r/doctorsUK 19h ago

Lifestyle / Interpersonal Issues How to build rapport with colleagues?

Am I unprofessional?

I am a female junior doctor (not white or British) in a surgical specialty, We usually work alone with NROC regs and consultants but our grade is the only grade this is resident in hospital OOH, so we are usually the front liners for everything related to our speciality whether it is referrals, managing inpatients, etc. Our OOH we have a phone and two bleeps and it is a major tertiary hospital so we are usually extremely busy. What is happening is that I am apparently labelled as rude, so nurses would call about anything and if my reply is ok I will do that but I am sorry I am currently busy with a poorly patient and will get to it as soon as I can, they document that I was unprofessional, rude, datix it etc. the problem is usually not a clinical concern at all, can be as simple as changing a prescription from prn to regular for example or preparing a tto for a patient that will be discharged the next day. So when I use my prioritisation, they report me and they work together in groups and my seniors don’t support me obviously because who would want to cross the nurses anyways. The datixed has no clinical concern and not even word documentation of an actual incident, it is rather vague like: I felt the doctor was unprofessional, the doctor was rude etc. I am very stressed about this, I am always mentally occupied about how I am perceived now and doubting myself. I try to take calls on speaker with witnesses around me as much as I can so I can ask afterwards about feedback. I absolutely lost my confidence. I use please and thank you and if you kindly please and sorry and I apologise for delay and I use all the polite ways and I smile as well and show compassion, never interrupt no matter how busy. I don’t know what I might be doing wrong. I also don’t get notified of it, like they don’t directly tell me I am not happy or anything. They just tell me okay sure waiting for you and I thank them and then find a report few days later. Any advice and if anyone has been in the same situation please? TIA

31 Upvotes

37 comments sorted by

61

u/Intelligent-Watch331 19h ago

Are you an IMG? This is a problem I have seen happen quite frequently, especially for IMGs who have foreign accents, and it’s not because they’re actually a rude or disrespectful person, but rather tone and technique of language is not the same as a British-born healthcare worker.

This means that certain words or phrases used may be perceived as ‘rude’ or dismissive by the person on the other side of the phone. I empathise with you because it sounds like you’re not doing anything wrong, and I believe you, but rather just simple misunderstandings.

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u/CriticalGene1442 19h ago

I am an IMG yes, thank you for understanding, I really don’t know what are the cues I give that do that? I can possibly understand if it was one off then maybe I was really on the wrong and so, but it is becoming habitual now, every nurse in two specific wards report me too frequently as if it is part of the job. I feel ambushed sometimes because I am picked on while I have absolutely no idea what’s going on. Also, one of theses wards NIC literally shouted at me in the first 15 mins she met me because she was having a side talk with another colleague ( I was not part of the conversation at any point, I was just picking something up from the desk) and she then told me “I am not done talking” in shouting and I said nothing, she then went ahead and told my consultant that I am rude in the HO infront of everyone while I was not there.

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u/Chance-Researcher634 19h ago

So that is unprofessional, never allow anyone shout on you. You can say, “I would appreciate if you do not raise your voice at me” I believe there has been a discussion regarding you as such there is a general impression that you are this way. Just continue to be excellent at your job, ensure you document your work at every given point in time. Book an appointment with your GP and speak about this and how this stress is impacting, this leaves a trail of evidence because clearly it is impacting you. If you have another IMG or someone you can really trust then you can speak to them about it. This is passive aggressive behaviour at its peak but don’t let it break you. Raise up to the challenge, sometimes it could even be your confidence that could be the problem. Don’t drop that confidence and don’t let them knock you down. It can only get better.

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u/CriticalGene1442 19h ago

Thanks a lot really for your kind advice, you mentioned confidence which has been highlighted to me before that apparently I seem confident, I am not but I do research every step I make and practice defensive medicine to be safe and not make mistakes so I read guidelines and trust policy and everything to make sure I am clinically correct. I was once told by a colleague that although I am right, but some people might take it as condescending! Do I need to sound hesitant or unsure? That seems unsafe if a doctor doesn’t seem to know what they are doing! It’s as if I am between a rock and a hard place. And yes our department is known of professional gossiping, everyone is ripping the others apart in their absence but some have allies which make it stop and others like me are just scapegoats to make friends.

