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DaretoDreamRN 4,715 Views

Joined: Apr 13, '06; Posts: 104 (16% Liked) ; Likes: 29

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  • Sep 25 '11

    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.

    Thank you.

  • Sep 25 '11

    All Im saying is that if you work in a highly diversified place where you cant understand your coworkers, it is best to find another job. Yeah, the defensive replies brought a nice smirk to my face.

  • Sep 25 '11

    I worked in England at a time when we had many Finnish and Swedish nurses coming over to work. We traditionally always already had many African and West Indian nurses. I never had any problems communicating with them. Some people said they did. Some perhaps genuinely had a problem, however I found very often found that those who did were either very impatient, intolerant types, or in some cases actually exaggerated the problem because they liked telling "shock, horror" anecdotes, or even worse, they simply liked laughing at foreigners.

    I wonder if any of the critics have actually ever had the boot on the other foot? I came to work in France with a reasonable knowledge of French but spoke with a heavy British accent. I didn't nurse here until I was confident in my fluency, but those first months in a strange system and a foreign language are scary. I have found most French colleagues overwhelmingly helpful and accomodating. In those early days if I mispronounced something they only had to politely ask me to repeat myself, I'd repeat it slowly and carefully and they'd usually understand. However, the rare occasions people snapped or mocked really hurt. After ten years here it's fine, but still occasionally if I'm tired - giving handover at the end of a 12 hour night shift - yes, some words escape me or I speak some Franglais. It is very rare that I'm given a hard time about it but it can still give you complex. I've got all the slang and the idioms now - but that doesn't come quickly and NO language course ever gives you that.

    Hence I will now go out of my way to be patient and helpful to newcomers with levels of French inferior to mine. We had an influx of Spanish nurses a few years back - some people complained about the way they spoke French but most of us understood them fine. And yes, if I had an anglophone colleague of course we'd speak our own language at coffee break - only natural.

    If you're frustrated by a colleague's accent or style of expression, they're twice as frustrated as you. Give them a break. No nurse sets out to be incomprehensible.

  • Sep 25 '11

    Understanding accents can be very difficult. But you know what else is difficult to deal with? Lazy people. And dopey scatterbrains. And we all have to deal with them too. If the person with the accent is a good worker I'd gladly accept them as a coworker.

    It's pretty insulting to have others imply that the reason for not being a jerk about accents is just because it's not politically correct. And this:

    Quote from Been there,done that
    Would it be OK to admit it doesn't work if a communication breakdown led to the demise of your loved one?
    seems just a little dramatic to me.

  • Sep 25 '11

    We have a great mix of diversity at my workplace. I might have a Filipina coworker, a Nigerian coworker, a Kenyan or Pakistani lab guy, an Indian med student, and a Brazilian resident. And you know what? There is way more miscommunication between native English speakers than when there is English as a second language involved.

    I'm not completely discounting the issue in OP....just saying (as another poster did) that miscommunication is miscommunication. Can't blame it all on the folks with thick accents.

  • Sep 25 '11

    Also don't confuse a thick accent and lack of knowledge. Those are two totally different subjects. The nurse who didn't know the procedure didn't know because she was t educated well, not because of his/her country of origin. A laparotomy in Somalia is the same laparotomy in San Diego

  • Sep 25 '11

    I stand behind my couch posting (yes pun intended)

    and it IS shameful to spout hateful rhetoric regarding people just because they are not like you.

    take my post whichever way you will....

    P.s NEWBIE and DARN proud of it!!!!!!!!!!!!!!!!!!!!

  • Sep 25 '11

    i have never understood why we americans feel everyone on the planet must speak fluent american-style english, when the persons in other parts of the world learn british english. words are spelled
    the same or very nearly so, but are pronounced differently.

    i live in a small town but a very culturally diverse neighborhood. neighbors are from india, saudi arabia, israel, germany, japan, china, korea, brazil, pakistan, and central america. there are many three
    generational families, who speak english with varying degrees of clarity, but we manage both on and
    off the job. most of the adults are mds or other advanced degree holders, the kids are as american
    as any other native born child. the children old enough to remember life in their native country still
    seem to embrace their new life in america and enthusiastically adapt to their new lives.

    only a few cultures find being asked by a mere woman to repeat themselves offensive, and where i worked longest, this was handled by having every single order written down. as for nurses and staff who refused to use english on the job, they were given a progressive warning system of reprimands.
    who cares which language is spoken during lunches or breaks? admittedly, some workers deliberately speak their own language just to be rude, but it has been my experience, that most don't. when they did, i just pulled out my book and enjoyed a bit of reading time.

    with orders and instructions, i became a good listener. if some colleagues become huffy if asked for clarification, too bad!

