Today was a bad day. So I just started at this nursing home, I've only been there a couple weeks and I work part time. Most of the nurses.... well ALL of the nurses in the nursing home are older than me... and most of the CNAs too. I'm and LPN, age 22. And my fear was that no one would take me seriously cause I was new and young and cause they've been there forever and are experienced. So far I've been able to assert myself (in a nice way) but sometimes I feel like a student nurse all over again! I try to help the CNAs whenever I have time but sometimes I AM BUSY and I can't and it seems like they are upset... but they always come to ME for help, I'm not the only nurse there! I think that I have been handeling myself well so far... BUT today, this nurse yelled at me, and she had no right to (at least I don't think so), I did nothing wrong. One of HER patients had a dressing and they were begging for it to be changed before lunch, and it definitely looked like it NEEDED to be changed, so.... I did it, I signed the treatment book, and told her. She went to look at the dressing then came back and yelled at me saying "If you don't know how to change dressings then don't do it! It's all wrong!" I KNOW it was NOT wrong, it was a basic dressing change, very simple, and I'd changed it before (but she didn't know that). I KNOW IT WAS RIGHT. I feel like she doesn't like me for whatever reason but I've been nothing but nice to everyone. I guess I'm just being a baby... sorry. :uhoh21:
Specializes in ER (new), Respitory/Med Surg floor.
If someone stepped in my way and did my job without my consent, I would be upset too. Now, I don't have the opportunity to assess that wound because YOU did the dressing. It's MY patient, that should be MY assessment.
You say you know her routine, you knew she'd get to it. Its' routine care, and not an emergency. You made an evaluation that her routine wasn't adequate care, you stepped in without permission and without asking and you took over her care.
OK, maybe trashing the way you did your dressing was an excuse. But you stepped over the line.
Unless you are in a team nursing role, you have no right to unilaterally interfere w/ a nurse's care of her patients. An emergency is one thing. What you did was make a judgment: I'm am better than this nurse and so I will intervene in order to prove it.
You should have asked. You didn't because you KNEW she'd say, "I'll get to it." And so, you were wrong. You made a value judgement on her care: "I do both, like, I'll give them their med and do their treatment while I'm there, i guess it just seems more efficient and it's easy for me to get everything done."
Sorry, that's my take. You might be getting some flak because you're young and new. But then, some of it might be because you are playing the 'I know everything from school' game. It's natural to want to impress with your skills and knowledge, but you have to know your limits.
Stop stepping on toes in order to impress. If it's not an emergency or extremely routine (a glass of water), you have no right to interfere with another nurse's nursing care WITHOUT THEIR EXPRESS PERMISSION. (If she had done some of YOUR job without asking, this thread would be about a more experienced nurse that doesn't trust your abilities and keeps doing your job for you, and rightly so.)
~faith,
Timothy.
Sorry but geeze! Ok I would suggest asking the nurse first as well before doing a dressing change. but my god it sounds like the op was just trying help out. Doesn't sound like she was trying to impress or "step over other peoples toes!" Op was just appeasing the pt and helping out the main nurse as well. How you can infer the op was doing that I don't understand. And the 'I know everything from school' game!!! I would think many realize how little they know and learn very quickly they need to learn lots more once your on the floor for the first time. I'm so sick of making a statement here or talking/working with other healthcare workers that feel either they are perfect or rather tear others down even if the person is correct. And it can seem like a supportive way to have people learn, but no, nurses have such egos.
Sorry but geeze! Ok I would suggest asking the nurse first as well before doing a dressing change. but my god it sounds like the op was just trying help out. Doesn't sound like she was trying to impress or "step over other peoples toes!" Op was just appeasing the pt and helping out the main nurse as well. How you can infer the op was doing that I don't understand. And the 'I know everything from school' game!!! I would think many realize how little they know and learn very quickly they need to learn lots more once your on the floor for the first time. I'm so sick of making a statement here or talking/working with other healthcare workers that feel either they are perfect or rather tear others down even if the person is correct. And it can seem like a supportive way to have people learn, but no, nurses have such egos.
I agree with you here mystic. Not only is she eating her young she swallowed her whole. There is such a thing as constructive criticism that is civil and doesn't sound near as much an a** chewing as this. I can understand asking first, certainly, but geeeez. That kind of butt chewing can make someone not want to help their fellow nurses anymore. OP ..... just ask next time if it's ok to do a service for their pt since they seem to be busy at the moment and you have a free moment to take care of it. Keep up the good work.... You'll do fine.
