I was yelled at by my nurse yesterday

Pepper The Cat, BSN, RN · Apr 11, 2012

Sats in the high 80s are not low enough to panic over.

A distended abd after abd surgery? - Most likely, not knowing the history,etc - was probably a build up of gas. To put in most simple terms, the intestines were shut down because of surgery. Once they become active again, and the pt starts to , um - pass gas - the distention will relief itself. (yes - all he needs to do is f@$%)

Finally - what was this nurse doing when you started asking questions? Was she pouring meds for another pt? Assessing another pt? I had a student interupt me while I was doing VS on my pt to report the vitals on their pt which were all normal. I was not pleased - but managed not to say anything. The next day, when he tried to do the exact same thing, I just told him to wait until I was done with my current pt.

alwayskatiek · Apr 11, 2012

I will say that there are times as a nurse on the floor that I don't have time for a students questions. For example, last week a student was asking about bowel movements on a pt that I had for the last 3 days and was getting back from the night nurse. We were trying to hurry as we had a pt close to death. I pulled him aside and asked him that this question was not appropriate at this time, but we could take about it later. The next day, I had another student I had asked to get me ablood pressure before I gave meds. She asked me how to doa manual blood pressure. Seriously! Are students even allowed in the floor without being able to do this??? I got a bit short with her, but I had 7 med surg pt's on a day shift and 6 students. I could not teach her that skill at that time. I felt it was her instructors responsibility to teach this. Was I right or wrong, I don't know. But it is what I had to do to keep all if my patients safe and getting my best care.

itzcuzimindian · Apr 11, 2012

i learned how to do bp manually as a junior in high school!!

cndn_grl08 · Apr 11, 2012

I'm the kind of person that knows my stuff but always wants to make sure I'm doing the right thing before I do it. I used to ask a lot of simple questions that I should (and did) know the answers to, and nurses and instructors got annoyed with me because of it. What I learned to do is instead of ASKING questions, TELL the nurse what YOU think is right, and ask if she agrees. That way it shows that you're putting thought into it yourself but yet still checking with her before you do it. If you're wrong, that's okay, then she can tell you the right thing to do, but at least it doesn't look like she is doing the work for you. That really helped me to grow in my clinical experiences.

IaCountryGirl · Apr 11, 2012

Never had a nurse flip out on me in front of people, but had a nurse flip out about me behind my back to my instructor until my instructor set her straight.

Short story- pt had surgery, was post op day 1, o2 sats continued to drop steadily. When they were in the 80's, I talked to my instructor and put o2 on- standard 2L NC doctor's orders that are in everyone's chart for that floor. This nurse was not nice to me at all, refused to even look at me, and dismissed me during report. Anyway, after I had done that, I left the room briefly to get pt's meds ready and nurse must have decided to check in. Made a huge scene according to others that I was harming the patient until my instructor set her straight about the o2 sats.

wooh, BSN, RN · Apr 11, 2012

... and she DIDN'T seemed worried AT ALL. I was asking her what other measures she would like me to try, if she would like me to stay and monitor him, at what point should I be concerned and bring other issues to her attention, and since I cannot pass meds myself- I asked if she could discuss his options available to him about pain medication. ...

The "she DIDN'T seem worried AT ALL," is probably what set her off. (Whether she was right or wrong, I'll advise you in how to not annoy future nurses.) Sounds like things that can be very typical in a post op patient. As said above, probably gas. If his stomach hurt, he's not taking deep breaths, and really, as much as people freak out over it, high 80s is not an emergency. (And I say this not just to students. There are experienced nurses that like to freak out over this too.) Your emphasis on the nurse not being worried leads me to bet that you were sounding a bit freaked out, and PERHAPS were coming across with an attitude that she wasn't properly caring for her patient since she wasn't worried AT ALL. And frankly, if a nursing student was insinuating that I wasn't taking proper care of my patient, that nursing student would immediately no longer have anything to do with my patient. MY patient. MY responsibility. NOT yours. NOT your instructor's. I'd be telling my charge nurse that the student needed to stay out of my room, and she would be telling the instructor. If I was having a particularly bad day though, it might not go so quietly.

I'm not saying you felt that way. I'm saying it's likely you may have come off that way.

I'm the kind of person that knows my stuff but always wants to make sure I'm doing the right thing before I do it. I used to ask a lot of simple questions that I should (and did) know the answers to, and nurses and instructors got annoyed with me because of it. What I learned to do is instead of ASKING questions, TELL the nurse what YOU think is right, and ask if she agrees. That way it shows that you're putting thought into it yourself but yet still checking with her before you do it. If you're wrong, that's okay, then she can tell you the right thing to do, but at least it doesn't look like she is doing the work for you. That really helped me to grow in my clinical experiences.

