My Med/Surg Christmas...it's lengthy, but I'd really appreciate some advice.

[AlisonBSN]

I just graduated from a BSN program and I've been working as a tech on this Med/Surg floor for a year that I'm thinking about working on when I get my license. I just have to tell some people about the night shift that I just worked.

There were 19 patients with 3 nurses and 1 tech, me. The first four hours or so were way more hectic than usual so we were all stressed, tired of running, etc. I catch up with my stuff, and I ask this nurse (who I've never worked with before) from the float pool if there's anything that I can do for her. She's in the middle of drawing blood from a patient, and asks which tube to use for a CBC. We determine that she's got the wrong one, so she asks me to go get the right one for her. Well, in the 10 seconds that it takes for me to walk out of the room, grab the tube and come back, she then states "I already pulled it out now." (referring to the butterfly needle). I saw that she filled up the tube that we had already established was the wrong one. I didn't question her at that point about her not even waiting for the tube that I had just fetched for her (that she asked me to get), and I told her that the lab would most likely take it anyways (since this situation had just happened 2 days ago and the lab took the CBC in this certain tube). I mean...she had already done the damage anyways by not waiting for the right tube, so I thought that you might as well send it to the lab because they might be ok with it.

So a few hours later the lab calls back. The girl working in the lab on this night said that she would not take the CBC in that tube and we needed to redraw. So when I get the idea that we need to redraw this lab...I'm like "Aw man, they did it before," (fully intending on drawing it for her since they're in the middle of shift change). Well then this crazy bitc..WOMAN says, "Just do the job, it needs to be redrawn now."

And I'm like whaaat... There was no "Could you redraw that CBC?" or anything of the sort. I didn't even say anything. It took me a minute to even process the statement. So I'm gathering up all the stuff to go redraw, and I was trying to find a semi-professional way of asking, "Why didn't you just wait for the tube that you ASKED me to get for you? I told you it was the wrong tube and you said you needed the right one, but then 10 seconds later you've filled up the wrong tube..."

And people, it's not like I took too long to get the tube so she's like "screw it." I really just stepped out and stepped back in and she's pulling the wrong tube off the butterfly thing.

My point in posting was to ask this...What was I supposed to do? I never said anything to her because I felt like it made me look crazier than her to call her out on it. But now I'm home and it's almost 2 o'clock and I can't sleep because I'm wondering if I can take working with people like that, and I'm thinking about how I wished I would have just told her off. And this wasn't this only thing she did all night. It was like she expected me to drop what I was doing for MINOR things. Like...acting impatient when I have my hands full with something else and she asks me what someone's blood sugar is...and I drop what I'm doing to look it up for her, and she's sighing all loud in front of the nurse coming on to day shift like she's tired of my crap.

It was like she was just asking me to do things just to see how quickly she could make me do them. I've never really felt that vibe from another nurse. I understand it was a stressful night, but still. I have no problem with dropping what I'm doing if I'm needed. I try to be a team player, but I also expect to be given a reasonable workload, which leads me to this...

Another situation came up with a different nurse tonight when I said that I would need some help getting all the labs done because there were so many to be done within a certain time frame. The nurse manager on the floor told me to ask for help when I feel overwhelmed, so that's what I did. And since this particular nurse knows I'll be a nurse soon, she gave me this huge speech on time management and how I can't be "miserable as a PCT and expect it to get better as an RN." And I'm thinking...I volunteered to work Christmas night for this sorry floor, and I never said or acted like I was miserable. I just said I would need help getting the labs done. So then she's like..."nevermind, I'll just do all of the labs for my patients." So I say..."I'm not saying I need you to do all of them, just maybe one or two." But the more I explained myself, the more she responded as if I was complaining. It was like she was trying to make me beg her to give them back to me so that I wouldn't look like a slacker, and then psych me into wanting to prove her wrong about my time management skills by doing all of them by myself.

Nursing is full of catty women - I know this. I've had to learn how to be quick about standing up for myself since working at the hospital, but this situation was just way worse that what I've been used to dealing with. I just don't understand how these ghetto/trailor trash/unprofessional social skills carry people through the nursing profession. I pray that I do not end up this way.

