Conflict in the workplace

[KellyRN4]

I am a couple years into my nursing career, so you could say that I am brand new to nursing. I, of course, have had run-in's with staff while trying to do what's right for my patients. Although I am new and am looking out for my patients best interest, I sometimes wonder if I am doing the right thing by going above the head nurses and doctors and notifying supervisors. I would love to hear other stories of conflict and how you resolved that conflict, even if it put you in "hot water" with the doctors and or other nurses. Especially from those who have been in this field for awhile. Do you call supervisors if you don't get an order that you think is critical to the patient's well-being and the doctor denied it? Thanks!

[leslie :-D]

i have.

there are some battles i wished i hadn't picked.

but anything that reflects a patient's concern or treatment, yes yes yes.

one time i wrote certain things in the report book. although it's not a legal document, i was pulled down to the don's office with all the bigwigs there, the np, the md, licsw....whole 9 yards. :chuckle

yes, i still laugh recalling the panic and fury in their faces. so although it wasn't a legal document where i wrote what i did, it certainly had legal implications for delay of care.

and that patient was treated that noc, after a simple case of conjunctivities turned into a systemic infection because no one would listen to me that tx wasn't working.

i told each and every one of those people in the don's office, quite calmly, that their inactions were deplorable.

and of course there's many other incidents.....hey, i could write a book.

a word of caution however.....there can be repercussions. just DOCUMENT every single phone call, conversation, intervention and make copies for yourself.

leslie

[purplemania, BSN, RN]

Your facility probably has a chain of command. Get familiar with that policy. Remember that your license is at stake and you are the patient advocate. However, it is important to communicate with peers to see if you are interpreting your actions the same as they are.

[BBFRN, BSN, PhD]

What kind of orders are you asking for? Maybe it's something that's not appropriate for the patient? What kind of "run-ins" are you having with your fellow staff members?

[KellyRN4]

Hey everyone, thanks for your replies. I am not having a lot of "run-in's" or a lot of problems with staff, I am more looking for stories of how to handle things in the future. Like I said, I have had them, such as: I had a younger patient with a very involved family, this family wanted everything here and now...and I mean now. This specific patient had an ACL repair, was only suppose to be there for a day, but he couldn't void on his own after the cath. was taken out. He had been straight cath'd twice and still could not pee on his own. The doctor was impossible to get ahold of wouldn't return my phone calls. So in this case, I did call the supervisor and was able to get the orders I needed.

Being new to nursing, I was just curious to hear of other stories of conflict and how you personally dealt with them. It could be helpful in the future by learning from other nurse's situations. The first story was great, thanks for sharing!:)

[leslie :-D]

i find that some of the hurdles are that many nurses are afraid to question an md's order; and that mgmt. is also unenthusiastic about support nurse's concern, esp. if this md is a big revenue maker for said facility.

what i have learned (the hard way) is not to respond emotionally. identify the issue, come up with a plan and execute.....and maintain your cool.

[barefootlady, ADN, RN]

I document every time I talk with a MD. Or don't talk to one after I page. This has saved my butt more than once, especially with the MD who is always a no return call. If I speak to answering service I put the name of person I gave page to, if I speak to family the I write their name. Once had a doctor who was horrible about answering page, patient was in CHF, needed orders and could not wait much longer, had been trying all could do for 2 hours, called partner, wife was very nasty, I told her, this patient is in need of help now, need orders, if I do not get them soon patient may code. I also told her I was keeping record of every call I had made and would add her name to list. She handed phone to hubby, patients was given treatment and transferred to ICU. Next day big stink between HN, MD, CN, and me. I was almost suspended for 3 days for truth. BUT patient lived and I did my utmost to give adequate care. Some battles have to be fought, but don't expect any thanks for fighting them.

