Condescending nurses

Nurses General Nursing

Published

I got into it with two nurses at work today and I'm wondering if I was wrong to handle the situation the way I did. I'm not an RN, but I work as an intern at a hospital that recruits BSN candidates who are very near to graduation, the objective being that you will continue to work for them as an RN after you pass state boards. Being an intern is almost like being an LPN (except that we don't have a license and didn't want to be bothered with the NCLEX PN since we're already prepping for the NCLEX RN). So, we get paid less than an LPN even though we do pretty much the same things they do (under the direct supervision of an RN, of course).

The situation is that the hospital is very short of nurses aides, and at the last unit staff meeting we were told that we have to work as a team to do total patient care on everybody until they fill all the vacant positions. I personally don't see anything wrong with that because, at least in my humble opinion, nursing is all about total patient care anyway. But there are a few nurses who think they are better than to help a patient with hygiene or toileting, or even eating. They want the aides to do EVERYTHING, and if there is no aide available some of these nurses are quite comfortable to let the patient wait for a very long time laying in feces, or vomit, or until the patient's food gets cold and nasty, until an aide becomes available to do it. I'm not talking about nurses who are genuinely busy with work, just a few lazy nurses period. Don't get me wrong, the majority of the RNs I work with are really awesome people who I believe to be among the best nurses out there, but as you know there are always a few bad ones trying to ruin things.

Things started out real busy today but the docs came thru and gave orders for many of their patients to be moved out of intensive care to tele/step-down and med surg. By early afternoon about 2/3 of the patients were gone and we were sitting there twiddling our thumbs for hours because we hardly had any patients. The charge nurse didn't want to float any of the RNs out because a number of post-ops would be soon coming up from PACU and the ER was getting ready to send people up to us as well. I commented to one of the nurses aides that it had been a really slow day (I'm not exaggerating when I said that for a few hours most of us were sitting around with absolutely nothing to do). But before the words were even out of my mouth, one of the nurses said to me that things seem slow to us because we're only aides, and all we do is basic patient care, that we have no idea what "real nursing" is all about because of all the charting and follow-ups, and reports, etc that RNs have to do. Then she proceed to tell me that I have no idea what patient care is until I finish with school and become a "real nurse". I took offense to that because I do far more patient care on all her patients than she ever does.

But she didn't stop there. She began talking to another nurse about how going to nursing school nowadays means nothing because of all these incompetent new nurses she's seen. Each time she opened her mouth her comments got more and more personal, until it became obvious that she was talking about me. This woman is criticizing my education even though neither herself nor her friend ever went to college! This is BS on so many levels. First of all, since when is basic patient care NOT a part of "real nursing"? And why do some RNs have to be so condescending towards nursing assistants who are helping them to take care of their patients? Wiping butts, giving baths, and feeding a patient may not be the most glamorous things about nursing, but they are just as important to the patient as taking orders from a physician or passing meds. I went off on her BIG TIME. I'm normally not the type of person who likes to make a scene anywhere but somebody was eventually going to have to assist this woman with an attitude adjustment, and since she came swinging at me, I figured that the honor was mine.

Specializes in Nursing Professional Development.
Hmm. So let's fast forward a few months and assume that the OP has passed his NCLEX and has two new little letters behind his name. And let's assume he then posts a vent describing this situation in which he was treated in a rude, unprofessional, condescending way. I can't help but wonder if the replies he is now receiving might not be a little bit different. .

My comments would have been the same. I would have expressed the same concern and asked him similar questions.

llg

Specializes in Community Health Nurse.

Hi Tony :)

When I was a student nurse working as a nurse assistant, I remember one particular RN who was rude, condescending, and without professionalism. I did not like floating to the unit she worked on. One day I ended up talking to the evening shift supervisor about her because I had enough of her bad manners projected at the nurse assistants. So, I agee with you that some RNs think they are the cream of the crop in all the wrong ways. :rolleyes:

Once I became an RN, I have always made it a point of embracing student nurses, appreciating the nurse assistants, and treating them with respect. If I had a problem with a nurse assistant's attitude, I would let her know that I wanted to talk with her in private. If that didn't change her attitude for the better, I would let her know that I was going to involve the nurse manager.

Regardless of the position held on the unit, sometimes personality conflicts will arise, and the best way to handle them is to first try talking them out in private with the person you have the problem with before involving others in the situation.

