maybe I wasn't being nice.....

[hearthelper]

So, maybe I wasn't being nice to my fellow coworkers, but common on we need to be a little more intelligent about our decisions. I work in ICU and had transferred my pt out of the unit to the Med/Surg floor when about 2 hours of her leaving she went into SVT with a HR around 200 (which I could see the second she went into it b/c we watch the telemetry for the hospital in ICU.) So, I watched the monitor for about 3-5 minutes (the telemetry tech notified them as soon as the pt went into SVT) hoping that they were going to turn her around but instead they called a rapid response. So, I went straight to the room to find 4 nurses standing around the pt, who was asymptomatic and stable. They did have the crash cart in the room, the BP machine on pt but the most important thing that no one had done was to notify the DOCTOR so you can get some orders for some meds, or I guess we could all just stand around her until crapped out on us!! At this point the pt had a HR of 200 for 10-15 minutes. I called the MD got orders and we converted the pt. Afterwards, one of the nurses overheard me being critical of their response to the pt and I know I should not have done that and I do feel bad for cracking jokes about them. This is a typical expected reaction on the med/surg floor and it happens too often. We are all nurses and all been taught the same principal things for ACLS response to a pt in SVT and they did act appropriately with a majority of the event but why wouldn't you call the MD as soon as you know your pt is in SVT??

[diligent-trooper]

I believe you are being overly critical. I also believe you are arrogant. Medical/Surgical usually has stable patients, so they are not use to the initial steps. I noticed you have 6 months of experience(assuming this is ICU), which makes you an expert.

[grandmawrinkle]

I believe you are being overly critical. I also believe you are arrogant. Medical/Surgical usually has stable patients, so they are not use to the initial steps. I noticed you have 6 months of experience(assuming this is ICU), which makes you an expert.

I don't think so. If you take monitors on your floor, you need to know ACLS and what to do in an emergency or ACLS situation. 4 nurses standing around the bed is just plain dumb.

Cracking jokes, however, was uncalled for. It's always the best thing to be respectful of your coworkers (even if they ARE stupid.)

[TheCommuter, BSN, RN]

So, maybe I wasn't being nice to my fellow coworkers, but common on we need to be a little more intelligent about our decisions.

Well, be a part of the solution by helping your coworkers become a little more intelligent about their decisions. Cracking jokes is not a part of the solution, but making helpful suggestions about what they could have improved upon during the next response is...

Even though we are all nurses with the same license, we all have not learned the same things, and we do not exhibit the same level of clinical judgment as each and every one of our peers. This is reality.

[TwilightRNurse]

Critical thinking is more important to a nurse than being critical of your co-workers and certainly making fun of them was totally inappropriate.

[perfectbluebuildings, BSN, RN]

Talking to these nurses in a respectful way, after the patient was taken care of, about what they should have done would have been much more helpful than making jokes behind their backs. Gossip doesn't fix anything nor help the other nurse know what to do the next time such a situation occurs.

[angel337, MSN, RN]

believe it or not, this is not the last time you will see nurses not using the best judgement, in fact YOU will also do or say something that is not entirely appropriate. The real issue is making sure the pt is safe and well cared for. Even if a pt is not mine, I think it is dumb for anyone involved not to do the right thing for a pt. 10-15 minutes is a long time to be in svt. This should be used as a learning experience for your peers instead of a critical one. Those nurses obviously were not comfortable and this is a major issue that needs to be addressed w/management becasue this pt could have coded and died. No one knows everything and a bad experience should always be used to improve critical thinking skills instead of being condescending and judgemental.

[hearthelper]

Actually, diligent trooper, I am not an expert and I know I have a lot to learn and I will make mistakes (I haven't updated my status in awhile I have been a nurse for over a year). I appreciate the critical comments and I know I did the wrong thing by not acting in a professional manner about my coworkers. I will say that I wasn't gossiping b/c I was just updating the nurse that had her the previous night in ICU. My comment that was said out loud and unecessary was that they were all standing around without notifying the MD waiting for the pt to code. I am sorry and these are serious issues that do need to be addressed with mangement. I do give kudos to my co-workers for taking it seriously and being with the pt just need to take the next step and notify the MD so you can get some med orders.

[misschiatia]

Of course, cracking jokes about the other nurses lack of good judgement was not the best response to the situation. However, we all get frustrated. Especially when you are in a situation where you are afraid for the pt and irritated with the nurse who had allowed things to get to that point. Of course, later on you feel bad. Usually I apologize to the injured party and that helps on both sides (yep, ive done it before too, and im sure im not the only one).

Some part of the reason you had 4 nurses standing around doing nothing is that obviously no one felt confident enough in their judgement and knowledge base to act. Not their fault, but isn't their a superviser or someone available for them to go to when theyre not sure, or do they just wait for ICU nurses to notice the problem and come down and respond?

[sunnycalifRN]

So, I went straight to the room to find 4 nurses standing around the pt, who was asymptomatic and stable.

Well, at least they were at the bedside!! We had the exact same thing happen and several nurses were standing in front of the tele monitors watching the classic SVT on the screen. The patient was fine but what happened to "treat the patient, not the monitor!"

Also, on this floor, whenever there is a code, the code team arrives including the code nurse from ICU . . . but, there is not one nurse from the floor . . . anywhere!!

[PostOpPrincess, BSN, RN]

Now that you know, don't do it again. Just fix the situation and move on.

[TiffyRN, BSN, PhD]

Your criticism will not be taken seriously when you act in such a way. You will stand a better chance if you remain calm & professional in your dealings with your co-workers and especially don't turn on your fellow nurses to the MD.

Present the objective facts to the MD, let him/her make the judgments about if actions taken were appropriate, if you present the facts objectively he/she will not fail to see that there were issues. Trust me, an MD following up on such issues will be taken much more seriously than some fellow nurse cracking jokes about those incompetent med/surg nurses.

I had a similar situation happen on my 1st code. After the code was concluded (didn't go well) and all the notifications, paperwork concluded, the supervisor stopped by to talk with the floor nurses. We were all relatively new to nursing. She had some questions and gently pointed out some actions that could have been done much better. Nothing would have changed the outcome. When the answer to the MD's question "how long have his pupils been fixed and dilated?" is "two years", you know it ain't gonna turn out good. She could have been harsh or joked about our less than stellar start to the code and we would have wasted all our energy hating her and not learned anything from the experience. The way she handled it I remembered her lesson every time since then that I was in a code situation.