Issues with a nurse who eat their young!

nursingpower · Apr 29, 2009

Hey there. This is my first time posting on the MICU blog. I graduated from my BSN May of 2008 and landed a job in a 14 bed Medical ICU with a 4 bed Neuro ICU. I started nights there and switched within 5 months because I like living in the day light lol Anyhow there are a couple of nurses on nights that are impossible to give report too. They are not rude to any of the day nurses that have been there for years but they always feel like it is their right to give the new grads a hard time. Well yesterday I had to give report to one of these nurses. The unit itself was really busy alot of transfers and admissions so I tried to help everyone out. I had Q 1 hour neuro checks and my other pt was on bipap and would desat very easily he was also in AFIB and as the day progressed his heartrate started going up into the 130-150s. By 1850 the doctor finally comes up to the unit and I tell him that I think we need to switch his PO Cardizem and start him on a Cardizem gtt. He agreed and wrote bolus 5 mg now and start gtt at 10 mg/hr and titrate to keep heartrate 70-100. Before the doctor was up on the floor I had already pulled out my 1800 meds and had already given my meds to my bipap pt but not to my other pt. I dont know how it is for you guys but we have an hour before and an hour after to give our meds. By this point the night shift nurse had showed up so I thought I would just go ahead and mix the cardizem gtt and bolus him. She goes mix the gtt 25 mg in a 50 cc NS bag. As I was at the pyxis I figured to make it easier Id mix 100 mg in a 100 cc bag since he gets 10 mg/hr and make it an easy 1:1 ratio (also it takes our pharmacy FOREVER to bring us our meds). I asked the chargre nurse and she said that was fine. So I went and found an extra pump and hung the gtt. The nurse sees the gtt and goes, "WHY DIDNT YOU LISTINE TO ME AND MIX 25 MG IN A 50 CC BAG! YOU JUST WAISTED ALL THAT CARDIZEM! PHARMACY IS GOING TO COME UP AND BRING A NEW BAG! YOU SHOULD HAVE JUST LISTINED!" So I responded, "I made it an easy 1:1 ratio for you, plus just call pharmacy and tell them not to bring up the extra gtt unless you order one later." Then she says "WHATEVER!" So then I go and grab my other pt's meds and I go do you want me to update you on the pt's first and give these meds after (I had given her report yesterday, doING report would only take 10 mins) and she goes, "NO GIVE THOSE MEDS NOW YOU ARE ALREADY LATE IT IS 1915 JUST GIVE THEM NOW! So I give them but I told her that we have an hour before and an hour after but it didn't matter to her. After the meds I gave report and she pretty much didn't say two words to me. Anyhow I don't know how many times I've seen other nurses go and pull 1800 meds at 1900. Plus if she was so concerned about the meds she could have been nice and given them while I was mixing the gtt for her. So I guess my question is was I in the wrong? And should I speak to my manager b/c this has been an ongoing problem for awhile now and these nurses are part of the reason why I switched to days. Sorry this is sooo long!

I think her attitude sucks but to be honest, when she asked you to mix it how she wanted it I probably would have done it how she wanted it done. You were leaving. You should have let her deal with the ratios. It almost seems as if you went out of the way to not do her simple request. It seems as if you took more time to ask the charge nurse about the reconstitution methods.

It seems that you believed that ratios were more important than conservation of resources. With an order of 10mg/hr with a 25mg/50ml bag it would have taken 2.5 hours to dispense. If the pt would have converted his/her rhythm or HR dropped due to the drip in less than 2.5 hours then you would have only wasted less than 25mg. I hope it doesn't take your pharmacy over 2 hours to bring up meds to an ICU!! Please don't say that..lol.

Anyways, I agree with that nurse with you wasting so much meds when the pharmacy was sending a bag up anyways. The reason why meds cost so much is because of this imbalance in supply and demand. We as nurses should be conscientious about healthcare/medication costs and properly using our resources.

I mean you didn't do much wrong but you succeeded in irritating her for no reason besides some convienence to yourself that you wasn't going to be around to see. This situation doesn't seem like what I would consider "nurses eating their young". I don't like being disrespected by anybody, especially if I show respect. So I know what you mean by that. Maybe she could have been more professional in her demeanor. I wouldn't be upset about someone not talking to me while giving report...lol. As long as you did what you had to do to care for your patient during your shift you transfer responsiblities during report. She assumes care of the patient. If she decides to not speak that is her perrogative. I am sure she listened to you and if she had any questons she could refer to the chart.

