Nasty LPNS AND RNS TO STUDENTS

[Lpnmandy]

I'm an lpn student who will graduating in november of 09. I was just wondering how other lpn or lvn students dealt with cruel nurses during clinical rotation. Just recently i was on the floor and i had a pt that lost a parent in icu at the same time she was in the hospital. When she(my patient) returned from seeing her parent, she was crying and upset. I comforted her until she calmed down (i was on the verge of crying with her). I gave her a moment with her other family member and she stated to me that her morphine (pca) was beeping early in icu and she thought she was out so i told her that i would let her nurse know. So i seen that her nurse was running around like crazy due to a couple of her patients so i stopped her and told her what my patient told me. She said okay and continued what she was doing. I sat and waited for my patients family member to leave so i could ask her if she needed a new gone or anything. My pt's nurses came out of the med room and went straight to my pt's room. ALL of a sudden she comes out saying (almost yelling) " A WASTE OF MORPHINE!" The pt heard her i know because i apologized to the patient for me misunderstanding her but the pt said the nurse had the attitude and it was ok. Another student followed her back into the med room and asked if she needed any help and she said " NO, YOU GUYS WILL JUST MAKE MORE WORK FOR ME". She gave me the EVIL EYE for the rest of the night.

Now i do know it was my mystake for not checking (my instructor actually had to show me where on the pca in the syringe where it was) But dont u think her reaction was alittle to much? IM A STUDENT AND STILL LEARNING AND AT ONE TIME SHE WAS TOO! SHE JUST TAUGHT ME TO DOUBLE CHECK WORK WHICH SHE SHOULD HAVE DONE

[dannyc12]

This is a general response to dealing with the situation of abusive colleagues and superiors, not a specific response to this case. This type of thing happens all the time in just about every walk of life, but it really gets highlighted in the nursing profession. Sometimes I think these interactions are just part of an ongoing Stanford Prison Experiment.

The following applies everywhere, not just in nursing.

What I have learned about this is that the abusers are not just doing this just because they enjoy acting like this - they need something from you. They need a reaction. They need a look of fear, horror, offense. They need to see you shaking. They need to hear your voice crack when you talk and they notch your tears on their bedposts at night. So don't give them any. They need the satisfaction that their behavior has affected you. Some of them actually live for it.

So don't give it to them. You know your role in the situation, and it is not to be an emotional handrag for colleagues - so don't be one. React in a way that surprises them. Some suggest, "Kill them with kindness." That works fine, although it can start a time-wasting cycle of "sarcastic fake kindness" between the two of you.

I try to "Kill them with competence." I know my role and I work very hard to make sure I know my responsibilities and I give my best effort at all times on the job.

When someone starts to big-time me, abuse me or try to probe me for emotional reactions, I give them none. I look them straight in the eye (yes, I know this borders on insubordination), deadpan and say "Very well, then" or "OK, I got it" or any other appropriate response that indicates I understand. If I don't understand, I restate their position and ask them if I am correct.

The abusive party hates this, and they don't even know why. They truly miss those disconcerted, hurt, dirty, or confused looks from you. Most of them will quickly realize that mining you for emotions is a dry well and they will move on to others. They need their fix and they will get it, but it doesn't have to be from you.

Now, when you honestly do screw up (and you will), it is your responsibility to acknowledge your mistake and calmly apologize. That's it, no histrionics or other stuff to feed the beast.

And by the way, that abusive person had better do their job exactly right. There will be no mercy on my part if they screw up. Used wisely, Incident Reports can be useful tools - just make sure you keep personal issues and emotions out of those too. Here is where your competence comes in. If you have not shown any, no one will listen to you. But if you have, they will.

This is so much easier said than done. I could not have done this in my younger years.

[greenfiremajick]

This is a general response to dealing with the situation of abusive colleagues and superiors, not a specific response to this case. This type of thing happens all the time in just about every walk of life, but it really gets highlighted in the nursing profession. Sometimes I think these interactions are just part of an ongoing Stanford Prison Experiment.

The following applies everywhere, not just in nursing.

What I have learned about this is that the abusers are not just doing this just because they enjoy acting like this - they need something from you. They need a reaction. They need a look of fear, horror, offense. They need to see you shaking. They need to hear your voice crack when you talk and they notch your tears on their bedposts at night. So don't give them any. They need the satisfaction that their behavior has affected you. Some of them actually live for it.

So don't give it to them. You know your role in the situation, and it is not to be an emotional handrag for colleagues - so don't be one. React in a way that surprises them. Some suggest, "Kill them with kindness." That works fine, although it can start a time-wasting cycle of "sarcastic fake kindness" between the two of you.

I try to "Kill them with competence." I know my role and I work very hard to make sure I know my responsibilities and I give my best effort at all times on the job.

When someone starts to big-time me, abuse me or try to probe me for emotional reactions, I give them none. I look them straight in the eye (yes, I know this borders on insubordination), deadpan and say "Very well, then" or "OK, I got it" or any other appropriate response that indicates I understand. If I don't understand, I restate their position and ask them if I am correct.

The abusive party hates this, and they don't even know why. They truly miss those disconcerted, hurt, dirty, or confused looks from you. Most of them will quickly realize that mining you for emotions is a dry well and they will move on to others. They need their fix and they will get it, but it doesn't have to be from you.

