Condescending nurses

Nurses General Nursing

Published

I got into it with two nurses at work today and I'm wondering if I was wrong to handle the situation the way I did. I'm not an RN, but I work as an intern at a hospital that recruits BSN candidates who are very near to graduation, the objective being that you will continue to work for them as an RN after you pass state boards. Being an intern is almost like being an LPN (except that we don't have a license and didn't want to be bothered with the NCLEX PN since we're already prepping for the NCLEX RN). So, we get paid less than an LPN even though we do pretty much the same things they do (under the direct supervision of an RN, of course).

The situation is that the hospital is very short of nurses aides, and at the last unit staff meeting we were told that we have to work as a team to do total patient care on everybody until they fill all the vacant positions. I personally don't see anything wrong with that because, at least in my humble opinion, nursing is all about total patient care anyway. But there are a few nurses who think they are better than to help a patient with hygiene or toileting, or even eating. They want the aides to do EVERYTHING, and if there is no aide available some of these nurses are quite comfortable to let the patient wait for a very long time laying in feces, or vomit, or until the patient's food gets cold and nasty, until an aide becomes available to do it. I'm not talking about nurses who are genuinely busy with work, just a few lazy nurses period. Don't get me wrong, the majority of the RNs I work with are really awesome people who I believe to be among the best nurses out there, but as you know there are always a few bad ones trying to ruin things.

Things started out real busy today but the docs came thru and gave orders for many of their patients to be moved out of intensive care to tele/step-down and med surg. By early afternoon about 2/3 of the patients were gone and we were sitting there twiddling our thumbs for hours because we hardly had any patients. The charge nurse didn't want to float any of the RNs out because a number of post-ops would be soon coming up from PACU and the ER was getting ready to send people up to us as well. I commented to one of the nurses aides that it had been a really slow day (I'm not exaggerating when I said that for a few hours most of us were sitting around with absolutely nothing to do). But before the words were even out of my mouth, one of the nurses said to me that things seem slow to us because we're only aides, and all we do is basic patient care, that we have no idea what "real nursing" is all about because of all the charting and follow-ups, and reports, etc that RNs have to do. Then she proceed to tell me that I have no idea what patient care is until I finish with school and become a "real nurse". I took offense to that because I do far more patient care on all her patients than she ever does.

But she didn't stop there. She began talking to another nurse about how going to nursing school nowadays means nothing because of all these incompetent new nurses she's seen. Each time she opened her mouth her comments got more and more personal, until it became obvious that she was talking about me. This woman is criticizing my education even though neither herself nor her friend ever went to college! This is BS on so many levels. First of all, since when is basic patient care NOT a part of "real nursing"? And why do some RNs have to be so condescending towards nursing assistants who are helping them to take care of their patients? Wiping butts, giving baths, and feeding a patient may not be the most glamorous things about nursing, but they are just as important to the patient as taking orders from a physician or passing meds. I went off on her BIG TIME. I'm normally not the type of person who likes to make a scene anywhere but somebody was eventually going to have to assist this woman with an attitude adjustment, and since she came swinging at me, I figured that the honor was mine.

I got into it with two nurses at work today and I'm wondering if I was wrong to handle the situation the way I did. I'm not an RN, but I work as an intern at a hospital that recruits BSN candidates who are very near to graduation, the objective being that you will continue to work for them as an RN after you pass state boards. Being an intern is almost like being an LPN (except that we don't have a license and didn't want to be bothered with the NCLEX PN since we're already prepping for the NCLEX RN). So, we get paid less than an LPN even though we do pretty much the same things they do (under the direct supervision of an RN, of course).

