Looooooong rant... Condescending nurse... advice please!

Sabby_NC · Oct 12, 2007

Ahhhh you can go either way here eh?

I know what I would do. I personally cannot stand working where there is this undercurrent. I have to have the 'air' cleared.

So for me I would ask to speak with her in private and sort this out.

I am a team player and by the sounds of it you are too.

I would be asking her why she is jumping all over you etc. Ask for some positive comments and assistance AFTER ALL you are learning and I am sure she has lots of experience.

Use some honey and say. 'I am sure if you let me I could gain a lot of experience and knowledge from you'. Yeah I know makes you wanna vomit but heck if it works you are on ya way!!! :)

Hang in there hon :)

lupin · Oct 12, 2007

As a new ER nurse myself (only been there three months), I can definitely relate. I've been a floor nurse and a gero-nurse and neither are anything like being an ER nurse.

Having said that, I have run across the same situation during my orientation, too. There is a nurse who's worked ER for a year and is taking NP clinicals where I work. She can be a bit condescending and tends to bring her "multiple" personal problems to work all the time. She could be very bossy toward me at first, like, while I was sitting at the computer typing up d/c info for a pt and she was doing the same at a different computer, the phone rang while the unit clerk ran to the bathroom and she turns to me and says "pick that up please". Since I used to be a receptionist I was already getting ready to do that but afterward (yeah I'm a little slow to pick up on insults sometimes) I thought, "Who the he!! does she think she is telling me to pick up the phone?!?".

Anyway, what I did was ask my charge nurses and my supervisor how I was doing so far, had anyone expressed concern regarding my work, did they have any concerns, and so far everyone has reassured me I'm doing fine. Also, in conversation with this nurse, I found out she had thought I was a brandee-new nurse, right out of the package so to speak and when she found out that, uhh, yeah I do know some stuff, she backed off.

I also perused charts that other nurses had charted on so I could get a feel for how that charting went. I noticed that everyone charted if their pt was out of the room. For instance if you have a pt that has q2 hr vitals and the pt is at xray or in the bathroom or (more commonly) out smoking, right that down. "pt at Xray" or "pt out of room", so it shows that you did physically check on the pt, they were just not there.

Last but not least, ask her to show you how to do something if she's not busy. Bite the bullet and try to learn something from her. Nothing flatters people more than being made to feel important. This particular nurse had worked in peds and L&D, so the first time I had to stick a child, I asked her to walk me through it. She complimented me on "knowing when to ask for help". But I have learned very good peds skills from her and that was a bonus.

All things aside, if your managers and charge nurses think you're doing okay and don't have any complaints, I'd go with that. It's their job to tell you when there is a problem. Talking to her privately and asking for her help might get her off your back, but if she continues to recheck your charts specifically when she's not charge and look over your shoulder, then it needs to be taken up with management or charge. If she's not a manager or even a charge nurse over you for that shift, then she needs to focus on her pt's orders and not yours (as long as you are keeping up).

Last thing, when someone tries to talk down to you in front of others, just remember that 9 times out of 10, unless it is a dangerous problem with a pt, they don't usually care nor are they listening, esp. the docs. And only you can make you feel bad.

Good luck to you hon! I hope it all goes better for you!

steelcityrn, RN · Oct 12, 2007

Sounds like this person is a angry/bitter nurse. There are many angry nurses out there, but the bitter type that try to destroy people must be stopped. You need to call a meeting a.s.a.p. with your manager and maybe one from human resources to discuss the terrible situations that this person is putting you in(not to mention your license). Leaving that person to struggle to breath to watch and see you run in panic is cause for termination. I pray she changes her attitute before she becomes a crnp, and has even more power.

longjourneydream · Oct 12, 2007

hello,

i too am new to the er, not only that, i am a new grad!

i am the first one to come in to the er as a new grad, i have had some of the experiecnces that you talk about.

i will not give advice because as you know; good nurses do not give advice, just theraputic communicaton.

let me tell you how i feel, then maybe you can gather your own thoughts.