I think you had the best of intentions and were only trying to help the patient out who was begging to have their dressing done. I don't think you were stepping on toes deliberately just to try to impress them. But let this be a lesson that this is how people think.
Once the nurse said she'd get to it, you should have left it alone. If the patient asked again, still you should say "the patient is really asking me to do it, would like me to do if for you?", if she said no then you could have gone to the patient and used therapeautic communication to let him no you're not his treatment nurse and it's not an emergency.
The dynamics of being a new eager grad in a unit that has an established culture is difficult at times. Just concentrate on doing the very best job you can do, offer to help if you have time, and go with the flow.
If someone stepped in my way and did my job without my consent, I would be upset too. Now, I don't have the opportunity to assess that wound because YOU did the dressing. It's MY patient, that should be MY assessment.
You say you know her routine, you knew she'd get to it. Its' routine care, and not an emergency. You made an evaluation that her routine wasn't adequate care, you stepped in without permission and without asking and you took over her care.
OK, maybe trashing the way you did your dressing was an excuse. But you stepped over the line.
Unless you are in a team nursing role, you have no right to unilaterally interfere w/ a nurse's care of her patients. An emergency is one thing. What you did was make a judgment: I'm am better than this nurse and so I will intervene in order to prove it.
You should have asked. You didn't because you KNEW she'd say, "I'll get to it." And so, you were wrong. You made a value judgement on her care: "I do both, like, I'll give them their med and do their treatment while I'm there, i guess it just seems more efficient and it's easy for me to get everything done."
Sorry, that's my take. You might be getting some flak because you're young and new. But then, some of it might be because you are playing the 'I know everything from school' game. It's natural to want to impress with your skills and knowledge, but you have to know your limits.
Stop stepping on toes in order to impress. If it's not an emergency or extremely routine (a glass of water), you have no right to interfere with another nurse's nursing care WITHOUT THEIR EXPRESS PERMISSION. (If she had done some of YOUR job without asking, this thread would be about a more experienced nurse that doesn't trust your abilities and keeps doing your job for you, and rightly so.)
Wow - sounds to me like the nurse who swallowed you whole is feeling inadequate about something. Nursing shouldn't be about competition, but about working together. Sure, we like our routines, but she should have been grateful that you were helping out. It's not a big deal that you changed the dressing. If the patient was asking you, and you had time, why not? And there's no difference in the assessment of the wound just because you put a clean dressing on it. The other nurse can still lift the dressing and take a look at it. Or, she could ask you what the wound looked like and how much drainage there was. You should do the charting on it since you were the one who did the dressing, but as long as she's aware of how the wound is, I don't see what you did as a big deal. If it bothered her that you interfered with her routine, she could have talked to you constructively and asked you not to do it next time, or to ask her first. I don't think you did anything wrong at all. Don't let her get to you - much worse is going to happen to you in your career as a nurse. May as well get used to it. ;-)
>As for the CNA issue, I worked as a CNA for a couple years and I rarely >asked a nurse for help or even expected it. They have enough to do! In >fact, it makes me very nervous when I see a nurse doing something I chould >be doing, i.e. positioning or getting a patient up. We had one nurse that >came in for wound care at the change of shift -- before any of us were >actually on the floor and when he was finished with the wound he would >come out and tell us that the pt. had a BM and he had cleaned it up. He did >not mean anything but to let me know so I could document it but it made >me very nervous and I started trying to get to this pt. before he got to him
PLEASE ask us for help!! Most nurses I know have no problem with that.
The job of a nursing assistant is a hard job, and it's basic nursing care.
There are days that I am unable to pitch in there
He simply did what needed to be done when he discovered the need...just as any nurse "worth his salt" would do...
Really, it's not about pointing out you didn't do something (how could you know it needed to be done if you weren't on the floor yet???)
I've done the same thing..and I've worked many years as an aide, so I know the job, and any nurse who refuses to take care of any basic needs should leave the profession
I think it was perfectly clear from the OP's post that she did not ask the nurse prior to offering treatment because she knew that nurse's routine and knew she would not approve. I think it was perfectly clear from the OP's follow up posts that she disapproved of the the way the nurse did her rounds.
Personally, I'm very particular that I assess my patients, including wounds. How else can I chart it? I AM responsible for MY patients. Therefore, YOU don't interfere with my being responsible. I think that's fair. I don't think it's unreasonable.
