Etiquette for interrupting other healthcare providers with your patient?

Burrell College of Osteopathic Medicine
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Seces

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So I understand that the doctor is de facto the leader of the healthcare team, but I'm looking for clarification regarding when they can interrupt another worker's session with the patient. Can a resident or attending always politely interrupt a CNA, social worker, nurse or OT/PT session to talk to the patient? Seems like an inconvenience to others.
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Don't be an elitist dingus and interrupt other peoples work unless it is time-sensitive. Can you stop other people's work? Probably. Should you? No, they also have work to get done. That said, if you are polite and respectful, and their schedule is flexible, many other healthcare workers may offer to step out for you, which is fine to accept. Just be nice is an easy rule.

Edit: First time I have ever triggered the censor. Nice touch.
 
Can? Yes.
Should? Probably rude, but sometimes the attending/resident only has a few minutes with each patient during rounds/pre-rounds so it's relatively time sensitive.
 
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Do unto others and all that. If you've got a compelling time-sensitive reason to interrupt, do so politely and apologetically ("I'm sorry to interrupt, but I only have a moment, may I butt in?"). If you can wait, do so. And if you're able to wait, try not to hover: it sends the message that you're willing to be patient, but not really.
 
HomeSkool said:
Do unto others and all that. If you've got a compelling time-sensitive reason to interrupt, do so politely and apologetically ("I'm sorry to interrupt, but I only have a moment, may I butt in?"). If you can wait, do so. And if you're able to wait, try not to hover: it sends the message that you're willing to be patient, but not really.
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Very sage advice.
 
General rule of thumb is that if another healthcare provider is in the room, you let them finish before going in. We skip these patients on rounds and come back to them. It's akin to the patient being on the toilet. You could interview them through the bathroom door, but you don't.

I was a CNA before med school and if it's a CNA-related task and I'm not very busy, I generally offer to help. Speeds things up and keeps everyone happy.
 
I try not to interrupt, but often I have a very limited time in the morning to see my people before I am in surgery all day. So sometimes I do have to interrupt. I always apologize when I do, however. Most people are surprised that the surgeon is apologizing to begin with, so I never get any flack. LOL.
 
Hell yeah I can and do. I am the captain of the ship. If a chest pain walks in the door what’s more important: asking them if they feel safe at home or have any suicidal thoughts or me taking an HPI? My staff pretty much uniformly know when I’m in the room it’s HPI time. That being said I move out of the way for an EKG or IV as these are important time sensitive interventions. I am all about efficiency. There is absolutely no reason to wait just to be polite when literally nothing can happen without me checking out the patient and putting in orders. I run my department like a well oiled machine and when **** goes down guess who the nurses come to first? Me.

Be confident. Be bold. Be kind. But most of all: be a damn good leader.
 
I work in the emergency department so my vision is skewed here.... I live life one interruption to the next but I agree.
- patient safety trumps all
- don't cry wolf
- be courteous if you need to interject
- be concise (if you interrupt and then tell me a story, I will lose my mind).

Had a resident (intern) once interrupt me, and I was doing something I thought was more pressing at the time, but they advocated for their patient, interrupted me again, and told me their patient was in status and I needed to be there. I was VERY proud at that moment.
 
As a resident, I came to take a patient for a procedure. I must not have shown the proper deference when I announced my intentions, as the nurse then verbally went for my throat, ranting about how important her time was and that SHE was the patient advocate. It kind of took me off guard
I probably should have cowered under her withering outburst, worthy of a trial of Lithium for her. Instead I went to my default position and queried, If You are the patient advocate, then that must make ME the patient Advisary. She sputtered and left the room. I guess saying ..Excuse me... when I entered the room wasnt polite enough. I Always advocate respect and diplomacy. Always. Sometimes diplomacy fails.. then there is Gunboat diplomacy. Which in this instance got me a meeting with my Chief and a lecture on being diplomatic, which he defined as Allowing the other person to have MY way. Always be polite and deferential. Unless you like meeting with your Chief or Dir of Med Ed and listening to lectures on diplomacy
 
Cawolf said:
Don't be an elitist dingus and interrupt other peoples work unless it is time-sensitive. Can you stop other people's work? Probably. Should you? No, they also have work to get done. That said, if you are polite and respectful, and their schedule is flexible, many other healthcare workers may offer to step out for you, which is fine to accept. Just be nice is an easy rule.

Edit: First time I have ever triggered the censor. Nice touch.
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How much of a problem is it to be hated for being the a-hole of the team? Everyone still keeps it professional, so the work gets done after all.
 
(Resident) I always go in the room when I get there regardless of whatever staff is in....