I agree w/tweety. Most nurses/people who act like this and make these cement-headed comments have serious inferiority issues.

However.... cleaning puke, poop, phlegm, snot, blood, bile, etc. is (i'm making this number up) ~85% of what aids/techs do...(and it's vitally important!)...and is how most nurses 'make their bones' before entering the ranks.

To nUrses, (on the other hand) this 'aspect' of patient care usually represents a much smaller (2%?--again making this up) part of their expected 'job' (varies depending on where you work, etc,).

A personal pet peeve of mine (i'm sure shared by many others...most of whom are embarrassed to say it) is when we're accused of laziness, no comapssion, poor nurse, whatever...because we're sometimes forced to leave this aspect of care to the aids/techs, etc. (whose primary function IS hygeine related)

many times the aid thinks 'i hate cleaning this slop...while she's away on her orifice somewhere...' which may in many circumstances lead to resentment and the FALSE impression that the nurses are purposely avoiding the ugly side of patient care. An understandable reaction...and lots of times wrong.

She was dumb for saying what she did...and your reaction a little misguided because you DONT (yet) have a true appreciation for what nurses 'jobs' entail...but you will in time. And a few years down the road you may very well find yourself face-to-face with an aid with an agenda and a chip on her shoulder ;)

Every time I have a laboring patient, I am the ONLY one cleaning all the vomit,stool, urine, blood, etc. No aid or tech helps me. If I go in to be the second RN at the delivery, I help the other nurse clean up all her instruments, the sponges, and all the other dirty things we have messed up during the delivery. We clean our own monitors as well. As an RN on an off shift, I am often one who helps our housekeeper wash my patient's bed and the bathroom after I get her up after delivery. If we do not happen to have a housekeeper that evening, then it is us RN's who do all the cleaning as well as all the patient care. RN's are not always escaping the down and dirty work, believe me. This is always in addition to all the other nursing duties (meds, assessmenst, treatments) that have to be accomplished by the RN as well.

Specializes in pediatrics.

I personally have seen nurses who are horribly patronizing and condescending to nursing assistants. We complain about physicians treating us as handmaidens and yet turn around and treat NA with the same level of arrogance. In al my years of nursing, I have also treated the NA's with the respect I would give any co-worker (resp therapist, case manager, etc...). I have worked with wonderful NA's and NA's who were practically worthless. However, my thoughts are this -- you have two kinds of people: those who are self-motivated and take pride in their work and those who simply do what they need to do in order to get paid. Nurses need to support, encourage and respect the first kind and they need to set clear expectations for the second kind. Do not expect the second kind to do anything more than what is expected. It is the reponsibilty of unit leadership to set clear expectations and consistent follow-up. More often than not, the second kind is not as much "lazy" as they simply won't go beyond minimal expectations and based on how NA's are treated, frankly I probably would not either

Specializes in Critical Care/ICU.
The point I was really trying to get at is lost, but thanks for everyone's input anyway.

Tony, I hope you got the answers you were looking for. From the beginning, I was trying to make the point (not very well I might add) of what the difference was between RN's treating each other with disrespect and RN's treating other members of the healthcare team with disrespect.

No amount of job description, or bad day, or the fact that you're a student/intern excuses condescending behavior. No matter what. And I think you know not to "go off" on someone. That is just as bad.

i think we've made the point quite well here - we need to treat each other with professional courtesy and respect for each other as a person with worth and dignity. everyone of us has, at one point or another in our lives, been the lowest of the low in terms of status. you never forget the people who continued to mistreat you or keep you "in your place," but neither should we forget those that gave us a hand, and said a simple thank you. when it comes to poor and/or inappropriate behavior, i try to give someone a break and grant them the possiblity of a bad day. too many of those bad days, though, and i know its more than a one time thing. i have a few of those people in my department, and i steer clear of them whenever possible. it is not worth my precious energy to engage them. when i do have to spend any time with them, i am cordial to a fault. where i work, we are spoiled by having a pct for each 2 ors. they assist with positioning, changing over rooms, procuring equipment, etc. lately, though, we've been having a hard time when calling for a pct - they seem to be nowhere. yesterday, i made more than 2 calls for a pct after an orthospine case, wound up moving the patient with the resident and crna, changing over all the equipment, moving case carts, cleaning up, plus finishing the documentation, etc. as i was walking down toward the front desk i count 6 pcts standing around in the halls, talking, laughing, lounging on stretchers with other pcts. i was not happy. :stone i said nothing to them, but i did say something to the charge nurse. while i don't mind doing and helping out after a case, flipping and moving a prone spine patient who is unconscious is not easy, particularly not a 280 lb. man. :o i am not going to spend time arguing with pcts down the hall. i've got another case to do, and these pcts are not the ones assigned to my room. yes, they could have helped out, could have answered my frequent pages for assistance. it was after the fact. i had other things to do. regardless of that incident, i still say thank you to my pct. i make it a point, everyday. what we do is hard physical and mental work, and i wouldn't want to do it alone. now, if only i could get the residents to do that, we'd live in a perfect world! :rolleyes:

