3 times before I could get to it. He started screaming. This time I started yelling at him to shut up and told him that his patient would be coding in 2 minutes if I didn't get some freakin orders. I got the orders.
sometimes you just have to tell them to stop because you don't tolerate that from anyone. Never. I never tolerated it from my kids and hubby the people I love,why would I let someone else get away with it?
Hmm...I didn't read it as the pt's PCP - I read it as whoever was on call for the pt that night. And also, the OP clearly states that it was NOT 2300 yet, so I don't think that's the same as waking him up at 0300, and even if she did, I still don't think that calling the person who is on call for this pt is inappropriate.
Yes, there are nurses who call docs for inappropriate reasons, but that doesn't mean that every nurse who calls after 5pm is a nutcase. And luckily for me, where I work I hardly ever have to deal with docs yelling at nurses. But if they do, I don't have a problem letting them know that it's not okay.
All that said, there are very few med rec related questions I will call a doc with, but abx and pain meds both fall into that category. As stated previously by someone else, of course it matters why they were taking the abx and also how far along in the course of the abx they are. But working with oncology pts, I would not have let abx wait - assuming that this wasn't the last day of the tx or that they were prophylactic or for something very minor. Also, time of day matters. 10pm? Sure, I'll call. 2am? I think it can wait - I'd just leave a note. Just my .
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?
Maybe it was late, but I had the impression from the OP that this was the admitting doctor. Anyway, in an acute care hospital they are there to get 24 hr care, not bankers hours care or why else would nurses be there at night??? WHy don't we all go to sleep and let it wait until the morning??
My point is, if he is really bothered by getting woke up at 11pm by a nurse who has one of his patients and needs an antibiotic order, then he needs to hire a PA or NP to answer his calls at night when he wants to sleep. There is no excuse for a professional to be yelling at another professional. This is not the dark ages, and we are not in the middle east where women get the death penalty for taking off their head scarf. And no nurse should be yelled at for trying to take care of her patient.. no matter what time it is.
Specializes in Home Health currently, med/surg prev.
I was yelled at over the phone by an MD because a rather new nurse paged them "for me." Long story, but basically I got pulled out of the station before I could page the MD on call. The new nurse was eager to help with anything and everything so she paged the wrong MD, and that wrong MD was on vacation in Mexico but she called back anyway. She was angry! I don't even know why the operator paged her since she was showing as not on call! When she was done yelling I told her to have fun on her vacation!
Did I go yell at the nurse who wrongly paged the MD? No. Yelling is uncivized, unprofessional and inappropriate.
I can't blame people for being upset or bothered, but adults should have the maturity to control themselves and act civilized. For my job now, I have to take call. Each time the phone rings I "prep" myself by making sure I'm smiling. Yelling at the caller is never an option.
I think you and I are reading this differently. I read it as the patient's primary care physician, who was not the admitting physician, was called at 11pm to answer a relatively insignificant question. Was he really on-call? I must have missed that part of the story. If so, then sure, he has an obligation. But if he's like most Primary Care docs these days, who do not admit their own patients, then he wasn't on-call for this patient, and it was a nuisance call. If that's the case, you really can't understand why someone might get hot under the collar?
Personally, I disagree. It gives you every right to yell at them. Someone who wakes you up in the middle of the night for something that is not only unimportant, but also that you have no responsibility for, absolutely deserves to get yelled at.
The fact that it is "hospital policy" does not trump the requirement to act with basic human courtesy. You do not wake up a person who is not on-call and not caring for a patient to ask some nonsense question. Anyone with half an ounce of common sense realizes this. Hiding behind hospital policy, or worse, making the physician responsible for changing an idiotic policy, is simply inappropriate. And I know you realize this, because you wouldn't have done it.
There's a tendency on this board to equate yelling with some kind of hideous assault that leaves people emotionally scarred. I've never understood that, and personally I'm grateful I've never worked in a place where people shared that attitude. There are times when it is perfectly appropriate to raise your voice, and I have employed it (effectively) on numerous occassions. It's not illegal, it's not unprofessional when done at the correct time, and I see nothing wrong with it.
