Conflict in the workplace

barefootlady, ADN, RN · Aug 4, 2004

Thanks for giving me support and understanding. I still remember walking into the HN office and thinking, "I only did my job." The CN and myself were not on good terms, so she enjoyed the situation. The end of the story is that partner did go to bat for me and HE said HE was very glad I was an observant and dedicated nurse. He made my day. This was an HCA facility with barebones staffing, and the attitude that the MD was King.

The funniest thing I have ever had happen was when a lady doctor gave us instructions not to call her between 21:00 and midnight. She wanted to get pregnant and did not want her evenings interrupted. Well, we passed her letter on to the HN, Supervisor, and CEO. (Keeping a copy for ourselves posted in our break room.) She was so embarrassed and furious she refused to come to our floor for weeks. Thankfully her partners covered for her and were there for us. She told our HN, Supervisors, and even the CEO we were making mountains out of her simple request for a few evenings of quiet time with her hubby. They simply told us not to call her, for no reason. At no time was she ever questioned about having patients in a acute care facility and not accepting calls regarding their care or treatment. Go figure?

BBFRN, BSN, PhD · Aug 4, 2004

Had she already discussed with her partners and made agreements with them to take call for her? That was kind of harsh of you guys to post that letter in the breakroom like that. I guess I can see why she was so embarrassed.

leslie :-D · Aug 4, 2004

Had she already discussed with her partners and made agreements with them to take call for her? That was kind of harsh of you guys to post that letter in the breakroom like that. I guess I can see why she was so embarrassed.

am i missing something here?

what letter was posted in the breakroom?

BBFRN, BSN, PhD · Aug 4, 2004

am i missing something here?
what letter was posted in the breakroom?

Oops- sorry...lol. I forgot to quote- this was in response to the post just above the one of mine that you just quoted. :rotfl:

leslie :-D · Aug 4, 2004

Oops- sorry...lol. I forgot to quote- this was in response to the post just above the one of mine that you just quoted. :rotfl:

:chuckle and here i am frantically searching in OUR breakroom for any letter.....

anyway, posting that letter was certainly unconventional but i'm not convinced it was harsh. this md did not sound exactly responsible, kwim?

leslie

RN4NICU, LPN, LVN · Aug 4, 2004

Thanks for giving me support and understanding. I still remember walking into the HN office and thinking, "I only did my job." The CN and myself were not on good terms, so she enjoyed the situation. The end of the story is that partner did go to bat for me and HE said HE was very glad I was an observant and dedicated nurse. He made my day. This was an HCA facility with barebones staffing, and the attitude that the MD was King.

Ah...That's a bit part of the problem right there! The "doctor is god" attitude is common in HCA facilities I hear (have to go by word of mouth because I refuse to work in one). Not surprising, considering Frist (CEO) is a doc himself.

Winknme · Aug 4, 2004

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.

I did document every page to the docs until my NM sent an email telling her staff that we could no longer chart that so and so MD did not return page. She told us that it was our license on the line and that it was our responsibility to track down the doc. What a load of crap. Needless to say I don't work for this place any longer. (Apparently one of the docs read the computer charting - and ran screaming to the NM...)

Dutchess · Aug 5, 2004

Isn't it amazing how much flack you receive for your standard of care? It makes me wonder what other nurses are doing (sometimes on previous shifts) that some of the care concerns aren't addressed. I've had situations where a previous shift gives you the information but says "I didn't want to call the doc just yet, we've been monitoring........." Pass the buck, please! There was a recent report that indicated several hundred thousand people who have died due to inadequate care. We don't need that kind of headline!

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

leslie :-D · Aug 5, 2004

I did document every page to the docs until my NM sent an email telling her staff that we could no longer chart that so and so MD did not return page. She told us that it was our license on the line and that it was our responsibility to track down the doc. What a load of crap. Needless to say I don't work for this place any longer. (Apparently one of the docs read the computer charting - and ran screaming to the NM...)

again, and from the voice of experience (me), i have been written up for documenting md did not return call....and i too was told not to document such.

well i documented anyway, thus being written up.

then when i DID listen to an order my don gave me, i was written up with the DON telling the state (and me present) "but i can't give those types of orders"...... :stone :stone :angryfire

the lesson i've learned is you document truthfully and don't cover anyone's a*s but your own.

....it is your license and no one else's. and you answer to your bon and nurse practice act. those are the guidelines i will follow and will always supersede any facility i work for.

kat911 · Aug 5, 2004

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!

Like others have already stated here, go through your usual chain of command. After hours utilize your supervisor. You should notify him/her if you are unable to locate a physician. You also need to document that the supervisor was notified. Sometimes they may have info you don't have access to, special phone numbers ( I keep every number I ever get) to sudden changes in call. There have been lawsuits that were won or lost based on wether or not the nurse notified the supervisor because of no contact, no orders or inappropriate orders. The supervisor is there to help out in just these situations, use them, and then DOCUMENT EVERYTHING.

Headhurt, ADN · Aug 5, 2004

Holy smokes! We have HCA facilities here in Kansas City. They are like a cancer that spreads, killing hospitals in its wake...all focused on the almighty dollar. Interesting enough that the only nurses unions here in town are at the HCA hospitals. They were really shafting their nurses BIGTIME.

I work in a teaching hospital, where this always a resident underfoot...which is nice. However, we document everytime someone was paged, and if they call back or not.

barefootlady, ADN, RN · Aug 5, 2004

No it was not drastic to post the MD's letter in our breakroom. We did have days off and a change in staff, it was common to post notice's from MD's there. I don't know if this MD had discussed with her partners about evening coverage, that was the point, she just instructed us not to call her, no further instructions regarding covering her patients were given. We, the nurses on the unit, felt like we were handed a bomb that could explode at anytime and given no safety equiptment. How would you feel, having this MD's patients in your care, she was scheduled for call coverage, and then you have this notice not to call her between 21:00 and midnight? People could die in those 3 hours! Funny that when this letter was given to the Supervisor, she did not know about any coverage being arranged other than the regular call list. The partners didn't take call well, but they did take care of our problems. The point is, this MD was negligent, but no one, especially the facility did a thing about it. Yes, we did file reports to the ethics committee, the county medical association, and the state association, but we never got any real action or answers.

Nurse's here are held accountable at a higher level than doctors. We can lose our license for being convicted of a misdameanor, but we have doctors who practice that have been convicted of fraud, conspiracy, and etc. Fair? No way, but nurses are expendable, or so the board thinks, not doctors.