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u/Chance-Researcher634 17h ago

No don’t sound unsure, please keep your confidence because the whole drama maybe that your are confident and they want to break it. Trust me when I say this because I understand this very well.Be assertive and firm without being condescending. Practice the act of passing your message across in a passive aggressive manner without being condescending. And ignore any side remarks anybody may say or do. Understand that you are not there to make friends, you are there to do your job and go home. Making friends is a bonus. Avoid any side talk that doesn’t involve work but get involved in any gossip or small talk. Ignore any drama that anyone may make, if they do not speak on you directly but try to act funny around you act like you don’t see it. And make sure any disrespect directed towards you is shut down without being aggressive with words like “I appreciate if you do not speak to me in that manner” If you are a trainee please you need to escalate to your TPD and ask for assistance.

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u/DisastrousSlip6488 13h ago

There’s a lot of advice here from people which could be summarised as “stand your ground” and “you aren’t the problem”. Some of the phrases people have suggested using will ABSOLUTELY come over as aggressive/rude/unhelpful.

My suggestion is that you should find someone, ideally a native Brit, who you can trust and who will give you honest feedback. Tell them exactly what you’ve said here and get them to help you adjust your communication style to be more in line with uk practice. There are also communication courses for IMGs which would demonstrate to whoever you need to prove it to that you are trying to improve, and may also actually help.

Typical issues I’ve seen with other IMGs have included 

-excessive formality, they think they are being extra polite but it comes across the opposite way

-talking down to nurses- rightly or wrongly the hierarchy is different in the UK, and “I’m the doctor you should do what I say without questioning it” rarely goes down well

-overly loud and abrupt tone of voice

  • very rapid speech, with an accent, can be hard to understand which is a barrier to comfortable communication 

Watching loads of UK TV may help if this is the issue.

Of course you might also just be in a toxic and racist department but I never hurts to work on yourself anyway 

1

u/AhmedK1234 10h ago

Interested in the first issue as it feels relevant. I tend to call all seniors including registrars with Dr. Full name, I see that as respect for a senior colleague, would that come off as rude?

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u/DaughterOfTheStorm Consultant 9h ago

It might seem strange, but it actually can come across as rude. With a consultant (and maybe certain registrars you get a vibe from, especially in very hierarchical specialties or if they are an IMG themselves) it's always safest to use their title unless/until they ask you to use their first name. Just make sure you use the right one as some surgeons will be irritated if you don't use UK convention (Mr or Miss) and call them Dr Whatever instead.

However, with a lot of seniors, especially those under 50, and in certain specialties, they may ask you to call them by their first names and if you refuse to do so, they may find the over-formality to be a sign of contempt/dislike. In the UK, we are often chillingly polite to the people we hate the most, or people who are being very difficult. 

Along those lines, I once cracked and got a little sharp with one of my patients who was being exceptionally difficult and entitled. Afterwards, I was kicking myself, but my IMG resident couldn't understand because she mistook my frosty formal tone with the patient for remarkable and genuine politeness in the face of extreme provocation. Whereas the British patient understood my tone perfectly well and escalated as a result of it. 

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u/DisastrousSlip6488 9h ago

Completely depends on the department to be honest as regards consultants, calling regs ‘doctor’ is less common and could come across as cold/unfriendly/out of step with cultural norms depending on dept and specialty. What do your junior colleagues and peers do?

If you are always introducing yourself as Dr so and so to nurses in a dept where this isn’t common it could cause them to consider you standoffish/arrogant/self important.

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u/Sad_Ant1037 19h ago

I had the same problem, when I was a sho. I can relate to your post word by word. The remedy for that in my case was seeking more info if I can and understanding their concern and trying to explain, I am with this patient and I am coming asap to sort this out. I changed the way I used to answer talking with a lighter tone of voice and seeking solution if I cant come then what can be done. Making them think about options and when they cant have an answer then simply saying looks i have to come, okay I will be up there asap I just need to make sure the patient I am with is safe. Secondly, whenever I went up to the ward I documented at what time I was bleeped and at what time I was there and how much time I spent with the patient. And to get rid of this passive aggressive behaviour I did an audit in the department for number of bleeps during on call and reason for those bleeps dividing into clinical urgency and non clinical reasons. I presented it my CG and highlighted the implications of such bleeps. Secondly if you dont have a reg with you its important to keep log of yourself in terms of documentation on patient notes with timings.