  • Sep 25 '11

    I understand that speaking with people heavy and thick accents can sometimes be time consuming and somewhat irritating but as a supervisor would so helpfully remind me from time to time: suck it up and listen harder. The only way to resolve this problem would be to stop hiring people with thick accents. This in and of itself would be detrimental to patient care because this would exclude some highly intelligent candidates that may be able to best help your patient with new ideas and research. Also, as an other person pointed out these people can also be a great asset as translators.

    Another thought however is to possibly spend more time talking to the people you are having trouble communicating with. In my experience, you begin to learn a persons inflections and meanings and the accent becomes less prevalent. Also by speaking you and other native English speakers more often it may help them to learn and understand us better as well.

    There will honestly never be a true solution to this especially as sneeze continues to become more diversified. It would behoove all of us to just take the time to listen and well all be better for it

  • Sep 25 '11

    Quote from Been there,done that
    I am working in a large inner city facility. Corporate expounds the benefits of a diverse working culture.

    I understand the benefits of a large pool of talent. There is every nationality on Earth represented in this medical center.

    Recently, I took report from the recovery room. The nurse had such a thick accent , I had to ask her to spell some of the words she was saying. During the shift, I "worked" with a resident that was also very difficult to understand. He is also from a culture that expects women to walk 3 feet behind them. Needless to say.. the communication was difficult and time consuming.
    At the end of the shift, I gave report to a nurse from another culture, that had never heard of the procedure the patient had undergone. Another language barrier ensued as I tried to explain the case.

    I find it interesting that they can understand my mid-west American accent, but not vice-versa. The communication effort is time taking away from patient care.

    I have seen a Chinese nurse, trying to describe a (emergent) patient's condition, over the phone to an Indian doctor, with a nursing assistant yelling in the background trying to interpret for them.

    Is there a solution?
    I ask this with all seriousness...what is your solution to the problem? Do individuals have to pass a very subjective "clear speech" test before they can get a license? Should nurses be able to refuse a patient because they have PCP who is difficulty to understand because they have a thick accent? I really didn't ask these questions to be a smart a**. I don't agree with the hiring of individuals only to create a more diverse workplace; however, I don't think it is right to deny a qualified applicant because they have a thick accent.

  • Sep 25 '11

    It's very possible to be fluent in a language but very difficult to understand. So the informations about English proficiency and communication tests aren't really relavent. On paper, someone might read and write in English just fine. But they may speak with a heavy accent. Even though they are saying the right words, it can be very hard to understand, especially over the phone. I, too, have had to ask people to repeat things or slow down their speech. English is a second language for many of these people, and if English was learned later in life or rarely used, it can be almost impossible to lose the accent during speech. Think about how difficult it must be for people in other countries to listen to Americans speak another language with out accents.

    However, having staff from different languages and cultures is very beneficial. If there are patients who speak the same language, the staff member can help translate. The staff member can relate to patients of the same culture in ways that other staff cannot. I've never had anyone get upset with me for not understanding them as long as I politely ask for clarification. So even thought it may be more work for me, I'd rather have a diverse workplace.

  • Sep 25 '11

    the examples you cite are exceptions to the rule.

    Foreign Physicians are required to pass stringent tests that measure their ability to comprehend and communicate in English.

    My advice to you is patience. learn to listen without bias. you may find that communication carries on without much hassle.

  • Sep 25 '11
  • Sep 25 '11

    In the words of the infamous Rodney King...."Can we all get along?"

    Thick accents are difficult to deal with, it is frustrating to not be able to communicate. I am somewhat hard of hearing from too much rock and roll, childhood illness, and old age. That can really interfere with my ability to communicate with co-workers and patients. In medicine it is important to communicate well.

    No solutions from me, just lets cut each other some slack, and try to all get along.

  • Sep 25 '11

    It's an arrangement of mutual benefit. I treat my employer with respect and am ethical and moral in my practice, but loyalty doesn't really figure into it.