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.
I don't think you did anything wrong. I personally would speak with the supposed upset charge nurse to find out IF that was accurate and clarify the situation.
You did an excellent job, especially with only 8 months experience. Nursing care for patients in the hospital is a 24 hour job. This is why we give report. Sounds like you spent a lot of time in this patients room during your shift, also. This patient, at this time, needed more care, as you recognized, and as your co-worker should have. Don't give it a second thought. This nurse may just complain to complain, or was having a bad day, or who knows. If we all stayed til every little detail was straight no one would ever go home. Nursing care carries on from one shift to another. Keep up the good work.
It sounds like you did what you could. As long as you documented all your steps, pt condition, etc, there's only so much you can do, and she just is upset that she has work to do. I doubt you will suffer any consequences as you didn't do anything wrong.
Definitely inappropriate email. Let's strive to keep these things professional, never personal. How was pt's pain level?? Often, keeping pain appropriately controlled, BP may normalize.
Here is a perfect example of how important documentation is. You must, must, must keep a detailed note on every exchange in this type of situation. Both to protect your license/job in the present and in the future if any litigation were to arise. Having said that, it sounds as though you did a good job and had to deal with a nurse who doesn't seem to remember that the shifts are 24 hours, not just 8 or 12. Some things have to be passed to the next, just as he/she may have to pass something back again in the morning. It's the nature of the beast.
On my unit, High Risk OB, if something is going to happen it is going to be at 6 a/pm. Always. My coworkers and I have had a patient go bad and within 20 minutes have an IV in put the patient on the monitor, have called the MD and Labor/Delivery charge nurse, and got the patient packaged and on the way to the OR. It's called teamwork and I'm always petrified I missed some clue that could have prevented the urgent run to delivery
Seems to me like you were working really hard to provide safe care and did a great job. I feel for you as well as the night nurse. If there is any way you guys can work to understand each others perspectives and cut each other some slack, I'm all for that! People sometimes blame each other and don't see how the system isn't providing enough support so that everyone can work at a reasonable pace most of the time and provide great care.
Would you say there was any opportunity for you (or night nurse) to get ask for more help so that other patients weren't neglected?
I hope things work out and that this conflict becomes an opportunity to learn more about your colleagues and yourself and eventually contribute to collaborative work!
I'll be honest and say i didn't read all 4 pages of the comments so i'm sure all this has been said by others. You cannot please everyone, and nurses like the one you described is what makes me never want to go back to the bedside ever again. These people want to walk in and find their patient neatly tucked away with perfect vitals and no work left for them to do so they can sit at the nurses station all night on Facebook. Heaven forbid they have to learn a new skill like dobhoff insertion! The horror!
I've worked with some really nasty nurses in my day. Brush it off, let that nurse know you did everything you could to get that patient's BP controlled before she got there.
OP, I had worked with a mean nurse. She put comments all of my nursing judgement, and was not even interested in why I did it. She was rude, and not competent from my point of view. She is the second most strangest person I have ever met. I tried to please her as much as possible. Even though she was rude, I treated her politely, and nicely........ She has never changed until I did stand for myself.
Specializes in Float Pool - A Little Bit of Everything.
Hi OP,
I have learned that there are some people that you can never make happy, and they always have something negative to say. I have learned that this is often related to burnout and compassion fatigue among our peers, because of the toll nursing takes on us. This is not the fault of us, this is the fault of the culture of nursing and our demands for safe working conditions not being met. I have been on both sides of this, the burnt out nurse and yours. What she did was very unprofessional and you did everything you could. I am sorry for the situation. Try not to let this get you down or make you angry. In my experience, things like this eat away at us and turn us into the nurse you were dealing with. People like that nurse turned me sour at my very first nursing job and I soon became just like them. It took a large effort and a lot of self reflection to become a better and happier nurse. Don't let your first job break you like it did me. Take this as a learning experience, kill her with kindness instead of further escalating the anger, and be the better nurse. If I could go back in time, that is what I would have done.
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.
I'm an experienced nurse and I feel you did the right things. Just make sure you document every little thing and you will be ok. That other nurse was out of line. Sounds like she just didn't want a shift that was gonna start out with issues and took it out on you. Too bad for her. She's not worth your anxiety. That is why we work in shifts. Hang in there.
lavenderskies, BSN
349 Posts
I don't think you did anything wrong. I personally would speak with the supposed upset charge nurse to find out IF that was accurate and clarify the situation.