I need to vent a little bit because my otherwise perfect day on the unit was ruined by a mean and ruthless nurse who engaged in the following behaviors while I was giving report: Shaking her head, sighing, making faces, more sighing. Me: A nurse of three years giving report to a nurse who was at least a decade older than me. Me, male, her female. I'm trying to let this go and remember how much I helped all of the other RNs on the unit throughout the shift and remembering that I Actually AM A Good Nurse!.
Patient was a transfer from ICU s/p small bowel resection and has hx of Acute Renal failure. Patient was incontinent with me once during my shift. Patient has been seen by Nephrologist twice since his transfer to my unt. The nurse I was giving report to engaged in the typical eat your young behavior, sighing, shaking head, asking tremendously challenging questions---Yes, I read every single physician and consultant note, you are working night shift and have eyes and a brain so you can read for yourself whatever I couldn't recall verbatim. Thank god we use EPIC and everything is right there.
I noted her behavior and I queried, " You seem frustrated". She stated "yes". I asked further, "what could I have done better?" She responded, "you could have followed up on this patient's out put."
I think I responded in a professional manner. I do not appreciate nurses who sigh, grimace, groan, or give you the thrid degree and expect you to know the name of every surgeon who ever did any procedure on the patient.
She asked me the creatine and BUN. I always have my labs available. I simply stated his BUN and creatine are within normal limits. Why was she having such a fit?
My effort to correct the situation: I went to the slightly confused patient and asked him to urinate in the urinal. He immediately put out 150cc. Not great, but not bad. I palpated his bladder and detected no distention. Patient denied pain in pelvic area. There were already numerous studies on his kidneys that have reviewed by the nephro.
I documented my findings, educated the patient on the need to void in urinal so we could measure. I reported to the oncoming nurse and she still seemed disastisfied. Does it matter that she was a 11-7 nurse who has most of the evening to comb the charts.
I read my physician and previous RN notes. I spend my entire shift prepping for for report. I just felt like this woman was unprofessional and rude and engaged in behaviors that did not benefit our mutual care of the patient until I took a step back and ask her some very objective questions and acted based on those responses.
It is not appropriate to sigh, groan, grimace, moan or otherwise engage in behaviors that are intended to make you feel superior and the observer of your behavior feel inferior or that they gave bad care!!!!
Lord and everyone here knows how many shoddy reports we have recieved. I don't use this as an opportunity to bring a nurse down, I say, don't worry about it, I'll follow up on it. Hey , we all have brains and eyes and ears. We are sisters and are suppose to be looking out for the patients. It's not a ******* match at who is the better nurse.
I will often arrive at least a half an hour early to work to read H&P, consults, results and what not and may be knowledgeable about some of that background info about a patient. But I don't hold it against the nurse caring for 6 patients, hanging blood on two patients, admitting two, discharging one.
NOw that I am in my third year of nursing I think it is even more important to foster an environment of respect that is often violated during report. This is the key moment that nurses eat their young. Stop it stop.
I tell myself, tonight, I helped another nurse clean up her incontinent patient, I did glucose checks for other nurses and I passed meds for other nurses who were swamped. I cannot let this one mean nurse get me down.
i worked with somekme like that in my first year so much less expereince than you and the only thing that worked was standing up to Her. But two things that were important for me to understand that I saw in hindsight..1) Every nurse has a different standard of detail. I satisfied the average standard. 2) This crabby nurse had very high standards that in time I decided we're what I would aim for.
The average standard was easier to work with but the higher standard was what I decided I wanted. There was no valid excuse for how Crabby treated me but I'm sure it was due to being exhausted with one new nurse after another. I took what she was demanding, separated it from the non professional delivery, and began implementing the practice. It earned me many kudos and respect from senior nurses, including Crabby.
I've since tried to temper my high expectations with being a reasonable co worker and have had to check myself many times to keep from turning into Crabby.
My my point is to look objectively at what she expects and reconcile it against what you're doing. If she's still being unreasonable as well as immature then I would want to speak with her privately with a supervisor's endorsement.
Not to minimized the importance of nursing and documenting correctly but this post is giving me the giggles but things can be so unrealistic and ridiculous. There are some people that are dead set on making your shift as miserable as possible.
