What would you do?

  1. The Nurse Manager calls you into her office to have a conference with you. You have been working at this facility for a year and a half and have had no other conference with her since your employment (neither positive or negative). Even your annual performance review was passed to you in an envelope for you to sign without conference. The main subject of the meeting is that three other nurses (who will remain nameless) have written incident reports on you for not getting your patient up in the chair during your shift. She then tells you "it is ok if you write any problems you have with your co-workers on a sheet of paper and slip them under my door. There is no need to sign your name to the paper if you don't want to"

    For this example you work in a icu where the nurse to patient ratio is generally 1 to 2.

    What are your thoughts, and what would you do?
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  2. 19 Comments

  3. by   Stargazer
    Originally posted by buck227:
    She then tells you "it is ok if you write any problems you have with your co-workers on a sheet of paper and slip them under my door. There is no need to sign your name to the paper if you don't want to"
    Whaaaat? What kind of weaselly, passive-aggressive management style is this supposed to be? If you can dig up dirt on your co-workers, it negates the complaint? She doesn't review the charting to see if, oh, I don't know, maybe there was a legitimate reason for not getting the patient up? Did this actually happen? More than once? Is there documentation to support it? If this were a problem, why wouldn't the nurses just come to you in the first place?

    Aaaargh. Crap like this makes me really happy I'm not practicing at the bedside right now.
  4. by   Q.
    Wow Buck, what a crappy situation. I guess I would NOT participate in the naming game, and would just take the not getting my patient up to the chair thing for what it's worth. If I had a legit reason for not doing so, I would mention that to my manager, if I didn't I guess I would just eat it. At the same time I would lose respect for my manager, I would feel suspicious around my co-workers, and probably feel like crap for a while until it wears off or I find myself in another job.
  5. by   JennieBSN
    I would tell him/her to review my charting (esp. if I had a good reason for not getting the pt. up), review the census/staffing levels during that shift (if it was busy), then state my reason for not getting the pt. up. THEN I would tell him/her (assuming that this complaint was a total crock of B.S. and not a legitimate complaint of me not doing my job when I was able) that if such complaints crossed her door in the future, to not waste my time by calling me in for a conference about such petty matters, as it is unproffesional, and we are adults who should be capable of speaking to each other face to face about our concerns. Then I would walk out and go on with my day.

  6. by   RNforLongTime
    Is this a real situation that you've found yourself in recently? This sounds like something that would happen at the facility where I was previously employed. First of all, do these nurses have nothing better to do than to write this incident up? We as nurses are supposed to be helping one another rather than stabbing eachother in the back every chance we get. i would say to the manager, "Well if those people are so worried that Mr. jones did not get oob into a chair then why didn't they offer to do it for me? They obviously had the time to help out if they had the time to write up incident reports." I would have to assume that there were other circumstances at work here such as the RN caring for that patient was probably busy with caring for other patients that getting a pt in a chair was not high on the priority list. There are some pretty petty people working in this unit and I'd be looking for a new job real soon or ask to transfer to another unit.

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  7. by   buck227
    This actually happened. It floored me. I found another job and quit. I miss some aspects of my old job but I am very happy with my new position. I am out of the hospital and am already close to my new co-workers.It broke my heart to realize how vindictive those nurses were. My documentation was in place and I did get those patients up that needed to get up. I consider myself a good nurse and a patient advocate. With me the patient always comes first- before the company or my co-workers. Sometimes this rubbed others the wrong way, but I sleep well at night. I do have some feelings of guilt like I abandoned my patients by leaving, but I can't tolerate lack of trust. I took a pay cut to leave, but pay isn't everything.

    Did I make the right move? I don't know. I am happier, but I am also very sad. Please always remember, what you do effects others. If you have a problem with someone then confront them directly. If you still have a problem then you should take it higher. We must work hard as nurses to take care of each other. I wish there was more loyalty in this profession. Why is it so common in nursing to dime each other out? It serves no purpose except to cause harm. We need to be more caring of eachother.

    buck
  8. by   nursejanedough
    buck, I am so sorry. I know it hurts. I had a similar situation happen to me as a graduate nurse. I started on a med/surg floor and when I walked up to the nursing station on first day as a graduate nurse and said "Hi" to the 5 nurses sitting down charting, they looked at me and continued charting and said nothing. The third day I was yelled at by the charge nurse for not giving NPO meds to a patient. I told her that my preceptor told me not to give those meds because the patient was NPO without meds. (I had been in an orientation meeting and missed report-so I trusted my preceptor).
  9. by   nursejanedough
    buck, I was not done with my story, but my computer went haywire. To make a long story short, I was terminated(fired) as a graduate nurse. It was a very traumatic experience. I was told by many friends that I did nothing wrong, that I worked with a bunch of jerks, etc. buck, best of luck, happiness to you.
  10. by   Mijourney
    Hi buck227. We know that management is capable of playing many devious tricks. Is this a ploy by management to get employees to rate each other thereby making management's job easy? What type of relationship did you have with these other nurses? How did you fare with your annual performance review? Was the patient alert and oriented enough to complain about not getting assistance to get up? Did the family or physician complain? Has the patient suffered some kind of adverse physical complication as a result of not being gotten up in the chair? I know I don't have all the facts, but just on the basis of what you wrote, I would be very hesitant about participating in critizing other employees on paper especially. It sounds like a lose-lose proposition for all of you.