The situation is that the hospital is very short of nurses aides, and at the last unit staff meeting we were told that we have to work as a team to do total patient care on everybody until they fill all the vacant positions. I personally don't see anything wrong with that because, at least in my humble opinion, nursing is all about total patient care anyway. But there are a few nurses who think they are better than to help a patient with hygiene or toileting, or even eating. They want the aides to do EVERYTHING, and if there is no aide available some of these nurses are quite comfortable to let the patient wait for a very long time laying in feces, or vomit, or until the patient's food gets cold and nasty, until an aide becomes available to do it. I'm not talking about nurses who are genuinely busy with work, just a few lazy nurses period. Don't get me wrong, the majority of the RNs I work with are really awesome people who I believe to be among the best nurses out there, but as you know there are always a few bad ones trying to ruin things.

Things started out real busy today but the docs came thru and gave orders for many of their patients to be moved out of intensive care to tele/step-down and med surg. By early afternoon about 2/3 of the patients were gone and we were sitting there twiddling our thumbs for hours because we hardly had any patients. The charge nurse didn't want to float any of the RNs out because a number of post-ops would be soon coming up from PACU and the ER was getting ready to send people up to us as well. I commented to one of the nurses aides that it had been a really slow day (I'm not exaggerating when I said that for a few hours most of us were sitting around with absolutely nothing to do). But before the words were even out of my mouth, one of the nurses said to me that things seem slow to us because we're only aides, and all we do is basic patient care, that we have no idea what "real nursing" is all about because of all the charting and follow-ups, and reports, etc that RNs have to do. Then she proceed to tell me that I have no idea what patient care is until I finish with school and become a "real nurse". I took offense to that because I do far more patient care on all her patients than she ever does.

But she didn't stop there. She began talking to another nurse about how going to nursing school nowadays means nothing because of all these incompetent new nurses she's seen. Each time she opened her mouth her comments got more and more personal, until it became obvious that she was talking about me. This woman is criticizing my education even though neither herself nor her friend ever went to college! This is BS on so many levels. First of all, since when is basic patient care NOT a part of "real nursing"? And why do some RNs have to be so condescending towards nursing assistants who are helping them to take care of their patients? Wiping butts, giving baths, and feeding a patient may not be the most glamorous things about nursing, but they are just as important to the patient as taking orders from a physician or passing meds. I went off on her BIG TIME. I'm normally not the type of person who likes to make a scene anywhere but somebody was eventually going to have to assist this woman with an attitude adjustment, and since she came swinging at me, I figured that the honor was mine.

Hey Tony!! Sounds like either she was having a bad day or was, as you said just condescending...maybe insecure, jealous???. As an LPN I have had some pretty nasty comments from some RN's. Even reading articles about nursing; seems as though LPN's aren't part of the health care team. I personally have had loads of experience in my 19 years, and have actually oriented RN's at times. We're kinda like the 'clean canvas' of nursing. The facilities do with us what they want based on what the nurse practice act allows us, which is a lot!! Sometimes this is confusing. What you can do in facilityA isn't what you can do across the street in facility B. I, too believe that patient care is the core of nursing and was taught (hospital school) that NO job was beneath us. I have had CNA's ask if I was ever a CNA beacuse I "knew how to clean up and turn a patient"!!! By the way, congratulations on your up coming degree and career!! (Talk about paying your dues!!!) Good luck to you!! Any time you need to "vent" we're here and probably had some similar experience!!

Specializes in Nursing Professional Development.

While you had every right to be upset, "going off" on someone is almost NEVER the right thing to do at work. It's not a professional response -- unless you "went off on her" much more tactfully and professionally than I am envisioning.

You left a lot out of your description of the situation that has a bearing on what the correct response would be. How many people (and who) were listening to this person? How much credibility/influence does this person have with the listeners? Were they ignoring her? If so ... you just got yourself a bad reputation for having a hot temper (and a mouth) that you can't control all to tell off a blow hard that no one takes seriously anyway. That's not worth it.

Is she a very influential person in that unit? If so, you just made an enemy of someone who might be able to make your life miserable. Before, she just didn't respect you (something that can be remedied with time) ... but now, she might really be out to get you.

Do you want to work there after graduation? Do you want a positive recommendation from the manager of that unit? How well do you and that manager get along? How well does your new enemy and the management get along?

