Why can’t we all just get along?

"To know me is to love me." I tend to win over people I work with. ER Nurses and I get along fabulously. Even the hardened battle-ax trauma nurses where I trained were sweet to me by the end of my residency, because I was sweet to them. That Golden rule "Do unto others" really does work.

The problem is that auxiliary departments (radiology, lab) are staffed by techs who seem to have a propensity for bitchiness, and I don’t interact with them enough to win them over. My interaction with them is limited to the occasional phone call when I am too frustrated to wait any longer for my results, "Hello, this is Dr. so-and-so. How are you today? Can you tell me the status of my test result please?"

You might expect the techs to be courteous to me because I’m the doctor, but gone are the days when doctors were treated with respect, by patients and by staff alike. Patients seem to think I’m a waitress ("Can I have a coke? Can I have a meal?") or that they are at a healthcare drive through ("I want my CT scan immediately then I want to be out of here 5 minutes afterwards"). One day I’m going to show up to work in a McDonald’s uniform and ask them "Would you like fries with my potentially LIFE-SAVING treatment that I trained 10 YEARS to be able to offer you!?" Even if you get a nice group of patients, there are still some nasty techs in the hospital’s auxiliary departments to contend with. They are nasty to EVERYONE… clerks, nurses, doctors and even their own bosses, as illustrated by what happened yesterday:

"Doctor!" yelled a nurse who had just answered the ER phone, "The CT tech is calling to inform us that they are getting ready to tie up the scanner with an hour-long procedure on one of the floor patients. They want to know if there are any scans we need done before they start." I urged them to do the head CT on my HIV patient with altered mental status, not because I needed the results within the ensuing hour for medical reasons, but as a courtesy so we wouldn’t delay his work-up for a whole hour when there were people in the waiting room waiting for an ER bed. The CT tech agreed to wait for us to start his IV line so he could get the study with contrast to rule-out ring-enhancing lesions.

While the nurses were getting the first patient lined and over to the scanner, they brought in a 64-year-old female with focal neurologic deficits. She probably had a stroke and definitely needed to have her head CT without delay. As soon as I examined her I ran out of the room and told the clerk to call over to CT and tell them I needed another scan done before they started their procedure. He called then said they’d agreed to do her scan too, but they weren’t happy about it.

While they were getting ready to rush the second patient to the scanner, the nurse brought me the chart of the newest ambulance delivery – a patient with brain cancer who was significantly confused with neurologic deficits. As soon as I looked at the chart I had the clerk call over to CT to make sure they also scanned patient number 3’s head first before they closed down the scanner to us for their in-patient procedure. He called and then gave me a look like I had just started World War III. "Now they’re PISSED."

A few minutes later the phone rang and I could hear the nurse explaining why a stat head CT was indicated in the 3rd patient. She sounded frustrated and defensive. "Wait until after your hour-long procedure?" I heard her ask incredulously. She looked at me with exasperation. I decided, as the MD in charge, to straighten the whole situation out. I held out my hand for the phone. "Hello, This is doctor so-and-so. I really can’t wait an hour to know if there’s blood in either of these last two patient’s heads, because if there is I need to fly them to a neurosurgeon immediately."

So much for my authority carrying any weight. The tech on the other end of the phone sassed back with all the insolence of a smart-mouthed teenager, "We have a PROCEDURE we’ve been waiting to do."

"I know you have a procedure, but I have two patients who are critically ill and we need to TRIAGE our care. They go first."

She huffed "Fine. Send them over" and then I suddenly heard dial tone. She hung up on me!

No one at the nurse’s station was surprised. "She’s always that way." I decided to take it upon myself to keep her from being "that way" anymore. I called the radiology supervisor and explained the needless hostility her tech had shown to my nurse, my clerk and me. She very politely agreed, as their superior, to look into the matter.

30 minutes or so the radiology supervisor came and found me in the ER. She introduced herself with an empathetic smile. "I called over to CT," she explained. "There are two techs over there. I didn’t talk to the one who hung up on you. I talked to the other one. She said she was standing there when her colleague was on the phone with you and that what she heard did not sound rude."

Typical.

"But," continued the supervisor, "she was not at all nice when she said this. And then she hung up on ME!"

It really is a wonder to me how these people keep their jobs. Why can’t we all just get along?