(going off theraputic communication now) :lol2:

i came to er 2 years ago as a 1st year nursing student,very complient aide and i was training as an er tech.

i was never formerly trained, due to two others coming down same time as myself, so i was left to fend for myself.

i was asked to perform on the fly with no knowlege, except 17years experience as an cna/pca.

i was treated badly and critisized, but i went on, day by day, because i really wanted to be a nurse and school was my main focus at the time, all other things were secondary.

things i was critized for were: i needed to become more proficient on the computer, in the main ed (they never scheduled me in the main ed, only once in a blue moon).

they said i did not know how to function in the main ed,

well, how could that be possible???

they said i could not draw blood properly.

charge nurse came down to watch me draw one day; no problem

ha ha !

then

i became a nurse in the main ed!

oh my

i have been working as an rn since june of this year.

since i have been off orientation, i have been feeling the pain.

they have taken all my mentors away and now i really feel the pain of the er.

i am not fast enough,smart enough, assertive enough, tactful enough, etc...

there are many that will say this is no environment for a new grad...

i have been told by many veteran nurses, i am being taken advantage of.

get them in and get them out, fast...

i'm not ready for fast yet!

i love many things about this job, but i do know that working 4 in a row of 12 hour shifts is not for me, because of a shortage.

it is the military in reverse, build them up(orientaton) then break them down(off orientation).

i have asked for more time with a mentor available at all times.

12 weeks, just is not enough time for a new grad in the ed.

i am getting more: mean,assertive,tactful, and even smarter, but i do have a long way to go.

er is a very hard place to work.

they have strong thick skinned personalities ; mostly type a.

much competition.

strong bonds (relationships)

group intimidation (calling out mistakes on the floor in front of everyone) i guess so all can learn from it.

one thing is for certain though.

it has to be a team effort.

everyone must work together.

have to be humble and ask for help, when needed.

listen to everyones advice; then decide to take it or leave it.

that has been the experience i have had for the past couple of years.

it has been humbling, but it has also been rewarding.

i love it and hate it...