There will always be people you disagree with ... or who offend you ... or whatever. While it may feel good at the time to "tell them off" ... or whatever ... there is often a big price to pay for losing control of your temper at work. It's rarely worth it. You are usually better off PROVING them wrong through your actions and/or using your political/interpersonal skills to maintain a well-respected place among your colleagues.

Standing up for yourself is a good thing. But it has to be done with a certain amount of tact and political grace. I can't tell from your post whether or not you handled the situation well or not -- but I hope my comments have helped you to analyze the situation a little better.

llg

Specializes in forensic psych, corrections.

I totally agree with llg here. To say it was unprofessional of you to "go off" on a staff member, particularly as a student/intern, would be understating the situation. While I'm sure it was gratifying at the moment, that type of behavior won't get you far as a professional nurse.

Another thing that I'm sure you don't want to hear is that its true that you don't understand the scope of an RN's responsibilities as a student. There's often quite a bit of documentation and follow up involved in transferring patients out to other floors that you may not be privy to. I also couldn't understand why nurses said they were so busy all the time when I could complete everything I had to complete -- as a student, and as a nurse extern -- in a reasonable amount of time... but I learned quickly as a new grad what actual nursing responsibilities are, and I suspect you will as well.

This concerns me:

But she didn't stop there. She began talking to another nurse about how going to nursing school nowadays means nothing because of all these incompetent new nurses she's seen. Each time she opened her mouth her comments got more and more personal, until it became obvious that she was talking about me. This woman is criticizing my education even though neither herself nor her friend ever went to college!

You said in your post that this person was a nurse. How can it be true, then, that she hadn't attended college? Or do you mean that she hasn't attended a BSN program?

I got into it with two nurses at work today and I'm wondering if I was wrong to handle the situation the way I did. I'm not an RN, but I work as an intern at a hospital that recruits BSN candidates who are very near to graduation, the objective being that you will continue to work for them as an RN after you pass state boards. Being an intern is almost like being an LPN (except that we don't have a license and didn't want to be bothered with the NCLEX PN since we're already prepping for the NCLEX RN). So, we get paid less than an LPN even though we do pretty much the same things they do (under the direct supervision of an RN, of course).

The situation is that the hospital is very short of nurses aides, and at the last unit staff meeting we were told that we have to work as a team to do total patient care on everybody until they fill all the vacant positions. I personally don't see anything wrong with that because, at least in my humble opinion, nursing is all about total patient care anyway. But there are a few nurses who think they are better than to help a patient with hygiene or toileting, or even eating. They want the aides to do EVERYTHING, and if there is no aide available some of these nurses are quite comfortable to let the patient wait for a very long time laying in feces, or vomit, or until the patient's food gets cold and nasty, until an aide becomes available to do it. I'm not talking about nurses who are genuinely busy with work, just a few lazy nurses period. Don't get me wrong, the majority of the RNs I work with are really awesome people who I believe to be among the best nurses out there, but as you know there are always a few bad ones trying to ruin things.

Things started out real busy today but the docs came thru and gave orders for many of their patients to be moved out of intensive care to tele/step-down and med surg. By early afternoon about 2/3 of the patients were gone and we were sitting there twiddling our thumbs for hours because we hardly had any patients. The charge nurse didn't want to float any of the RNs out because a number of post-ops would be soon coming up from PACU and the ER was getting ready to send people up to us as well. I commented to one of the nurses aides that it had been a really slow day (I'm not exaggerating when I said that for a few hours most of us were sitting around with absolutely nothing to do). But before the words were even out of my mouth, one of the nurses said to me that things seem slow to us because we're only aides, and all we do is basic patient care, that we have no idea what "real nursing" is all about because of all the charting and follow-ups, and reports, etc that RNs have to do. Then she proceed to tell me that I have no idea what patient care is until I finish with school and become a "real nurse". I took offense to that because I do far more patient care on all her patients than she ever does.

