Dear Doctor,

By February 5, 2016Uncategorized

Heard at the Nurses Station (TM)

“Hi! NurseyNurse, RN here! Your patient Mr T R Ainwreck has crackles in bilateral bases and complains of dyspnea.  His SpO2 is 85% on 4 liters nasal cannula.  He had a neb treatment, and his heart rate is 115, resps are 26, B/p is 168/84.  Would you like  a BNP, some  Lasix and a chest x-ray?”

<shouting on the other end of the phone>

“No Doctor, I was not telling you how to take care of your patient at all.  I was using my nursing judgment and suggesting possible diagnostic testing and treatment.

<more delightful shouting>

“No, I did not go to medical school. You are correct.  Yes, I do know what time it is, but your patient appears to be in distress and….no…..he is still breathing but quite rapidly and…. Yes, thank y-”

<puts phone down>

<writes phone orders for a BNP, 40mg of Lasix, and a CXR>

<thinks about new career>

Did that look familiar to you?

Abusive and disrespectful Physicians are not a new thing.  Since the days when we were required to put out our cigarettes and stand when a Doctor entered the nurses station, there have been issues with this.  Hardly any nurse has not had an incident.  Florence Nightingale probably had to bite her tongue a few times.

What happens if a Doc is disrespectful and abusive at your hospital? Where I work, the physician will be sternly talked to, written up, and probably not ever fired.  This is a common theme in healthcare.  Tell me about your experiences with this nonsense, and what we can do to come together as a healthcare team instead of a physician abusing you because you woke him or her up for a valid reason at 0200.

My Suggestions for fixing this situation:

  • Be clear with the physician that he is inappropriate and unprofessional. 
  • Explain that you will use your hospital’s grievance system to call this to the attention of the medical director.
  • Ask the Physician at the very first sign of anger if she is on call. “You seem to be upset, would you prefer I phoned someone else?”
  • Maintain your professional language and tone.  You are right.  Don’t make yourself a target by returning the attitude.

Anything that you would like to add? Let me know!

Love,

 

Janie

 

 

 

 

 

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Author Janie Garner

More posts by Janie Garner

Join the discussion 13 Comments

  • Carla says:

    I’ve had a situation and the doc straight up called me a liar. So, I didn’t lose my cool and corrected him knowing that I had charted in real time what had been going on. I told him that it was not professional and that I did not lie. I was seeking an apology. He was flustered but never apologized. Guessed what is coming his way? A written grievance from this RN!

  • tama ellis says:

    I for one have never apologized for waking a doctor. That to me seems like I am weak and afraid of his backlash for calling. I am not sorry to wake them, I am in need of orders I can not put in by myself.

  • Jackie says:

    Once in a place that I worked one of the doctors went after one of our seasoned nurses for a similar situation. She called a couple of the other nurses on the station over and told them what the doctor had just said and that no one should ever have to put up with that kind of treatment. She of course did this with the doctor sitting right next to her. Needless to say he was not very happy with being called to the mat. After that I heard that when ever a doctor was giving one if the nurses a hard time they would call a “code Beulah ” which was a signal for the nurses to stand together and support the nurse that the doctor was treating poorly. I think every nurses station needs a code Beulah button.

  • Sarah says:

    It would be nice if nursing schools would teach students techniques for talking to angry doctors.

  • John Wheat, M.D., R.N., BSN says:

    I am an RN and an MD; unfortunately I’ve experienced far more rudeness directed at me from nurses as a physician than I ever received as a nurse from physicians.

    Just one man’s experience…

    • Janie Garner says:

      I have seen older nurses attempt to eat baby doctors very occasionally…and without much success if I was around. However….I will tell you that I have been so thoroughly abused by a physician that I was vomiting in the parking lot on the way to work every day.

  • Karen says:

    Thank you Janie for empowering nurses to respond appropriately to verbal abuse from a physician with appropriatel documentation, then following the chain of command. This needs to be taught in all orientation programs across the board. Karen

  • Brie says:

    I work in a rural hospital in the South where the Old Dogs still rule the roost. Demeaning physicians are common place and little is done, if at all. I remember reporting an incident where I was compared to be less useful than a circus monkey, “accidentally” hit with a lead shield, and arterial blood shot at me across the room with a syringe when I wasn’t moving fast enough. I was allowed to transfer out of that area. Beyond that, nothing was done.

  • Ann Bancroft says:

    I was viciously attacked, verbally, by a surgeon during a complex suturing. It was after hours and I am sure the surgeon had a long day followed by being called in to the ED to repair a complicated laceration. I immediately apologized if anything I had said or done had angered him. He continued. I attempted deescalation, suggesting we both take a moment to take a deep breath and collect ourselves. He continued to berate me. I asked the surgeon to please consider the patient who was listening to this tirade. He continued. I finally asked if he would prefer to have a different nurse assist him, which he very foully agreed to. However, the nurse that was available to assist him was a traveller and unfamiliar with our laceration carts and supply stocking. I stayed outside the room and handed the traveller nurse everything he needed to keep ahead of the surgeon. The patient outcome was fine. I was humiliated, embarrassed, frustrated, and baffled as to what caused the tirade in the first place and why I was a target. Following the procedure, the surgeon walked up to me, stuck out his hand, and told me he thought I was an excellent nurse who would excel anywhere I chose to go. I know the look on my face betrayed the absolute incredulity of this patently insane approach, but merely said thank you and forewent shaking his hand. When I reported his behavior to my superior, I was told “Yeah, he does that.” When I talked to others higher up the food chain, I was told “That’s just the way he is.” Completely unacceptable. I had to endure a 15 minute public verbal assault for no reason. Many others in the same hospital have stories similar to mine involving the same surgeon. Absolutely no action has ever been taken against this surgeon.
    One other story with a different twist: Early in my career a doctor came on to the med/surg floor and immediately started yelling at me about a patient’s condition and lack of updates to the doctor. I flat out interrupted him and told him “First of all, I literally just walked onto the unit, so I have no idea what is going on with any of the patients. Secondly, you WILL not speak to me like that. Thirdly, lets find out what is going on and how I can help you.” Now this was an old-old school surgeon who had ruled the hospital with ease, and I doubt anyone had ever spoken to him that bluntly. He just stopped, apologized for yelling at me, and agreed to team up and solve the issue at hand. And we worked smoothly together ever after.

  • Anonymous for a reason says:

    I asked a Dr if she wanted insulin, D50 and Kayexalate because pt had K above 9. Pt was asking to see wife, pt was conscious at the time. Dr ordered the first two and all I asked was why not Kayexalate for my learning purposes because another nurse had requested we get these meds. Got pulled into mgr office with HER mgr AND HR for asking a question. Dr wrote an email stating I was argumentative. I asked a question… that’s it. The next shift a different Dr ordered 1G of benadryl for a pt weighing 107 lbs. I was very hesitant to ask the Dr a question to clarify order because of what happened previous shift. He thanked me and changed it to 25mg and said it was an error. Because of what the other Dr did, I am terrified to ask questions now. Bullying at its finest, unprofessional, and inappropriate. I welcome any advice for this situation.

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