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NewRN24 NewRN24 (New Member)

Co worker issue

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i need advice. I have been a registered nurse for several years and currently work in the emergency room. We

Edited by NewRN24

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Was the charge nurse calmly, without making excuses, told about the child's condition, that an EKG was needed (from what you describe), almost stat.

From what you present here you did nothing wrong. Can you ask the charge nurse for another meeting to discuss what happened? Try to not get defensive. I guess it's possible you did not handle the situation well? Listen to her point of view.

I'd be interested to hear what she says.

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The charge nurse came to me after the PCA complained and initially I was surprised because I did recognize that perhaps I may have been "mean." She told me it was better I apologize and I did. I also explained to the PCA why I was stressed. When I spoke with my charge nurse I explained the symptoms and that I did not know I hurt her feelings or was maybe to harsh. I will post an update after speaking with my manager.

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You come across as very reasonable and direct. I hope this gets resolved for you and that you and your coworker come to an understanding.

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I hope in all this stupidity someone told the PCA that unless otherwise indicated all EKG's should be done ASAP?

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I explained it to her but I highly doubt it was reinforced!

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From what you describe, you were more than reasonable. Hope this works out for you and your meeting with the manager is productive.

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Classic case of how we are expected to act in a professional manner and then that is not actually supported.

I would have said (one time only), "I'm worried that this little guy is having a cardiac issue; we need a STAT EKG please." And when I heard whatever x, y, z reason it couldn't be accomplished in the next 5+ minutes, I would've given a brief patient report to the charge nurse along with a very neutral version of the hold-up: "I believe Sam is still dealing with the splint issue" or simply "Sam isn't available" along with "is there anyone else we can call? This probably shouldn't wait."

The nuance here is that someone else finds out what exactly x, y, z was all on their own. I prefer the tack of sending authority to the source of the problem, without any drama. I would prefer to try to handle it the way you did, but again, it is not a supported nursing function. So my next best MO is to just ask for help and let the "authority figure" recognize the situation for what it is.

Good luck with your meeting. As always, listen way more than you talk. And when you do talk, sanitize every word to be free of any drama whatsoever.

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I hate dealing with defiant and difficult techs!

In my ER the techs do the EKGs as well. But, if one is tied up, we nurses certainly have access to the EKG machine! The standard is to obtain an EKG within 10 minutes. You should discuss this with your manager.

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One problem is that a PCA, per her job description, doesn't have the expertise or authority to prioritize between different STAT measures. So, if the PCA is being told by another nurse/doctor/PA that some other measure must be prioritized instead, it's not really her duty to decide for herself which one to do first. She should do one then the other, and the conflict between different priorities should be resolved by your charge nurse or whoever is most directly for supervising her.

If, on the other hand, she is deciding on her own that some other measure is a higher priority than what you asked her to do, then you need to tell her on no uncertain terms that you are bumping her onto a higher priority medical intervention and that you expect her to act accordingly. Then, if there is any pushback, immediately notify your charge, and write her up on the same day, so you dont wind up appologizing for prioritizing correctly and holding staff to their job description.

Might also want to advocate in shared governance (or however your unit does things) for RNs to have their own access to 12 lead ekgs.

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Classic case of how we are expected to act in a professional manner and then that is not actually supported.

It also brings back one of my pet peeves, having it suggested to me that I apologize when I have done nothing wrong.

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One problem is that a PCA, per her job description, doesn't have the expertise or authority to prioritize between different STAT measures. So, if the PCA is being told by another nurse/doctor/PA that some other measure must be prioritized instead, it's not really her duty to decide for herself which one to do first.

Agree, and I normally have a generous measure of understanding (aka patience) for this. But the initial refusal was predicated on a desire to attend to a matter that was already a done deal (the splint issue), and at the point of interaction it was, in reality, nothing more than concern with a little drama thrown in. And a refusal to listen to the OP's reassurance and explanation that the PCA was in no way at fault in the previously ensuing kerfluffle.

All together, these behaviors are kind of ? recklessly brazen? I don't know exactly what I'd call it but it sounds like it may portend future difficulty in interacting with her.

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