Specializes in PICU, Nurse Educator, Clinical Research.

Maybe it's just that in my experience the RN's do every bit of patient care in the ICU. I like it that way. I usually know things like - my patient has a small light brown round mole with smooth even edges on the left side of their right mid scapula. :chuckle Maybe that's just the anal cc nurse in me.

The NA's are there to help us with things that take two or more people to do. I can't imagine sending in the aide to clean up a bm or bathe a patient without me being there.

we have a couple of nurses who worked on the floor for years and years, where the NAs do all bathing/toileting alone, then came to the icu (where i'm a nursing assistant now). both have asked me to bathe comatose patients who weighed 300+ pounds....alone, which is beyond unsafe....AND had no intention of looking at the patient's skin, seeing their stool, etc. one was *really* bad about it- she was a nurse manager for 14 years, and somehow lost that position. she would have the secretary page me (which is against policy, as we have locator badges) and send me to her patient's room "stat" because she'd gone in, seen a bm, stripped them and left to have a cigarette.:angryfire i finally took her aside and pointed out that (a) i wasn't her servant, i was the only NA for our 16-bed unit; (b) i wouldn't do anything that was a safety risk to me OR the patient, which meant i wasn't bathing her unresponsive 300 pounders alone; and © if I didn't come running when she had the secretary page me, it meant i was helping another nurse with a different patient, and it would save her time to page me directly with the locator badge. what really fixed things was when i said that i did my own visual skin assessment during bed changes, just for practice, but i wasn't going to document them on HER patients, since it exceeded my scope of practice as a CNA. That finally hit home with her. For a few months, she didn't talk to me or look me in the eye- i think nobody had ever stood up to her before. now, after almost a year, she's friendly and VERY polite and professional.

kudos to tony for standing up to this rude bully. i've had to do the same thing to a couple of nurses, my manager, and even the director of my nursing program. if it's done privately, tactfully, and based in fact, not emotion, i think it's *always* the best course of action.

Specializes in Psych.
Tony, from your posts I can tell you're an understanding, intelligent and compassionate nurse to be. I'm glad to hear that it wasn't a dramatic loosing of your temper and "going off" on someone. I think it was very appropriate for you to assert yourself, your education, and your feelings about nursing to this person who obviously has an inferiority complex masked as a superiority conflict. A profressional response does not mean being someone's whipping post for their negativity. Of course, we must choose our battles wisely and sometimes walking away and rising above it all is the thing to do. Or sometimes just taking a deep breath before going off. But I feel this is a situation where you did the right thing in standing up for yourself.

I'm also glad you're taking heed of some of the good advice here.

Good post llg as always.

I agree with you, RN work does not just entail charting, assessments, etc. Sometimes we have to get our gloves dirty.