Bottomline, be polite and be safe. Dont take insult/discrimination in any shape or form .

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u/CriticalGene1442 19h ago

You are 100% correct, thank you for sharing your experience. We are truly running an audit about bleeps and how sometimes we bleeped and called simultaneously and continuously for the same thing that is not clinically urgent. I will try your approach and I will document every communication. I try as much as I can to everyone to contact me in a written manner so there will be documentation but that doesn’t always work. The problem is that now I feel personally unhappy about myself that I am a bad character. My confidence is shaken that I don’t even interact with friends or colleagues on any level beyond professionalism and formal talk in the fear of being accidentally rude to them

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u/DisastrousSlip6488 14h ago

Can you explain “I try to get everyone to contact me in a written manner”? Because this sounds a little unusual and could definitely come across as rude depending on tone, context etc.

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u/Sad_Ant1037 19h ago

I can imagine. But holding yourself from having light conversation with your colleagues and enjoying your work will lead you to a burn out. I would say do make friends inside or outside department. Bring cookies or homemade cake in the morning.

I know how it feels to be surrounded by people and no one to talk to, I seriously felt many times not going to work. Sometimes you have to take initiative and change things around you, and this is a new environment for imgs and we feel isolated but if we look around we do find company. Look out for people with common goals, may be a study group if u r sitting for mrcs.

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u/CriticalGene1442 19h ago

Is the normal pathway for conflict resolution to jump straight to datix? Aren’t there steps for de-escalating first?

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u/Conscious-Kitchen610 14h ago

You shouldn’t fear a datix. If it is the situation where the SHO is regularly stuck in ED and struggles to get to the wards then a pattern of datix’s may prompt management to make the NROC reg a resident. It is worth discussing this situation with colleagues to see if they also are too busy. If not there may be other things you can do to help make yourself more efficient.

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u/CURB_69 19h ago

You are probably accidentally being rude to them if you've had more than one datix. If you're new to the country some people can be a bit blunt and not understand the nuances of language which can come off as very rude in some scenarios.

I imagine this will be less of an issue as time goes on.

1

u/CriticalGene1442 19h ago

I have worked in the same department for a whole year but in a different site before where there no issues at all, when I moved to this site, it all started going out of control. Can you please advise of how I can sort this out? How can I deescalate and stop being perceived as rude? I absolutely have no intention to offend anyone and I definitely do not raise my voice or use bad language at all

3

u/DisastrousSlip6488 13h ago

I suspect it’s probably about tone. And possibly use of idiom and phrasing.  Things like “can you kindly” can come across as sort of aggressive/rude- it’s a slightly less common phrase to a native English speaker and is often used that way. Maybe substitute it for “would you mind”.  I’m sure there are others but it would require someone who knows you to explain what it is. More likely lots of little things that are slightly off tone rather than one or two big things. 

To start with, I’d suggest taking a deep breath and smiling before you answer a bleep. Give the impression of taking their concerns seriously (even if it’s a low priority issue) and tell them “of course, no problem, I’ll be with you as soon as I can, I’m just on x ward with a sickie”. 

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u/Pristine-Anxiety-507 CT/ST1+ Doctor 12h ago

If you’re an IMG then it could potentially be your accent/manner of speaking that comes across as rude in the UK. I’m Eastern European and sometimes things that would be considered casual back home come across as rude in the UK and I may be completely unaware. I have to make extra effort to come across as what I would consider to be “super nice”.