Oh yeah, please don't run to the manager about something like this. Always try to work things out with your coworker first and foremost. Maybe you should swallow some pride and ask to speak to her one day. Saying something like, "Look, I think we started off on the wrong foot. I know we have different views/opinions on things but we have one thing in common: our patients and their wellbeing. It's for that reason that I would like to start over with you. I would like to use you as a resource. Do you think that is possible?" Listen to her and she what she has to say and take it from there.

I am a Dec 2008 new grad. My gig now is CVICU. I get along with people because I listen and I am professional and respectful. But if I did get off to a bad start with any one person, I would do the very same thing I suggested to you. The sooner the better.

Good luck!

RN1982 · Apr 29, 2009

I am sorry your co-worker said that to you. It wasn't necessary for her to do that to get her point across. I think you should approach your co-worker and tell you that you did not appreciate the way she spoke to you. If she continues to display this type of nasty behavior towards you I would speak with management. You need to stand up for yourself. You don't have to take her crap.

The next time something like this happens, hand her the meds and say goodbye.

cloister · May 1, 2009

I think her attitude sucks but to be honest, when she asked you to mix it how she wanted it I probably would have done it how she wanted it done. You were leaving. You should have let her deal with the ratios. It almost seems as if you went out of the way to not do her simple request. It seems as if you took more time to ask the charge nurse about the reconstitution methods.
It seems that you believed that ratios were more important than conservation of resources. With an order of 10mg/hr with a 25mg/50ml bag it would have taken 2.5 hours to dispense. If the pt would have converted his/her rhythm or HR dropped due to the drip in less than 2.5 hours then you would have only wasted less than 25mg. I hope it doesn't take your pharmacy over 2 hours to bring up meds to an ICU!! Please don't say that..lol.
Anyways, I agree with that nurse with you wasting so much meds when the pharmacy was sending a bag up anyways. The reason why meds cost so much is because of this imbalance in supply and demand. We as nurses should be conscientious about healthcare/medication costs and properly using our resources.
I mean you didn't do much wrong but you succeeded in irritating her for no reason besides some convienence to yourself that you wasn't going to be around to see. This situation doesn't seem like what I would consider "nurses eating their young". I don't like being disrespected by anybody, especially if I show respect. So I know what you mean by that. Maybe she could have been more professional in her demeanor. I wouldn't be upset about someone not talking to me while giving report...lol. As long as you did what you had to do to care for your patient during your shift you transfer responsiblities during report. She assumes care of the patient. If she decides to not speak that is her perrogative. I am sure she listened to you and if she had any questons she could refer to the chart.
Oh yeah, please don't run to the manager about something like this. Always try to work things out with your coworker first and foremost. Maybe you should swallow some pride and ask to speak to her one day. Saying something like, "Look, I think we started off on the wrong foot. I know we have different views/opinions on things but we have one thing in common: our patients and their wellbeing. It's for that reason that I would like to start over with you. I would like to use you as a resource. Do you think that is possible?" Listen to her and she what she has to say and take it from there.
I am a Dec 2008 new grad. My gig now is CVICU. I get along with people because I listen and I am professional and respectful. But if I did get off to a bad start with any one person, I would do the very same thing I suggested to you. The sooner the better.
Good luck!

Ummm......I think perhaps you're missing the point of what the OP was trying to convey.

Mixing the drip one way or another is not the issue here. In any event, she checked with her charge nurse, so that she made sure that she was doing it correctly. As far as the cost goes, hey, if she was worried, she could have called the pharmacy and cancelled the drip. It's not rocket science.

The night nurse had no reason to be rude to her for what she did. Hey, she stayed over to try to make it right. Had it been me, receiving attitude from this individual, I'd have been sorely tempted to remind her that there are 24 hours in a nursing day, and my hours were now officially over. (I said tempted. I didn't say that I would actually do that.....)

I agree with the poster who told you to be empathetic, but firm. "Hey, I know this is a busy assignment, but I did my best, and I'd ask you to please not speak to me like this. Now, is there anything I can do to make it easier for you to get started?"

