I've Had Absolutely ENOUGH And I Cannot Believe The Managers I work Under!

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So let me start with last shift. One of the assistant managers told me she had to speak to me regarding my ''documentation'' so now I'm thinking what now? Over the last few months I've made it a habit to have excellent documentation and even in my last evaluation which was 2 weeks ago they said my documentation was good.

So getting right to it. She wanted to give me a verbal warning because during her ''chart review'' she found that a second set of cardiac enzymes was not drawn on a patient. Ok understandable. So I asked did the patient decompensate? No she said, the patient was fine, but she still needed to basically write me up about this. And might I add I had this patient a week ago. I had to stop and think and comb through the chart to remember who this patient was and what she was here for.

Then the second complaint was that I did not do my double charting. Yes they want us to double chart. They want us to chart in one computer system, then re-chart in another computer software system after the patient is admitted, and although I did two complete and spot on assessments of the patient within 10 hours (patient was completely stable) I still deserved to be reprimanded because I did not do my ''double charting" as I call it.

Now I already received a ''verbal warning'' because once again during a ''chart review'' the manager said I had no focused assessment of the patient, which was wrong. She failed to read the entire chart and looked over where I documented my focused assessment, but she was still able to ''get me'' on the write up because the patient was under ICU evaluation. Mind you the patient (who was to be an ICU eval because she vomited a small amount of blood twice at home, none on my time, completely hemo stable, and A&O) This occured during shift change and the patient had become an ICU eval literally 45-60 minutes prior to shift change and I was scrambling around trying to make sure she was on fluids, med drips etc.. but I had stopped to give report, therefore I was not able to placed the patient of the monitor, BUT a full report was endorsed to the evening nurse.

So on this second write up I'd just had enough. This time I had to have my delegate present. The delegate was peeved. She said do you know how many times this happens? You might as well write everyone up! She said she knew plenty of nurses that committed the same mistake and where was their write up, why weren't they sitting in the office as well?

It seems as though they love ''reviewing my charts'' and finding anything to bring up to me.

Now I understand being warned for something, but both patients NEVER decompensated, both were actually completely stable.

To be honest I just feel so terrible. I work in a crazy busy level 1 ER, where we get up to 14 patients sometimes, some of them being critical, intubated, hypotensive. Literally every shift I give 110%. I can understand if the patients decompensated, I'd take fully responsibility,but honestly I feel as though since I'm not a favorite of theirs, they try to ''get me'' you know?

This is the same place who gave new grad nurses (myself being one) only 2 weeks of unit training before throwing us on our own. I NEVER had anything major happen to a patient that was directly my fault, I've never suffered from the big mistakes a new grad can make working in a high pressure area, but yet it's as if they can still find something to slap in my face.

I am appauled at the way management treats there own nurses here. You get no credit, no respect, but if you do anything wrong, BAAM, like lightning they catch you. What kind of environment is this to work in?

I'm seeing more and more who they want to succeed and who they are trying to tear down. Nurses come and go here often.

I just cannot believe they are really picking at straws. No other of the new grads I started with have had verbal warnings for this type of stuff. Favoritism is big there.

The managers literally snoop around and pick on nurses, what is wrong, was wasn't done, etc...

I am more floored than anything, I cannot believe this.

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Do you think you are being watched? Talk to somebody you trust... find out.

If you are, hang it up and find another job.

Were there orders for a second set of enzymes? Or are you expected to obtain them?

Putting the patient on the monitor is actually your first priority. I'm sure you won't forget that again.

Sigh.... nursing sux.

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Specializes in ICU, Telemetry.

Actually, that's what's nursing like. Doesn't make it right, but this is reality. I had a nurse who routinely messed up heparin drips, including one woman who ended up having an MI after a hemorrhagic bleed from a dialysis cath dropped her so hypotensive she had an arrest -- we literally couldn't get fluids in her fast enough, she went into HIT, and even protamine didn't fix it. She eventually died. I wrote an incident report, as she'd never pulled the first PTT -- I walked thru the door, turned around and ordered a stat PTT and called the MD. PTT> 250. No charting on how much heparin she'd been given, and an empty sack was in the trash, despite the patient just getting there that morning. Did she confuse the tracts in the IV pump and run the heparin in at 100cc/hr? The NS back only had about 50 ccs out of it for all day. She was reported to the BON by the charge nurse, but the facility made a few phone calls and nothing was done.

That nurse was promoted to charge nurse. There ya go.

