Nurses experience various types of stress in the workplace, including staffing shortages, issues with staff members and the physical and emotional exertion involved in patient care.
Another stressor that a nurse may encounter is that of the intimidating or hostile physician. Many nurses have dealt with a difficult colleague at some point in their career but an unpleasant or hostile episode between a nurse and a physician can be a more challenging one for the nurse to manage.
Historically, the status of the physician and nurse in the hospital setting has been seen as that of superior and subordinate. Hospital administrators may view physicians as important in attracting patients to the facility and perhaps see nurses as less valuable in that respect.
Of course, the nursing care provided in an institution will have a significant impact on patient and family satisfaction and, in turn, can impact a hospital’s bottom line. Patient care is most effective and efficient when nurses and physicians communicate and work well together toward a common goal.
Managing Disruptive Behavior
Disruptive behavior from a physician may include: abusive, demeaning or profane language; rage or violent behavior such as throwing objects and physical abuse; insulting or disrespectful comments to or about staff, patients or families; inappropriate sexual comments or touching; repeated failure to respond to calls; and failure to take recommended corrective action.
Faced with such behavior, nurses could consider taking the following steps to manage difficult situations:
- Approach the situation factually and without emotion or opinion
- Control body language – stand straight, do not retreat and convey a sense of self-confidence
- Behave respectfully with the expectation that respect will be returned
- Apologize when appropriate
- Refuse to accept inappropriate treatment – walk away, stand silently or ask to be spoken to in a respectful tone
- Document the behavior objectively to produce a record in case of future situations or confrontations
- Prepare for situations known to provoke disruptive behaviors and attempt to be organized, communicate well and provide important information that may help minimize problems
- Report to a manager or administrator if necessary to ensure official acknowledgement of the physician’s behavior.
Responsibilities of the Nurse
It is imperative that nurses and physicians keep in mind their mutual goal of quality patient care. This may be compromised if a nurse is hesitant to call a physician when a patient’s status deteriorates or is fearful of questioning an unclear order regarding medication, testing or a procedure.
The feelings of fear and lack of confidence in nurses who find themselves exposed to such a situation can have a significant negative impact on patient care.
Nurses may help to alleviate any miscommunication with physicians by exhibiting professional behavior, being prepared when reporting patient information or assisting with a procedure, advocating for the patient and family and treating staff members, patients, families and physicians with respect and consideration. These are components of professional nursing practice that should be demonstrated every day.
Building Collaboration, Easing Tension
Nurses are essential members of the healthcare team whose importance to patients and families cannot be overstated. Their duties and responsibilities are vital to achieving optimal patient care. That goal is more easily accomplished when there is collaboration between the nurse and physician.
When lines of communication are kept open and a feeling exists of mutual respect and recognition, the work environment likely will improve, allowing nurses to fulfill their patient care duties with confidence and physicians to be assured that their patients are receiving the highest level of care.