frustrated

Tweety, BSN, RN · Dec 21, 2008

Sounds like your priorities aren't matching up to hers.

Unfortunately she is the charge nurse and you need to find a way to work with her. If you know what her pet peeves are such as hanging blood and discharging patients, keep her in the loop. Next time try: "I'm going to discharge Mr. Jones now, but I'm going to give Ms. Smith her Insulin first". "I know I need to give blood, but I'm going to do such and such first since the patient isn't symptomatic of anemia". Keep her in the loop before she has a chance to get on you.

She's just doing her job, but if you communicate what your doing based on what you know bugs her, it might get better for you.

If not you might talk to her constructively. "The other day you told me my priority was to give blood, and I think that...........you made me feel..........." Talk it out.

Jules A, MSN · Dec 21, 2008

Truthfully I don't think what you have written sounds that bad. Without knowning the whole story I'd have probably given the blood first anyway but in any event since this is how she wants it and she is charge it does kind of give her the right to tell you how to do your job. :)

NurseInTheD · Dec 21, 2008

What I have learned is that no matter where you work, there will always be a person like that - but it's the worst when that person is in charge. Is she actually one of your managers, or is she a staff nurse who takes charge on occasion?

I would have prioritized giving insulin over discharging the other patient. It takes time to go over d/c instructions, and make sure everything is in order before sending that patient out the door, and in the meantime your diabetic patient is supposed to wait for their insulin injection - which takes all of a few minutes to draw up and administer? No way.

As for the blood transfusion pt, if he wasn't in distress, he could wait a little bit until you finished your med passing. You did the right thing by going in and seeing him, maybe you could have told him that you were waiting for the blood bank to send his unit(s) (which is true, the blood isn't sitting up on the floor waiting for his arrival). If you had started his transfusion at 10am before passing meds, you wouldn't have gotten your meds passed right away because you have to stay w/your transfusion pt to take his vitals and monitor him for a transfusion reaction.

Don't let her get you down. If she is your manager, calmly explain your rationale for your prioritization. If she's a coworker who is filling in as "charge", be polite, and then talk to your manager about her behavior.

Good luck.. :-)

RN1982 · Dec 21, 2008

I don't think what she said was all that bad. I don't really think they were smart comments. I've heard worse. If it was me, giving the blood transfusion would be more of a priority than giving meds. You could have sent for the blood, passed some meds, hung the blood, passed the rest of the meds.

We all do things differently. No one's priorities are the same.

Maco · Dec 21, 2008

I think what gets to me is that there are only certain ones she treats this way.......she doesn't question other nurses on the floor. One time i was walking through the nurses desk and I answered the call light.....well it was another nurse wanting help in a patients rooms with the patient. well I went to help( meanwhile I had just set my phone down when I answered the call light-we carry portable phones) well after I helped with the patient I went back to the desk to get my phone well this charge nurse has tried to call me and realized my phone was at the desk) she freaked out-stating you need to keep your phone with you at all times. I have seen her try to reach other nurses and thier phones were left at the desk and she didn't say a word to them. I realize that she is the charge nurse and to an extent she can tell me what needs to be done but she doesn't have the right to tell me how to prioritize. Especially when I don't agree with her priorities. As with the patient recieving blood-the issue was he didnot want to wait.....i'm sorry but I had 6 other patients.......if it had been certain nurses she wouldn't have said a word about it......I

racing-mom4, BSN, RN · Dec 22, 2008

On the weekend our outpatient clinic is closed so if ICU has an open bed we get the outpatient blood patients---they do get testy and iritated because they feel like they have to wait or are not getting the low ratio comfy feeling tx they would in the outpt setting---I always say "When in a hosp it is good to be last on the list--as that means your the healthiest" that usually gets a smile out of them and helps them understand that we must prioritize.

As far as the charge nurse--some people can not find the balance between being a boss and being bossy!!! There is one in every crowd!!

NurseInTheD · Dec 24, 2008

I don't think what she said was all that bad. I don't really think they were smart comments. I've heard worse. If it was me, giving the blood transfusion would be more of a priority than giving meds. You could have sent for the blood, passed some meds, hung the blood, passed the rest of the meds.
We all do things differently. No one's priorities are the same.

Agreed :-)

My rationalization for the meds before the blood: When hanging blood, I stay w/my patient for the first 15 minutes or so to assess for a transfusion reaction and take serial vital signs. And in this case, it seems that this patient was coming in for a transfusion as an outpatient - which means obtaining consent, starting a PIV, obtaining the blood from the bloodbank with RN verification at bedside, getting the infusion going, assessment/vitals.. and then what if the worst does happen and there is a reaction? Then you have a whole new and serious situation on your hands... and one that's going to eat up a whole lot of time away from your other duties.

That's where I was coming from in that regard.. :twocents:

Ruby Vee, BSN · Dec 25, 2008

doesn't sound like what the charge nurse said to you was out of line. perhaps you need to take a step back and take a look at your own behavior and how you're interacting with this charge nurse. she is, well, in charge, so you need to get along with her!