Advice needed - when the charge nurse just won't listen

Specialties Emergency

Published

Specializes in Emergency Room.

I had a situation yesterday which has left me wondering what to do. I work in the ER and yesterday was particularly busy. I had several critical patients who all needed interventions at the same time. I had just sent one patient up to the cath lab for an emergent angioplasty and there was another patient next door who had been brought directly in without being triaged for severe SOB and I had not seen her yet, among other high acuity patients.

My managers stress communication (which I am a big fan of) and claim that if we need help or a break in patient turnover etc we need to communicate it because "they can't help us unless they know what we need." There was absolutely no one available to help me as there had been sick calls and we were short staffed. So I very politely asked the charge nurse to give me a few minute break before giving me another patient so I can catch up as there were still critical patients whom I had not seen. She was completely unreceptive and basically said "If you have an empty room (the patient had just been taken up to cath lab) I need to use it. This is critical care and all the patients are sick. Just do one thing at a time like everyone else."

As she walks away, a new patient is wheeled in to the newly vacated room, and I'm informed by the PCA "The doctor said to bring her straight in, she has an abnormal EKG" My co-worker in the next district was also overwhelmed, and overhearing our conversation, she approached the attending MD and asked him to tell the charge RN to give us a break (I.e. put the next few patients in other districts). He did, and she immediately backed off and gave us a nice break.

My main issue is, do I escalate this to my manager? I do not want to come across as a complainer. This is also a nurse I have to work with often and I don't want it to backfire on me. I did feel that this was a patient safety issue, as I could not feasibly attend to 3 critical patients all at the same exact time. They were *all* priorities. Additionally, she respected the attending MD enough to give him a break in patient turnover, yet did not respect me when I approached her with the exact same request. Her tone to me was also very degrading, insinuating that I was overwhelmed because I couldn't do as good a job as "everyone else". She made another underhand comment as well when I was leaving saying "so you survived critical care?" in a very obnoxious tone.

What would you do???

Ask her how come she denied your request for a break but granted the staff a break when the MD asked for it.

I would make a note of when this happened and what happened to file for later. If this situation occurs again then I would escalate it as it is a legitimate concern. I feel like you did the right thing...maybe she also felt overwhelmed and pressured and her response was not her typical character. But again, if this occurs again, I think talking with her privately or with your management would be ideal. I am wondering if she offered to step in at any time to assist you with your patients by putting them on the monitor, starting an IV getting labs or if she was just completely unhelpful which is a definite issue to tackle.

Mho: If the dr handled then I wait and see if it happens again.. She may have learned something there. Make a note of the date and time as suggested and give her the benefit of the doubt for now..

And ps you might want to give a sincere thanks for the break for positive reinforcement.

You can try to disarm her with charm, ignore her tone and respond to comments such as "so you survived critical care" with yes, thank you for asking, are you surviving charge nurse?

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