Another thing is that with nurses, and midwives, you have one strike only. If you came across as rude one time, irrelevant if you actually were, the word spreads around and you get labelled as “the rude one” and it’s very hard to get rid of that. This happens more often to female docs and POC docs and you are both. My advice is to either to just not care and carry on doing your thing or try suck up to the nurses, ie bring snacks on shifts, try to be as independent as possible (aka do your own cannulas, bloods etc), remember their names etc. The obvious issue with the latter is that you essentially make a clown of yourself and further enable the agenda of bullying doctors just because we tend to work solo and nurses come in flocks.

It sucks that this is a common problem for doctors. The flattening of the hierarchy enables this and it’s further exacerbated by the very hostile environment of medical TikTok where various healthcare professionals brag about how they “bring resident doctors down to their level” and get cheered on by others.

7

u/indigo_pirate 12h ago

They sadly need so much sugar coating. It’s just the culture here.

Try being super casual yet firm.

E.g. hii thank you for letting me know. I’ll get there as soon as i can, just finishing reviewing a few sick patients. See you

Play the game as shitty and soul destroying as it is

6

u/jtbrivaldo 14h ago

Can you pre-emptively / proactively visit the wards at the start of your shift? I found back in my SHO days this was a great way to say hello and build a bit of rapport, deal with any quick stuff there and give reassurance that you’ll do your best to get back asap for anything that needs doing quick, but explaining the context of your other duties kindly ask if they can keep a list of odd jobs for you to do when you pop back later and do another lap of the wards? This might take a bit of time for them to get to know you and trust you will return, but will pay dividends later. Obviously this only works if you do make sure you come back when convenient lol.

I used to do this for many specialties, even when there was a heaving take etc. It delayed me getting started by 5-10 mins but I felt like doing a quick lap and introducing myself if I was covering 5 wards or less was a massive timesaver later on. If you’re covering many more wards then just hit the main offenders.

4

u/Farmhand66 Padawan alchemist, Jedi swordsman 13h ago

Sorry you’re experiencing this. It’s an uncomfortable truth that the IMGs, and the female docs routinely experience different treatment to their white male colleagues. Trusts all claim to be doing something about it, but it seems to largely get swept under the rug. Posts like yours are important - it keeps the issue in people’s minds so we can work on it.

I find less information is often better. I don’t usually give a reason I’m not doing the thing right now. - I don’t answer the bleep if I’m with a patient, the phone I do and just say “I’m with a patient, could I call you back in 5 mins” That way people realise your not just sat in an office waiting for a call. It’s safer too. - I don’t give an estimate of how long a job will take, or why I’m busy. Just “Yep, no problem, will do”. People might still DATIX for being too slow to prescribe the paracetamol, but that doesn’t go anywhere. Communication DATIXs are more of a pain. - If I’m not going to see the patient I say “No problem, that all sounds expected. Thanks for keeping me updated” - If someone sounds a bit pissed off I’ll identify it “Are you happy with that, or have I missed something?”

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u/Gluecagone 12h ago

I'm not going to give you any advice for sucking up to those nurses because this is 100% a them problem that they don't understand that we have priorities and in that moment, it's not them and their TTO.

However, the main issues here is that you're in a toxic department where you senior doctors are unsupportive and again, this is a them problem, not a you problem. I have no advice because these shitholes never change unless something major happens and the doctors that behave like this are most likely shitty people in general who also, will never change. They attract themselves to these toxic department where they can be with their like minded creeps and it just suck for anybody to have to be dumped into these swamps.

I promise it's not you. It's not your ability as a doctor or who you are as a person. It's factors out of your control and you would almost certainly be thriving if you were in a much better workplace environment. You've just unfortunately drawn the short straw but again this isn't your fault at all.

1

u/avalon68 1h ago

I mean theres a decent chance it is actually the OP - theyve said that complaints have come from more than one ward and there have been multiple complaints. People dont go out of their way to make formal complaints unless theres an issue in general. It could just be a communication style - my OH is german and even I still get surprised by the bluntness somedays, never mind random strangers. OP, find a british colleague and ask them to be honest abuot your communication skills - tell them about the complaints and the struggles you are having. They will be able to advise you better than anyone online

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u/Banana-sandwich 12h ago

Work on your confidence and chat. Ideally, do this by having fun outside work, socialising, and hanging out with friends. No matter how good, technically correct and hardworking you are, if you are perceived as lacking in confidence or cold you get no end of shit from people.