How do you stand up for yourself without falling into the catty trap? Do you just ignore it? Or sometimes does it take one good snap back to let them know that they can't speak to you in that way? And with my already subordinate PCT status, how do I handle these things without sounding whiny?

On a more immature note: I hope they read this and understand how much they suck, and why no PCTs want to work with them.

Thank you for reading, and please let me know if I'm somehow in the wrong with all this. I'd love to understand their perspective because I just don't understand how people can be like that.

[gonzo1, ASN, RN]

I'm sorry you had such an awful night. Emotions run high when people have to work holidays and they would rather be home with their families. You did nothing wrong. You were just caught up in the horror of having to work short staffed with crabby people on a major holiday.

Our ER was a mess. I got a call from our charge nurse begging me to come in and help out so I left xmas dinner with my inlaws to go help. Everyone was crabby as hell and the NP that I had to work with in urgent care was upset by the doctor she answers to and because she was upset with him she rode my ass all night until one of the clerks told her to chill. This is a NP that is normally the sweetest person.

From time to time you will have to work with dumb/nasty/mean/arrogant nurses and other staff but please don't judge being a nurse by one bad night. I have worked several places and am very happy with the people I work with, but once in a while all hell breaks loose. Happy New Year and congratulations on graduation (with a BSN no less) welcome to the field. We need you.

[Antikigirl, ASN, RN]

It sounds like you chose your battles well this night, so be proud of yourself! I too would have not really battled anything and just did what I could and waited till I got home to punch a pillow or something! LOL!

When I run into shifts like this, and believe me I do...I do exactly this. I say to myself "is this a battle I am willing to put the energy in to win!" Sometimes if it is too busy I don't, I have pts to care for and they come first to me, but some days...oh yes I stand up for myself in a professional mannor (well...maybe a few social tricks I know mixed in..LOL!).

If it isn't a battle I want to fight...I concentrate on just doing my best and that is the best I can do! That I will fight for if needed, and I would typically bring that type of battle straight up to managment! In your case I would have gone staight to my manager and said something like "I am having a hard time being a team player right now, and need some time to re-manage my time with all the activities flooding in. So in so is asking a lot of me, and I can't seem to break away to help others with their important needs. I want to be there to help, but I need help sorting and sharing my time...do you have any advice?"

Notice I didn't play a real blame game here, and pointed that I needed time to RE-Manage (points to your acknowledging time managment and you are trying), that you wish to be a team player (keyword...always use keywords in a positive spin), and just need some help spreading your assistance. Takes practice to use this technique of communication...but it is worth it in the end and typically works quite well in making YOU look good, and others can look not bad, but not utilizing you in the right way....hey look...that was the problem in the first place! :)

Another one that is going into battle is using the harrassment word. This one is much more damaging and should never be used lightly...HOWEVER, if you feel unsafe talking to someone, or you feel that that communication probelm will hurt a patient..needs to be done. In that case you go to your manager and say that you feel harassed, unapreciated, and inimidated enough not to be able to communicate with this nurse, and that you wish to change that so both of you can do your jobs! (note another positive spin there...BOTH...that points to you not being catty!).

OR...you can always take that nurse and tell her yourself in a private area. That one takes much courage, and is dependant on if you can get the RN alone in the first place. This convo is identical to the management one really..and must start out with something positive as not to get the RN's defences up right off the bat or that will be a uphill battle from the get go. "I realize you are stressed, and I wish to help you...however, I need to also be available for others...so if we can pick a few tasks I can do now and perhaps some I can do after I help others and maybe get to a slower time...that would really help me to be a great teamplayer for all of you!" If she starts being catty, then "Again I realized you are stressed, but you are treating me as if I was against you...I am not, I just want to help. If you don't quit being intimidating towards me, I will have no choice but to speak to management so that I can continue to help everyone without feeling threatened or unappreciated and do my job. I really don't want to do that, so what can we do as two professionals to stop this and get back to helping our patients."