We had a couple 'come to Jesus' moments thanks to all the nurses complaining to the manager about unprofessional behavior during report. The manager wrote out a statement of professional behavior and described unprofessional behavior right down to 'eye rolling' and sighing.
It's not like nurses who do these unprofessional behaviors are doing them IN SPITE of management's directive. They do it because of what's going through their heads when they receive report. It's what the oncoming nurse brings with her to the report, her collection of personal assumptions that are rooted in some kind of fear for him/herself.
I worked 3 to 11 and heard the stories from day nurses about how hard giving report to some of us evening shifters was. The people pointed out as difficult to give report to didn't exactly shock me. In general, they were the very nervous, anxious to the extreme, and often said things like 'It's my license on the line' and so forth. They were good nurses AND they lived in a state of self-perpetuated fear of being 'called out', humiliated, punished, 'at fault'. The very THOUGHT they could be held responsible for a mistake would cause them to go straight into defensive anger or break down in tears, literally falling apart emotionally.
A nurse who has a more realistic view of what she's responsible for is easy to give report to. A secretly terrified nurse comes across angry and demanding, she/he is consumed with fear of screwing up. She/he is unable or unwilling to tolerate being wrong about something, where the rest of us live and learn and do our best.
I handed off report to one such night shifter, a pt receiving a chemo infusion that needed half hourly VS and slow infusion due to moderate 'reaction' (chilling, rigors, dropped BP). It's an infusion we do all the time, and the reactions are not life threatening, just uncomfortable and alarming to the patient. This nurse was aghast I had not 'finished' this infusion and after enduring a grim and angry reception to my report, later saw her in tears. She was THAT terrified, of whatever garbage her own attitude was generating. Talk about control issues.
I can understand what 'motivates' a nurse to behave unprofessionally and rudely during report, but I have no sympathy for how they act their own psychological problems out on someone else. Get a grip. Stop setting yourself apart as 'too precious' for a bit of challenging nursing work, or perhaps needing some help and direction. And get a grip on that egocentricity for god's sake, most of us learn when we are around seven or eight that it is NOT all about me. The off going nurse is NOT trying to set you up. If you lack that much confidence in your nursing skill set, then get some help -- it is NOT the responsibility of the off going nurse to soothe you. Put on some Big Girl panties and be one of the chickens.
One thing that helped with one of the night shifters was to silently listen to her go off, and then return to my report as if she hadn't had an emotional outburst. It was not exactly comfortable lol, but I just pushed on and she stayed more quiet after that. Since I didn't engage with her and go into self defending mode, all there was was her outburst, which looked stupid. She looked stupid to herself, I had nothing to do with it. Later, I also joked with her, complimented her, and that sort of thing, and she and I had 'good' report experiences, for the most part. You don't have to be louder and more bullying than the bully to make your point :)
Specializes in Psych, Corrections, Med-Surg, Ambulatory.
Quote:
"One thing that helped with one of the night shifters was to silently listen to her go off, and then return to my report as if she hadn't had an emotional outburst. It was not exactly comfortable lol, but I just pushed on and she stayed more quiet after that. Since I didn't engage with her and go into self defending mode, all there was was her outburst, which looked stupid. She looked stupid to herself, I had nothing to do with it. Later, I also joked with her, complimented her, and that sort of thing, and she and I had 'good' report experiences, for the most part. You don't have to be louder and more bullying than the bully to make your point" :)
Too right. Only if you're insecure yourself, do you need to let other people's outbursts register on your radar. Focus on giving the most useful, concise report you'd want to receive. Do not respond to theatrics by trying to produce additional bits of minutiae or placate the drama queen in any way. If she's really contorting or vocalizing, just stop talking and look at her till she settles down. Then calmly continue.
This works best if you'e conscientious and a bit seasoned. New grads may get some feedback on their report until they get the hang of it. But sighing and eye-rolling are not ok.
i worked with somekme like that in my first year so much less expereince than you and the only thing that worked was standing up to Her. But two things that were important for me to understand that I saw in hindsight..1) Every nurse has a different standard of detail. I satisfied the average standard. 2) This crabby nurse had very high standards that in time I decided we're what I would aim for.
The average standard was easier to work with but the higher standard was what I decided I wanted. There was no valid excuse for how Crabby treated me but I'm sure it was due to being exhausted with one new nurse after another. I took what she was demanding, separated it from the non professional delivery, and began implementing the practice. It earned me many kudos and respect from senior nurses, including Crabby.
