Certain charge nurse is very irritated by my newbie questions

[eggyweggy, MSN, RN]

I'm still a fairly new nurse, about two years into my career. I've been at my current job for almost 3 months, off orientation for the last three weeks. Needless to say, I didn't encounter every single possible thing that I might need to know during my orientation period, so I still have quite a few questions for my more experienced coworkers when it comes to skills that i haven't done at our facility. The expectation is that if we are doing something for the first time (even after being off orientation), we will grab a more experienced coworker to talk us through the skill and sign us off on our competency checklist before we do it on our own.

The majority of my co-workers are fantastic and more than happy to take a few minutes to help the newbies. There are quite a few of us on the unit who very recently came off orientation, so I get that it can be overwhelming sometimes if you're constantly being pulled away from your own patients to help someone else. The charge nurse who I was working with during this particular episode that has me feeling kinda crummy is a very nervous and easily frustrated individual. She doesn't handle unexpected very calmly and was tense and jumpy for the bulk of our shift the other night due to some staffing changes and some issues with a few of the patients on the unit. So she was already on edge before the shift even started.

So a few nights ago, I had a patient pass away toward the end of my shift. I've dealt with this before in different facilities, but I was unfamiliar with the protocol for my current unit. It was an expected death, so I had just been providing comfort care for the patient until they quietly passed. After confirming absence of vital signs, I notified the charge nurse and told her that I would need help as this was my first time dealing with a patient death at our facility. I asked her where I could find the checklist for this (as I had seen one out on the unit another time, so I knew it existed) and she replied that it wasn't necessary, then rattled off an incomplete list of what needed to be done. She picked up the phone and called a few people to notify them of the event (without telling me who she was calling), and told me that I needed to wait for the MD to pronounce the death before we could do anything else. I again asked where I could find the list of tasks that needed to be completed and she replied with "For heaven's sake, haven't you ever dealt with a patient death before?" I said "Yes, but not at this facility. I know in general what needs to be done, but I don't know the protocol HERE."

I know that she was having a stressful evening, but her lack of assistance made it very difficult for me to do my job properly. Thankfully the family was very understanding and patient when I honestly answered their questions about what would happen next with "I'm not sure exactly what the procedure is here because I'm still new to this unit, but I'll let you know as soon as I find out." Still, it was a lot of running back and forth because I was flying blind by the seat of my pants with so little assistance. I did eventually find the checklist that I had seen before, so that helped somewhat. But there were still things on the checklist that I was unfamiliar with, and when I tried to clarify those things with the charge nurse she gave me answers that were different from what was on the checklist. I simply did not feel confident that I was doing things correctly because of all of the conflicting information I was getting and I could tell that she was getting more and more stressed/irritated with each question I asked. I said "I'm sorry, I know you're really busy tonight and you don't have time for this, but I need to make sure that I'm doing this correctly. This is my first time dealing with this here." She threw up her hands, made a sigh of disgust, and walked away.

OK, so that was mostly a vent session but I'll welcome any suggestions for dealing with a co-worker who doesn't want to answer questions from a newer nurse. Again, the majority of my co-workers are great and approachable if I need help. I could see where it would be bothersome if I was asking for help with things that I had done several times before, or asking for help with every single little thing. I try to utilize my own critical thinking skills before I bug someone, so I'm not asking questions every hour on the hour or because I'm too lazy to find the information on my own. After this experience with this particular charge nurse, I'm honestly a little afraid to approach her if I have other questions. It may just be that she is not a good resource when she's also doing charge duties, so maybe I'll make her my last resort from this point forward. I must be getting tougher because while it rattled me a little that she was rude to me, I didn't take it personally or as an indication that I was incompetent for not knowing exactly what to do the first time. Still, I'll take any feedback for how to handle people like this in the future.

[AJJKRN]

How many other "newbies" were on that night also? Out of curiosity, because the charge could have only been dealing with your questions (which all seem very valid) and then everyone else's as well with having a full patient load and all the little tasks a resource is responsible for. It doesn't make it excusible only that I can relate.

I've been the newbie and now the charge with often working with more newer nurses than not. Not that the charge shouldn't be helping you, but were there others that you could have asked?

Pretty much what I'm saying is that were you able to utilize other staff as a resource instead because, as you are well aware of, just having the title of resource doesn't automatically make someone a good resource!

[eggyweggy, MSN, RN]

Thanks for the insight. The staffing was not ideal this particular evening. We had a mix of RN/LPN and two were floats from other units, so not ideal in terms of resource people for new nurses. I did ask some of the other staff and they were unable to help, so the charge nurse was really my best resource that night. We worked together again tonight (she wasn't charging) and she apologized to me for not being more helpful. I told her that I understood she was stressed and that I appreciated what she was able to do under the circumstances. It was an unusually busy night and her patient load was way heavy for a charge nurse. Charge nurse usually gets a lighter assignment so they can be more available. She was frustrated that nobody was offering to help out (which is something that she always does when not swamped and is a vey nice thing to do), but wasn't delegating any of her tasks either.

So I think my takeaway is that I'll try to use her as my last resort when I can see that she is busier than usual. Knowing how stressed she was the other night, I helped her with a few things tonight and she was very appreciative of that. The charge nurse tonight was much more comfortable in the role and had time to help me troubleshoot a particular drainage system. She has a little bit more approachable personality and I'm sure that helped.

[jadelpn, LPN, EMT-B]

And take a minute to find out where all he various forms are located. Find out if there's clinical resources that you can use to familiarize and set up procedures prior to having a coworker watch your technique.

Know the policy/procedure manual--and where to find it.

And if you have a comfort care that is close to death, then would be the time to get out said forms, so that they are accessible. Or when you get report, you can ask the off going nurse to hit the highlights of the process--so that you are not completely in the dark when it happens.

Best wishes

[iluvivt, BSN, RN]

Yes I agree please locate all of your policies and procedures. Are they on line?..if so you may be able to easily access from home and you can read them on your own time. I have written IV policies and procedures for years and I do it because I want the nurses to have very clear cut guidelines to follow but I know many do not even know where to find them. I have to commend them for calling though and asking what they are and then they want to make certain I am sure. Yes.. I am sure,I wrote them! I sure wish they would read them though.

You should be able to approach the charge nurse at any time for help and questions and if this role is just too much for them then I believe they should not be in it. The reality is that many nurse are in roles that they do not seem suited for and the rest of us have to cope with it. I think that if you convey the attitude and demonstrate that it is a two way street and you too are willing to pitch in then that person will be a resource for you. It sounds like you did that on another shift but I would make a point of it. You can also use more than one person as a resource so you need to identify those people and help them too! Also please remember to thank that person for helping you and let them know you appreciate them. It does get exhausting at times to be constantly teaching. You did just fine..it sounds like that nurse was way too stressed and took it out on you!

[Been there,done that, ASN, RN]

Approaching the charge nurse repeatedly, with many questions over post mortem protocol, would be aggravating.The patient was dead. What did you think you could do wrong?

Find the protocol, ask somebody else, or tag the body and get it to the morgue.