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?

[sbic56, BSN, RN]

"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. "

This is just plain nuts. Yelling is never effective and is always counterproductive in any instance, except perhaps getting someone's attention if they are about to be hit by a bus or something. If you think you are getting your point across better by yelling, Tired MD, you are not only a poor communicator, but an irresponsible practitioner. This type of aggressive behavior in the workplace only causes undue stress, distraction and the potential for creating an environment where errors are more likely to occur. Temper yourself and stop kidding yourself. I can guarantee you are misreading your co-workers if you think yelling at them does not bother them and is actually helping any situation.

[Babs0512]

"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. "

This is just plain nuts. Yelling is never effective and is always counterproductive in any instance, except perhaps getting someone's attention if they are about to be hit by a bus or something. If you think you are getting your point across better by yelling, Tired MD, you are not only a poor communicator, but an irresponsible practitioner. This type of aggressive behavior in the workplace only causes undue stress, distraction and the potential for creating an environment where errors are more likely to occur. Temper yourself and stop kidding yourself. I can guarantee you are misreading your co-workers if you think yelling at them does not bother them and is actually helping any situation.

Yeah That!!

[canoehead, BSN, RN]

Tired MD- Perhaps you can give us an example of a situation. I find it bizarre that a doc that comes here to read and post would also be one of those crabby docs. Tell us what you mean.

[GooeyRN, ADN, BSN, CNA, LPN, RN]

I like putting docs on speaker phone when they yell at me for something petty. Then everyone can hear what an a$$ they are. It helps me not get angry. The last place I worked, there was a doctor who always yelled. He just did not like being called after a certain hour, but rarely left prn orders for new admits. Not even tylenol. So, yeah, I had to call him a lot for things that really could have waited. If I had someone with a temp of 102, I would get into trouble for not medicating. I can't medicate without an order. So I would have to call. Then get yelled at for calling about something minor at 3am. It would have waited just fine until morning if I had a prn for tylenol... I went through this almost weekly. I loved that speakerphone. That is being passive agreesive, and I don't suggest doing it, but it is quite satisfying.

[sbic56, BSN, RN]

I can remember one doc I used to work with...very smart, great surgeon and a total perfectionist with a tendency to yell loudly no matter where he was when he was frustrated. One super busy day he was upset at a nurse for not having his patient ready when he came to do rounds...the patient was in the bathroom *sigh* He hollared at her so loudly that the entire unit could hear. She was mortified. You could clearly feel the tension on the unit from his outburst for a long time afterward. Later on, when he came back and was OK, I asked him to come into the office so I could speak with him. I asked him if he realized that when he yelled like that it was actually harder to understand what he wanted...I told him when he yelled like that, ironically, it's really hard to really hear him. He understood that and apologized and went on to tell me about problems in the OR that day. So, yeah, doctors are painfully human, but need to hear that what we need from them is commuication, not tirades and tantrums. I was glad I confronted and discussed his behavior with him. I wish the nurse he had targeted would have done it, but she was too freaked out to try. I've dealt with a few docs in this same way. Wait til the heat of the moment is over, then confront. It just may help.

[bluemalibu]

If you really believe this, I encourage you to call the police the next time a physician yells at you.

Careful what you wish for doc... you just might get it. I would think that you'd be wiser than to brazenly step outside of the scope of your expertise, 'doctor'; but you know what they say about fools rushing in where angels fear to tread...

I spent a very full and satisfying career adding to the population of jailhouse lawyers; smiling at many an "expert" that tried to educate me as to why their conduct was perfectly justified, just as you've done here... while I proceeded to place a pretty set of chrome bracelets on their wrists.

A mere threat to harm is not an assault. There must also be an ability to carry out the threat. If subsequent physical contact is made, then it becomes assault consummated by battery.

And, while the essential elements of the crime of assault would not have been met in the "yelling" scenario that we are discussing, (as a reasonable person would not have had an apprehension that an imminently harmful or overt offensive contact was about to be realized), that same reasonable person might well have had sufficient cause to believe that the conduct of the physician on the phone, coupled with the content of his oration, constituted a viable threat to her, as it very well may have been perceived an act of coercion wherein a negative consequence is proposed in order to elicit a response... thus meeting the elements of the crime of 'Conveying a threat'.