If it’s a consult, I introduce myself and say I’ll listen in since the conversation might save me some questions later, then I sit down and let them have the patient

If it’s the nurse I introduce myself and say I can work around them if they need and ask if there is anything they need from me so they can care for the patient. If it’s the forever long registration procedure I ask them to pause so i can get out of the way and place orders

I don’t stop transport to imaging, an ecg tech, phlebotomists. I can talk around what they are doing or do the short version in 30seconds of the urgent stuff
 
Cawolf said:
Don't be an elitist dingus and interrupt other peoples work unless it is time-sensitive. Can you stop other people's work? Probably. Should you? No, they also have work to get done. That said, if you are polite and respectful, and their schedule is flexible, many other healthcare workers may offer to step out for you, which is fine to accept. Just be nice is an easy rule.

Edit: First time I have ever triggered the censor. Nice touch.
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Not sure what was censored, so I took the liberty of translating everything I could into cuss words in my head and I have to say you are quite the potty mouth.
 
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One of my favorite things about rounding was seeing the annoyed faces on other staff members when the Attending would just burst into the room and just start talking to the patient like he/she wasn't even there lmao. It was obviously rude and reeked of entitlement but it was so bizarre that it was hilarious.
 
As above. Most of the time people automatically yield when I come in the room as the surgeon. Not because I’m more important but because they are waiting for my input or the patient has a surgical emergency (im an emergency general surgeon). Recently a pharmacy tech or registration person kept talking and didn’t ask if I needed to step in so I politely interrupted them as I had a patient going to sleep in the OR and needed to see if this patient had an acute abdomen so she can follow my current case. They seemed to understand and indeed the patient did have an acute abdomen and was in the OR as soon as my other case finished.
 
You’re the doctor, yes you can enter the room as you’re more valuable than pt/ot/rn/etc
 
Merely said:
You’re the doctor, yes you can enter the room as you’re more valuable than pt/ot/rn/etc
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Except no one is more “valuable.” Unless you want to spend your days cleaning floors, serving food, or transporting people... respect the jobs of others. This is a field, not a pyramid.
 
I'm only a 3rd year but at my core site we're fortunate enough to have respectful ancillary staff who actually defer to the residents/attending/ even students when we come into the room. They seem to understand that they're going to be on the floor and can come back if it's pressing, whereas we probably won't be able to get back for hours. If they're getting a history I'll just sit in and not interrupt cause it means less questions for me on consults.

Getting them to do anything that I as a student ask is a whole different story though, even if it's relayed directly from the attending. I'd might as well write down the order on a piece of paper and throw it in the trash.
 
OrthoTraumaMD said:
Except no one is more “valuable.” Unless you want to spend your days cleaning floors, serving food, or transporting people... respect the jobs of others. This is a field, not a pyramid.
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There is a colloquialism describing the problem as “a dollar waiting on a dime”. A dollar shouldn’t wait on a dime in a hospital or anywhere for that matter unless there is a functional reason.

I’ll keep talking but work around an ecg tech in a chest pain patient because functionally I need them to hurry. I will not delay my care for the janitor(or patient registration, or food services, or “insert a ton of ancillary services”). I’ve been a janitor. No problem with janitors. But the system is inefficient if the expensive parts wait on the less expensive parts. It’s part of why a resident defers to the consults...frankly my hours cost less
 
It really depends on the situation. Like people have said, if it’s somewhat time-sensitive then I would politely interrupt. If it’s clear that what’s going on is going to take like half an hour but I just need 2 min with a patient then I also politely interrupt. Sometimes I get interrupted by a tech while I’m in the middle of examining the patient and I tell the technician to please give me a few more minutes because it does seriously interrupt my workflow when I have to stop halfway through my exam and return half an hour later to finish it.

You really need to weigh the benefits of interrupting someone in the context of how it will likely affect patient care.
 
OrthoTraumaMD said:
Except no one is more “valuable.” Unless you want to spend your days cleaning floors, serving food, or transporting people... respect the jobs of others. This is a field, not a pyramid.
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Of course some people are more valuable than others. The person capable of saving the life is more valuable than the janitor. Is the janitor worthless? No..but he’s obviously not as valuable as a physician. There are a million people that can clean the floor but only a few doctors. It’s a nice idea to say we’re all equally valuable and we should all hold hands and sing kumbaya but that would be depressing for those of us that worked hard to earn our increased value.
 
Merely said:
Of course some people are more valuable than others. The person capable of saving the life is more valuable than the janitor. Is the janitor worthless? No..but he’s obviously not as valuable as a physician. There are a million people that can clean the floor but only a few doctors. It’s a nice idea to say we’re all equally valuable and we should all hold hands and sing kumbaya but that would be depressing for those of us that worked hard to earn our increased value.
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Perhaps our work is more valuable for the patient at that moment. But your post sounded, and still does, as ascribing value to the person. That is what I have a problem with. A lot of doctors get an ego trip thinking they are gods. No one benefits from that.
 