But she didn't stop there. She began talking to another nurse about how going to nursing school nowadays means nothing because of all these incompetent new nurses she's seen. Each time she opened her mouth her comments got more and more personal, until it became obvious that she was talking about me. This woman is criticizing my education even though neither herself nor her friend ever went to college! This is BS on so many levels. First of all, since when is basic patient care NOT a part of "real nursing"? And why do some RNs have to be so condescending towards nursing assistants who are helping them to take care of their patients? Wiping butts, giving baths, and feeding a patient may not be the most glamorous things about nursing, but they are just as important to the patient as taking orders from a physician or passing meds. I went off on her BIG TIME. I'm normally not the type of person who likes to make a scene anywhere but somebody was eventually going to have to assist this woman with an attitude adjustment, and since she came swinging at me, I figured that the honor was mine.

Hi, I was just reading your post and I have to agree that blowing up at someone, especially as a student/aide was not a good idea. You will soon learn that you will have problems with people such as this on a daily basis. All you need to do is be sure and do your best job everyday, despite opinions of others. Also, I work in an icu where it usually only takes about two wks. of employment for the aides to feel as if they are more knowledgeable than nursing. Thus I have to continually point to the letters behind my name (rn, bsn), and tell them I have everything under control and I will be making the decisions today. My point is, that type of attitude from aides gets very annoying sometimes, and maybe this is where the rn was coming from, she was just putting you in a general category. All the aides I have worked with, came back to me after starting in the icu as an rn, and have said "I had no idea it was this stressful or there was this much to worry about"

Specializes in Med/Surg, Ortho.

I suspect you mean she was a graduate of a diploma school. Well im sure she knows her stuff just as well as any other nurse on the unit. Diploma programs were no cup of tea.

I agree you may have done absolutely the opposite of what you should have. You would have been better served to get up, walk away and go find a patient to talk to or work on a little housekeeping on the unit. No im not saying you are a housekeeper, but you could have worked off some of your anger instead of directing it at someone who very well may be sitting in a position to evaluate you later. A lot of facilities have a co-worker evaluate another employee along with a self eval and a nurse manager eval. You will have to make sure all the T's are crossed and I's are dotted now for sure. And regardless of how wrong she was, you were too. A nurses station is not the place for behavior like that.

On a side note. I have seen a lot of students come through our unit. Some come to work with us and unfortunately i may have to agree with her. Because of the decreasing clinical time spent on units students seem to be book smart but havent really learned how to apply the knowledge they have to the patients they care for.

While you had every right to be upset, "going off" on someone is almost NEVER the right thing to do at work. It's not a professional response -- unless you "went off on her" much more tactfully and professionally than I am envisioning.

You left a lot out of your description of the situation that has a bearing on what the correct response would be. How many people (and who) were listening to this person? How much credibility/influence does this person have with the listeners? Were they ignoring her? If so ... you just got yourself a bad reputation for having a hot temper (and a mouth) that you can't control all to tell off a blow hard that no one takes seriously anyway. That's not worth it.

Is she a very influential person in that unit? If so, you just made an enemy of someone who might be able to make your life miserable. Before, she just didn't respect you (something that can be remedied with time) ... but now, she might really be out to get you.

Do you want to work there after graduation? Do you want a positive recommendation from the manager of that unit? How well do you and that manager get along? How well does your new enemy and the management get along?

There will always be people you disagree with ... or who offend you ... or whatever. While it may feel good at the time to "tell them off" ... or whatever ... there is often a big price to pay for losing control of your temper at work. It's rarely worth it. You are usually better off PROVING them wrong through your actions and/or using your political/interpersonal skills to maintain a well-respected place among your colleagues.