i am finishing my orientation as a new employee in an er, and over the past couple of weeks i have been working alongside another nurse who, unlike literally everyone else, has not even bothered to do the friendly introduction. i love this place... everyone else has been so nice, helpful, welcoming, and willing to assist/answer questions whenever necessary.
this individual, however, seems to go out of her way to be insulting and condescending. she is a lead occasionally on nights when the other 2 assistant managers are off, and is a nurse practitioner student doing her clinicals at our er as well. i hate to take this personally, but there is a decent group of established staff that she seems fairly chummy with (though her personality in general is dry and kind of flat/blunted as well), and yet toward me individually she has developed an attitude i've honestly never encountered and can't quite read.
i'm still learning (i'm sure you'll have that as a new er nurse who's 6 weeks of orientation is, as of today, complete), so obviously i'm a tad slower than the more experienced rns. over the past couple weeks, when i have someone who is discharged, she has jumped on the opportunity to grab the chart while i'm finishing something else up and goes in and discharges my patients. i would think she was doing this to help me out in a kind way, however, she's kind of rude and cold to the patients, and when i walk in to see if i can finish up, she abruptly says "no, i did it" and when i show appreciation, genuinely saying things like, "thanks so much for your help -- i saw the discharge pop up on the screen and was finishing and then had planned to head right in here, but i appreciate you helping me out!" she doesn't have the decency to even say you're welcome -- nothing. she doesn't respond, and then walks away. what on earth?! a few days ago, i had 2 patients -- one of which came in with abd pain and vitals were stable, the other also abd pain but bp was around 100/50. i had been in the stable pt's room around 1945 to give her a pain med, and saw that the bp was going to be taken (by the machine) at 2000 (q2h vitals required in our er)... i had charted my last set of vitals at like 1810 so i figured i'd just let the machine take the next set at 2000 and i'd come in shortly after and check her pain after the med, and chart the vitals. in the meanwhile, the stable pt went to the bathroom (so she took off the bp cuff), and i was in checking on the other pt and took her bp finding it had dropped to 74/40. while dealing with this pt, i didn't make it in to check on my stable one for about 20 minutes or so, popped my head in and checked to see how her pain was, noticed the bp cuff was off, and didn't check her vitals but went back to do some more stuff with the hypotensive pt. when i finished, i went to the nurse's station to print off some things for the more stable pt that was going to be admitted, and as i was getting ready to go in her room to get a set of vitals prior to calling report, this nurse addresses me in front of several nurses and er docs, saying, "well amanda since you haven't gotten a set of vitals on your patient in room 10 in god only knows how long, why don't you just call report so we can get her out of here?" where this came from, or why she had nothing better to do than to check my charting, i have no idea. she wasn't lead, and we were pretty busy so i'm sure she could have been helping someone or taken one of however many admits were rolling in.
i blew off the remark, despite the fact that she was obviously trying to make me look bad in front of the other staff standing or sitting around, and continued doing what i had planned. at that time it was about 2100, so my patient went 3 instead of 2 hours without a set of vitals. i realize i screwed up by not going in exactly every 2 hours or less and physically making sure the patient was hooked up to the vitals machine, and that's my bad, but i guess i prioritized making sure my other patient didn't bottom out completely ahead of a set of routine vitals on a stable patient.
so after i call report on my stable pt that was admitted, i very casually mention to her what happened (why i didn't have my 2-hr vitals in for the last set), and i get a very motherly, "well, we can't always rely on machines, can we? patients do some funny things, but this is why you need to check on your patients every two hours," and on and on talking to me like i was a 6 year old child.
today, she jumped on one of my discharges literally within a few minutes of the discharge being put in the computer and rx/instructions being printed off by the doc. the patient was spanish-speaking and the translator was gone, so the only other people in the room were his mother and wife (both also only spanish-speaking). i had done fine with him his entire stay due to my being able to speak pretty decent spanish, and was looking forward to discharging him so i could make sure they understood everything. she went in and when i came in, the same cold detached attitude, and in english -- how can you stand there and have someone talking to you in spanish and not even stop and think maybe you should have someone there who can understand the patient to know if they have questions or even understand the instructions for when they go home???
then while i was drawing blood/starting an iv/giving insulin to a new pt later, she calls on the overhead pager for me -- i hit the call light in the room because i'm trying to get the j-loop connected and fill the tubes with blood... she tells me i have a new patient in room 2. i say "ok, thanks -- i still need to finish up in here" and *click*. i quickly finish what i'm doing (maybe 5-10 minutes including assessment, answering questions, sending stuff to lab), and go to room 2 to find my new patient has tears rolling down her face crying, unable to breathe, clearly stating she can't breathe, o2 sat is 87% with 2l of o2, and she's standing there over the pt trying to get the pt to hold a thermometer in her mouth for a temp (when the pt is clearly very sob, gasping and bawling and then trying to keep her mouth shut for the temp to take)....
and she'd been in there since the patient arrived and had been standing there waiting for me, when she could have been triaging the patient and maybe putting a non-rebreather on her or calling respiratory for a neb?
i'm just floored. i really don't like working with this chick, and part of me would like to just ignore her and hope whatever this issue is will go away... but i'm afraid it won't. the other part of me would like to flat out confront her and ask her what her problem is -- whether she's always this condescending and degrading, or if she just has a personal issue with me individually (and if so, what on earth is it?!). the other little hidden "i used to be a prison nurse" part of me wants to go all out gangsta and tell her to get off my freaking back! but, i am out on parole and now in a position where customer service and nicey-niceness are priority. so, the prison nurse has been tucked away. lol.
i know this is a super long rant, but i am so frustrated... i hate being treated like that, and in another situation i would definitely be uber-assertive (borderline aggressive) and not tolerate this at all, but being a new employee, not knowing who i can talk to in confidence and who belongs to what clique, i am just being the passive new rn.
this woman is just another staff rn, and on occasion she acts as lead when the 2 assistant managers (who both work 7p-7a) are off, so she works as lead 1 day a week... the other days she works, like tonight, she's just another rn like the rest of us, but oddly enough she doesn't take patients for what seems like forever. tonight she spent the majority of the night (when she wasn't a thorn in my side) sitting next to the lead rn, took no patients from 7pm all the way up until 1am when i left... i just don't get it -- 6 hours of playing lead when we already have a lead? what gives?!
how do i address this? i don't think she's going to be receptive of me taking her aside in private and asking if there's something i'm doing wrong or if i've done something to offend her (seeing as how we've never had a conversation outside of my team of patients i don't know how that's possible)..... should i mention this to my nurse manager or one of the mentors for us new employees? at least now i've vented to you guys -- i got 90% of my frustration out -- now i just have to take the other 10% and resolve the issue at work!
thanks for listening! even if no one listened, at least it's all typed out and i can rest without being irritated by this tonight!
-a

