What would you do about this...

[Miller86]

Hey everyone,

I worked nights this past weekend and there was an issue that came up about a nurse (call her nurse A). There was an order that nurse A did not carry over from early within her day 12 shift. Nurse B that had the patient on night was very furious and started talking horrible about this particular nurse and all her past mistakes. I don't know nurse A well and never commented on the specific situation since I know nothing of it. The charge nurse told nurse B to either take it up with nurse A or management if she thought it was a real issue but that there was nothing she can do about it. While she was talking about this nurse, other nurses threw in their issues about her and it all seemed to be the same re-occurring issue.

Fast forward to this week, I'm back on nights and the issue about nurse A comes up again. She forgets to enter two important orders. Now here is my concern. Nurse B again went on a rant to all the nurses on the unit but never mentioned anything to nurse A. I asked if she was going to mention this issue to the nurse and she said she did not want to get into the whole situation and did not want to deal with it. I told her, looking at it from my own point of view, I would want someone to tell me if I am doing something wrong and if this nurse had warnings early enough then why should she be allowed to continue this behaviour? It's certainly not fair to other staff to carry her orders nor is it safe for patients to not receive important written orders. Definitely not safe for patients and that is what I'm here for. If this nurse was never told her faults how in the world would she ever know what she is doing incorrectly? I think nurse B has every right to speak to nurse A about the issue in private but nurse B does not seem to think that is the right thing to do. Then why gossip about it?

Am I just too new to this or would you see this as an issue? What would you do about it?

Thanks for listening

[shoegalRN, RN]

This is simple.

Because Nurse B is a passive aggressive. She would rather complain about it to others, have a whine and cheese party, and never get anything accomplished or resolved. It would be alot better if Nurse B would woman up, take Nurse A to the side, tell her the issues she is having with her, and shut up complaining about it to other nurses who can't do anything about it.

And nursing is a 24 hour job, it could be that Nurse A got slammed that day, had a code, a rapid response, and a total care patient all in the same shift. Everyone deserves the benefit of the doubt.

[tyvin, BSN, RN]

If there are medication errors it must be reported and written up. Omitting/not writing an order in the MAR is a med error where I'm from. Nurses learn from their mistakes. During the investigation of the error the situation is usually looked at the why and how etc... how to avoid future mistakes etc...there is no beheading (usually).

Everyone makes mistakes and if they aren't told and don't have a chance to rectify the situation they will probably keep on making the same mistakes.

As for gossiping; it's a group activity that resembles a shark frenzy and I stay away........someone always gets hurt.

[netglow, ASN, RN]

I "might" tip off said nurse on where she needs to improve. Take her aside, explain calmly give her a wink and say, "This is news you should use, FYI." And then offer to coach on that issue.

[systoly]

"Hey, are you ok? I worked that order from earlier. Did you get slammed or just have a brain fart?"

Nurse A may also be experiencing emotional distress. As afrocentricRN said, give her the benefit of the doubt and a caring attitude before loading the gun.

[Kooky Korky, BSN, RN]

B's behavior is typical. Loves to complain and belittle and gossip, lacks courage to openly approach A. Typical, typical, stinking typical.

Keep out of it or B will start doing you the same as she does A.

Do you know A well enough to talk to her? Don't mention B, just say you thought there might have been some missed orders. On 2nd thought, just stay out of it. Since no good deed goes unpunished, A will probably get mad at you if you say anything.

[Miller86]

Thanks for replying everyone. I don't feel comfortable approaching A since I really don't know her well and don't want to start any unnecessary drama, even if I do tell her watch her back in private it would still be adding to the gossip. I just don't understand why B does not want to tell the nurse about the situation if she feels A is not working hard enough. I completely agree that nursing is a 24 hour job and we're all in it to help one another and it could be very well she was swamped since her patients were either unstable or completely dependent.

Either way it was an eye-opener for me and being a new grad I'll definitely know what to expect and how to ensure I get all my work done so ABC won't be gossiping about my lack of work ethics.

[Altra, BSN, RN]

I just don't understand why B does not want to tell the nurse about the situation if she feels A is not working hard enough. I completely agree that nursing is a 24 hour job and we're all in it to help one another and it could be very well she was swamped since her patients were either unstable or completely dependent.

Either way it was an eye-opener for me and being a new grad I'll definitely know what to expect and how to ensure I get all my work done so ABC won't be gossiping about my lack of work ethics.

1. Nurse B's goal in discussing Nurse A's performance is NOT process improvement.

2. Do your best, and do learn from others' examples good and bad, but DO NOT get in the habit of, "I have to make sure to do X or Nurse B/C/D will talk about me." Give the best patient care you know how and don't worry about the gossips. They'll find something/someone else more entertaining to focus on.

[canesdukegirl, BSN, RN]

I agree with the above posters. Don't get directly involved, unless you see that patient safety is being compromised. Nurse B has a passive aggressive issue, and doesn't have the intestinal fortitude to handle conflict, clearly. It is such a simple fix, but for some reason, people have trouble confronting mistakes with peers.

[shoegalRN, RN]

Thanks for replying everyone. I don't feel comfortable approaching A since I really don't know her well and don't want to start any unnecessary drama, even if I do tell her watch her back in private it would still be adding to the gossip. I just don't understand why B does not want to tell the nurse about the situation if she feels A is not working hard enough. I completely agree that nursing is a 24 hour job and we're all in it to help one another and it could be very well she was swamped since her patients were either unstable or completely dependent.

Either way it was an eye-opener for me and being a new grad I'll definitely know what to expect and how to ensure I get all my work done so ABC won't be gossiping about my lack of work ethics.

That's just it, sometimes you WONT be able to get everything done all the time. You never know what to expect when you come into a shift, and it's unrealistic to think you are gonna walk into a shift and just go about your day doing your assessments, etc. It's learning to expect the unexpected.

There have been times when I worked the floor and an admit from the ER didnt get up until 0500. I did all I could for the next shift, but I made sure I told the day nurse this is what I DIDNT do, simply because the pt didnt arrive until 0500, besides, there was a rapid response, and we were short, that's why I'm working this unit tonight. And I let it go. I ask right then and there "do you have any questions about anything I didnt have time to get to?" This usually resolves any issues or concerns.

Do not worry about what others talk about. I can bet you these same nurses are insecure in their own nursing abilities, so they focus on someone else to make themselves look better. And that complaining nurse is not woman enough to tell Nurse A what her mistakes are, but I bet all the change in my purse that she runs to the manager to complain and still speaks to Nurse A like nothing is wrong. I can't stand these types!

If you are woman enough to dish it, you should be woman enough to take it and solve the issues!