Standing up for yourself is a good thing. But it has to be done with a certain amount of tact and political grace. I can't tell from your post whether or not you handled the situation well or not -- but I hope my comments have helped you to analyze the situation a little better.

llg

llg,

I appreciate your input, and I understand what you are saying about professionalism in the workplace, but this situation was not as dramatic as you might have thought. I did not lose my temper, and it was only the three of us who were standing at the nurses station before the change of shift so I doubt anyone else overhead the conversation. All I did was remind these two nurses that an RN title doesn't entitle them to make belittling comments to support staff. Interns are support staff, too, and their insulting comments are also directed at us. I'm sure they didn't like what I had to say but they're always making insulting remarks to the CNAs, and I also reminded them that what they're doing is no different from those times when the doctors yell at them and tell them how stupid and incompetent they are. They tried to counter with more put-downs, but I calmly told them to 'stuff it' (in nicer words, of course) because there was no audience there to observe their drama. I was thinking that the alternative would be to say or do nothing but I really felt it was time someone told them that what they're doing is not cool.

These women are no threat to me in any way, and as far as either of them being influential---I seriously do not think so. I think a part of their behavior towards me has to do with the fact that I am very well liked by most of the nurses there and also by the DON. A big problem for them is that they are not fond of the idea of men as nurses, and it may be that they feel more threatened by the incoming group of BSN graduate nurses. The hospital is aggressively seeking to hire more BSNs, and they are offering us a VERY generous sign-on bonus and benefits package after we're done with state boards. On the other hand, they are cutting back on the use of these agency nurses and I'm sure these two nurses feel that we are taking the bread out of their hands. I don't get it. These two women are always complaining about how much they hate working at the hospital so I don't understand why they keep coming back every week. And why do they feel that its reasonable for them to take their frustrations out on us?

As far as enemies go, this place isn't bad compared to what I've heard about most other places with the politics and the BS that goes on everywhere. Morale is relatively high because the DON is a very progressive lady who works hard to make it so, and its not a secret that she wants to get rid of some of these nurses who're always spreading their negativity all around.

Specializes in Critical Care/ICU.

Tony, first and foremost, drop the BSN stuff. Years of experience trumps any amount of bookwork done by the new grad.

Second, as I was reading the original post I thought to myself, how can any nurse not be interested in the total care of a patient or find only some things worthy of their attention? I attributed my feelings to having worked only in ICU where we have one NA for 29 beds and no NA at night (when 99% of baths take place). Everyone else is an RN, or respiratory, or housekeeping, or central supply. The RN does TOTAL care. The only time the NA is needed is to assist with baths, turning, or moving patients from the bed to a chair. They DO NOT feed patients.

Then I saw that you were talking about ICU! How do these nurses do full assessments on their patients if they are not there to watch them swallow, or there to see their stool, or there to check the skin of their patients during baths!? The ratios in this ICU must be outrageous and I think that the NA (or interns) must be doing much more "nursing" than you or they think.

No one should ever talk down to anyone for any reason. Who cares what initials you have after your name if you can't at least respect the value of each and every member of the healthcare team who's there to take care of the patient?

I also don't think one should have to take any form of insult or condescension just because that person might have a word in your professional evaluation or how friendly they are with the manager. That's just wrong and doesn't sound like a very fair workplace.

It's also wrong though that one should feel superior due to a degree.

We tell people to call the bully out all the time. What's the difference here?

There will always be people you disagree with ... or who offend you ... or whatever. While it may feel good at the time to "tell them off" ... or whatever ... there is often a big price to pay for losing control of your temper at work. It's rarely worth it. You are usually better off PROVING them wrong through your actions and/or using your political/interpersonal skills to maintain a well-respected place among your colleagues.

The best thing to do when you have a problem with an individual is talk with that individual about it first. As long as it's done properly, there's nothing wrong with it.

Another thing that I'm sure you don't want to hear is that its true that you don't understand the scope of an RN's responsibilities as a student. There's often quite a bit of documentation and follow up involved in transferring patients out to other floors that you may not be privy to. I also couldn't understand why nurses said they were so busy all the time when I could complete everything I had to complete -- as a student, and as a nurse extern -- in a reasonable amount of time... but I learned quickly as a new grad what actual nursing responsibilities are, and I suspect you will as well.

This concerns me:

You said in your post that this person was a nurse. How can it be true, then, that she hadn't attended college? Or do you mean that she hasn't attended a BSN program?