Look them in the eye when you do it. A lot of times, that's all it takes.

We all get frustrated with each other from time to time. It's tempting to roll the eyes and sigh when starting with a cluster in the evening. I have to remind myself, however, that I'm not God's gift to critical care and sometimes I really leave a mess for the next person. I appreciate it when they extend me some grace and don't berate me. I do the same for them after a bad day. We have to support each other.

nursingpower · May 3, 2009

Ummm......I think perhaps you're missing the point of what the OP was trying to convey.
Mixing the drip one way or another is not the issue here. In any event, she checked with her charge nurse, so that she made sure that she was doing it correctly. As far as the cost goes, hey, if she was worried, she could have called the pharmacy and cancelled the drip. It's not rocket science.
The night nurse had no reason to be rude to her for what she did. Hey, she stayed over to try to make it right. Had it been me, receiving attitude from this individual, I'd have been sorely tempted to remind her that there are 24 hours in a nursing day, and my hours were now officially over. (I said tempted. I didn't say that I would actually do that.....)
I agree with the poster who told you to be empathetic, but firm. "Hey, I know this is a busy assignment, but I did my best, and I'd ask you to please not speak to me like this. Now, is there anything I can do to make it easier for you to get started?"
Look them in the eye when you do it. A lot of times, that's all it takes.
We all get frustrated with each other from time to time. It's tempting to roll the eyes and sigh when starting with a cluster in the evening. I have to remind myself, however, that I'm not God's gift to critical care and sometimes I really leave a mess for the next person. I appreciate it when they extend me some grace and don't berate me. I do the same for them after a bad day. We have to support each other.

I don't think I am missing the point at all. The OP came to allnursing.com forums to get a different perspective on the situation. I gave my perspective. Sorry but opinions are like A-Holes. Everybody has one. So don't expect mines to be like yours. You think what you want and I will do the same.

I never excused the other nurses attitude. Maybe you skipped over the part where I said, "I think her attitude sucks..." So it really wasn't necessary for you to give the whole spill about her attitude. That is your mistake for half reading my response. I also don't excuse wasting resources, which I see you as a nurse don't care too much about. Even if she had of called the Pharmacy to cancell the med the whole point was that you never know if that pt would have needed that whole bag. You don't know if Pharmacy made the bag or not. If it was due at 1900, it probably was made already by change of shift.

In my honest opinion, I seen wrong on both sides. Really I think its a communication problem between the two. The whole problem is that people tend to take sides instead of looking at things from the other person's perspective and

I choose to look at why the other nurse got upset to begin with. We may not condone or agree with other people. We can't change how other people think, act or react but we certainly can modify our our own behavior to illicit or inhibit certain responses from people. That's just life.

It's funny how you say that mixing the drip was not an issue but that is why the other nurse got mad and specifically made a complaint about. You may choose to ignore the response but then that is why the person got disrespected and felt compelled to post to this forum.

highlandlass1592, BSN, RN · May 3, 2009

I don't think I am missing the point at all. The OP came to allnursing.com forums to get a different perspective on the situation. I gave my perspective. Sorry but opinions are like A-Holes. Everybody has one. So don't expect mines to be like yours. You think what you want and I will do the same.
I never excused the other nurses attitude. Maybe you skipped over the part where I said, "I think her attitude sucks..." So it really wasn't necessary for you to give the whole spill about her attitude. That is your mistake for half reading my response. I also don't excuse wasting resources, which I see you as a nurse don't care too much about. Even if she had of called the Pharmacy to cancell the med the whole point was that you never know if that pt would have needed that whole bag. You don't know if Pharmacy made the bag or not. If it was due at 1900, it probably was made already by change of shift.
In my honest opinion, I seen wrong on both sides. Really I think its a communication problem between the two. The whole problem is that people tend to take sides instead of looking at things from the other person's perspective and
I choose to look at why the other nurse got upset to begin with. We may not condone or agree with other people. We can't change how other people think, act or react but we certainly can modify our our own behavior to illicit or inhibit certain responses from people. That's just life.
It's funny how you say that mixing the drip was not an issue but that is why the other nurse got mad and specifically made a complaint about. You may choose to ignore the response but then that is why the person got disrespected and felt compelled to post to this forum.

