Verbal attack by co-worker

Nurses General Nursing

Published

We have been having multiple issues in our unit regarding staff following standards. We have a new manager that was promoted up from staff nurse, she has been kind of harassing one of the nurses she did not like when she was staff nurse with us and has given her a couple of written warnings. All in all things are not well in our unit.

I know I can tend to be anal about my patient care, or to be fair to myself, I like taking good care of my patient and I like to follow a nurse that has taken good care of the patient. I am the type to clean out the toe jam and belly stones, I rub the backs and soak the feet and in my unit there is generally time to give good care.

One of the areas in which we have been very lacking is dating our IV's when a patient comes in. Generally, if I walk in a room and the IV is not dated I simply go back and look for the start date and put it on the IV. Generally when I come across something that is not done, I will simply do it, not say a word, and move on.

However things are not good in the unit. People are habitually late, nothing is done, IVs are not dated, nothing is done, patient care is lacking and nothing is done, there is a lot of socializing and nothing is done. When I find time and again, the same person is slacking, I speak up.

Last week I took over on a patient in which the IV was in for 6 days. I did ask the previous nurse that always complains about everyone else, how long the IV had been in and she had no clue. I looked it up in the chart and saw it had been in 6 days. I moved on, I pulled the line and put in a new one.

Today I got in report that the patient had a line in his right arm, "it looks kind of crusty but is working well" is what the nurse signing out said to me. I asked when it went in, and she did not know, looking in the chart, it had been put in on the 8th, day of admission, now 5 days in. I said to that nurse, "we have not been good about dating our IV's" she took offense and told me to write it up then, I tried to explain I was just concerned about our IVs being in so long and people not being accountable for the care that is given. I moved on but then I became kind of p***** at her attitude and I did start to write it up. At that point she launched into a verbal attack on me about how I am "always" complaining ( no, I barely talk to this person), she mentioned that she felt bad for me because I must not be sleeping well because I am up thinking of things to complain about. She went on and on, and twice I told our conversation was done. I assured I slept well because I go to bed knowing I did the best I could, I get daily compliments from my patients. I move on and if there is a good reason a co-worker did not get to something I am happy to do it, I don't like picking up the slack of slackers. Same patient had a dsg on a skin tear, for 5 days, all nurses documented "dsg D+I" , the dsg was stuck to wound and I had to soak it off, he had an AV fistula, bruit and thrill, never documented on this renal patient. My question: is it wrong of me to expect nurses to do their jobs or am I just complaining??:uhoh3:

First off-you seem like an Awesome nurse & don't let others try to make you feel bad about doing such a wonderful job. Sure there are some days when you won't be able to pick up the extra slack, but thank goodness you do or there seems like their would be an awful lot more problems on your unit. How unprofessional of that nurse to berate you for you reminding her of policies! I would of let her just kept on fussing at me and write the write-up right in front of her!:yeah:

Specializes in MS, Hospice, LTC.
First off-you seem like an Awesome nurse & don't let others try to make you feel bad about doing such a wonderful job. Sure there are some days when you won't be able to pick up the extra slack, but thank goodness you do or there seems like their would be an awful lot more problems on your unit. How unprofessional of that nurse to berate you for you reminding her of policies! I would of let her just kept on fussing at me and write the write-up right in front of her!:yeah:

I agree! That nurse that started in on you sounds a little silly to me in addition to being unprofessional. I think if the dating the IV's on your unit is a perpetual problem, then you have no choice but to write it up. There's a reason that policies and procedures are in place. Good luck in dealing with the problems on your unit, hopefully it'll pass, or you'll come across a great opportunity to move on.

Specializes in ICU.

I know where you're coming from. Sometimes it gets hard to keep coming back to work, , specially when I've been off a day or two. I know that when I'm working, things get done. I can be off for one day and come back and my patient is soo dirty,, the same dressings, the same tube feeding, the same SHEETS that I put on the patient two days ago still there.