A part of my job is to shadow the RNs that I work with and to assist with paperwork and with many procedures as instructed (as long as it is legal to do so). Much of the time I am there when they are taking new orders from the doctors, when there are med changes with the pharmacy, when the different consulting MDs come in to see the pts, when the charge nurse comes by for his/her update, when the relatives call or come to visit. The nurses that I'm working with have been showing me the ropes since day one, and although I don't claim to know everything that an RN does, I have a pretty good idea what its like to be an RN in an ICU on a day to day basis. I am privy to everything that goes into a chart because although I don't do any charting I assist kinda like a fill-in unit secretary with putting the whole thing together for new admits and also when preparing the pt for transfer, obtaining consents for procedures, or for discharge.

You don't understand. This was a down day with a VERY low census in all the ICU areas. They did all the charting and called report on the patients. I was there helping with the whole process. I even helped the transporters to move the patients to their new rooms. In their unit it was three RNs with only two patients, until the charge nurse asked one of them to move to the critical care unit. The nurses were done. They had nothing at all left to do. They were sitting at the nurses station watching the news on the TV in one of the patient's rooms and talking about the pope, and Michael Jackson, and Terri Shivo, etc. Until the new admits were stabilized and transferred from PACU and the ER hours later.

However, this is not about me being a student. It is about nurses who are just plain rude.

Tony, first and foremost, drop the BSN stuff. Years of experience trumps any amount of bookwork done by the new grad.

Second, as I was reading the original post I thought to myself, how can any nurse not be interested in the total care of a patient or find only some things worthy of their attention? I attributed my feelings to having worked only in ICU where we have one NA for 29 beds and no NA at night (when 99% of baths take place). Everyone else is an RN, or respiratory, or housekeeping, or central supply. The RN does TOTAL care. The only time the NA is needed is to assist with baths, turning, or moving patients from the bed to a chair. They DO NOT feed patients.

Then I saw that you were talking about ICU! How do these nurses do full assessments on their patients if they are not there to watch them swallow, or there to see their stool, or there to check the skin of their patients during baths!? The ratios in this ICU must be outrageous and I think that the NA (or interns) must be doing much more "nursing" than you or they think.

No one should ever talk down to anyone for any reason. Who cares what initials you have after your name if you can't at least respect the value of each and every member of the healthcare team who's there to take care of the patient?

I also don't think one should have to take any form of insult or condescension just because that person might have a word in your professional evaluation or how friendly they are with the manager. That's just wrong and doesn't sound like a very fair workplace.

It's also wrong though that one should feel superior due to a degree.

We tell people to call the bully out all the time. What's the difference here?

The best thing to do when you have a problem with an individual is talk with that individual about it first. As long as it's done properly, there's nothing wrong with it.

I think some of you are taking this entirely another way than I intended. PLease note the context within which I mentioned the BSN. I am not putting anyone down with it, simply stating that it is a possible cause for resentment from some people who do not accept that new graduates are coming in and receiving all these benefits just because the hospital has a hiring policy that favors people with that degree.

All I was asking is about was how to respond to people who are constantly attempting to put you down at work because they feel they are better than you, for whatever reason. I didn't mean to put anyone on the defensive about their nursing education or experience. The point I was really trying to get at is lost, but thanks for everyone's input anyway.

Specializes in Critical Care/ICU.

Well in that case Tony, do a search on the boards for threads on bullies. I'm on your side. The whole BSN thing really wasn't clear to me, but what is clear is that no one should talk down to anyone else, ever.

Specializes in NICU, PICU, educator.

I have to agree, don't go off on someone on the unit...it only makes you look bad. Sometimes it takes a bigger person to get up and walk away. And it is very different to be an LPN, aide, whatever than an RN...heck, I'd gladly let them to half the paperwork I have to do and do patient care! And the BSN thing is old, even if you don't mean it condescendingly. I really could care less what degree people hold, as long as they can do the work.

But, if you truly feel this nurse is bullying, then you need to go to the unit manager about it.

And I think that people took the post the wrong way because you stated how you went off on someone. Okay, that sounds confontrational to me.

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