DoubleblessedRN, ADN, RN, EMT-B, EMT-P · Oct 12, 2007

I am sorry you are going through this. I can't give any advice to give but this is one of my fears when I get my RN. I feel comfortable with my skills and knowledge as a paramedic but I have never worked in the hospital before. It's the multi tasking and being organized is where I think I will have a problem. I hope it gets better for you.

bigsyis · Oct 12, 2007

i think you should not confront this woman alone. there is no telling how she would twist what you say when she repeats it back to the others she hangs out with. i agree that the air needs to be cleared-no question. is your preceptor/mentor a friend of hers? is there anyone there that has been there for a while but that doesn't seem to be tight with her? you may be better off not asking anyone on staff in er about her, but i think i would speak with your nm about this before she does. speak highly of those with whom you are impressed, and how well they have treated you. then, regretfully;), mention this thorn in your side but in such a way as not to point afinger or lay blame. something like, "i'm not sure if nurse sassypants is as sure of my abilities as the rest of the staff seem to be." this should open an avenue of conversation to enable you to share some of what you have been experiencing. choose your words carefully-if you, being new, know what a slacker she can be about taking pts, so do the nurses who have worked with her a lot longer. good luck with this.

if nurse sassypants was the angel she appears to be, she could have put the bp cuff back on the pt and reset the machine, or called for resp or the erp for the sob pt (or taken her temp in her ear!). it sounds to me as though she is one of those insecure people who tries to make herself look bigger by stepping onto folks that she perceives are weaker than her. she doesn't know what she stepped on this time, huh?

RNcDreams · Oct 12, 2007

I feel your pain!

I am a new graduate in the ED, and there is one nurse in particular who behaves quite similarly to the one you describe... (skip to the last paragraph if my stories are too long hahaha)

Her first encounter with me was when I was still a Senior in my BSN program during my preceptorship there. She picked up a patient from my preceptor and I, and long story short, I had not yet learned the importance of setting the monitor to go off every 15 mins, 30 mins, etc. In the end, she found herself 4 hours into the shift with no vitals... which to me, means she didn't bother to check them for 4 hours...

but anyway, we have had a few encounters since then (now that I am a new RN there in the new grad program), during all of which I have made an error...

One such error was that I sent a blood bank tube with a regular label on it, because I wanted to save it for a later T/S sample... no one ever told me they will trash it unless it has a special label on it.. and she came up to me in the middle of the trauma room, while we were inserting a TC pacer, and said, with no expression on her face, "Did you sent a pink top on this man? It was disposed of because it was labeled improperly." and walked away. I turned purple... I know how you feel.

Recently, I called the pharmacy for some fluid with K in it, and she somehow got it before I did.. and would you like to know how she gave it to me? She threw it on the counter next to the chart I was writing on and walked away, without a word.

On another instance, a nurse who works in the ED came in with her husband who was having vertigo, and he needed a line for some fluid. he had very, very large veins. The triage nurse said to me, "Hey can you go throw a line in him?" and I said sure... and the evil nurse, in earshot, runs over and says "Where are you going?? No, no... one of us should do it."

Clearly, she finds me to be incompetent. Recently, I tried the tactic of asking her for advice, to make her feel important. She still would not make eye contact, and would only muster a mumble. I like to think it helped, but I have a feeling she is set in her ways and could care less whether or not we are on good terms.

We are not working to kiss other people's rear ends and make them feel powerful.. we are working to make a decent living, be professional, and to contribute positively to a team of other nurses, with the overall goal of practicing safe, competent, nursing. We are there for the patients, not to boost ego's.