Different criminal charge, same receiving cell.

(And we haven't even broached the topic of his actions being tortious conduct... just think how loud he'll yell when he gets slapped with a civil lawsuit for the intentional infliction of emotional distress.)

~Blue

[LilyBlue]

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.

I sure hope you don't employ this theory with kids - your own or anyone else's. Wow.

[TiredMD]

I sure hope you don't employ this theory with kids - your own or anyone else's. Wow.

I absolutely do.

[TiredMD]

And, while the essential elements of the crime of assault would not have been met in the "yelling" scenario that we are discussing, (as a reasonable person would not have had an apprehension that an imminently harmful or overt offensive contact was about to be realized), that same reasonable person . . .

Again, let me encourage you to take this cop mentality to the hospitals, and attempt to get one of your physicians arrested for raising their voice. You'd be famous in the hospital for years to come, even if your employment was short-lived . . .

[TiredMD]

Tired MD- Perhaps you can give us an example of a situation. I find it bizarre that a doc that comes here to read and post would also be one of those crabby docs. Tell us what you mean.

Don't do it too often, but off the top of my head:

1) Patient acutely decompensating, I asked for critical piece of equipment (pericardiocentesis needle, ET tube, etc) that is not in the room. The quality nurses and techs are busting their behinds to get done what needs to be done and can hardly drop it to run to the supply room. The 5 "lookie-loos" standing by the door just stand there staring and chatting.

2) Fellow physician begins performing OR procedure . . . incorrectly

3) Intern/medical student makes potentially dangerous error (I've been on both the giving and receiving end of this one)

or, my favorite

4) Walk on to a neuro ward one night, and CNA is announcing in a loud voice at nurses station that he is "sick and tired of cleaning up these old people's " and that he wishes "someone would just take them out back and shoot them like dogs".

The first 3 are patient safety issues requiring strong and rapid intervention. The last one was just cathartic.

[eriksoln, BSN, RN]

Don't do it too often, but off the top of my head:

1) Patient acutely decompensating, I asked for critical piece of equipment (pericardiocentesis needle, ET tube, etc) that is not in the room. The quality nurses and techs are busting their behinds to get done what needs to be done and can hardly drop it to run to the supply room. The 5 "lookie-loos" standing by the door just stand there staring and chatting.

2) Fellow physician begins performing OR procedure . . . incorrectly

3) Intern/medical student makes potentially dangerous error (I've been on both the giving and receiving end of this one)

or, my favorite

4) Walk on to a neuro ward one night, and CNA is announcing in a loud voice at nurses station that he is "sick and tired of cleaning up these old people's " and that he wishes "someone would just take them out back and shoot them like dogs".

The first 3 are patient safety issues requiring strong and rapid intervention. The last one was just cathartic.

Just me, but I've learned being stern, unwavering and delivering a confident message without the yelling is more effective. When you yell, even if your point is correct.......it is lost in the defensiveness that yelling promotes from the recipient. Being firm but remaining in control gets just the same results, and the people on the next unit down dont have to know about it. This is more for example number 3 than the others.

You said your work environment is mostly male. What is it you do? Not corrections like I thought when I first saw that, at least not according to the examples you gave. Just interested.

[eriksoln, BSN, RN]

Again, let me encourage you to take this cop mentality to the hospitals, and attempt to get one of your physicians arrested for raising their voice. You'd be famous in the hospital for years to come, even if your employment was short-lived . . .

A handfull of what you do outweighs a truck load of what you say.

I've issued you an offer. I am being serious. I will have a former friend of mine who spent an additional 3 years in jail because he yelled at a bus driver call you. Just PM the info. he needs to reach you. You can argue its not true all you want, but I have actually seen people with your views on verbal assault find out differently. Just PM me. Tell him your story, and he will tell you his. Honestly, he was never within 5 feet of the bus driver while yelling. He went to jail.