Other nurses taking over your patients without asking?

  1. 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
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  2. 34 Comments

  3. by   Boston-RN
    From a fellow assertive personality she may not realize she's offending you and she may truly believe she's helping. Let her know (in polite but clear terms) you'd like to keep the wheel next time something comes up. You may want to say it when there's nothing going on instead of the middle of when something is going on. You could say something like "thanks for your help with Patient X the other day in the future the best way to help me would be to keep an eye on my other patients" You can always add in a "I've learned a lot from watching you handle these situations but I'd like to take the lead next time so that I can be comfortable with those situations myself"

    Where I work we kind of all jump in and help out when something starts to go south and that may be just what she's used to.
    Last edit by Boston-RN on Oct 26, '07
  4. by   UM Review RN
    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.
  5. by   Hellllllo Nurse
    Why are there so many pts coding, anyway?
  6. by   UM Review RN
    Quote from Hellllllo Nurse
    Why are there so many pts coding, anyway?
    That stuck out to me, too. But the little blurb by her picture says "Med surg/onco" and I know Ca patients have this nasty habit of trying to leave us.
  7. by   Hellllllo Nurse
    Quote from Angie O'Plasty, RN
    That stuck out to me, too. But the little blurb by her picture says "Med surg/onco" and I know Ca patients have this nasty habit of trying to leave us.
    Yeah, but that many in only four months?
  8. by   txRN07
    I apologize for not being more clear. The 4 times that I am talking about were situations in which a patients SaO2 started decreasing fast, they were on their way to coding, but stopped fast.
  9. by   UM Review RN
    Quote from txRN07
    I apologize for not being more clear. The 4 times that I am talking about were situations in which a patients SaO2 started decreasing fast, they were on their way to coding, but stopped fast.
    To me, it's a good thing that she came in to help. And what you needed to do was to give her updates on what had already been done while still trying to stabilize the patient. In other words, enlist her aid to save the patient instead of fuming about who's doing what and when.

    I mean, you could've said, "Oh thank goodness you're here! This CHF'er is decompensating and I've called the doc, so could you please run and get me a couple of flushes and 40 of Lasix? or an O2 mask?" (Or whatever....)
  10. by   Jo Dirt
    Quote from txRN07
    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
    I have experienced this. I'm a very quiet person (can't stand loud blabbermouthing)and I guess others take this to mean I don't know what I'm doing, which really gets on my nerves (truth is, a lot of times I have known MORE than they did.)

    There is this one nurse in particular (was this one nurse, I don't work at this nursing home, anymore) who would come in about 40 minutes before shift change and take over the medicine cart, start drilling me about this or that patient and did I do this and did I check that....made me want to scream. She would also try to twist things around to be wrong and make it look like I was the one who messed up--you'd just have to be there to know what I mean by that. She was insecure or something, but I'd get tired of it and when she would start the blaming game I'd finally snap at her and she'd back off, but it would be the same thing the next time. I didn't truly dislike this nurse, she wasn't a bad person, she just got on my nerves until I couldn't take anymore.

    Thank goodness I don't work there now.
  11. by   KristiePDX
    Where I work, it is expected that the other nurses take over the code.
    I work on the tele floor so we know how long the person has been in trouble (heart wise). We are all ACLS.

    I have not been involved in that many codes, but our unit holds regular code inservices where we can practice acting as an organized team.

    1.Someone calls the code
    2.The first responder takes airway and breathing
    3.Second responder does circulation
    4.third nurse gets code cart fluids started ect.
    5.Most seasoned/code experienced nurse runs the whole thing
    6.the next person is the recorder.
    7. primary nurse who knows the patient the best has the chart and is on the phone calling the MD. Primary nurse also gives report to the code team.
    8.Respiratory therapy takes over airway and most of the time compressions (if backup is availiable).
    9.Code team takes over code.

    Other nurses act as runners and cover the floor/other pts, and another will stand close by to relieve others if they become fatigued

    The reason the primary does not act as a primary in the code is because they are the only person who knows the Pt the most and can more effectivly ADVOCATE for the Pt. (latest labs/meds/dx/hx/ect.)
    It is not a matter of other nurses taking over the Pt. It is more acting in an organized manner to ensure the best outcome for the Pt.
    Last edit by KristiePDX on Oct 26, '07
  12. by   Hellllllo Nurse
    Quote from txRN07
    I apologize for not being more clear. The 4 times that I am talking about were situations in which a patients SaO2 started decreasing fast, they were on their way to coding, but stopped fast.

    I see, but I'm just wondering if a anticipatory, proactive approach to caring for these pts was used? I'm not trying to critisize; I just don't have a full understanding of the situation.
  13. by   EmmaG
    I called for RRT and one of my co-workers and her brand-spanking-new-grad orientee rushed in when they heard the overhead page. I was working on the patient, trying to assess and get some VS/sats, as the team arrived. The orientee pushed me out of the way and started telling them about my patient (the same patient she'd never laid eyes on until just moments before). When the team leader, naturally assuming she was the primary nurse here, began asking her about the patient's diagnosis, what meds he'd received, etc., she just stared at him. I said, "Well, TELL us! We're waiting!"


    Ya see, it can work both ways
  14. by   txRN07
    Well let's see, we'll have a patient that has been on a nasal cannula all the way up to 6 liters, and have been keeping sats over 95%, and so many times the sats go down out of nowhere, and they need to be upgraded to a face mask.

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