    [This message has been edited by Mijourney (edited March 27, 2001).]
  11. by   Sunshine55
    Wow! Buck227 and Nursejanedough you've definitely had some difficult co-workers and tough bosses. Please don't hold it against me because I'm going to tell something stupid I did as a new graduate. Remember the rule to always follow all lines to their source? Well, I never forgot it again. Part of my assignment was to start all the tube feedings on my floor. Well, to make a long story short...I failed to notice that the tubing from the foley bag had become disconnected and was lying under this patient's wheelchair. I connected the tube feeding to her indwelling catheter which was in plain sight and looked just like her G-tube and filled her bladder full of tube feed. Another nurse asked who hooked up so and so? Naturally, I replied, I did. She said, "come here". I was horrified! I went to my Nurse Manager immediately. She called the Doctor, orders were received to irrigate her bladder. I worked in an 850 bed facility. It spread like wild fire and went all the way to the top. My punishment was my total embarassment and empathy for the discomfort I must have caused my patient. I was not written up. I really had some great team members. Felt lucky to keep my job and continue to develop my newly learned skills and become an asset to the floor.
  12. by   buck227
    Originally posted by Mijourney:
    What type of relationship did you have with these other nurses? A good one as far as I know. I never had anyproblems and they were all very cordial to my face

    How did you fare with your annual performance review? I was rated very highly and recieved the normal annual raise that is afforded to above average performers by their scale.

    Was the patient alert and oriented enough to complain about not getting assistance to get up? No, as a matter of fact my intervention saved one of the patients lives. he was rushed to the OR and was sedated post op for most of my shift. If I had not acted to get the surgeons involved and waited to pass it on to the next shift, he could have died.

    Did the family or physician complain? No, no complaints from either.

    Has the patient suffered some kind of adverse physical complication as a result of not being gotten up in the chair? Not to my knowledge, but it was the policy of this unit to put patients up in the chair to assist them with respiratory function. I was sensitive to that fact and did get my patients up except if they were too unstable.

    I know I don't have all the facts, but just on the basis of what you wrote, I would be very hesitant about participating in critizing other employees on paper especially. It sounds like a lose-lose proposition for all of you. I feel the same way. I have never instituted paperwork against another nurse. I have once had to write up an incident where a nurse was involved, but I didn't name the nurse and this was an unrelated incident to what we have been discussing.

    [This message has been edited by Mijourney (edited March 27, 2001).][/B]
  13. by   buck227
    Sunshine,

    Although your story is very amusing it goes to show how the system should work. I commend you on your honesty and courage to bring your mistakes to your supervisor and to admit them to your peers so that we/they can learn from them. Anyone who says that such a thing could never happen to them will find that if you are in this business long enough, it will happen to you. I am sure that you are so very careful now to make sure you know where every tube goes before hooking somthing up and it probably will never happen to you again. Thanks for sharing, your post shows that you have great character and I bet you are a very good nurse
  14. by   Jay-Jay
    Buck, I'm floored that your coworkers would be so petty. My understanding of incident reports is that they should be reserved for things such a med. errors, falls, etc., and other situations that have caused actual or potential harm to the patient.

    I have written up incident reports on other nurses, but as an agency nurse doing hospital relief, I didn't even know the names of the nurses involved. There are times when it has to be done, eg., when I went to hang an IV antibiotic on a pt. and found the previous dose still hanging, with the bag full and the line clamped shut. If the patient's wellbeing is at stake, the other nurses and the doctor should be informed, but it should never be a personal thing aimed at the nurse responsible, IMO.

    Sunshine: LOL about the catheter incident! We had a topic on the board awhile ago entitled "New grad stupids", in which we took great delight in posting the booboos we made as newly graduated nurses. You might want to hunt it up, I'm sure it will make you feel better about your goof! One of the funniest ones was about a nurse who put too much methylene blue in a tube feed, and when it came out the other end in the form of large quantities of loose stool...well, I'll let you read it for yourself!

    [This message has been edited by Jay-Jay (edited March 28, 2001).]

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