Horrible day

  1. Hey all :stone

    Last noc was a nightmare. I can't go into it but basically my patient desatted and had a high heartrate and I feel I did everything OK and my charge feels I was unsafe in my care.
    I've never felt so violated and hurt by what someone could say. I felt I did my best, I called docs, I told charge what was up but it seems I didn't "handle" it exactly right. I'm OK with constructive critism but blatantly telling how bad I was without any constructive criticism is painful. I don't believe I acted unsafe but that I did the best I could.
    Oh well, I have to go try to get some sleep for tonights shift but I'm so disheartened.
  2. Visit zacarias profile page

    About zacarias

    Joined: Oct '01; Posts: 1,352; Likes: 81
    RN; from US
    Specialty: 14 year(s) of experience in tele, stepdown/PCU, med/surg


  3. by   RN-PA
    I'm sorry that you had a rough night. It makes it even worse when we're criticized for our actions when we feel we did the best we could. I would recommend getting the charge nurse alone before your next shift and speak to him/her about what happened. Listen to what the charge nurse has to say, see if any of it is valid, and if you still think your treatment was unfair or misunderstood, communicate your feelings. Sometimes in the heat of the moment, people respond poorly and maybe the charge will rethink how he/she handles things in the future after you talk it out.

    All the best to you, and hope you get some sleep!
  4. by   traumaRUs
    I'm with above poster - talk with charge nurse alone and find out what the perceived problem was. It may have just been a bad night for everyone!
  5. by   SnowymtnRN
    UGH that just sucks. I'm sorry it was a bad night. But you know what? A Charge nurse isn't supposed to construct your care that way, she's supposed to be a resource and a leader. If you as the bedside nurse feel you gave the appropriate care and your patient received everything they should have, she has no right to be as judgemental as it sounds like she was. I'd have a talk with her about it, and tell her that while you appreciate her input, her attitude was less than positive and maybe youhave different methods and techniques, and its not for her to criticize that. If she's hostile, then take it to your NM. Good luck, and sleep well knowing you did your best!!!!!
  6. by   Tweety
    I'm sorry to hear that. You need specific details on what your charge nurse thought you did wrong, and how you can improve in the future. "You didn't handle it right" is not good feedback that is going to help you. In fact it's destructive. Talk to this person.

    It's angers me that when a person crashes everyone wants to assign blame, or scrutinize the nurse. Unfortunately in this business depite our best efforts people are going to crash and there is nothing that we can do about it.

    Just want was your charge nurse doing after you told him/her you were having a problem with a patient. As a charge nurse I feel it's my job to step and support, help and do what I need to do for the safety of the patients on the floor. Perhaps during your discussion you can point out how as a charge nurse they did a crappy job.

    Good luck. I know how you feel.
  7. by   jemb
    Sorry you had such a horrible shift.

    I agree that you should ask your charge nurse for feedback. Ask her for specific suggestions on what you could/should have done differently.

    However, I would recommend having a 3rd party present- a union rep if you have one, or a respected coworker who was not present nor involved in the situation for which you were criticized. This can help keep the conversation from becoming emotionally charged, and can also provide an additional objective memory of the conversation should it need to be remembered later (as in a performance review or a legal process).
  8. by   MelissaRN
    The exact same thing happened to me a couple weeks ago. I came in at 7:00 pm and was told that this patient was awaiting palliative care consult (cancer with mets) and that she gets SOB and aggitated and then the aggitation makes her SOB worse. I guess this had been going on for days.

    Well when I went in to assess her she was sleeping soundly. I went in to give her IV push meds as scheduled and she didn't wake up. Her O2 sats were in the high 90's on 6 L oxyen. At midnight her BP was normal, pulse normal and sats again in high 90's on O2.

    At 1:00 am I went in to giver her IV prednisone and the tech and I repositioned her as she was waking up more and moving around. Her sats were still good and she wasn't overly aggitated.

    About 4:00 am the tech reported that she was aggitated and respirations in the 30's. I got an O2 sat that was still 93%. I had an order for IV Haldol which I gave and the was going to wait to see if it was effective.

    In the meantime my charge nurse wanted report, while giving report dept. head walks by pt's room and notices she's in further distress and got angry with me because she thought that I wasn't doing anything about it. She acted as if this patient was like this my whole shift and basically said that I needed to go to an inservice with palliative care nurses because real life isn't like learning things in school. :imbar

    She took over while I called the doctor to get higher doses of morphine for the SOB. I was giving her that and IV Ativan. She was still like that by morning but had settled down somewhat. Day nurses were like, oh she's been like that for days, she's really suffering! So basically I got bashed by dept. head for something that the doctors should have been doing something about days ago. The patient ended up dying two days later.