It gets very frustrating to feel like you're the only nurse that pays attention to details, and gives good care. I am not there just to pass out meds. I go to work and do the best I can, and that includes making sure DOI's are on everything from the foley to the PICC,, to the dressings.

I even started writing with a permanent marker on my patient's briefs just before I leave for the night,, to see if they changed his brief during the night. And guess what,, they didn't. Guess what happened to the nurse? Nothing. Obviously it doesn't matter if the patient lays in his own urine all night,, as long as the hospital has a warm body to fill their bed, and a warm body to fill the nursing position.. Its all about money.

Sorry for the rant,, it just brought up some feelings.

Specializes in Intensive Care , Coronary care emergecy.

Would you like to come and work in my unit!!!!!! :specs:

Keep doing your job and keep raising the standard, and hopefully the rest of the staff will catch on.

When it comes to writing things up, it is a must!! it means you have found a problem and you are doing something about it. These are not just little issues, these are huge problems. People get all sorts of problems from IV's that get left in to long. MRSA Cellulitis, septic shock, death ect ect.

You are doing a great job, and you need to keep it up. Yes it may be an unhappy unit at the moment but, as the standard of care improves, the complaints and incident reports will become less, and the mood in the unit will improve. It will take time, but it will happen. I have seen this in 2 units I worked in and became unit manager in. Now that I am an educator, I am picking up on these things all the time.

It works:

High standard of care equals, low complaints equals happy unit!!!

Some staff will not like it and they will go to another unit where they are happier and more suited, but then your unit can pride it self in what it does.

Best of luck.

Gaffa

PS. If you want a job here in Australia just email me. I would love to have a nurse with such good work ethic working for me.

Specializes in LTC/Rehab, Med Surg, Home Care.

Sounds like this nurse was feeling guilty about slacking, and turned it around by getting defensive and attacking you.

Continue to set a good example for your coworkers, don't take this personally, I doubt it was meant to be.

Specializes in Med/Surg; aged care; OH&S.

You sound like a very safe and diligent nurse to me. The IV site issue really sticks with me (no pun intended). Hospitals in Australia have quite a high rate of infection with IV sites due to being undated often, and IVs not being changed routinely, which used to be every 72 hours (from memory), as per hospital policy.

Morale sounds very low in your unit which often results in nurses turning on each other unfortunately.

Part of a nurse's job is to advocate for her patients and you are doing this, to promote safe practice. Don't let anyone manipulate you into feeling bad about it.

sounds like the nurse was upset because you notified her to her face about the situation. Really not sure why some nurses think they are above being called out on things that effect patient safety. It reminds me of a situation I had experienced when I was working. I was getting report and the nurse told me a patient was NPO, when I asked for the reason, she shot me a dirty look and said I don't know. When I looked through the chart I didn't see any doctors orders for the patient to be NPO. When I looked back in the chart even further, I noticed their was never ever a diet ordered when the patient was 1st admitted. so knows how long the patient had gone without meals before I had gotten assigned to her. I called the doctor right away for a diet order.

Specializes in Emergency Nursing.

My opinion is pretty short and sweet when it comes to this.

Keep up the good work and start writing people up if they're doing things (or not doing things as the case may be) that endanger patients. Its nurses like them that make everyone else look bad and nurses like you who are keeping the standards and quality of care at their highest.

It's easy to allow things to stay the way they are but its never easy to fight to make things better like they should be.

!Chris :specs:

Specializes in Critical care.

It seems to me that the larger problem is poor leadership from your nurse manager. I think you are alluding to that with your first few sentences and then when you say "nothing is done." Is this manager playing favorites with who she disciplines with the write-ups?

Playing devil's advocate, perhaps the NM is discussing these issues with the nurses being written up. In fairness to those RNs being spoken to the results of the discipline should not be given to you. It's a privacy issue. However, since the same issues seems to keep coming up it may be safe to assume the NM isn't dealing with them in the first place or isn't an effective leader.