While I do see your point, as I have worked with people only a couple days out of jail (when I was a landscape crew boss) and understand certain people dont respond to anything other than a raised voice, I dont think nurses fall into that category. When I was dealing with the landscape laborer who was fresh out of jail and had a habbit of ending arguements by stabbing his opponent, and saw him argueing with a customer, a raised voice was not only appropriate but necessary. I dont think he and the OP trying to clarify medications compares though. Not even close.
Actually, raising your voice is illegal. Its called assault. The laws views on assault are not the "slap on the wrist" variety when it does get reported either. You can take that to the bank. If you hear nothing else in my post, hear that, from someone who has seen people returned to jail for 3 years because they yelled at a bus driver for passing up their stop.
If you dont think there is an intimidation factor to yelling, then explain a little phenomenon/trend I have been witness to as a male nurse. I know for a fact I get yelled at much less than female nurses. I've witnessed upset physicians bypass yelling at me and picking the newer, younger female nurse out of the crowd at the nurse's station to vent on. Physicians are VERY selective about who they act this way with. I am, by means of my anatomy, often spared the drama. In my first job, one or two did decide to try that go that route with me. It didnt last long niether did it happen again. Again, I'm used to dealing with people on parole for murder. Nothing any physician brings to the ring shakes me. Not bragging, but............it makes my point about how selective the process is.
So, if it is professional and legal and everything you say, why does it not happen to me as often as my female co-workers? If you ask me, its because there is something that tells them I dont tolerate it (my size, my personality....whatever gives them that impression, I dont have to work at presenting it) and its just going to end up in them being embarrassed. So, they pick someone else.
Like I said, physicians are very selective about when they do it. I'll let you in on a little secret I happen to know of that they teach in anger management. First thing they point out is:
When one has a temper and can not help what they say or do when under stress, the idea of being selective is lost. We've all seen the person who yells at everyone, at any time, regardless of the consequences. That is the person with an uncontrollable temper. If, by any chance, you are able to remain selective though, there is something else going on. It is not "a loss of control". We've also seen the person who is completely patient with their boss or their peers, but abuses the smaller wife/child. They can remain calm when the threat of retaliation is present, but not when there is no consequence for loseing their temper. That is not an "anger management" problem. It is cowardice and immoral.
Thats why I lose so much respect for the physicians who decide to bully younger, female nurses. As far as I can see, not much difference between them and the chronic low lifes I often worked with as a landscape crew boss. I would like them more probably if they did it to me too. But they dont. And dont forget, this post is by someone who thinks the call made by OP was unecessary. We are on the same side, but WHOA are we there for different reasons.
I dont expect this to make much difference to you. Most people who hold the "yelling and raiseing your voice is appropriate" attitude when it really is not necessary have gotten there through years of being pushed around themselves. It will take a lot to make you want to think differently, and then even more to actually change your thinking. Guess, in the meantime, I can be embarrassed for you.
I can agrree that there is a time and a place for yelling - like, say, if my 5 year old is getting ready to wander out in traffic, I walk in and find my patient in cardiac arrest, etc. Otherwise, no. Someone with such an advanced education should have surely learned more effective ways to communicate. I would assume they are just being a bully - and that shouldn't be tolerated.
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?
basically if she hadnt taken it all day, (and who knows how long before that, lol) it was not a current med. so, i would think no need to call, and the doc was right, how would he know? out of all the patients he has seen ......and calling the pharmacy is not an option with hipaa...unless the patient signs a permission form and you can fax it over...and i would think they (pharmacy) would have to verify the sig. with what ever they have on file
There's a tendency on this board to equate yelling with some kind of hideous assault that leaves people emotionally scarred. I've never understood that, and personally I'm grateful I've never worked in a place where people shared that attitude. There are times when it is perfectly appropriate to raise your voice, and I have employed it (effectively) on numerous occassions. It's not illegal, it's not unprofessional when done at the correct time, and I see nothing wrong with it.