I decided AGAINST speaking to this woman in private, for a variety of reasons:

1. I know in my head and heart that she is an excellent nurse clinically... that means the patients she cares for are safe, and that's all that matters.

2. Her life does not change if we are on bad terms; I'm the only one whose upset; I am giving her power by letting her make me feel bad and doubt myself

3. She has clout. She's been doing this for 25ish years... the ramifications of her complaining about me could be paramount if I pull her aside and imply that her behavior is less than desirable.

4. Not everyone is going to like you, end of story. Every job you take will entail a coworker who has it out for you...

My plan is just to press on, improve upon my skills, and prove to be a strong team member through my care.

Best of luck, and do not let her get to you!!

P.S.

If patients are in danger because of it, then you must speak up, but consider doing so anonymously or with your nurse manager in private, and do not mention that you think she has it out for you. Document what you see/what happens, provide objective explanations and examples, and follow the chain of command professionally.

alkaleidi · Oct 13, 2007

Thanks everyone for your responses. My nurse manager and the assistant managers have come up to me several times a week over the course of my orientation asking how I'm doing, to which I generally respond "I think I'm doing ok!" and then they say really encouraging (and hopefully true *crossed fingers*) things like "Well I've heard you're doing really well" or "I hear you're doing great!" or "Well the way people talk about you, you're catching on really fast and are doing fantastic" -- all very complimentary and speaking highly of me, which is nice to hear. So I don't think this single individual's perception has in any way influenced my "real" supervisor's opinions.

That said... my biggest annoyance with the whole taking it upon herself to discharge my patients when I'm not even swamped, busy, or worse yet drowning with other things to do is that she doesn't even ASK if she can help. It would be different if she, like EVERYONE else that has ever discharged a patient for me, would poke her head in the room I'm in and just ask, "Hey, your pt in room 5 was discharged -- do you mind if I finish up and let them go so we can clean the room?" or something similar...

One of my pts that she discharged was a pregnant woman that was on the verge of preeclampsia, incredibly stressed because she and her family had just moved to town and she had been living with her aunt but her aunt had drama at the house and kicked her and her kids and nephew out... so they're living out of a hotel, and she's crying. I told her I would give her some information re: places, organizations, services that could really help her... she's worried about the baby and her kids, etc. She was really grateful when I said that we could try and help her, and at least refer her to some places... well needless to say when jerkhead booted her out while I was with another patient, I didn't get the opportunity to do that. I felt really bad, and was like Ok, now I can't even mail stuff because who knows what hotel they're staying at... AUGH!

I don't let it show at work because I generally don't let people get to me because I'm very laid back and realize that when people try to insult you or make you look bad, it's just a tactic to try and create a false sense of self-confidence for themselves... and I'm trying really hard to not be sarcastic and nasty when I kindly tell her to back off/leave my patients alone/ASK before you do something for me.

Again......... thanks so much for "listening"! :)

alkaleidi · Oct 13, 2007

I pray she changes her attitute before she becomes a crnp, and has even more power.

YES. This was my other thought. She acts cold and distant to the patients, as if they're simply categorized by their diagnosis instead of their name or person... reminds me of "Patch Adams," and how the little residents run around assessing people but not actually ASSESSING people. There's no holistic approach whatsoever -- I realize the ER is busy, but not too busy to take the time to call your patient by name or be slightly kind, warm, and understanding.

rjflyn, ASN, RN · Oct 13, 2007

This is part of the first sentence of your whole post "I am finishing my orientation as a new employee in an ER,"

Where is your preceptor? At 6 wks in the ED they should still be fairly close to you and if not why? They should be the first person you should be talking to. Next would be the both of you going to management it that treatment continues.

Rj

cousx2 · Oct 14, 2007

I had to check to see your location to make sure you weren't working in my ED! Your experience is so similar to mine. I'm a new nurse in the ED too dealing with similar situations. I'm sorry I don't have any advice to give since I haven't figured out how to deal with it. I just wanted you to know that I can definitely feel your pain and empathize with your situation. Hang in there.