Bullied by a new grad, wth???

[jayebug]

Hi all,

I've been a nurse for 10 yrs. Currently, I 'm a travel nurse on assignment at a university based medical center, which is a nice facility, and the people are generally pretty personable. Up to this point, I 've been comfortable. I'm experienced in the specialty where I've been placed, and I was trained in a university based metro hospital, so, I thought this assignment was a good fit. The other day, when I finished my shift, I was giving my patients back to the person I got report from. I received a direct admit overnight, and I hadn't done a direct admit before, so I was a little slow on the uptake, and it seemed to take all night to get all the stuff I needed for the patient, who required antiboitics, pain meds, a CPAP, etc. The doc on duty seemed overwhelmed and argued with me about prescribing pain meds for the patient who had pancreatitis. She said she couldn't prescribe anything until I entered the patient's home meds into the computer (huh?). I told her the pt. just got pain meds during the ambulance ride to the hospital and tolerated them, so why not just give more of the same. After 2 hours, she finally prescribed him something oral that he was allergic to. So, back to the drawing board.

That's how the night went. It was like pulling teeth to get anything done. I had to wait for everything, and make multiple phone calls to follow up. Plus, he was a hard stick, and I had to call phlebotomy to get his labs cuz I stuck him 3 times with no luck. Meanwhile, I had started a Heparin drip on my other pt. @10p, so I knew I needed to follow up with a PTT with am labs. That pt. was pretty grumpy (understandably so, because most sick people are) so I had to talk him into the blood draw. After our discussion, I was running about a half hour late from the time the PTT was ordered, and just as I was rushing up to bag the labs and then go to the unit next door to tube them, a co worker stopped me in the hallway, frustrated that her pt.'s PICC line was clogged. I looked around for someone else to help, but of course the hallway was vacant, and I felt bad for her because her pt. was pretty difficult and I could see she was at her wit's end. A half hour later (one hour after the PTT was due) I finally sent the labs.

So, by the time the results were posted, I was already giving report. The person I was giving report to was this new grad with a very flat affect, who was actually reading the chart and looking at the computer the whole time I was talking to her (I hate that, I always feel like, what do you need me for ??) And she bashed me the whole time cuz "this wasn't done, and this wasn't done, etc. etc., and so on". I felt like saying, hey, it's a 24 hr job, but I did manage to hold my tounge. She had actually given me report on my new admit, and told me he was in this one rhythm that he wasn't in upon arrival, and when we were talking about his cardiac status, I said (and not even to be smart, really, I just wanted to know) , who told you that? The nurse who gave report from the OSH (wondering if maybe she had heard it elsewhere, like one of our docs or something). Yeah, she didn't like that. Anyway, I came back into work after her shift, and of course, got more of the same bullying, but this time she was upset cuz my new admit didn't have a wristband from our facility (he still had the old one from the OSH, and I still asked him his name and birth date, etc, I mean, I had to to complete the admission paperwork), and the PTT for my other pt. was late (even though she told me he had been discharged to home). I was bothered by her attitude, cuz, I mean really, it wasn't like I had been sitting on my butt the night before, but tried not to l let it get to me, cuz really, I needed to focus on my job.

That's when I went to see one of the other pt.s we shared, only to find her stinking to high heaven, covered by sheets with dried urine stains, call light hanging over the IV pump outta reach, with a symptomatic syst. BP in the 60s. I hate to say it, but I did have the thought "talk about stuff being overlooked, have you even seen this person in the past six hours?" I dealt with the situation, the pt had a raging UTI, borderline septic, and dehydrated. I wrote a note, but didn't report her cuz I thought I'd talk to her first and ask what happened. She didn't relieve me in the morning, but that whole day I had management from my agency and the hospital blowing up my phone (which I didn't even realize because I was sleeping so I could come back into work) because of the whole wrist band/PTT incident. Really? So, you can basically kill someone, but God forbid, you forget a wristband. In all fairness, management doesn't know about the UTI/sepsis pt., and I have to meet with them next week, but I'm afraid if I say anything, it will appear to be in retaliation. Any thoughts? (Sorry for the long post)

[SL2014]

Sorry that you feel you are being bullied... It can be frustrating at the very least. But what you are describing I have had happen to me and I have seen happen to other people a MILLION TIMES.

She's telling you that you didn't get things done... Who cares? If you are really doing everything that you can, that is all that you can do and other people will have to get over it, just like you will have to get over it. Getting upset doesn't fix anything.

AS far as management... Again, this stuff happens all the time, you forget something small and it is a huge deal sometimes, depending on who finds it, the patient and the mood of management that day. All you can do is accept that you missed something and be accountable.

The LAST thing that you want to do is bring up anything that the other nurse did wrong. DO NOT. I repeat DO NOT do that. Pointing out the shortcomings of another nurse when you are in trouble is an absolutely terrible idea. Just stay calm, stay accountable and in the future when working with that nurse DON'T miss anything, document like crazy and follow the correct channels when things are missed by her.

