Communication Burn Out

[sleeplessinseattle]

Hi all, made the switch from med surg to critical care. Need some advice on communicating effectively to fit in or if maybe this isn’t the role for me and I should move on.

I’ve been on this unit for a few months 8 week orientation and struggled with my preceptor. She told me though I had a experience that I would be treated like a new grad and need to learn all over again. Same words from management. They asked what I needed from orientation I told them support, switching to a critical mindset and other unit specific advice, that I was confident in my assessment and other nursing skills. They took this as me saying I already knew everything.

They told me I need to let charge know everything I’m doing, which I can understand updating them after each q4 assessments, but it’s fast paced and I don’t always have time. I do always go to them if I’m unsure or have other questions. But for example  I had a patient with a low BP and went to assess them. While retaking their BP I was assessing, asking the pt questions and messaging the MD. They were asymptomatic and the MD arrived quickly, but charge was upset I didn’t tell them first.

Another incident I had two patients admitted back to back, the first one had specific post op meds. While I was administering the second patient arrived. A nurse came to tell me, I told her I would be in as soon as I finished with the meds as they were already crushed and in the syringe. She got upset. 5 minutes later I was in the second patients room with the same nurse telling me I needed to message the MD about a list of things that she let the charge nurse know. I thanked her for letting the charge nurse know, but that I would like to assess the patient myself too, that I had already messaged the MD after getting report about things they wanted me to watch over night. I let the charge nurse know and they acted like they didn’t believe me and called the MD again. The other nurse and charge said this unit wasn’t for everyone and people didn’t understand how much work it was.

Another incident I had a patient with an open wound the MD wanted left open, they said there would be bloody drainage, it was normal they redid the dressing for me. The drainage was under control, but the pt needed a new gown and sheets. Another patient began c/o of chest pain and had a change in rhythm. I never got a chance to let the aide know that I would be back to clean up the last patient as this one became my priority. I got a call from the charge minutes later asking if I had even assessed the other patient, that they were a mess and now she and the aide were going to have to clean them up. I told her the current situation and she told me it wasn’t OK.

Sorry this turned into a venting sesh, just need advice on how to better handle situations like these or if maybe this isn’t for me.

[JKL33]

What are you doing and saying in reply to these chastisements?

Are you responding:

On 11/12/2020 at 12:36 AM, sleeplessinseattle said:

They were asymptomatic and the MD arrived quickly, but charge was upset I didn’t tell them first.

"I am directly in the middle of communicating about this as we speak."

On 11/12/2020 at 12:36 AM, sleeplessinseattle said:

The other nurse and charge said this unit wasn’t for everyone and people didn’t understand how much work it was.

"I have already communicated with the physician, so I am not understanding what you might be referring to."

On 11/12/2020 at 12:36 AM, sleeplessinseattle said:

I got a call from the charge minutes later asking if I had even assessed the other patient, that they were a mess and now she and the aide were going to have to clean them up. I told her the current situation and she told me it wasn’t OK.

"I was already aware; I'm currently dealing with an urgent situation. If you would like to take care of the chest pain patient, I can change my other patient's bedding."

Make sure that you aren't skipping communication steps that everyone adheres to. Other than that, you need to avoid being provoked by these sorts of comments.

The behavior of trying to make someone else look lesser in order feel better about oneself is really old and tired and is neither a sophisticated nor professional comportment. You need to let them take responsibility for the way they are acting instead of necessarily thinking that it means something about you.