This is VERY GOOD ADVICE. :)

Esme12, ASN, BSN, RN · Apr 11, 2012

Well, without writing a novel about my patient, he was a young guy in his 40's, & he had come back from abdominal surgery very early in the morning. About 2 hours after I had first checked him out, his abdomen was significantly distended and he was complaining about how painful it was. His O2 sat was in the high 80's (how is this not a scary vital!?), deep breathing/coughing/repositioning him was not helping. So I relayed all this info to her immediately- and she DIDN'T seemed worried AT ALL. I was asking her what other measures she would like me to try, if she would like me to stay and monitor him, at what point should I be concerned and bring other issues to her attention, and since I cannot pass meds myself- I asked if she could discuss his options available to him about pain medication. I guess it was a lot of questions. Maybe it's because I am a student and everything seems very serious, I just don't want to miss anything.

First of all, that nurse was completely out of line for berating you publicly....regardless of how much of a pest you were. That is belittling and abusive....peroid. If I was her manager I'd have her in my office....pronto. The only things yelled at someone is STOP, Help, and code blue. The rest is behind doors with an indoor voice....period.

If this was a "normal" healthy 40 year old an O2 sat on a new post op IS a big deal as is a "significant" increase of abdominal distention and needs to be dealt with promptly in a controlled manner. Panic never helps anyone. When you are feeling panicked take your own pulse first....this gives you the moment to gain control and move forward.

My feeling is that the nurse made you the scape goat because she had no clue how to answer your questions and felt inadequate and embarrassed herself, so to cover her inadequacies she projected onto you.....very unprofessional and insecure.

I tell students, of the inquisitive nature, to keep track and write down their questions they go and deliver them in bunches so that they don't badger their mentor's to death with the constant onslaught of inquisitive inquiries. I liken the behavior to that of the toddler "what's that?" "Mommy what's that?" "Mommy how come?" So that about the 1 millionth time you are ready to explode so I encourage student to modulate their behavior. But this sounds like this guy needed intervention and if it was no big deal, you deserve an explanation.

:hug: I'm sorry you were treated so badly. Now I know why new nurses feel the experienced nurses "eat their young". :cool:

mindlor · Apr 11, 2012

Where I come from, unless a pt is a COPDer, an o2 sat in the 80's totally grabs my attention. It is a big fat hairy deal.......that said, IS, cough, deep breath will usually take care of it.....

For some COPDers a sat in the 80's is a darn good day......

OnlybyHisgraceRN, ASN, RN · Apr 11, 2012

I hope you reported her. Yelling at a student is NEVER acceptable. I don't care what other people tell you. Yes, this behavior happens in the real world but this should not be happening to a student.

nerdtonurse?, BSN, RN · Apr 11, 2012

First -- nobody should ever yell in front of a patient or in public. Unless you're calling for help or announcing a code where you can't reach the button.

But....norms change depending on where you are, too. We had a student in ICU who flipped out several weeks ago because she walked into a room to help turn a patient (other student's patient) and the person's heart rate was 33. On the floor, scary stuff. With us, and with that particular patient, we were tickled pink that it was that high. The patient was going for a pacemaker placement, doc didn't want her externally paced, had probably lived in the 30's and 40's for months. So for that patient, at that time, 33 was fine. In that particular case, I blame the charge nurse as much as anybody -- when we have student come in for dayshift, I take them aside and give them a fast run down --- Bed 1 is going to be terminally extubated, DNR, Bed 2 has tachy/brady syndrome, so don't worry about wild changes in rates, we know, Bed 3 is a GI bleed, etc. Surprises are not a good thing.

And it's the same with us. I see someone with a suction canister filling up with blood, I'm going to get a little tachycardic myself. In the OR, it' probably a "ho-hum" moment.

nerdtonurse?, BSN, RN · Apr 11, 2012

I only ever yelled at someone once -- a student was disconnecting a Levophed drip so she could change the patient's gown, despite being told the patient was critical and not to touch her -- we gave her another assignment because the patient was so fragile. But that particular student didn't listen to anybody, did what she wanted to do. I hooked the patient back up, got her out of the room, and in private told her to NEVER, EVER TOUCH A DRIP IN ICU AGAIN, and then I told her instructor. I'm sure she ran back and told everyone how mean I was, but the patient's BP went from a SBP of 80 to a SBP of 60. Had I not glanced in the room, the patient would have coded. I guess that would have made me a "meanie" for letting her kill a patient. She failed the program for repeated unsafe behaviors....

nowim clean · Apr 11, 2012

After all these posts all I can add is you've been given a great example of what type of nurse NOT to become. There is no reason to yell at anyone be it student, cna, co-workers or anyone else unless it is STOP, HELP, CODE BLUE.