I disagree strongly. Yelling is completely unprofessional, and serves to try to intimidate others, therefore undermining the team work environment. Not to mention that if the yelling is done within the ear shot of patients, it can undermine the trust and faith in their health care team. If the yelling is done in front of other staff, it again, undermines the entire team and puts the yeller in a dominant albeit unflattering light, and the person being yelled at is push into the uncomfortable subservient position - and can effect the way others relate to that person.
Not to mention, yelling is just plain childish - and serves to block communication rather that foster communication.
We have to do that at our hospital when we get an new admit who can't remember a med as a part of med reconciliation. Yes, I think it could wait, but no, my bosses don't think it can. And it's the idiots down the hall who keep me on the payroll, not the PO'd doc on the other end of the phone.
I do make a point of saying, "Sorry, Dr. X, but my manager requires that I call you and clarify....."
Wow, reminds me why I left hospital nursing.A physician should not be called at night for information he obviously will not know off the top of his head. This is a silly rule that was obviously written by someone who has never had to call a doc at night. I probably would have looked the drug up - a lot of the newer broad-spectrums only come in one dose, or tried to contact the pharmacy and hope it was open 24/7. There is never and excuse for that kind of behavior, but keep in mind that the doc was venting at the nature of the call and not you. You have no choice but to make the call, perhaps you could suggest venting at the folks who make that stupid policy. Another example of the great need for networked electronic medical records.
I think you and I are reading this differently. I read it as the patient's primary care physician, who was not the admitting physician, was called at 11pm to answer a relatively insignificant question. Was he really on-call? I must have missed that part of the story. If so, then sure, he has an obligation. But if he's like most Primary Care docs these days, who do not admit their own patients, then he wasn't on-call for this patient, and it was a nuisance call. If that's the case, you really can't understand why someone might get hot under the collar?
Personally, I disagree. It gives you every right to yell at them. Someone who wakes you up in the middle of the night for something that is not only unimportant, but also that you have no responsibility for, absolutely deserves to get yelled at.
The fact that it is "hospital policy" does not trump the requirement to act with basic human courtesy. You do not wake up a person who is not on-call and not caring for a patient to ask some nonsense question. Anyone with half an ounce of common sense realizes this. Hiding behind hospital policy, or worse, making the physician responsible for changing an idiotic policy, is simply inappropriate. And I know you realize this, because you wouldn't have done it.
There's a tendency on this board to equate yelling with some kind of hideous assault that leaves people emotionally scarred. I've never understood that, and personally I'm grateful I've never worked in a place where people shared that attitude. There are times when it is perfectly appropriate to raise your voice, and I have employed it (effectively) on numerous occassions. It's not illegal, it's not unprofessional when done at the correct time, and I see nothing wrong with it.
I recently left bedside nursing. Part of my decision was based on this mindset.
TiredMD, I usually respect your opinion and enjoy reading your posts, but yes, yelling at people IS abusive and I assure you, it IS traumatic. I urge you to re-think your stance on this issue.
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Mrs Doolittle
9 Posts
I think 2300 hrs is late. The physician may have ordered the abx but if he's seeing a large number of pts per day, it may be asking a lot to ask for his total recall at that hour. No, he shouldn't have yelled at you but I think the med reconciliation could have waited until morning.
I've grown a thick hide over the years. Nothing much bothers me these days. Many years ago a doc swore at me "the f word" when I had to call him for an emergency c-section. He had been up all night.... had probably just gotten into bed, when I called him back. I happened to see a card soon after that incident that said "50 ways to use the f word". I bought it and gave it to the doc who swore at me. I told him he should keep handy it incase he ran out of ideas in the middle of the night.
My co-worker was being yelled at on the phone. In the middle of the ranting, she say "Dr Paul.... I love you". It got the doc to shut up and listen to her. I laughed so hard, my belly hurt.
Last week I had to call a doc about taking on a pt who was going to a LTC facility and that I needed him to complete the forms. He whined and complained for about 5 minutes. I didn't argue but listened to him and then asked if he felt better, and told him I wish I could get him a cup of tea or coffee if he was having a rough day in the clinic. Then he say "thanks so much for letting me whine. Fax the forms, and I'll look over them later".