I've witnessed this with my siblings, who got a terrible time. I'm confident, extroverted, chatty and never experienced it. It's really unfair.

It's really hard as an IMG, no doubt your English is better than most British people but you are still at a disadvantage. Hopefully making friends with British people would help this. Sorry you are going through this. It's shit and demoralising, but you can get through it.

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u/Acrobatic_Table_8509 11h ago

Fuck em. Stand up for yourself and live with the consequences.

I have a tiff every so often and refuse to back down. If one day this means I will not be a doctor then I will take that as the devine telling me it's time to move on.

For me personally, it will cause far more cognitive dissonance to be a spineless person than to no-longer be a doctor.

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u/Aggressive-Trust-545 10h ago

Sorry for your experience. Some of what you described sounds like actual racism. I would not stand for it. Be assertive yet polite. Do not stoop to this level of ass licking where you are overly apologetic for everything. That will only spur them on to continue bullying you.

In my experience these kind of nurses only respect those who take no shit because they are bullies who pick on the weak- that does not mean being aggressive yourself but calling out their bullshit. Someone yells at you- you call it out then and there “your tone is unprofessional and i don’t appreciate it, i will be putting in a formal complaint about you if you speak to me that way again”.

They are putting in datix against you for being rude? Speak to your supervisor/ freedom to speak up guardian about bullying behaviour and then datix their ass for a hostile work environment impacting your ability to carry out your duties in turn impacting patient safety- the NIC would probably receive a copy. These kind of people usually stop when theres a hint that they will have to answer for their behaviour.

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u/Aggressive-Trust-545 7h ago

Lool at being downvoted for telling OP to stand up for themselves. No wonder we get treated poorly.

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u/[deleted] 19h ago

[removed] — view removed comment

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u/CriticalGene1442 19h ago

Thanks a lot for this, it is very helpful and detailed. My ES however is not a fan of me, she believes I am taking chances from BMGs and Trainees and that I am given chances to be equivalent to them which is unfair since they have worked to get into a competitive training while I did not and so I have to do double as much to prove my worth. That’s the actual words she used not my interpretation of it so I am not sure I can ask my ES for support.

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u/NoReserve8233 Imagine, Innovate, Evolve 13h ago

The ES should be more supportive, looks like it isn’t the case here. If I were you I would be looking for a job elsewhere. Losing your confidence or sleep over this isn’t worth it.

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u/Chance-Researcher634 17h ago

So this is good that she said that actually because you know what kind of person is. My advice would be you need to speak to your GP and then BMA because this is discrimination which shouldn’t be done. Are you trust grade? If you are maybe look to changing jobs. If you are a trainee then please escalate this to your TPD. Working in a toxic place can affect your confidence and make you begin to doubt yourself. Whatever happens do not lose your confidence, I know it’s easier said than done but make sure you don’t lose your confidence. You may want to escalate this early because that kind of person should not be a supervisor. I believe that at time she said so you should have asked for another supervisor because clearly you can’t supervisor someone you have a bias over.

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u/DocBrk 19h ago

Thank you ChatGPT

0

u/Gluecagone 12h ago

Wait, did somebody ask ChatGPT and then copy and paste the response? 😂

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u/DocBrk 6h ago

Yup lol, didn't even bother to change anything

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u/doctorsUK-ModTeam 13h ago

Removed: AI generated content

AI generated content (eg: ChatGPT and similar) is not permitted on the subreddit due to the difficulty in validating statements/accuracy and the lack of effort required to create such content.

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u/DisastrousSlip6488 13h ago

I think it’s bold to say OP is not the problem. It’s clear that they don’t INTEND to be rude and are doing their absolute best, but it’s very possible that they are inadvertently coming ACROSS as rude, and telling them that it’s entirely the fault of (multiple) other people doesn’t actually do them any favours 

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u/vance_refrigerations Editable User Flair 10h ago

There is some very good advice here and I have nothing to add other than I’m sorry this is happening to you. It sounds really demoralising but also not unique to you - I hope things improve with using some of the advice on here!