I hope these are helpful to you, and are just some of the items in my bag of tricks that I use. When other nurses or healthcare professionals are being catty...I tend to be more like a hawk, I bide my time silently till the best opportunity to make a move and swoop in before anyone realizes I did it and by then...woosh...my battle is done . And I follow the rules and key words (or even mission statements) to CYA! This took LOTS of practice, many losses on my side..but learning from each 'battle' helped me to be very good at it IF I feel the need to prove a point.

Good luck to you..and believe me, it isn't just nursing...it is every job!

[Beary-nice]

Number one, I would not let a couple of people dictate my destiny. If this is somewhere you are contemplating working at, then you can either be sucked in or above it. People like these are everywhere, they just have different names and faces.

Number two, I imagine it is hard to have gone through all of your schooling and until you have your license you have minimal say in the position you are in. Lots of people go through it, I myself am going through it right now too. So do not feel alone.

Number three...I am on a roll with the number thing sorry...hang in there and vent when you need to. I am here with open ears.

[AlisonBSN]

I really appreciate all of your suggestions. But really...I can communicate on the professional level that you all have suggested, but the situation on this floor is beyond professional. I'm really trying not to exaggerate, but most of the time the nurses are already so angry and defensive on this floor that it is impossible to speak to them about "my perception that they think I'm against them." I tried to handle the situation with one of the nurses from tonight in this way. I told her that I felt like she took what I said the wrong way, and that the situation has become more of a big deal than it was intended. She just laughed and said, "Yeah, I think it has." Maybe I should have said it differently, but it just seemed to me that she wasn't open to discussing anything in a professional manner. After all, she had the upper hand in the situation. I felt like she was just trying to use my uneasiness about starting a new career as a control mechanism. Because if I feel the need to prove how fast I can be, then that's less work for her. I just thought it was a really manipulative move on her part. I guess since there's no good way to tell her that she's manipulative, I should just ignore this type of behavior and vow to work on a floor that doesn't have to hire the absolute worst in the profession. As far as the other nurse who said "Just do your job": it wasn't the task that bothered me. I was getting up to redraw it, she was facing away from me when she said that. It's just that a nurse shouldn't speak to her tech or CNA in that way. I mean...don't tell me to "just do my job" like that, especially when it's something that she knowingly messed up. I really don't understand why she put it in the big lavender tube when I told her that it goes in the small lavender tube, and while I was gone to get the tube that SHE ASKED ME FOR, she fills up the big lavender tube, then removes the needle from the vein. And then is just like..."Oh well." I know I'm harping, but I really want you guys to understand that normal professionalism is out the window on this floor. I've been there for a year and I rarely have these problems elsewhere in the hospital, so I know it isnt me.

I guess what I really wanted input on was... what is an appropriate response for just absolute sarcastic nasty comments? I guess from what you guys said...it's best to just respond to the actual question asked, and not to respond to the obvious sarcasm behind the question/comment.

[gitterbug]

Some units are toxic and attract toxic staff. Do your tasks, help when asked if possible, go ahead and ask if you need help, if this nurse or others continue to treat you badly, remember, there will be other floors and ones with staff that work as a team. Two units come to mind that I have left because the atmosphere was so hostile. There are times the battle is not worth the effort and moving on is better for the peace of mind.

[ladytraviler]

My favorite ways to handle sarcastic hateful comments are this,

I'm sorry I didn't understand what you said, could you repeat it?

I'm sorry I don't quite understand what you want me to do, could you explain it?

I'm sorry, but do you talk to other nurses, doctors, mother, father, SO, child or any other in this tone? What is the difference with basic common curtasy (?)? Did I miss that some where?

That asked in a sincer voice usually gets there attention and draws a big fat arrow to their behavior without having to resort to sarcasm. I feel that I can be politely professional without being friendly. The difference? With polite professionalism, you do as asked by the nurse or other but not one thing more than asked to do. Being friendly, seeing something that needs to be done and just doing it. Example: You know the room needs cleaned. You strip it only and tell the RN. polite professional

You strip the room and call housekeeping and let them know. friendly.

sounds simpl but does work.

kelly

[PANurseRN1]

Uhm, unless things are really different in your hospital, CBCs do go in the lavender top tubes. I've enver seen them done otherwise.