Bad situation and mad coworker? What could I have done?

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Some context: Pt had surgery, and doctors did not resume some of pt's BP meds. Since the previous day, Pt had SBP in 200s. Nurse on each shift called the doctor to complain pt's BP was that high. The doctor would order an extra PRN and SBP would go back down. Later though, it would spike back up.

During my shift, his SBP was 200. Called the doctor who told me to wait because I had given his regular medications and PRN medications (I called 30 minutes after giving IV BP medications and not seeing a change) by 12pm SBP is 169. They ordered an extra one time dose PRN and told me they were aware and monitoring. Informed my charge nurse (and clinician) of this guys BP, who called the doctor personally as well. She looked through his chart and said he's done this before. By 4pm, the pt's BP spikes back up, I give all the PRNs again. At shift change, I told the nurse I gave BP medications roughly 40 minutes ago. I reminded the charge nurse his BP was crazy high, and she told me to give the extra prn medications. I was hoping it would go down on night shift because I gave the most potent one ordered.

Also during the shift, he pulled out his dobhoff (completely alert and oriented patient, he was just "moving around and it came out"). By 6:30pm I found out it was coiled in the stomached, and it needed attempted reinsertion. His IV also went bad and he's a hard stick which was replaced during my shift.

I passed this onto night shift, who complained the whole time. She was mad his BP was high and was mad she would have to reinsert a dobhoff. Both of us never did it before. I got a senior nurse to help me, and I suggested she do the same.

Anyway She sent me an email the next day, complaining the charge nurse was mad his BP was so high all day, and complained she spent multiple hours in the room and neglected her other patients. I thought this was completely unprofessional and rude. I did what I could.

I am a nurse with 8 months of experience, so I'm still learning. Is there anything you can suggest? I felt I did what I could, but this coworker doesn't think so.

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Sounds like you did everything you could. Nurse's like the one you described are nearly impossible to please. Nursing is 24/7. You did your job and Now Its time for her to do hers. Hang in there nursing can be tough.

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Thank you, I needed to hear that. I feel horrible about the situation. I expect to be reprimanded or talked to because of the situation.

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Specializes in Critical care.

As long as you documented every conversation regarding the BP as an SBAR note I think you should be fine. You can't force the providers to place orders. Just document, document, document. I think that nurse was out of line. I'm a new nurse too, been working about the same amount of time you have, and none of my coworkers would have reacted that way. As one reminds me when I get stressed- nursing is a 24/7 job, you can only do what you can do. It happens. If you do have concerns, like what to do in a situation where you need to escalate things up the change of command, I think it be a good idea to talk with your manager and it would show you are receptive to being a patient advocate.

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Sometimes, there really is nothing you can do. Some patients do pull our their IVs, PICC lines, foleys, NG tubes etc. right at change of shift. Having said that, there are also nurses who "don't notice" those earlier events until 6:45 ...sometimes because they're intimidated by the tasks and sometimes because they're just lazy.

Assuming you're not one of the lazy ones, I would just ignore the other nurse and assume she was having a very frustrating day. Emailing you that someone else was "mad" was childish, but it won't do anyone any good to keep the conflict going.

I'll tend to be extra nice to a nurse when they leave me a train wreck and they feel horrible about it. It usually creates goodwill for future hand-offs, even if they've been less than understanding and kind in the past.

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Specializes in Critical Care; Cardiac; Professional Development.

Your coworker is in for a rude awakening if these things get her that upset. You did your job and when her shift started it was time for her to do hers.

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Nursing care is a 24 hour job. You did what you could during your shift.

Do not give a rat's patooty if oncoming nurse is "mad" at you. Oncoming nurse needed to get a grip and deal with the ongoing problems.

Save that inappropriate email.. send it to your immediate supervisor and CC one step up.

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Sometimes, there really is nothing you can do. Some patients do pull our their IVs, PICC lines, foleys, NG tubes etc. right at change of shift. Having said that, there are also nurses who "don't notice" those earlier events until 6:45 ...sometimes because they're intimidated by the tasks and sometimes because they're just lazy.

Assuming you're not one of the lazy ones, I would just ignore the other nurse and assume she was having a very frustrating day. Emailing you that someone else was "mad" was childish, but it won't do anyone any good to keep the conflict going.

I'll tend to be extra nice to a nurse when they leave me a train wreck and they feel horrible about it. It usually creates goodwill for future hand-offs, even if they've been less than understanding and kind in the past.

"I would just ignore the other nurse and assume she was having a very frustrating day. "

Disagree. Cannot ignore or condone the oncoming nurse's behavior. Oncoming nurse cannot deal. S/He needs to be called out this.

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Specializes in Registered Nurse.
Sounds like you did everything you could. Nurse's like the one you described are nearly impossible to please. Nursing is 24/7. You did your job and Now Its time for her to do hers. Hang in there nursing can be tough.

Exactly. I have this happen a lot. The shift before me has commented about the other shift (my shift), in general, that they have to "clean up" after us...but they never seem to think how much we go through, how much work we get done, and that something left over is not our fault if we do everything we can to do as much as we can. I had someone give me "dirty looks" the other day because my patient was not doing well during my shift. The oncoming's eyebrows raised like somehow it was my fault that she may have to deal with a sicker patient. Some people really are difficult or impossible to please.

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i have learned the hard way, do not give this.... person... an inch. professionally, calmly let nurse manager know about this attitude.

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Specializes in Hospice.

You left an Iv , ng tube, and high blood pressure....... Sounds like you tried your best....but this pt was not well managed. Logical or not..... Most nurses get frustrated at the other nurse when getting a pt like this. ( ps. I tried never to leave a ng tube or Iv for the next shift.....either I found a nurse sitting around or did it myself( both tasks take five minutes max)

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Specializes in Registered Nurse.
You left an Iv , ng tube, and high blood pressure....... Sounds like you tried your best....but this pt was not well managed. Logical or not..... Most nurses get frustrated at the other nurse when getting a pt like this. ( ps. I tried never to leave a ng tube or Iv for the next shift.....either I found a nurse sitting around or did it myself( both tasks take five minutes max)

Not to be argumentative, but if the tasks only take 5 mins (I would say they take a little longer all and all), why is it a big deal that they were passed on? Just making that point. I agree that NGT insertion being left behind might annoy me, however...sometimes, you have to give the other shift slack that they ran out of time. On a 12 hr shift, staying over an hour (assuming there is more charting to do too, etc.) is not going to go over very well with managers and is not desirable for getting rest and coming back the next day/shift. Anyway...there are some situations that may be worked on but not totally resolved during a shift. I think this happens with BOTH (12 hr) shifts. I've had "issues" run over into my shift and visa versa.

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