Hmmm...and your opinion is based upon your vast years of experience. Wasting resources huh? That seems to be a big point with you. You are right about one thing though..we certainly can't change others, we can only change ourselves. And your posts come across as being a bit harsh and judgemental.

Freedom42 · May 3, 2009

I'm a new grad. I have to give report every morning to a nurse who loves to be miserable. Every report is met with criticism and complaints. She loves to find fault. If I were 22, I'd probably find her discouraging and intimidating. I'm 46. I find her boring and tiresome or hilarious, depending on how bad my shift has been. She has no problem launching an attack on other people's work when she has no idea about the circumstances.

As a new grad, I've found that silence works wonders. When this nurse decides to start ranting and raving, I don't respond. If she doesn't want to know why something is the way it is, I don't volunteer the information. Eventually she figures out that everyone is staring at her during her little tantrum, and she stops talking. I sometimes find it hard not to start laughing. But her attacks are fewer and fewer between.

I agree with other posters about how to handle the situation. If my problem with this nurse persists, I will confront her directly -- calmly, out of earshot of our coworkers, in a private setting. If that doesn't work, then I'll go to my supervisor. Because I know the first thing a good manager will ask is if I've tried to work out the problem myself. And if that doesn't work? Then the problem is with management, not the individual nurse who's allowed to

continue her bullying ways.

cloister · May 3, 2009

Sounds like you know how to deal with this mensch. You're right on both counts, the silence, and the age factor. It's GOOD to be 40+........

Nursingpower, I gather from your previous post that I have offended you, and if that is so, I apologize. My main point, which I obviously fumbled, was that the OP shouldn't have met with that kind of behavior from the night nurse, regardless of how she mixed the drip or handled the situation. I have unfortunately seen a lot of this kind of behavior in the ICU, and I feel strongly that professional nurses shouldn't behave this way toward their colleagues. It would appear that I didn't communicate this well, however, and again, I apologize.

Freedom42, I agree with your tactics and only wish that more of our newer staff had your wisdom and maturity. It's hard to be new and young when one of the "old guard" gets you in their sights. We've had folks leave the unit over this kind of stuff. It's a real problem.

Freedom42 · May 3, 2009

No doubt it is a problem. It's too bad that some managers don't recognize that bullies cannot be tolerated, no matter how good the rest of their performance, no matter how much their seniority, because the cost of keeping them is far too high. I think that some of these managers who fail to act ironically believe that taking action would be too much of a headache.

nursingpower · May 4, 2009

Hmmm...and your opinion is based upon your vast years of experience. Wasting resources huh? That seems to be a big point with you. You are right about one thing though..we certainly can't change others, we can only change ourselves. And your posts come across as being a bit harsh and judgemental.

Hmmmm....vast years of experience doesn't always reap common sense either. You know nothing of my experiences. Maybe you wish you did. Well, my intent was to respond to the OP. I have done that. Your opinions about how my post came across is irrelevant to me. Have a nice day senior.

nursingpower · May 4, 2009

Sounds like you know how to deal with this mensch. You're right on both counts, the silence, and the age factor. It's GOOD to be 40+........
Nursingpower, I gather from your previous post that I have offended you, and if that is so, I apologize. My main point, which I obviously fumbled, was that the OP shouldn't have met with that kind of behavior from the night nurse, regardless of how she mixed the drip or handled the situation. I have unfortunately seen a lot of this kind of behavior in the ICU, and I feel strongly that professional nurses shouldn't behave this way toward their colleagues. It would appear that I didn't communicate this well, however, and again, I apologize.
Freedom42, I agree with your tactics and only wish that more of our newer staff had your wisdom and maturity. It's hard to be new and young when one of the "old guard" gets you in their sights. We've had folks leave the unit over this kind of stuff. It's a real problem.

Not offended at all. As I stated before, I never agreed with that type of attitude. It doesn't just happen in the ICU, it happens in life. We will always run across people who give attitudes for no reason. We can only control our own reactions. I know one thing I don't think I would go above and beyond trying to do favors for someone who doesn't appreciate it.

organichombre, ADN, BSN, MSN, LPN, RN · May 27, 2009

Go directly to the manager. Smack that idiot around a bit first but...

As a male in the nursing profession I see crap like this all the time and it never fails to tick me off. This person is a burnout, short and simple and needs to find another job! Good luck and keep on truckin'