Discouragement

Ruby Vee, BSN · Dec 1, 2016

I've been a nurse for some time now (>20+ yrs). I have had my ups and downs, days I felt good about my career and days I didn't. My last shift involved care of a freshly post-op open heart patient with slowly deteriorating hemodynamic vital signs. With orders from the cardio-thoracic nurse practitioner I gave many (many!) blood products and titrated the vasoactive drips the patient had infusing when he came to me from surgery. After the nurse practitioner went home, the decompensation continued. I spoke numerous times with the cardiovascular surgeon regarding labs, drips, chest tube and urinary output, vent settings, blood products given. He was increasingly rude and sarcastic, focused primarily on berating me instead of providing orders or guidance on improving the patient's condition. He (finally) came in to see his patient, at which time he got a chest X-ray and echo, but continued to berate me, first because I had called labs to him, then because I shouldn't have bothered him with lab results. He also expressed severe anger at ME for giving the blood products his own nurse practitioner had ordered, stating I "should have known that was inappropriate." End of the story, the patient got MORE blood and is now doing well. So, the point of this post is this:
Do any of you experienced nurses ever just feel like throwing in the towel? Do you get that discouraged? That's how I feel right now. I don't want to go back to work for my next shift, and I sure as heck don't want to be talked to that way again. I just don't have any fight left in me. Advice? I could use whatever help you all can offer. I'm really discouraged right now.

I wouldn't set one nasty and sarcastic cardiac surgeon make me question my career choice. Cardiac surgeons have enormous egos and sometimes, especially when their patient isn't doing as well as expected, they act out in inappropriate ways. Kinda like overgrown two year olds. As long as you're confident that you communicated accurately and appropriately with the NP, and that you were professional and appropriate with Dr. Imanastysarcasticsurgeon, just let it roll off your back. He's a donkey. Sometimes we work with donkeys.

Go back to work your next shift, and chances are he will have forgotten all about it. If you feel like you can do so professionally, take him aside and tell him that his communication with you lacked professionalism and you don't care to be treated like that in the future.

I've worked with cardiac surgeons for 30 years -- I can tell stories that would make your hair curl. I'll never forget the time I was in the cath lab with a patient who had tombstone Ts. We went from the cath lab to the OR with me on the gurney, doing chest compressions. We got the patient into the OR and the OR staff took over. I was leaving to go back to my unit, and as I walked by the other OR, the door burst open and two guys in scrubs came rolling out (literally, on the floor, rolling) with their hands on each other's throats. As I got over my shock, I recognized the guy on top as a cardiac surgeon. "Oh, good!" he exclaimed. "Ruby! You tell this moron how to do a cardiac output."

Every time I think a cardiac surgeon (or anyone else) has been rude to me, I remember the cardiac surgeon and the anesthesiologist rolling around on the floor over a disagreement on how to do a cardiac output.

Love your avatar, by the way!

NotMyProblem MSN, ASN, BSN, MSN, LPN, RN · Dec 1, 2016

A nephrologist blew a gasket with me one night during the summer over being called about labs. I knew dialysis patients always had critical results. But one of the on-call hospitalists just was not accepting this and as such, ordered me to notify the nephrologist. This was about 2 a.m. Before I could clock out at shift's end, I was sitting in a chair listening to my manager 're-educate' me on the disease process of end stage renal patients....even though it was the young hospitalist that needed that training.

Funny, though, how no one wants to put in writing 'don't call critical labs on dialysis patients', claiming there is a policy "somewhere", but has yet to be presented as a reference to newcomers to the profession as well as to the facility. In the meantime, without a written accessible â€‹policy, we are BSN, RN, DM (door mat).

Sour Lemon · Dec 1, 2016

He's a jerk. I can't speculate as to why, but he's a jerk. All I can think of that might be encouraging is that he'd be a a huge jerk if you were a grocer store cashier, too ....and you'd be making less money while listening to him berate you about the way you set his tomato down on the counter. Sorry, I know that's not much help. :saint:

dec2007 · Dec 1, 2016

He's a jerk. I can't speculate as to why, but he's a jerk. All I can think of that might be encouraging is that he'd be a a huge jerk if you were a grocer store cashier, too ....and you'd be making less money while listening to him berate you about the way you set his tomato down on the counter. Sorry, I know that's not much help.

