silence is golden

Nurses Relations

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Specializes in Certified Med/Surg tele, and other stuff.

I will be voicing this concern to my manager at the next meeting. We have a few nurses that go in pt's rooms and voice their opinions over things that should not be said in front of the pt. A select few have done this over and over and they wonder why the pt's and families are upset with us or the nurses abilities are questioned.

What do they teach in nursing school when it comes to nurse /pt communication?

Example: A pt had a lot of bleeding post hip. The nurse, totally freaked, pulled me in the room and said in the front of the pt how much blood there was, and she had never seen so much, and wanted to know if we should call a rapid response. I told the nurse later to never let the pt see you sweat, but during that time, I told the nurse in front of the pt, that I had seen plenty of bleeding like this and it was most likely a pocket. Ok..never had I seen that much bleeding but didn't want to freak out the pt!

I have seen some issues with CNA's but from nurses, I expect more, I guess.

It's stuff like this I see a lot of, and wonder if anyone else does.

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I have seen lesser situations. Most of them had to do with the day to day operations in LTC facilities. Did not involve things to upset the resident directly, with one exception. It had to do with deliberate acts to intimidate and upset residents and coworkers alike. Basically overt threats.

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Specializes in Certified Med/Surg tele, and other stuff.
I have seen lesser situations. Most of them had to do with the day to day operations in LTC facilities. Did not involve things to upset the resident directly, with one exception. It had to do with deliberate acts to intimidate and upset residents and coworkers alike. Basically overt threats.

Yikes!

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Specializes in Psych (25 years), Medical (15 years).

Some things just don't need to be said in earshot of the Patient. This reminds me of being a Scrub and the Surgeon informing me, "During the surgery, don't say 'oops!' when the Patient is conscious."

Our primary goal is the comfort of the Patient, both short and long term. Bottom line: Blatant reality is for us to deal with and the Patient should benefit as a result of our actions.

When a Co-worker says something the Patient doesn't need to hear, I find a way to control the situation by easing the Patient's anxiety without confronting the Co-worker. I then deal with the situation and later approach the inappropriate comment made by the Co-worker situation through the concept of "critisize in private".

For example,in your case, tokmom, I might have replied, in front of the Patient something like, "Yes- that IS quite amount of blood. It's so good of you to note this and brought it to my attention. However, it's nothing that we can't deal with." (Or like you said, "pocket") And directly to the Patient I might say something like, "How are YOU doing with this? Is there anything I can do for you?" I might then inform the Patient of my actions, "I'm going to contact the Surgeon, inform him/her of the situation and the Surgeon will probably do this... but I need to get some orders from him/her." Or some such.

After everything is stable, I would then approach the Co-worker with something like, "You know, you did a good job in there identifying that situation and bringing my attention to it. However, we need to spare the patient of any undue stress. That Patient may have become upset over hearing he deatails of their blood loss. Wouldn't you? I mean, sometimes the less I know, the better. I would just want someone to deal with the situation and let me know only what I have to know. What do you think of that?"

Basically, what I would be doing is accentuating the positive and confront the situation without placing undue blame on the Co-worker. I would makle the Co-worker part of the problem-solving process by putting all three of us on an equal level.

Of course, there are those who just don't get it. Under those circumstances, I become the Bottom Line Boy: "Do not unduly upset the Patient. Deal with the situation to the best of your ability. Otherwise, if you don't feel comfortable handling the situation, get someone who can."

There is only so much we can do once the proverbial cat is out of the bag. Sometimes we can only try to do our best to smooth over an emotionally-charged situation while still requiring us to use our logical sense, expertise, and knowledge in order to rectify said situaion. Such is life.

Informing your Manager of your concerns is probably a good move. However, when I was hired at the Facility where I'm presently employed, I informed my Supervisor, "If I have a problem or concern with a Peer or Co-worker, I will attempt to deal with it directly with that Person. If we cannot resolve the situation, I will inform you in an attempt at rectification." It's worked for me. I don't mind confrontations all that much. But, to each her/his own.

