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How do you handle a bullying doctor?

Temper tantrums at work

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By: Lillee Gelinas, DNP, RN, CPPS, FAAN

How do you handle a bullying doctor? 

Most nurses have witnessed or been the victims of doctor bullying. I know I have. What drives a clinician to fly off the handle and lose their temper?

Lillee Gelinas
Lillee Gelinas

It can be hard to explain an adult temper tantrum. When I envision a temper tantrum, I think of a 2-year-old lying on the floor, kicking and screaming. This behavior—outbursts of frustration—is a normal part of childhood development between the ages of 1 and 4 years. Children grow out of their temper tantrum behaviors as they learn how to express their feelings in a socially acceptable manner and exercise better control over their emotions.

Then why do we see cases of this behavior extend into adulthood? Adult temper tan­trums can be verbal, physical, or both. For example, someone might shout, curse, slam doors, kick, or throw objects. Nurses need to understand that adult temper tantrums are the result of uncontrolled emotions, and not necessarily related to something they said or did.

As the nursing profession continues to take steps to reduce bullying and violence in the workplace, doctor’s temper tantrums have been added to the list of situations perceived as attempts to intimidate or bully a nurse or worse, an instance of workplace violence. Publications describe doctor bullying as jeopardizing nurses and patients. The media report stories of physicians berating nurses, hurling profanities, or even physically threatening or assaulting them. Nurses in the operating room describe doctors throwing stethoscopes, scissors, pens, or surgical instruments at them. In one story I read, the nurse described a surgeon yelling, “Are you stupid or something?” and hurling a bloody surgical sponge at him. Another story captured a nurse’s account of a surgeon throwing a scalpel at her and saying he was angry because she didn’t have a rare piece of equipment he needed. “He endangered me and several others by throwing a tantrum,” the nurse said.

Why is doctor bullying not better exposed? Nurses might be afraid to report a doctor’s behavior because they believe nothing will be done, they’re concerned they might lose their jobs in retaliation, or they fear the stigma of being perceived as a whistleblower. Don’t let fear define your work life. Instead, consider some of these actions:

  • Reframe how you think about the doctor-nurse relationship. View it as a professional collegial one that deserves mutual respect and support.
  • Remember that the outburst probably isn’t about you, but rather a reaction to frustration the doctor is experiencing at work or in their personal life.
  • Don’t be intimidated. Calmly tell the doctor that their behavior isn’t professional and that you expect to be spoken to with respect.
  • Follow your organization’s policy for reporting bullying behavior. Getting a handle on this issue requires that nurses report it appropriately.
  • Contribute to a healthy work environment through your own actions and words. You and your physician colleagues all want to achieve the same goal: excellent patient care.

Through our individual actions and collective professional attitudes, temper tantrums—and projectile stethoscopes—can remain in the past where they belong.

 

 

Lillee Gelinas, DNP, RN, CPPS, FAAN

Editor-in-Chief

References:

Robbins A. The Nurses: A Year of Secrets, Drama and Miracles with the Heroes of the Hospital. New York City, NY: Workman Publishing; 2016.

2 Comments. Leave new

  • Judy E. Davidson DNP RN MCCM FAAN
    August 24, 2022 4:40 pm

    Thank you for opening up this discussion. There is so much published about the topic of bullying in the workplace but very little about what is known to work to address these behaviors. Bystander training is one idea that needs to be specifically tested in nursing. The person being bullied often cannot respond in the moment due to the ‘possum’ reflex invoked by the limbic system..the flight of ‘fight vs. flight’..so actions by bystanders to deflect the bullying are critical. Also, as alluded to in this piece, bullies may be showing aggression as a maladaptive coping mechanism. The bully may be a victim of previous trauma (e.g: ACE) that has not been processed. The bullying may be a cry for help. Professional help may be needed to retrain the brain to respond differently under stressful situations. Irritability can be a symptom of untreated depression or anxiety. Sadly the irritability can be the result of excessive work compression (too much to do in too little time, too many barriers to doing the right thing). Hopefully future research can test strategies to address these topics specifically in the healthcare environment to develop best practices. In the meantime, when I see bullying happening I wonder, “What triggered this? What happened to cause these triggers? Does this person need help? Is there something about our workplace that needs to change to decrease the likelihood of this happening again?” Just like in clinical issues where mistakes happen, bullying is a caring mistake that may benefit from addressing through a systems approach. Good people can act badly when in distress or when the system fails.

    Reply
  • Let’s not infantilize this behavior by describing it as a temper tantrum or bullying. Call it what it is — violence. There’s no tolerance for verbal harassment or assault in the workplace. Physicians are adults. They are fully capable knowing when their behavior is inappropriate and deserve to face the consequences of their actions. You should be able to refuse to work with someone who puts you, your colleagues or your patient’s safety at risk.

    Reply

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