Nursing is one of the largest occupations in the United States. In 2020, nursing schools saw an enrollment bump amid the pandemic, with “nurse” being the No. 1 term that people asked “how to become” on Google. Once treated as assistants rather than peers to physicians, nurses have proven to be a vital part of the healthcare system. The nursing field holds its weight, too, with interdisciplinary collaboration, scopes of practice, and career development as a health-oriented profession.
Despite statistics that prove nurses are an essential part of the healthcare team, there are still perceptions among healthcare professionals that nurses are “assistants” to physicians and the nurse-physician relationship is often strained. As a result, workplace conflict can arise. This guide will explore that relationship and leave nurses with practical advice on effective conflict resolution in nursing and dealing with difficult doctors.
COVID-19 and the tension between nurses and doctors
With the increased stress from COVID-19, many feel the tension between nurses and doctors has increased. In a private Facebook group for nurses, one nurse asked members if they’ve noticed doctors have become ruder since COVID-19 started. The post received hundreds of comments with nurses venting about their concerns with doctors since the pandemic.
With hospital policies, CDC, and department of health guidelines constantly changing, mistrust and aggravation among healthcare professionals continue to rise. Physicians feel they have to justify their medical decisions, while nurses aren’t getting the support they need and feel they must defend their ability to care for their patients. These situations, paired with short-staffing and some facilities not having the support and supplies they need to care for patients, are a recipe for stressful environments, tension-filled workplaces, and interpersonal conflict.
How to deal with difficult doctors
We learned in nursing school that excellent communication between a nurse and patients’ interdisciplinary team, including the physician, improves patient outcome and creates a professional and healthy work environment among disciplines. But it can be difficult and overwhelming when interacting with a doctor who is perceived to be rude, disrespectful, or demeaning.
These types of conflict or tension can start from anywhere: A nurse corrects a doctor related to a medication. Or a doctor makes a nurse feel incompetent in front of their peers or a patient. A nurse calls the doctor in the middle of the night. Maybe a physician yells at a nurse and speaks in a condescending tone.
How do you handle these situations and resolve conflict? Here are seven ways to improve communication skills and your workplace experience, demand respect, address bullying or harassment, and avoid confrontation with a doctor.
1. Communicate clearly and assertively
Use communication tools like the Situation-Background-Assessment-Recommendation (SBAR) to relay all pertinent patient information. Doctors are busy and see a lot of patients, so their time is valuable. It’s your responsibility, to yourself and to patient safety, to ensure that you communicate all information that the provider should know and that they have a clear picture of any concerns you have regarding your patient.
Remind the doctor that you are a part of the patient’s healthcare team and your assessments, findings, and concerns are valid. Also, remember to be assertive. You are as equally important as any other member of your patient’s healthcare team. You are not the doctor’s assistant and, depending on the environment, they’re not your boss. As a nurse, you have a license to protect—just as doctors do—and the right to demand your respect.
2. Be direct
Sometimes, the physician is not aware their interactions with others are considered difficult or demeaning. Address the issue head-on by letting the physician know you feel disrespected and give clear examples:
- “The tone in which you spoke to me was demeaning or rude.”
- “The way you spoke to me, in front of the patient, was unprofessional and rude.”
- “The comment you said Tuesday during your rounds was inappropriate, and I’d appreciate it if you didn’t speak to me like that again.”
It’s a good idea to do this privately, if possible, to avoid confrontation.
3. Remember, doctors are human too and are just as busy as nurses
Before you page or call a physician, be sure to have everything you need to present. When the physician is rounding, try to have all of your questions and concerns ready so that you don’t have to interrupt them when they are with other patients, on another unit, or at home. Remember, they also have lives in their hands and deal with large amounts of stress and pressure. You can quickly acknowledge their busy workload when speaking to a physician. For example, “I understand you’re really busy right now, so I’ll try to make this quick.” Or, “I’m sorry to call you so late. I’ll try not to hold you for long.”
4. Ask yourself, am I just annoyed with this person?
Sometimes personalities don’t mesh, and some people just don’t get along. Think about your interactions with the doctor and determine if the tension is there because they created it or if you genuinely just do not like or care for one another. We are all human, and that is okay. Ask yourself: “Is the doctor really creating tension, or am I just annoyed with them?” If it’s the latter, brush it off and find ways to make the most comfortable work environment for all parties involved. For example, you can ask another staff nurse to round with, call, or give reports to the doctor.
5. Report behaviors of abuse and harassment
Nurse bullying is a prevalent issue in the healthcare industry. But if you feel a physician is bullying or has attacked you, you should report it immediately. Too many times, nurses sweep things under the rug. If you do not report these incidences, then they can not be addressed. Remember, you do NOT have to tolerate abuse, harassment, or bullying. You should always report:
- Sexual harassment or assault
- Threats of physical harm
- Physical assault
- Any derogatory epithets or slurs (race, color, religion, gender, national origin, age, or disability)
You can learn more about workplace violence and nurse bullying from the American Nurses Association.
If you or someone you know is a victim of sexual harassment or assault, to speak with someone trained to help, call the National Sexual Assault Hotline at 800-656-HOPE (4673).
6. Know your chain of command for reporting incidents
Most organizations have a chain of command, so it’s important to know yours for reporting incidents. The first person in your chain of command is usually your charge nurse, followed by your unit manager or director of nursing. However, if they fail to address the issue, most healthcare organizations have a safety or compliance officer you can reach out to. But if your facility does not have an officer, then the human resource director may be whom you should see.
7. Learn your facility’s policies and procedures
These safety or compliance officers oversee, develop, and revise the facility’s quality assurance and risk management plans, including employee-to-employee abuse reports. It’s their job to find ways to address these incidents and create policies and procedures to prevent them in the future. If you’re interested in learning about the policies and procedures, find out who your facility’s compliance officer is and then ask them about the process for reporting workplace bullying or harassment. And if you are reporting an incident, always follow up with them until the issue is resolved.
Bottom line, there are practical ways to implement effective conflict resolution in nursing and improve communication with doctors. But remember, you have the right to demand respect. Nurse bullying or harassment of any kind in the healthcare setting shouldn’t be tolerated and should always be reported.
Portia Wofford is an award-winning nurse, writer, and digital marketer. After dedicating her nursing career to creating content and solutions for employers that affected patient outcomes, these days, Portia empowers health practices to increase growth opportunities and become the number one providers in their communities through engaging content that connects and converts. Follow her on Instagram and Twitter for her latest.