And I don't think I took the OPs comments out of context. I think SHE presented her situation in the best light, but which of us wouldn't.
She stepped on her co-worker's toes and then comments that she can't understand why her co-worker is acting like their toes had been stepped on.
I think it was perfectly clear from the OP's post that she did not ask the nurse prior to offering treatment because she knew that nurse's routine and knew she would not approve. I think it was perfectly clear from the OP's follow up posts that she disapproved of the the way the nurse did her rounds.
Personally, I'm very particular that I assess my patients, including wounds. How else can I chart it? I AM responsible for MY patients. Therefore, YOU don't interfere with my being responsible. I think that's fair. I don't think it's unreasonable.
And I don't think I took the OPs comments out of context. I think SHE presented her situation in the best light, but which of us wouldn't.
She stepped on her co-worker's toes and then comments that she can't understand why her co-worker is acting like their toes had been stepped on.
I know why and I said it.
~faith,
Timothy.
after reading other posts from you, I am beginning to think that this is really about power for you. Team work has never been a detriment to patient care or to any endevor, unless someone appts. themself the only one that is right. And kindness and tact certinally are deserved by all human beings not just co-workers. The statement "Therefore YOU don't interfere with my being responsible", seems to me to be a bit smug. Do you not think anyone else could asses a wound and make a judgement? If that is not something you feel comfortable with there are many possibilities of ways to deal with it. Not the least of these, actually not getting mad or upset or teritorial and just thanking the person for doing something to help you but that in the future that you would appreciate being asked first, and that you appreciate their willingness to help and you would certinally let them know if you did need it in the future. That would be a good way to promote openess within your team. The op, yes in hindsight should have asked and I'm sure that she will from now on, what I hope she doesn't do is become shy in helping at all due to the way she was treated in this example. As for as interfering with you being responsible, have you considered that you are responsible for teaching, through your example, those around you or were you just born knowing all the right things? I urge you to think about how that attitude can go a long way to open communication and trust between people.
I am beginning to think that this is really about power for you. Team work has never been a detriment to patient care . . .
It's not about power; it's about ME knowing what I need to know about my patients. And to the extent it IS about power, it was about the OP exercising power in the situation - power not hers to exercise.
I think the OP was trying to show off, which is a peculiar failing of lots of new nurses. I agree the nurse shouldn't have blown up, I disagree that it was completely unjustified.
There was some passive-aggressiveness on both sides there.
If you listen to the OP, she was subtly attacking the way the other nurse did things because her (the OP's) way was better. And she decided to prove it to that nurse by going behind her back to provide routine care without permission.
And I am sure that this event didn't happen absent a vacuum of the patient being presented with some sort of (whether expressed or implied) "Since your nurse can't get to it, I'll do it.'' So not only did she undermine the other nurse's ability to assess a wound, she undermined the nurse/pt relationship.
I have worked in environments where my co-workers help me as part of a 'team' in all sorts of ways (and vice versa): but that teamwork is based on trust. Trust is earned over time and experience. What the OP did was violate that trust.
I'm only one opinion here and y'all are welcome to beat up on me. But, if all the OP hears is how perfectly right she is in this situation, what will she learn from it? And she does need to learn that having a license doesn't give you license to run over your co-workers and then whine about it.
Yes, her co-worker's reaction was wrong - but so was the OP.
If someone stepped in my way and did my job without my consent, I would be upset too. Now, I don't have the opportunity to assess that wound because YOU did the dressing. It's MY patient, that should be MY assessment.
You say you know her routine, you knew she'd get to it. Its' routine care, and not an emergency. You made an evaluation that her routine wasn't adequate care, you stepped in without permission and without asking and you took over her care.
OK, maybe trashing the way you did your dressing was an excuse. But you stepped over the line.
Unless you are in a team nursing role, you have no right to unilaterally interfere w/ a nurse's care of her patients. An emergency is one thing. What you did was make a judgment: I'm am better than this nurse and so I will intervene in order to prove it.
You should have asked. You didn't because you KNEW she'd say, "I'll get to it." And so, you were wrong. You made a value judgement on her care: "I do both, like, I'll give them their med and do their treatment while I'm there, i guess it just seems more efficient and it's easy for me to get everything done."
Sorry, that's my take. You might be getting some flak because you're young and new. But then, some of it might be because you are playing the 'I know everything from school' game. It's natural to want to impress with your skills and knowledge, but you have to know your limits.