Now, when you honestly do screw up (and you will), it is your responsibility to acknowledge your mistake and calmly apologize. That's it, no histrionics or other stuff to feed the beast.

And by the way, that abusive person had better do their job exactly right. There will be no mercy on my part if they screw up. Used wisely, Incident Reports can be useful tools - just make sure you keep personal issues and emotions out of those too. Here is where your competence comes in. If you have not shown any, no one will listen to you. But if you have, they will.

This is so much easier said than done. I could not have done this in my younger years.

I can certainly resonate and agree with your post! One thought comes to mind though...There are many more and varied reasons that a colleague or superior will choose to act in such a manner. It could be that they are unaware of their effect on others and are simply "drama queens." These are the really fun borderline personality types that thrive off a need for control and then feel comforted they are able to have that control when they see others walking on egg shells around them. There are some that choose to act this way because they are just plain selfish and don't care how others feel. There are those that act this way because they are simply in a bad mood and have little regard or concern in how they appear to others. There are MANY reasons, not just what you listed.....

That all being said, this is why I think it's important to have some sort of understanding in psych/soci-emotional behaviors because not only do our colleagues. superiors act this way at times, we can also be presented w/these behaviors from patients and the families of our patients! Awesome post, Danny!

[HeartsOpenWide, RN]

Just blow it off. Like you said, she was running around busy. M/S is a crazy unit and having a student makes it harder. Many students assume that it makes the nurses job easier because they are there to "do their work for them" but the nurse is still responsible for HER/HI patients, still has to do assessments on ALL her/his patients (even the ones you have) because she has to make sure your assessment is accurate, has to monitor your narcotics, stop what she is doing to answer your questions,; so if anything having a student adds MORE of a work-load... and although she should be nice about it; stress is huge a factor and does not alway bring the best out of people.

Note how you feel when you are way stressed out on your shift when you become an RN, and then maybe you will understand where this nurse is coming from, and then remember how you felt like you did when you were a student (now) and be the better person and be nice anyways. But if you do slip and snap at a student like your nurse did to you, at least at that point you will finally understand where that nurse while you were a student was coming from...

[Rylee2008, ASN, RN]

Sometimes they forget they were students at one time. Some are nasty because they are on power trips. I use to be a surgical tech and was reminded everyday I was at the bottom compared to the doctor and the nurses. We are all a team and the patient deserves great care whether we get along or not. Blow it off, she may be redirecting her anger to you instead of where it actually needs to be. Most nurses love having student. Good luck and don't take it personally.

[canoehead, BSN, RN]

I wish people would quit attacking the original poster. I know it's not meant as an attack, but that's how it's coming out. I believe that the RN acted very unprofessional by making a scene while coming out of the room.

There was no scene, the RN made a rude comment and walked away. Once students get on the floor and working every day they will realize that you have to forgive your coworkers at least once every 4 hours, and on bad days every 30 minutes. They will be doing the same for you in all likelihood. Just walk away. If I was the student I would have actually apologized for calling her to do an intervention that wasn't needed, and with that approach I would have asked her to show me the ins and puts of the pump briefly. (sneaky, eh?) Amazing how many times people will say "I didn't mean to snap at you, I was so stressed." when you approach them with kind words.

IMO if the student was assigned to that patient she should know how to read the pump, at least to tell what the various alarms mean. If the instructor wasn't doing that education they should be.

[NurseCubanitaRN2b, BSN, RN]

IMO if the student was assigned to that patient she should know how to read the pump, at least to tell what the various alarms mean. If the instructor wasn't doing that education they should be.

That's very true, and I'm glad you pointed that out, however it would also depend on which rotation she was in and how far she was in nursing school. We didn't learn about the PCA's until the middle of 2nd Semester when we were doing pharmacology. So how is a RN going to hold me and my instructor responsible during my clinical rotation during the 1st & part of 2nd semesters when we weren't exposed to it yet. If it's not part of our curriculum until a given day then we shouldn't be made responsible for it. I have no idea what clinical rotation the original poster was doing so holding the instructor responsible for it only applies if they were exposed to it during theory and clinicals. During my rotation we were taught how to use it even though we weren't allowed to touch it. It was for knowledge, to know how the machine works, but again I wasn't exposed to it until later in the 2nd semester when we did IV calculations etc. Also I want to add that we were limited on the PCA's. We didn't learn more about it until IV Therapy Certification AFTER we graduated. I don't know how it works in other states, but in California we have theory simultaneously with clinicals. So if we learned it in theory and we were signed off on it, then we could apply what we've learned. I would imagine that's how they do it in other states too. But IMO, you can't blame the student for the RN's actions. The RN should have NOT assumed the patient needed morphine. She should have checked it out herself because again, we're dealing with students and patients, most likely they're not familiar with everything.

Now that the student had that experience with the PCA pump, now she knows what to do next time. It was unfortunate that the incident happened but we learned from our mistakes. Now she knows to look at the PCA pump first and if she ever has to relay a message later she can state "I'm unsure, but I believe the patient needs more morephine on her PCA" That way she's covered on her end. The RN learned from her mistake because now she will NEVER assume the patient needs more morpine. She will go and check it out herself. We as nurses have also learned from this. We now know what to do and not to do. That's what's great about allnurses because we have a team of "students" and "nurses" who will share information and learn from each other. Thank you to both!