Delicate Question About thick skin?

jadelpn, LPN, EMT-B · Jan 27, 2016

As a tech in the ED, (or any unit) there will be specific things that you can not do as far as skills. Of which you should not take on yourself to perform without being 100% sure what is your specific scope of practice.

Scopes vary widely from unit to unit, facility to facility.

It is a nursing skill to suction trachs. (or RT skill).

Nurses get all worked up when an unlicensed assistive person starts doing skills that are not within their scope, as at the end of the day it falls on the licensed nurse who holds responsibility on what UAP's do.

It doesn't matter if as an MA (who falls under a practitioner's liability) you could practice an advanced skill set. It doesn't matter that as a tech/aide in ICU etc. you were able to do all sorts of stuff. There's even units where UAP's can NOT do finger sticks. There may be skilled care where UAP's CAN suction trachs.

But where you are at present, you need to be mindful of your scope, and stay within it. And be mindful that if Nurse A asks you to do a finger stick, make sure it is recorded so that every nurse who cares for that patient can see it, and verbalize same to Nurse A, not Nurse B who may be curious. In other words, always report to the primary nurse, not just any nurse who is standing there. And keep up with documentation regarding same.

Although you may see it as mean, nurses are ultimately responsible for the care of patients by their license. I'm sure that the intent was to be helpful, but you need to stay in scope.

Extra Pickles · Jan 27, 2016

I think that when I was a student I definitely judged some of the nurses and aides too harshly. I would say that I'm never going to be like that or say things like that. I was pretty sure I was way better than any of them, because I was much kinder, and so on. I also think they probably knew how I thought of them.

Now I look back on those judgments and wonder why one of those so-called mean nurses or aides didn't just take out a hit on me! I'm embarrassed at some of the things I used to think of them, because I thought I knew so much more than I really did! At the time I thought Yay me, coming into a profession that is so in need of compassionate and caring and helpful people (because these ones suck). And now, let's just say I'm glad they let me live, so I can tell people like you to cool your jets, learn what's really going on around you, and don't be so judgmental. You don't know what you don't know until you actually know something :)

Ruby Vee, BSN · Feb 3, 2016

Ok before feeling the need to tell me about my grammer & English. Enlish is not my first language I am taking classes & working on this. I KNOW my English sucks lol. Thank you =).
I am a PCT & about to start working in ED. The college I went to is one of the best in my state for many medical careers. My story is I started as a MA & worked 6 years with a plastic surgeon doing Pre-post op skills. Four as a cna 1, home health aide memory care, special needs. And did 5 months of the PCT class & 3 months clinics in ED, Icu, Pcu, and a rehabilitation unit. The nurses were kind, very helpful & always grateful when we took suctioning, catheters or out other skills off their back whixh allowed them to relax more id the shift was busy.
However, I won't lie ED was where myself & other students started seeing a big difference the way some nurses acted. One En chewed out one student while 4 were including myself were standing behind her making allegations that the student didn't report a high glucose level when indeed did to another RN in the very same pod WHO DIDN'T report it to her.. myself & that student split 12 pt's in that pod & couldn't believe how she never even apologized lol. She was just not a nice person? We also had a charge nurse almost blow a lid when he heard a partial converaation when one of the students told a pt who had a trach she'd be right back to suction her once she found our instructor. He walked up to her in front of ot's & again other Rn's & said "you are NOT allowed odo that it's not in your scope". Turns out this Rn works with our Instructor in this ED & our instructor ended up oulling him aside & said YES they are as long as Im observing. Why is is such a big deal to bot just say sorry for some?
Why do I see so many NOT All but some tell the newbies to stop whining (which I'm not) or get used to it? I think what I learned in clinics is if they are like that and almost looking for a reason to be rude to just stay away as much as possible and report & stay away which is ridiculous imo. I try to be a nice person & understand not all people cope with stress the same. Other team members shouldn't have to deal with that behavior.
So my purpose for this post is HOW TO HANDLE IT professionally, knowing now I maybe working with some Rn's who act this way? Or not to drop my jaw when I hear an Rn say bye, bye under her breathe to a pt who is in the hallway crying because they have so much pain and they can't get anything but tylenol until Dr says so.
Should I just turn off all emotions basically?

I know English isn't your first language, and I am always impressed (and envious) when someone is able to speak, read and write in a second language. But . . . Please use paragraphs -- it makes your posts easier to read.

As a tech or student, you don't really understand the full scope of the responsibilities of the nurse. That's OK. No one does until they've been a nurse. We get that. The problem is when you start judging the nurses around you based on your incomplete and possibly rose-colored view point. Nurses are judged more harshly than other professionals -- we not only have to be perfect at our jobs, but we have to be NICE while we're doing it. Sometimes students and techs do really dumb things that make our jobs more difficult, and it is not always easy to be nice when educating that person about it. Especially when that person displays an attitude that the nurse is ALWAYS supposed to be nice to them, and "since you're not being nice, I'm not going to listen." I'm not saying you did that last, but be careful of doing it.

The glucose should have been reported to the nurse caring for the patient, not some other RN who happened to be in the pod asking about it. It could have been just idle curiosity that she asked; at any rate it wasn't HER responsibility to inform the correct nurse. It was the responsibility of the person to whom the task was delegated.

As far as the apologies go, think about this: You screwed up. You were told you screwed up. Why should anyone have to apologize for doing so? You said that English isn't your first language -- it is possible that you come from a different culture. What you're seeing as that nurse not being a nice person for not apologizing for letting you know you screwed up could be just the difference in cultures. In the US, we expect ourselves to be culturally aware. That SHOULD (but doesn't always seem to) mean that we expect those who relocated to our culture to be aware of and respect OUR cultural norms. Congratulations -- you have just noticed a cultural norm that is different from your own. Now it is time for you to learn to respect that norm.

Since you are now participating in a job where the culture is different from your own, I would expect that you keep an eye out for cultural differences and learn to operate in your adopted culture without judging. Not only are you operating in the general culture of your location, but you also must learn to operate in the health care culture, which is different. Realize that you are a guest in our culture; we did not choose to become guests in yours. So it is up to YOU to adapt to OUR culture, not the reverse.

Extra Pickles · Feb 3, 2016

RubyVee, you are so right! When people move from their native countries and relocate to a different country and a different culture, the person who moved in should not expect that the natives of that country and culture change to suit their own sensibilities. For example, If I moved to the Philippines, China or Hungary, I would expect that I would need to conform to those cultures in order to blend, in order to work there. I might find them rude or too laidback, or maybe something else that didn't feel normal to me. But if I want to live there and work there, I know I have to adjust my way of thinking.

For some reason I see too many people who come to the USA from other countries and cultures and expect those of us who have lived here all our lives to change how we do things to make it more comfortable for them! I don't want to make it harder for them, but they sure shouldn't be making it harder for me. I didn't move to their country, they moved to mine.