OrthoTraumaMD said:
Perhaps our work is more valuable for the patient at that moment. But your post sounded, and still does, as ascribing value to the person. That is what I have a problem with. A lot of doctors get an ego trip thinking they are gods. No one benefits from that.
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I am ascribing value to the person in the hospital. In the hospital the doctor is the leader. We are not all equal, we are the most valuable people in the hospital. Now, am I saying the doctor as a human is more valuable than the janitor? Hell no my bet would honestly be on the janitor, he’s probably nicer, spends more time with his kids, and is more loved by his family. My only point is that in the workplace there’s a hierarchy that exists for the patients best interest. Outside of the hospital we’re all just upper middle class schmucks
 
Merely said:
In the hospital the doctor is the leader. We are not all equal, we are the most valuable people in the hospital.
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If only that were true.
But in the era of hospital administration, we are cogs in the machine. We are not very valued. You’ll see when you enter residency.
 
Ya man gone are the days of drs leading in the hospital. It’s administration and nursing territory now. That’s why I’m bailing for outpatient at the quickest exit I see.
 
So many of these responses are staggeringly self-centered!
How about considering what's most important for the patient? Sometimes that is PT or OT or their tray of food not a doctor who is just doing their daily assessment so they can finish their note. Certainly sometimes your task is most important for the patient but honestly many times it isn't. If you kick the PT out of the room so you can round and they aren't able to get back to your patient that day you've probably done more harm than good.
 
MeatTornado said:
So many of these responses are staggeringly self-centered!
How about considering what's most important for the patient? Sometimes that is PT or OT or their tray of food not a doctor who is just doing their daily assessment so they can finish their note. Certainly sometimes your task is most important for the patient but honestly many times it isn't. If you kick the PT out of the room so you can round and they aren't able to get back to your patient that day you've probably done more harm than good.
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If only one of us gets to see the patient in the hospital that day it is absolutely better to be me than PT
 
DO2015CA said:
Ya man gone are the days of drs leading in the hospital. It’s administration and nursing territory now. That’s why I’m bailing for outpatient at the quickest exit I see.
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Idk. I think super hotshot docs like neurosurgeons still have the most clout in a hospital. They are usually paid the most too (above CEO) and are more valuable. MBAs are a dime a dozen.
 
nimbus said:
Ummm no. Doctors are a dime a dozen. CEO’s are not.
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Not at community hospitals where the surgeons bring in money. That's the only situation I've ever seen the nurses throw their own kind under the bus: when a surgeon threatens to take his patients elsewhere. Maybe it was just that hospital though.
 
nimbus said:
Ummm no. Doctors are a dime a dozen. CEO’s are not.
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Neurosurgeons are a dime a dozen compared to CEOs? About 3700 neurosurgeons in the US. There's probably double the amount of only hospital CEOs. Forget about CEOs in general lol.

My point is that super specialist docs that bring millions to a hospital (NSGY, Ortho, IC, etc) have far more intrinsic value to a hospital than any single member of administration. Hospital CEOs are literally a dime a dozen because most MBAs are qualified to do the job. I would say 90% of hospital CEOs make less than 800k. MGMA mid career median for neurosurgeons is above 1M. Also consider hospital CEOs get fired like they are a dime a dozen too. Docs, if fired, get the same job down the street.

Sure administration is strong, but they still don't rival the top MD's.
 
LebronManning said:
Neurosurgeons are a dime a dozen compared to CEOs? About 3700 neurosurgeons in the US. There's probably double the amount of only hospital CEOs. Forget about CEOs in general lol.

My point is that super specialist docs that bring millions to a hospital (NSGY, Ortho, IC, etc) have far more intrinsic value to a hospital than any single member of administration. Hospital CEOs are literally a dime a dozen because most MBAs are qualified to do the job. I would say 90% of hospital CEOs make less than 800k. MGMA mid career median for neurosurgeons is above 1M. Also consider hospital CEOs get fired like they are a dime a dozen too. Docs, if fired, get the same job down the street.

Sure administration is strong, but they still don't rival the top MD's.
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We have around 10 neurosurgeons on staff and one CEO. We had a highly regarded neurosurgery group cover trauma for our hospital. One day they were replaced. It was no big deal.

Most MBAs are not qualified to become hospital CEO’s and when CEO’s get fired they move on to their next gig along with their golden parachute. I’ve seen it several times.

No doctors or CEO’s are irreplaceable.
 
It depends on what they’re doing and if it’s reasonable for me to come back later. For instance - our nurses have probably an hours worth of admission assessments (fall risk scores, tobacco cessation, endless other things) to do when the patient gets to the floor. If I need to get the pt assessed and get orders for the nurse and it will take me 10 or 15 mins - the nurse usually invites me to get to it while they chart for a few, or I’ll politely ask if I can cut in for a few mins. If it’s Saturday with 1 PT on the floor and 5 patients who need PT eval prior to discharge this morning...I’ll go do something else, see the next patient, while my patient finishes their PT (or home oxygen or speech or whatever the case) eval. We’re all on the same team. Sometimes what the other care provider is doing is more immediately important than what I need to, sometimes vice versa.
 
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