Other nurses taking over your patients without asking?

FireStarterRN, BSN, RN · Oct 26, 2007

The thing is, unless it really is an emergency, you need to be checking with the primary nurse who has been doing ongoing assessments of the pt throughout the shift. You shouldn't be doing interventions on a pt with whom you are not familiar, I don't think that's safe practise.

I think you should discuss this with the nurse in question. You can pull her aside and say "I really appreciate your efforts to help. In the future, however, I'd like for you to refrain from intervening on my pts before I can assess the situation, unless it is a dire emergency, as I think this is in the best interests of the pts and safer nursing practise. Thanks again for all your efforts!"

Then next time she does it, remind her of your conversation. You can also remind her that O2 is a drug and can't always be used in every situation without knowing more about the patient.

bill4745, RN · Oct 26, 2007

I would welcome anyone helping me with an unstable pt, just as I take over one of theirs if I need to. The pt comes first; my feelings are second.

classicdame, MSN, EdD · Oct 26, 2007

Tell her you are glad she is there to call upon, but please let you do the calling. Tell her how you feel when she comes in unrequested. Focus on how you feel, not how she acts. Smile. Then put your foot down if she continues to act this way.

UM Review RN, ASN, RN · Oct 26, 2007

I agree with the above- I think I just got distracted by the number of codes mentioned in the first post.

Yeah, me too. Just reading about it made me want to jump up and go get the crash cart. :lol2:

Not to take over, of course, just to help.

FireStarterRN, BSN, RN · Oct 26, 2007

Yeah, me too. Just reading about it made me want to jump up and go get the crash cart.
Not to take over, of course, just to help.

:lol2: :lol2: :lol2:

DusktilDawn · Oct 26, 2007

Honey, if any of my patients start de-satting or coding, I want that nurse and every single one of my coworkers to get in there and help me!
This is not about personalities; this is about patient survival. If she's faster than you are with this stuff, then you need to learn to get faster and do this stuff before she does. She's trying to help you.
Please take it in the spirit in which it's intended. One day, you'll have a Code when she's not there, and no one will come to help you when you need that extra pair of hands, and you'll see what I mean.

I was working nights once, came in at 1845, resident called code in room as I approached nurses desk. Threw the bag I was carrying in the direction of the desk and went in to immediately assist with code since the resident who called the code was by herself. The code team arrived shortly, begin asking questions about patient. I know absolutely nothing about this patient. The resident had to answer the questions as best she could. The patient's nurse, no where in sight the entire time this code is going on. No nurse from dayshift even came into the room. I was the only staff member on the unit that responded. After this patient was stablized and transferred. I was livid when I found this patient's nurse at the opposite end of the hall from where her patient assignment was sitting on her butt chattering away.

Another incident, new-grad with previous issues regarding patient safety. Code called, when I arrived at the room, a nurse from the opposite end of the hall was already doing chest compressions on this patient, and the other nurse (also a new-grad) arrived right behind me. We had to find this patient's nurse 2-3 times so that the Code team could ask questions. Someone calls out "Who's documenting the code", this patient's nurse says "I am." A few seconds later I look over, he's not documenting the code, he's pulled out a sheet from the chart and is writing on it. I said, "Dude, that's not what they're talking about when they asked who's documenting the code, their talking about the form on the clipboard on the side of the code cart." His response was a calmly detached "Oh, that's OK, I'm just documenting my own notes." At this point I noticed someone had already started the documention for the code. Since it was not the time or place to teach this newbie, I told him to go into the corner (out of the way and where he could be found if there were questions regarding the patient he needed to answer) to do his notes and not to leave the room. I later found out that when he found his patient unresponsive, he went and got the NA, it was the NA who pushed the code button. I highly doubt had other staff not assumed control of the situation, this patient would have survived.

Has anyone experienced this? I am a newly licensed RN since June, and I have been off orientation for many months now, I have not gotten into any trouble, I am assigned to 6-7 patients per day, and things have been going great. There is this LVN who has only been there a few more months than me, and every time one of my patients starts de-sat'ing or codes, she leaves her patients and goes flying into my patient's room and just takes over, and tells me what to do as if I don't already know, this has happened 4 times so far. I am very soft spoken and am trying to subtly tell her to back off. It is starting to really upset me, she asks me "are your charts opened? have you done this, that? etc." Tired of being treated like I don't know what I'm doing. My boss has been happy with my work so far, no problems.:angryfire

Yep, I'm one of those nurses that would just jump in there and no doubt take over in a situation like this, especially where the staff member is relatively inexperienced/new or it is someone I'm not familiar with (float/agency). The least of my concerns would be whether I'm stepping on anybody's toes and I'm not about to hazard a guess on what they do or do not know, nor make assumptions about what they did or did not do. I doubt the LVNs intent is to belittle you during these situation, her intent is to help and stabilize your patient.