If the issue persists then ask to talk to her with management present.

[generalRN2008]

Just a note on MD not being able to put in med orders, some e chart programs block the MD until height, weight, home meds, and allergies are entered

[jadelpn, LPN, EMT-B]

Some people are just not personable. If you feel you are being bullied, report it. But as the pp stated, DO NOT trash the other nurse when you are being spoken to by management.

Unfortunetely, patient identifier errors are a pet peeve of any number of facilities. And it was an error on your part. The only thing you can do is go on from here, state how this will change in the future.

If you have incident reports, I would fill one out on the person you found in the state that you did. Hospital acquired infections are also huge. And that was also wrong on the part whomever was responsible for that patient's care.

But truly, do not say "but I found her patient covered in urine" "Her attitude stinks" while you are in a meeting pertaining to the PTT situation. You can certainly relay the busy-ness of the unit, that you attempted to manage your time, that you were asked to assist another nurse that was priority. That going forward, you will check the wristbands more mindfully of your patients. (Which with blood draws is another credentialling body mandate).

Another thought about the nurse with attitude, you can certainly say "I am sensing that you are frustrated. Circumstances on the unit prevented me from doing all of this admission." Then redirect on what still needs to happen. Do not engage in this nurse's attitude.

[NurseFrustrated]

Unfortunately this kind of stuff happens all the time in nursing. It's one of the things I really hate about this job. You can work your tail off and the next shift nit picks everything apart as if you sat with your feet up all shift. It drives me nuts. I will be as polite as I can in this type of situation and keep it professional but I will not allow another nurse to bully me during report and try to make me feel as if I have done nothing the entire shift. I make sure I don't behave this way to others during report. I try to be understanding after someone has had a terrible shift but has tried their best. There is a difference between the kind of shift you described and the kind of shift where the nurse really has just been lazy and is trying to dump everything on you because they don't want to do it. No matter how frustrated you get just remember to always keep it professional.

[BrandonLPN, LPN]

I need paragraphs!

And I have a pretty flat affect and I often read charts or flow sheets while the other nurse gives report. I don't feel that's rude at all. I'm listening. Maybe this new grad was just sounding off what hasn't been done so she knows what still needs to be done.

It's possible she was being a bully. It's also possible you just precieved it that way because you were already stressed out and mistook her no-nonsense demeanor as being 'mean'.

[CaitlynRNBSN]

It is always my pet peeve when nurses get on my case for about what I did on MY shift.

I worked a night shift, and I had an Open heart patient that had some cognitive delays. He was VERY VERY difficult to deal with. He would not allow you to touch his IV, his chest tube. He would scream and hit if I even got near it. He doesn't understand. His parents stayed with him around the clock. There was always his mom or dad around to help us because he was so difficult. The doctors were fine with us not doing a chest tube assessment, keeping old IV etc. Anything to keep him calm basically.

Anyway, so around 1:00AM the patient's mother wanted to have all 4 siderails up. I put up all 4 siderails because in my eyes the patient is not ambulatory in the first place, the mother was there, NEVER leaves and lets us know if she has to leave to go to the bathroom or something. So I never got a doctors orders to put all 4 siderails up. I'm NOT calling the surgeon at home to request this. Freaking ridiculous. Because I've had this patient for several days and I know the plan with this patient is to do anything he wants to make him calm. Heck...I even had orders that I did not have to do a chest tube assessment if he didn't allow.

So the oncoming nurse FLIPPED out at me. I mean...flipped a nut. she walked in there, put a siderail down and the kid started screaming to put it back up. The mom said to her "I requested to have all 4 up. I know its against regulations, but it helps keep him calm." She went on and on about our regulations and how she will need to call the surgeon first. She even tried explaining it to this poor patient who doesn't understand and is just screaming. The mom got a little ticked off I could tell and she put it back up and was like "Well I'm putting it up." and she put it back down and said "I will put it down when I get the ok from the surgeons"

I just stood there in shock and silence.

she reported me for restraining a patient without orders to do so. What I found funny was the mother requested a different nurse not 30 minutes into that shift.

Ridiculous!!! Some may not agree with me on that, that I didn't call and didn't get orders...but really?? What I should have done was just put them in, tell her the orders are in and tell the doctor in the morning what I did. That is the only thing I regret not doing.

[jadelpn, LPN, EMT-B]

Restraints are a whole different thing. You need an order, and in some facilities the MD has to come in, look at the patient, order them, and they can not be "prn" type orders. And as nutty as it sounds, 4 side rails are a restraint. If Mom had fallen asleep, and patient attempted to get out of bed and fell, it would be on you that there were 4 side rails up. Lots of things could happen, especially with a patient who is difficult to begin with.

Perhaps this nurse's methods were not very kind, however, she was correct. Especially if your facility policy dictates the same.