Stop stepping on toes in order to impress. If it's not an emergency or extremely routine (a glass of water), you have no right to interfere with another nurse's nursing care WITHOUT THEIR EXPRESS PERMISSION. (If she had done some of YOUR job without asking, this thread would be about a more experienced nurse that doesn't trust your abilities and keeps doing your job for you, and rightly so.)
~faith,
Timothy.
Tim, that is a lot for you to say, to not even know me. Number ONE, I don't try to IMPRESS anyone that I work with, we are all nurses, I just try to get along with everyone. Secondly, I don't play games and I KNOW that I don't know everything from school, yeah I'm very BOOK smart but I know I have a lot to learn. As far as my system verse her system, the way I do it is EASY for me, the way she does it is most time efficent and EASY for HER. My POINT with saying that in my earlier post was that I know she doesn't like to be interupted during the med-pass portion of her care.
AND... she has changed dressings on MY PATIENTS WITHOUT MY CONSENT, I didn't bite her head off about it, so I didn't think she would have a problem if I tried to help her, and that is what I was trying to do, HELP. The patient was concerned, they wanted the dressing change... she WOULD get to in later, but the patient wanted it NOW. I don't know about what you think, but PATIENTS COME first. I don't think I'm "BETTER" than that nurse and I wasn't trying to attack her, I know that she knows a lot more than me. EXCUSE me for trying to HELP! Furthermore you made way too many assumptions without knowing the dynamics of my workplace, yes, I guess I should have asked but as I said she doesn't like being interupted during her med pass... But I guess next time I'll ask. AND THIS IS AN UPDATE ON THE SITUATION:
Today, she apologized. She said that she shouldn't have yelled at me and that she appreciated the help. We had a long talk, apparently she's going through some personal issues and took it out on her coworkers...
So TIM, what do u think about that?
ANYWAYS, thanks everyone for the kind words, I feel so much better and you were all right. YOU GUYS ARE ABSOLUTELY GREAT!
Specializes in med/surg/tele/neuro/rehab/corrections.
Wow I'm glad to read the update. I couldn't say for certain where that nurse's head was until now. Guess we are all human after all. My bet is that she wouldn't have spoken like that to a new nurse on her unit who was over 40 tho! Either way good communication cleared up the confusion.
Today was a bad day. So I just started at this nursing home, I've only been there a couple weeks and I work part time. Most of the nurses.... well ALL of the nurses in the nursing home are older than me... and most of the CNAs too. I'm and LPN, age 22. And my fear was that no one would take me seriously cause I was new and young and cause they've been there forever and are experienced. So far I've been able to assert myself (in a nice way) but sometimes I feel like a student nurse all over again! I try to help the CNAs whenever I have time but sometimes I AM BUSY and I can't and it seems like they are upset... but they always come to ME for help, I'm not the only nurse there! I think that I have been handeling myself well so far... BUT today, this nurse yelled at me, and she had no right to (at least I don't think so), I did nothing wrong. One of HER patients had a dressing and they were begging for it to be changed before lunch, and it definitely looked like it NEEDED to be changed, so.... I did it, I signed the treatment book, and told her. She went to look at the dressing then came back and yelled at me saying "If you don't know how to change dressings then don't do it! It's all wrong!" I KNOW it was NOT wrong, it was a basic dressing change, very simple, and I'd changed it before (but she didn't know that). I KNOW IT WAS RIGHT. I feel like she doesn't like me for whatever reason but I've been nothing but nice to everyone. I guess I'm just being a baby... sorry. :uhoh21: 
I can understand asking first, certainly, but geeeez. That kind of butt chewing can make someone not want to help their fellow nurses anymore. OP ..... just ask next time if it's ok to do a service for their pt since they seem to be busy at the moment and you have a free moment to take care of it. Keep up the good work.... You'll do fine.
mysticalwaters1
350 Posts
Sorry but geeze! Ok I would suggest asking the nurse first as well before doing a dressing change. but my god it sounds like the op was just trying help out. Doesn't sound like she was trying to impress or "step over other peoples toes!" Op was just appeasing the pt and helping out the main nurse as well. How you can infer the op was doing that I don't understand. And the 'I know everything from school' game!!! I would think many realize how little they know and learn very quickly they need to learn lots more once your on the floor for the first time. I'm so sick of making a statement here or talking/working with other healthcare workers that feel either they are perfect or rather tear others down even if the person is correct. And it can seem like a supportive way to have people learn, but no, nurses have such egos.