I stumbled onto this post b/c I was thinking of starting my own thread for strictly selfish reasons, namely: I was a ***** RN today! I am so ashamed of myself. I was overwhelmed w/rn duties and was not able to help my VERY experienced, usually COMPETENT aide and lpn. I had multiple complicated discharges, deadlines, incessant calls from family and critical pts. My co-workers (aide and lpn), kept coming to me for things they could have done themselves and interrupting my "flow", which was critical for today's busy day. It was a horrible day and I was a HORRIBLE person. I actually yelled at my lpn when she asked me how long a discharge would take (in front of the dischargee and his family member, mind you), "I am working on it NOW!" And I had been trying to work on it for some time. Oh, and my charge nurse decided to leave early. She actually went to the trouble to find her own coverage, but, what we needed was MORE help, not substitute help. This woman is notorious for taking all the best and most staff for help w/her unit and she has the LESS critical pt's. To top it off, when the nurse who follows came in for report and proceeded to c/o of something left undone on my shift (not critical to life or limb, but pertinent paperwork, which, by the way, he had left undone on his own shift the night before), I lost it w/him, too. I had just finished a phone call and SLAMMED the phone down and told him in no uncertain terms that HE was not the ONLY one that had difficult shifts. Just so you know, I have had to take grief from this individual repeatedly and have shut my mouth and let him vent and insult and belittle and act superior. I just COULD NOT LISTEN TO IT ONE MORE TIME. And I told him so. I said, in effect, "Do not START w/me today. Not a good day for you to start this **** up w/me" (just the 2 of us heard this, probably the only good thing that happened today, I wasn't being b****y in a public forum for a change. My aide who is a hard worker and a credit to our unit, gave her opinion on how a certain pt should be handled and I said (not in a nice tone of voice), "then WHY didn't you do it". I am not kidding, I was awful. I am usually a person who prides myself on trying to keep a positive attitude and setting the tone for taking things in stride and just doing the best job we can w/a minimum of complaints and drama. NOT TODAY. I am so ashamed. To top it off, I had to hear, again, complaints about a certain co-worker that are quite valid and had to say again, "What can I do? Please tell the supervisor". I feel like my non-rn co-workers believe I have the power to resolve personnel issues. This is not my venue/area of expertise. I CAN NOT hire/fire/provide vocational counseling. PLEASE, I HAVE ENOUGH TO DO ALREADY! Maybe I have been a little too prideful of my good attitude and need to give more credit to the "BIG BOSS IN THE SKY". Or maybe I need to stand up for myself and start demanding better and more staffing on my VERY CRITICAL unit. Nah, If I thought this would help (demanding), I would have done it a long time ago. I didn't intend to hijack this thread, but man I needed to vent. We RNS feel very overwhelmed as well, sometimes. And I am not one to sit around and do nothing if there is downtime. I sincerely believe that this is theft of the worst kind and try to find SOMETHING to do. Sometimes (gasp!), I even use that downtime to get to know/provide 1:1 social time to my patients and their families. I just feel so bad about how I acted. I am almost ashamed to show my face tomorrow. Thank you for the space to let it ALL hang out. And, by the way, op, you may be amazed at the difference you will see in your job when you are the actual RN. I can't even describe it. Wish you the best, and shame on that co-worker for making you feel bad. :uhoh21:

Specializes in Psych.
we have a couple of nurses who worked on the floor for years and years, where the NAs do all bathing/toileting alone, then came to the icu (where i'm a nursing assistant now). both have asked me to bathe comatose patients who weighed 300+ pounds....alone, which is beyond unsafe....AND had no intention of looking at the patient's skin, seeing their stool, etc. one was *really* bad about it- she was a nurse manager for 14 years, and somehow lost that position. she would have the secretary page me (which is against policy, as we have locator badges) and send me to her patient's room "stat" because she'd gone in, seen a bm, stripped them and left to have a cigarette.:angryfire i finally took her aside and pointed out that (a) i wasn't her servant, i was the only NA for our 16-bed unit; (b) i wouldn't do anything that was a safety risk to me OR the patient, which meant i wasn't bathing her unresponsive 300 pounders alone; and © if I didn't come running when she had the secretary page me, it meant i was helping another nurse with a different patient, and it would save her time to page me directly with the locator badge. what really fixed things was when i said that i did my own visual skin assessment during bed changes, just for practice, but i wasn't going to document them on HER patients, since it exceeded my scope of practice as a CNA. That finally hit home with her. For a few months, she didn't talk to me or look me in the eye- i think nobody had ever stood up to her before. now, after almost a year, she's friendly and VERY polite and professional.

kudos to tony for standing up to this rude bully. i've had to do the same thing to a couple of nurses, my manager, and even the director of my nursing program. if it's done privately, tactfully, and based in fact, not emotion,

Good for you. You stated your case in an effetive and non-offensive way. I wish I could have done the same thing today. (see previous post, if you dare), and I am not an RN who acts like the offender in the account above. I HELP w/direct pt care duties WHEN I AM ABLE. I HAVE (just today, in fact) paged my non-rn colleagues over head (we don't have locator badges). I did this, though, because said colleague is notorious for disappearing. She will leave the unit and go to the break rm for 10-15 minutes mid am to "take her medicine", wtf, take it at home and it doesn't take THAT long to swallow some pills, and then she expects an am break, besides. I think I am truly at my limit. God help me.:uhoh21:

+ Add a Comment