[leslie :-D]

I document every time I talk with a MD. Or don't talk to one after I page. This has saved my butt more than once, especially with the MD who is always a no return call. If I speak to answering service I put the name of person I gave page to, if I speak to family the I write their name. Once had a doctor who was horrible about answering page, patient was in CHF, needed orders and could not wait much longer, had been trying all could do for 2 hours, called partner, wife was very nasty, I told her, this patient is in need of help now, need orders, if I do not get them soon patient may code. I also told her I was keeping record of every call I had made and would add her name to list. She handed phone to hubby, patients was given treatment and transferred to ICU. Next day big stink between HN, MD, CN, and me. I was almost suspended for 3 days for truth. BUT patient lived and I did my utmost to give adequate care. Some battles have to be fought, but don't expect any thanks for fighting them.

bingo barefoot! not only don't you get thanks, they treat you with contempt. after all, it is our actions that magnify their inactions.

[Stitchie]

This is a great example of being a good advocate and also how being a good nurse means that you aren't necessarily a well-behaved employee.

I'm sure the dr's wife was 'annoyed' at all those pesky phone calls from nurses...the ones that put food on her plate and diamond tennis bracelets on her wrists.

I don't have a story to share at this point but that situation struck a nerve with me. Good for you, barefoot.

[RN4NICU, LPN, LVN]

I document every time I talk with a MD. Or don't talk to one after I page. This has saved my butt more than once, especially with the MD who is always a no return call. If I speak to answering service I put the name of person I gave page to, if I speak to family the I write their name. Once had a doctor who was horrible about answering page, patient was in CHF, needed orders and could not wait much longer, had been trying all could do for 2 hours, called partner, wife was very nasty, I told her, this patient is in need of help now, need orders, if I do not get them soon patient may code. I also told her I was keeping record of every call I had made and would add her name to list. She handed phone to hubby, patients was given treatment and transferred to ICU. Next day big stink between HN, MD, CN, and me. I was almost suspended for 3 days for truth. BUT patient lived and I did my utmost to give adequate care. Some battles have to be fought, but don't expect any thanks for fighting them.

This kind of BS is exactly why nurses should be consultants rather than employees (or at the very least, a consulted service like PT, OT, or ST). The way things are now - youre d***ed if you do and d***ed if you don't.

The very idea of you being suspended for getting your patient the care s/he needed is infuriating. If ANYONE should have been slapped on the hand and told they were a bad little child, it should have been the doctor. HE was the one not doing his job. If you didn't respond to a patient's needs because you didn't feel like it - you would lose your license. Why are docs not accountable? Because they stick together and cover each other - they do not feed each other to the wolves like nurses do (like your HN and CN did to you - when you did nothing wrong). I'm not saying doctors and nurses shouldn't be accountable, but the train should run in both directions, rather than just over the top of the nurses.

[MountainMama]

This kind of BS is exactly why nurses should be consultants rather than employees (or at the very least, a consulted service like PT, OT, or ST). The way things are now - youre d***ed if you do and d***ed if you don't.

The very idea of you being suspended for getting your patient the care s/he needed is infuriating. If ANYONE should have been slapped on the hand and told they were a bad little child, it should have been the doctor. HE was the one not doing his job. If you didn't respond to a patient's needs because you didn't feel like it - you would lose your license. Why are docs not accountable? Because they stick together and cover each other - they do not feed each other to the wolves like nurses do (like your HN and CN did to you - when you did nothing wrong). I'm not saying doctors and nurses shouldn't be accountable, but the train should run in both directions, rather than just over the top of the nurses.

Exactly!!! This was a huge problem where I worked before. No one liked our little rural hospital and got annoyed when we called (no residents, etc) . Well, I am sure they were cashing thier nice fat paychecks. So aggravating.:angryfire All I can say is document, document, go up the chain when necessary, and expect crap but do it anyhow.

I have a real jaded disdain for most doctors because of scenarios like this. It is the most frustrating, powerless, unbelieveable feeling. The salary and respect they get compared to nurses... :angryfire :angryfire

[leslie :-D]

This kind of BS is exactly why nurses should be consultants rather than employees (or at the very least, a consulted service like PT, OT, or ST). The way things are now - youre d***ed if you do and d***ed if you don't.

The very idea of you being suspended for getting your patient the care s/he needed is infuriating.

there are some of us that have even been terminated because of it. :stone

but it is the fury and the gut-wrenching determination that i carry with me, that will not put these very issues to rest until the truth be known and justice prevailed. what is it they say?

hell hath no fury like a red-headed nurse scorned.