You've mentioned that the LVN has only been there a few months longer than you, but you've failed to mention whether or not she has had prior nursing experience. Like it or not, as a new RN, an LVN with experience is an extremely valuable asset to YOU. Like it or not an experienced LVN will be more up to speed and on the ball in a crisis than a newbie.

If you've got the situation under control, TELL HER THAT. If you need assistance, tell her what you need. In these types of situations you can't be soft spoken or subtle.

Virgo_RN, BSN, RN · Oct 27, 2007

1) It's easy for others to interpret "soft spoken" as timid or lacking in confidence.

2) It sounds like you have trouble being assertive, and because of that you feel resentment toward people who can't possibly know what you're thinking unless you communicate.

3) When a patient is in crisis, teamwork is very appropriate. It is the RN's role to assess the situation and make the phone calls necessary. The LVN is doing you a favor by performing tasks, freeing you up to focus on coordinating things.

nyapa, RN · Oct 27, 2007

Has anyone experienced this? I am a newly licensed RN since June, and I have been off orientation for many months now, I have not gotten into any trouble, I am assigned to 6-7 patients per day, and things have been going great. There is this LVN who has only been there a few more months than me, and every time one of my patients starts de-sat'ing or codes, she leaves her patients and goes flying into my patient's room and just takes over, and tells me what to do as if I don't already know, this has happened 4 times so far. I am very soft spoken and am trying to subtly tell her to back off. It is starting to really upset me, she asks me "are your charts opened? have you done this, that? etc." Tired of being treated like I don't know what I'm doing. My boss has been happy with my work so far, no problems.:angryfire

You will have to stand up to her, but it may be best to do it when its not a stressful time, ie when someone is not coding et al.

Maybe she is stressed herself when this happens. If she is doing this when it is a 'normal' time then let her know that you are coping at the moment.

Like someone else said though, you need all hands on deck when a serious situation is occuring.

Cherybaby · Oct 27, 2007

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some have said that in a crunch they want all available staff to help. they're right, but helping does not include taking over and making the primary nurse look/feel like an idiot.

i think this sort of thinking is dangerous for the patient. the point is to be there for the patient...not whether or not someone is being made to "look/feel like an idiot".

the only person who can make me look foolish is me...and that is what i would be if i didn't accept the help of a co-worker during a "crunch".

leslymill · Oct 27, 2007

. No nurse from dayshift even came into the room. I was the only staff member on the unit that responded. I was livid when I found this patient's nurse at the opposite end of the hall from where her patient assignment was sitting on her butt chattering away.
If you've got the situation under control, TELL HER THAT. If you need assistance, tell her what you need. In these types of situations you can't be soft spoken or subtle.

I had a similar instance happen to me, but on the reverse. We here don't know all the details about what is bothering you about this territorial dispute, but I agree you need to get assertive enough to tell her.

Working nights for many many years, I make my 2 hr rounds like clockwork. Some of my co-workers don't. I have found quit a few crashing and dying, but at least none were in riger....(that has occurred BTW, and day shift found them and V/S were been charted????)

One night on a Acute Long Term Care Transitional Unit, ( Stable extended ICU patients), I was making rounds while my co-worker was, I think, SLEEPING...I called a code on her patient. We are a few minutes into this code, I am documenting since there is a wonderfully aggressive and super code team there, the Primary Nurse finally shows up. She snatches the clipboard out of my hand and steps infront of my face,l ooks back and says I have it now, would you please GO.

Okay get my adrenaline going. I was offended (and it is one of the things that make me re-think my thoughts on going back into nursing), but it isn't my patient and the last thing any nurse needs is MORE DRAMA.

If this nurse is stepping on your toes don't hesitate to tell her to get off of them, but grant it, don't offend her. Her assertive concern for YOUR patient may someday help save one of them. We are a team....we all have different personalities.

bagladyrn, RN · Oct 27, 2007

The variety of "takes" on this situation does highlight the problem. Some will see this as "teamwork" or "helping". Some nurses will be truly trying to help, other time you have that person who likes to be "the hero" or "the expert".

This person will not acknowledge this of course, so your best handling of this may be to approach her after the fact and say "I really appreciate your help with that but I need you to let me try to manage myself and take the lead when one of my patients has a problem. This is the way I am going to develop my skills and confidence. You will not always be there when I am working and I need to know that I can do this. It does help me knowing that you have my back and knowing that I can count on your help when I need it". This will feed her ego a bit while still establishing some boundaries.

If it continues after this discussion, you may need to talk to your supervisor, using the same line of reasoning as above.

By the way, it's not always that you are a new nurse. I have a coworker doing this to me right now and I've worked in this specialty for over 18 years. We just had "the talk" the last shift we worked together and I'm waiting to see the effect.