Dave

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Specializes in Emergency Department.

This was one of the first things they taught us in the ED. Even the CNAs. :D It was like we were 90 percent healthcare professional, 10 percent actor. I saw some Oscar-worthy performances by the staff, too. But the crux of the issue is not adding to the patient's distress by freaking out. It takes a cool head. Never let the patients and families see you freak. :) I will admit to freaking out once or twice in the privacy of the supply closet, however. But then it's back to my stage face.

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Specializes in Psych (25 years), Medical (15 years).
It was like we were 90 percent healthcare professional, 10 percent actor.

Or, to paraphrase Yogi Berra, "Healthcare is 90% professional and the other half is acting like you know what you're doing!"

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Specializes in NICU.

I remember learning this by watching others in our unit while I was on orientation. We'd have codes running on a baby with the heart rate in the 30s, O2 sats in the 20s, yadda yadda. I learned "how to be cool" by the example of the other nurses just getting in there and doing what has to be done. I remember once or twice looking at my fellow orientee at the time mouthing, "OMG!!!" and she the same, but not so much anymore.

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Specializes in Certified Med/Surg tele, and other stuff.
Some things just don't need to be said in earshot of the Patient. This reminds me of being a Scrub and the Surgeon informing me, "During the surgery, don't say 'oops!' when the Patient is conscious."

Our primary goal is the comfort of the Patient, both short and long term. Bottom line: Blatant reality is for us to deal with and the Patient should benefit as a result of our actions.

When a Co-worker says something the Patient doesn't need to hear, I find a way to control the situation by easing the Patient's anxiety without confronting the Co-worker. I then deal with the situation and later approach the inappropriate comment made by the Co-worker situation through the concept of "critisize in private".

For example,in your case, tokmom, I might have replied, in front of the Patient something like, "Yes- that IS quite amount of blood. It's so good of you to note this and brought it to my attention. However, it's nothing that we can't deal with." (Or like you said, "pocket") And directly to the Patient I might say something like, "How are YOU doing with this? Is there anything I can do for you?" I might then inform the Patient of my actions, "I'm going to contact the Surgeon, inform him/her of the situation and the Surgeon will probably do this... but I need to get some orders from him/her." Or some such.

After everything is stable, I would then approach the Co-worker with something like, "You know, you did a good job in there identifying that situation and bringing my attention to it. However, we need to spare the patient of any undue stress. That Patient may have become upset over hearing he deatails of their blood loss. Wouldn't you? I mean, sometimes the less I know, the better. I would just want someone to deal with the situation and let me know only what I have to know. What do you think of that?"

Basically, what I would be doing is accentuating the positive and confront the situation without placing undue blame on the Co-worker. I would makle the Co-worker part of the problem-solving process by putting all three of us on an equal level.

Of course, there are those who just don't get it. Under those circumstances, I become the Bottom Line Boy: "Do not unduly upset the Patient. Deal with the situation to the best of your ability. Otherwise, if you don't feel comfortable handling the situation, get someone who can."

There is only so much we can do once the proverbial cat is out of the bag. Sometimes we can only try to do our best to smooth over an emotionally-charged situation while still requiring us to use our logical sense, expertise, and knowledge in order to rectify said situaion. Such is life.

Informing your Manager of your concerns is probably a good move. However, when I was hired at the Facility where I'm presently employed, I informed my Supervisor, "If I have a problem or concern with a Peer or Co-worker, I will attempt to deal with it directly with that Person. If we cannot resolve the situation, I will inform you in an attempt at rectification." It's worked for me. I don't mind confrontations all that much. But, to each her/his own.

Dave

I did make the pt feel better by diffusing the situation, and I normally don't bring in the manager, but I'm thinking two nurses really need some remedial work done on how to approach pt's when something isn't quite right.

I guess if I have to approach this all in a positive manner toward the nurse when in front of the pt, does that mean I can't put duct tape over the nurses mouth?;) JK of course.

Good advice, everyone, thanks. Glad to know I'm not alone.

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