Continue to give your patients outstanding care and don't compromise your work ethic. Continue to point things out in report as the come up, and document everytime something happens. As a previous poster pointed out there are serious consequences to leaving IVs in too long....what else are they compromising if there is such a lackadaisical attitude towards IVs? It is hard to deal with co-workers who have such poor work standards. Scary, IMO.

If it's really serious with the NM not enforcing things you could consider going up the chain of command to HER boss. Perhaps her superior doesn't know what's going on. You could write an anonymous letter.

As far as a verbal attack from a co-worker, just remain calm and professional. That way you don't get in trouble for sinking to that other person's level. You should be careful how you word comments about IVs, dressings, etc so that a defensive response isn't elicited, but it may happen anyways so just be professional.

Specializes in Utilization Management.

Personally, I would've gone about it a different way because as you say, everyone's been slacking in this area. So if you start writing one or two up for it, guess what, those folks feel they've been picked on unfairly. Suddenly you're working on a unit made toxic by paranoid nurses who have to watch their patients and their backs.

I've been in your position before and handled it successfully. What I did was to gather evidence -- I wrote down only the facts of what I found for about a week "Rm 232 on a heparin gtt and no CBC done x3 days" -- and took it in to the NM. I refused to name names, so she was sure that I wasn't singling anyone out, because I wasn't. She was concerned, and the fact that I stuck to the facts made it an issue that had nothing to do with personalities, only processes.

Next staff meeting, the NM made an announcement about the problem, so everyone was informed that there was to be a change in process -- that is, that the old process was going to be severely adhered to -- and it worked. There was a discussion about what problems there were in implementation -- in my case, "the nurses aren't noticing a daily CBC on the order sheet because the writing is too small." Everyone came up with ideas about how to better implement the process and the NM took the best ones and began an improvement on the process.

You see, you're talking about getting on the back of one nurse about an outdated IV, when that IV got outdated because other nurses on other shifts let it go too. Why pick that one nurse? Now the problem is not about the patient, it's about why you picked on that one nurse. Get what I mean?

Everyone says that nurses are resistant to change, and I'll bet this is why. Traditionally, TPTB would attack one nurse, hoping to "set an example" for all of the nurses. I disagree with that method.

If you do it the way I'm suggesting, all those who are guilty of letting a date lapse on an IV will be fully aware of the problem and the new method of dealing with it, and the consequences. Your team attacks a problem as a team of professionals, not as you, the self-appointed IV police, bringing those slackers to justice with writeups. See the difference?

You might even suggest incorporating the date of the IV into your reports in order to raise awareness. You might suggest letting a designated IV person stay over shift to change IV's if one shift is particularly busy and someone can't get to change that IV. And I'm sure we've all had the wonderful experience of pulling an old IV only to find that it was impossible to get a new one. So you might want to include in the new process something like, if the patient's a known hard stick, call the doc and get an order to keep the IV over date, or DC it altogether.

Sorry this is long, but I strongly feel that there's a better way to go about this than alienating your coworkers with random writeups.

Best wishes in your endeavor. It is nurses like you who have such passion that keeps a unit functioning with excellence.

Specializes in psych. rehab nursing, float pool.

This topic resonates within me also. I start my shift going from room to room checking Iv tubing and solutions hung and if not labeled. I take them down and toss them. We all knows the standards , we know the policy. If something is not labeled and dated, throw it out. Start new. Same with outdated things. Gripes me, when I start find a flush solution which is date and found to be 4 days old, as an intermittent iv solution our policy is only up for 24 hours. To me it is simply bad habits, we all feel rushed. However if we get into the habit. No new line goes up unless labeled, no solution goes up unless properly labeled, this would not be a problem. All dressings are to be signed and dated. sigh,,,, some people will always find an excuse as to why they don't do something, some will get irritated if we remind them of policy.

Keep up your good work.

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