Maybe not, but it makes me feel better! Thanks!

dec2007 · Dec 1, 2016

A nephrologist blew a gasket with me one night during the summer over being called about labs. I knew dialysis patients always had critical results. But one of the on-call hospitalists just was not accepting this and as such, ordered me to notify the nephrologist. This was about 2 a.m. Before I could clock out at shift's end, I was sitting in a chair listening to my manager 're-educate' me on the disease process of end stage renal patients....even though it was the young hospitalist that needed that training.
Funny, though, how no one wants to put in writing 'don't call critical labs on dialysis patients', claiming there is a policy "somewhere", but has yet to be presented as a reference to newcomers to the profession as well as to the facility. In the meantime, without a written accessible â€‹policy, we are BSN, RN, DM (door mat).

Exactly! And his demands are constantly changing, so it is not possible to predict what he will prefer with the next patient. The only thing predictable is that whatever the nurse does it will be wrong!

dec2007 · Dec 1, 2016

I wouldn't set one nasty and sarcastic cardiac surgeon make me question my career choice. Cardiac surgeons have enormous egos and sometimes, especially when their patient isn't doing as well as expected, they act out in inappropriate ways. Kinda like overgrown two year olds. As long as you're confident that you communicated accurately and appropriately with the NP, and that you were professional and appropriate with Dr. Imanastysarcasticsurgeon, just let it roll off your back. He's a donkey. Sometimes we work with donkeys.
Go back to work your next shift, and chances are he will have forgotten all about it. If you feel like you can do so professionally, take him aside and tell him that his communication with you lacked professionalism and you don't care to be treated like that in the future.
I've worked with cardiac surgeons for 30 years -- I can tell stories that would make your hair curl. I'll never forget the time I was in the cath lab with a patient who had tombstone Ts. We went from the cath lab to the OR with me on the gurney, doing chest compressions. We got the patient into the OR and the OR staff took over. I was leaving to go back to my unit, and as I walked by the other OR, the door burst open and two guys in scrubs came rolling out (literally, on the floor, rolling) with their hands on each other's throats. As I got over my shock, I recognized the guy on top as a cardiac surgeon. "Oh, good!" he exclaimed. "Ruby! You tell this moron how to do a cardiac output."
Every time I think a cardiac surgeon (or anyone else) has been rude to me, I remember the cardiac surgeon and the anesthesiologist rolling around on the floor over a disagreement on how to do a cardiac output.
Love your avatar, by the way!

From now on whenever he is nasty I'll picture your two docs rolling in the floor! I'll try very hard not to laugh in his face. Thanks!

Been there,done that, ASN, RN · Dec 2, 2016

Most surgeons, but ESPECIALLY CVT surgeons , feel they are the right hand of God. God- surgeon.. really did not want to be bothered. He is a cut and run kind of guy.

You advocated for you patient.. and finally obtained the correct orders. You did a good job.

You did not deserve verbal abuse. His attitude is dangerous to patient care. This was the time for nurse-doctor collaboration.

Do NOT put your tail between your legs and run. God- surgeon needs to be written up.

dec2007 · Dec 2, 2016

Most surgeons, but ESPECIALLY CVT surgeons , feel they are the right hand of God. God- surgeon.. really did not want to be bothered. He is a cut and run kind of guy.
You advocated for you patient.. and finally obtained the correct orders. You did a good job.
You did not deserve verbal abuse. His attitude is dangerous to patient care. This was the time for nurse-doctor collaboration.
Do NOT put your tail between your legs and run. God- surgeon needs to be written up.

I totally agree with you; but sadly the god-surgeon brings in a lot of money for the hospital, so the hospital admin caters to his every whim. If he says the nurse was wrong, then by-golly the admin thinks the nurse was wrong too. It gets a little discouraging after awhile. Thanks for your support. It means a lot!

mmc51264, BSN, MSN, RN · Dec 2, 2016

We have a "Just culture" as a policy where no one is supposed to be treated that way and you can file a report for lateral violence, which is what that was you experienced.

I am sorry you had to go through that.

dec2007 · Dec 2, 2016

We have a "Just culture" as a policy where no one is supposed to be treated that way and you can file a report for lateral violence, which is what that was you experienced.
I am sorry you had to go through that.

We have a "just culture" policy, but I think ours is more like a "suggestion". It looks good on paper. Appriciate the support!

Libby1987 · Dec 2, 2016

I think you might still be circulating estrogen. I would have lit him up, and not because I'm smart. I'd be jobless no doubt.

I'm sorry though, that really sucks that he can apparently get away with that, or at least he and his ilk have worn you down to the point that it seems hopeless.