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Specializes in Neuro ICU and Med Surg.

I agree placing the monitor is first priority. Were the second cardiac enzymes ordered or were they just expected? If no order then you did nothing wrong. You aren't a mind reader. In my ICU it is an expectation that everyone gets an ABG if vented, and all pts get a CBC w/diff, and lytes,mg,and phos.

If you feel you are being watched then maybe it is best to get out of dodge while the getting is good.

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

Time to see the writing on the wall. The very best time to look for another job is while you still have a job. Now is the time for you.

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Yes I have learned from them mistakes, but the fact that no other nurse I started with has this issue makes me suspicious. Also the fact that I and other nurses have seen other nurses make this mistake and we know they haven't been disciplined over it.

I don't understand I am an excellent worker, I work well, do not complain, and have no major incidents. Like I said I can understand if the patients decompensated, I would have appreciated if I was brought aside and advised certain things instead of paperwork going in my file.

One thing I wholeheardedly disagree with is the double documenting, that is where mistakes arise.

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In reality the job market is tough, and I need the experience, I need atleast another year to feel comfy to move on, so far I am doing well, they haven't brought up any major issues with me, it seems they are looking at what I do through a magnifying glass.

I think alot of is is also race based, but I won't get into that.

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Actually, that's what's nursing like. Doesn't make it right, but this is reality. I had a nurse who routinely messed up heparin drips, including one woman who ended up having an MI after a hemorrhagic bleed from a dialysis cath dropped her so hypotensive she had an arrest -- we literally couldn't get fluids in her fast enough, she went into HIT, and even protamine didn't fix it. She eventually died. I wrote an incident report, as she'd never pulled the first PTT -- I walked thru the door, turned around and ordered a stat PTT and called the MD. PTT> 250. No charting on how much heparin she'd been given, and an empty sack was in the trash, despite the patient just getting there that morning. Did she confuse the tracts in the IV pump and run the heparin in at 100cc/hr? The NS back only had about 50 ccs out of it for all day. She was reported to the BON by the charge nurse, but the facility made a few phone calls and nothing was done.

That nurse was promoted to charge nurse. There ya go.

I understand what you're saying although I think this is a bit different from my situations in that the patient was not harmed, which is my FIRST priority. But I definitely understand the example you gave.

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Specializes in Critical Care.

This is what nursing is like for many people. If your a pet you can get away with anything and if they don't like you they can write you up for the pettiest things. And now with the big brother computer it makes it even easier for them to do this.

Just do your best and be on the lookout for a better job if need be. Hopefully the manager will move on and leave you alone or have enough other work to keep her busy.

Funny thing is I've never seen this type of petty harassment in other job I've done outside of nursing. I feel sorry for people who have not worked outside of nursing and think every job is like this and it is not!

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Specializes in Intermediate care.
Actually, that's what's nursing like. Doesn't make it right, but this is reality. I had a nurse who routinely messed up heparin drips, including one woman who ended up having an MI after a hemorrhagic bleed from a dialysis cath dropped her so hypotensive she had an arrest -- we literally couldn't get fluids in her fast enough, she went into HIT, and even protamine didn't fix it. She eventually died. I wrote an incident report, as she'd never pulled the first PTT -- I walked thru the door, turned around and ordered a stat PTT and called the MD. PTT> 250. No charting on how much heparin she'd been given, and an empty sack was in the trash, despite the patient just getting there that morning. Did she confuse the tracts in the IV pump and run the heparin in at 100cc/hr? The NS back only had about 50 ccs out of it for all day. She was reported to the BON by the charge nurse, but the facility made a few phone calls and nothing was done.

That nurse was promoted to charge nurse. There ya go.

wow.....all i can say!

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Specializes in Gen peds,ER,Retail medicine, peds heme.

Double charting is a liability, I say this all the time at work. We will soon implement an electronic medical charting system that will eliminate the whole double charting thing. It is a waste of time and, again, a huge liability. Caregivers need to have patient info in one place that is accessible. We shouldn't waste our time looking for paper charts, clinic charts or spending time charting the same thing in a gazillion different places!!!

Sorry, major pet peeve of mine. I hate inefficiency

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"Yes I have learned from them mistakes, but the fact that no other nurse I started with has this issue makes me suspicious. Also the fact that I and other nurses have seen other nurses make this mistake and we know they haven't been disciplined over it. "

Do you have access to discplinary files? Maybe one of the people you are discussing these things with is going behind your back?

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