Is there a place for non-confrontational nurses in ICU?

icuRNmaggie, BSN, RN · Oct 20, 2014

Ask your manager how you should have handled this situation.

There should be a policy in place for CTs and possibly MRIs to be done prior to transport to ICU.

I think you handled this very well by not delaying the MRI until the next day. It would have been more efficient for the ER nurse to get it done and bring the pt straight to the ICU.

delphine22 · Oct 22, 2014

MRI and CT are right by the ER in our hospital. If the ER sent a pt up without scanning them, and I had to bring them alll the way back down, I'd be spitting nails.

Think of it this way. You are not being "witchy." You are advocating for your pt, for them to get the best care. Keep that forefront in your mind: "What is the best I can do for my pt?" And then fight for your pt. If you don't make it about yourself, and feeling you're getting dumped on, get riled up about the pt and what needs to be done for them.

Salter444 · Nov 14, 2014

The ED nurse should have done it, but bickering with her about this solves nothing. I would have informed the charge nurse of the situation and let him/her follow with the ED and I would have taken the patient for the test. When I came back I would have written up the incident and forwarded it to the manager/director.

Bottom line is conduct yourself in a professional manner and the primary concern is patient care. Let others deal with the ED nurse shirking her responsibility. If you were still down there when the next shift arrived they should have sent someone down to relieve you.

Here.I.Stand, BSN, RN · Nov 17, 2014

I don't like confrontation, but sometimes we have to be assertive because it's about what the pt needs--not about what is comfortable for us.

I'm not going to throw the ED nurse under the bus because you don't know what she was dealing with on her end. Sure maybe she was being lazy, but maybe someone was circling the drain and they were holding a bunch of demanding pts for the floor...and maybe she truly thought that passing that on to you would be best for all pts involved. Maybe she was supposed to be working from 0700-1500, or even 0300-1500 (We have hospitals in our area that have that kind of shift) and she was staying late by leaving at 1800. In any case, dwelling on that won't solve anything. And even if you were the most assertive nurse in your ICU, you can't "make" the ED nurse do anything.

I would ask your manager how she/he suggests you handle it in the future. And stop dropping hints when you want something. :yes:

suanna · Nov 18, 2014

I think you handled it fine. You don't know what was going on in ER. For all you know the nurse giving you report wasn't able to take the patient to MRI without risking other patients. You stayed over- (not OK without supervisor approv. at most hospitals), but you acted in the intrest of your patient. Confronting the ER nurse may have made you feel less dumped on, but it wouldn't have changed the patients need for an MRI. Sometimes you have to pick your battles and just get on with it. I can whine with the best of them- I rarely feel others are putting forth the effort I feel is required to work in a hospital, but I will rarely confront- It is more often than not a waste of my time and will do nothing to prevent the same thing from happening in the future. The only time I confront is when a patients wellbeing was put at risk and the person causing it was unaware of the seriousness of the situation.

CandiceNTexas · Nov 26, 2014

I work with a lot of new nurses, a lot of soft spoken nurses, and with nurses who are ESL. I feel sorry for them, because they get dumped on a lot!

Your post says that the order was put in AFTER the er nurse gave you report, as a stat order, the mri dept called the er, the er nurse probably thought, "I already gave report, the pt is being moved", and technically, it was a ccu order. That seems to be the fault of the doctor, and they often don't have any sense of how it will inconvenience nursing or delay treatment, etc.

You could have ASKED the er nurse if she would mind stopping at MRI, and offered to meet her in MRI to take the pt to icu, something I have done several times when the ED is slammed.

I will say, I do understand how you feel, but sometimes you will have to stand your ground, and confrontation, in a professional manner, may be needed. You may have to even question doctors, especially residents, or they will eat you for lunch! Your patient comes first, and they need you to speak up for them. You did a good job by taking the pt yourself, in spite of the way it happened.

Mouserabbit · Nov 29, 2014

I don't like confrontation and I am in the same situation as you are... I often find myself not fitting in the group and being isolated from other aggressive ICU nurses. I often go home and feel angry or frustrated because i felt that i spent way more time dealing with personal conflict rather than concentrating all the time focus on patient care... I am still struggling right now... just may not be as bad used to be, or as bad when I first started to work in ICU

delphine22 · Dec 8, 2014

Your post says that the order was put in AFTER the er nurse gave you report, as a stat order, the mri dept called the er, the er nurse probably thought, "I already gave report, the pt is being moved", and technically, it was a ccu order. That seems to be the fault of the doctor, and they often don't have any sense of how it will inconvenience nursing or delay treatment, etc.
You could have ASKED the er nurse if she would mind stopping at MRI, and offered to meet her in MRI to take the pt to icu, something I have done several times when the ED is slammed.

Both excellent points. I've spoken with some ED nurses that will absolutely not carry out an order that was written by the admitting physician, even if the pt is still in the ED. Here it helps to just ask nicely and directly, not use confrontation or drop hints. The offer to meet in MRI is a great one.