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

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I am quite soft spoken by nature and a guy. English is also my second language so sometimes I am not that quick to respond back to people verbally or it would sound quite hard to understand with my accent. I also always try to be polite and avoid any confrontation. Fellow nurses love me and enjoy working with me, but I am not sure I stand as reliable to them because of this.

I have ran into situations that because of my reluctance and communication style I have had to take it for the team yet people think of me as ineptitude.

For example, the other day I had to take my pt to MRI at the change of shift and stayed super late. Charge nurse thought I did not know how to manage my time. But the reality was I got dumbed on by the ER nurse. The MRI STAT was put in just a minute after she gave me report. I noticed it on the computer and called her back and tried to give hint by saying "Is there any order for MRI and CT?". I was hoping she would see it and do MRI before transferring the pt to me. Apparently she told the MRI techs when they called that the ICU nurse would do it (I confirmed with the MRI tech later for this). She pulled an attitude and pretended that she was not aware of the order and made it like I was incompetent to not able to confirm c the docs by myself. Then, 15min later, she transferred the pt and left at 1800. MRI closed early on that day at 1930 and I had to do it because I did not want to dumb the same thing to my relieve or delayed care to my pt. Some of the headstrong nurses on the floor told me I should have just confronted her and made the ER nurse to do it because it was really her duty, or told the MD that I could not get the MRI in on time and let them decide.

It's just an instance, there are several more cases that I feel like I got push-overed. And I am annoyed. At the same time, I don't want to become that nurse who just barks at any one that gets in his or her way. Due to my "style", I feel like charge nurses on the floor don't trust me as much anymore and tend not to give me crashing patients. They are afraid I can't handle it.

Obviously this is an opportunity for me to learn and improve here. But at the same time, I wonder if those "nice & soft" nurses would survive ICU in the long run, or eventually they have to change. Because a lot of the "assertive" nurses on my floor to be frank are quite ....."witchy" and I am not at their levels. ^^

icuRNmaggie, BSN, RN

Specializes in MICU, SICU, CICU. Has 24 years experience.

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

Specializes in Quality, Cardiac Stepdown, MICU. Has 5 years experience.

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.

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

Specializes in SICU, trauma, neuro. Has 16 years experience.

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

Specializes in Post Anesthesia. Has 30 years experience.

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.

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.

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

Specializes in Quality, Cardiac Stepdown, MICU. Has 5 years experience.

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.