I've since tried to temper my high expectations with being a reasonable co worker and have had to check myself many times to keep from turning into Crabby.
My my point is to look objectively at what she expects and reconcile it against what you're doing. If she's still being unreasonable as well as immature then I would want to speak with her privately with a supervisor's endorsement.
Specializes in Mental Health, Gerontology, Palliative.
I had an enrolled nurse tell me the other day that I should have rung the patients doctor at home on a Saturday afternoon to inform them that the patient had a fungal infection of the groin.
I'm like 'If you want to ring a doctor at home on the weekend to inform them of such, go right ahead. However this is was the course of action I formulated with our oncall and it was on her direction"
People bring their own stuff to report. I'm over being upset by other peoples 'asshattery". My rule of thumb is the following. Have I done the best job that I can do? Have I documented everything that happened on my shift so that when the next nurse decides shes got better things to do than listen to report the information is present?
This type of behavior is typical of an oppressed, powerless, group. They have no power and/or control, cannot effect change or even stand up for themselves to management, for fear of losing their jobs.
The powerless turn on each other, rather than turning on the individuals who perpetuate our situation, in order to validate their self importance and self esteem. It is rampant in nursing, and starts with eating our young. It will continue until nursing can self govern, with out outside factors chiming in.
This type of behavior is typical of an oppressed, powerless, group. They have no power and/or control, cannot effect change or even stand up for themselves to management, for fear of losing their jobs.
The powerless turn on each other, rather than turning on the individuals who perpetuate our situation, in order to validate their self importance and self esteem. It is rampant in nursing, and starts with eating our young. It will continue until nursing can self govern, with out outside factors chiming in.
Yep. It's really obvious when you look at it with this in mind.
This 'oppressiveness' hanging over the heads of nurses is coped with differently, and some folks have a harder time with the 'self governing' than others.
From personal experience, an individual nurse can be 'self governing' long before our profession as a whole becomes self governing. The examples given here from nurses who ignore nasty report behavior are examples of self governance.
If you feel helpless and believe you must 'wait' until outer conditions are good enough for YOU to feel good enough, you'll wait forever.
Specializes in Informatics / Trauma / Hospice / Immunology.
Maybe having the computer open and giving report at bedside would help? I'm new but that's what I'm being advised to do. Perhaps this inappropriate nurse would be less prone to act like a child in front of the patient after you have introduced her as the amazing oncoming nurse. That's the theory anyway.
Ironically in my experience, these types of nurses, who want their reports spoon fed to them, are the ones that need the most help on the unit to get things done, never get their charting done on time and are nurses I wouldn't want taking care of me or mine. I see them on the units taking advantage of the techs and transport, while they do god knows what, and delaying care for pts in an effort to make others do their work. Sometimes they are so wrapped up in their heads you have to repeat important information you already included in report but they were too worried about writing down what diet the patient was on.
Everyone knows these nurses in the units and avoids trying to give them report. I have rearranged patient assignments due to nurses like these because I wanted the sickest patients to get proper care.
I appreciate the rationale for them being terrified that some have posted, and that may be true. Mostly I think they are lazy, have poor time management skills, cannot triage what is most important in a pt's case, and probably shouldn't be working in acute care in any role.
However this is was the course of action I formulated with our oncall and it was on her direction"
Libby1987
3,726 Posts
"Could you use your words?"
i worked with somekme like that in my first year so much less expereince than you and the only thing that worked was standing up to Her. But two things that were important for me to understand that I saw in hindsight..1) Every nurse has a different standard of detail. I satisfied the average standard. 2) This crabby nurse had very high standards that in time I decided we're what I would aim for.
The average standard was easier to work with but the higher standard was what I decided I wanted. There was no valid excuse for how Crabby treated me but I'm sure it was due to being exhausted with one new nurse after another. I took what she was demanding, separated it from the non professional delivery, and began implementing the practice. It earned me many kudos and respect from senior nurses, including Crabby.
I've since tried to temper my high expectations with being a reasonable co worker and have had to check myself many times to keep from turning into Crabby.
My my point is to look objectively at what she expects and reconcile it against what you're doing. If she's still being unreasonable as well as immature then I would want to speak with her privately with a supervisor's endorsement.