Need some advice...

[IMA]

I used to work at Progressive Care Unit,step down unit of ICUfor more than 3 yrs. then trasfer to CV-ICU & been working there for 3yrs & 4 months.We have a bully CV surgeon who screams & yell anytime he feels like doing it.I've been a victim of his tantrums,after those incidence I told my charge nurse I don't want to handle any of his patients anymore,I dont mind taking care of difficult patients as long as he don't scream & yell at me in front of everybody,it's too demeaning & demoralize me.Here's my dilemna now,still refusing to be train for fresh CABG,& pt w/ IABP just bec. I dont want to deal w/ that CV-surgeon. I have this ambivalent feeling ,there just few of us now who dont handle fresh heart,it makes me feel inferior w/ the rest,it just blow my egos,am not happy working at that place anymore,feels sad & inadequate most of the time(just bec I still dont handle fresh heart),having this chronic back pain,series of X-rays had been done from cervical to sacral,everything looks okay,just swollen muscles,now on Flexeril 10 mg daily PRN,went to rheumathologist,does series of lab works,did not find anything wrong w/ me.Is it possible I'm just depressed causing this chronic back pain,been flaring -up again lately been sleeping a lot too,working nights (7P-7A).Found opening at neuro-ICU,neuro-surgeons & neurologist were great,just thinking on moving there for good,I'm willing to be trained & willing to handle fresh craniotomy pts. & the like,even difficult cases.I really dont know on what to decide now.I'm comfortable w/ sets of pt I've been handling at CV-ICU,my manager gave me a good evaluation & reassured me not everybody is for fresh heart,but I have this feeling of discontentment, feel insecure w/ the rest just bec I refused to take care of fresh heart(CABG) & worst I dont have peace of mind,this troubles me,aggravating my insomnia,already taking Lunesta 3 mg,just to have a good sleep.Your insight will be highly appreciated.Thanks.

[anurseuk]

If you're not happy taking a fresh post op cardiac patient then CVICU is probably not for you. Generally under supervision our newly qualified nurses will take fresh hearts as soon as their 6 week supernumery period has finished. And taking IABP's withing the first 6 months or so.

Try neuro, there's a speciality for you but maybe CV isn't it.

Hope that helps :)

[shocker29]

If the only thing that is keeping you from upgrading your skills is one bully surgeon, then I say, "to heck with him!" We are all part of a team... his part is not anymore important than ours. Next time he throws a tantrum, simply say: If you would like to continue yelling at me, perhaps we can finish this conversation in my manager's office... or something to that effect. Definitely don't be rude back, but you are not his subordinate... you are both part of a team, so don't let him think that he has the authority to treat you that way.

[criticalHP, MSN, RN]

If the only thing that is keeping you from upgrading your skills is one bully surgeon, then I say, "to heck with him!" We are all part of a team... his part is not anymore important than ours. Next time he throws a tantrum, simply say: If you would like to continue yelling at me, perhaps we can finish this conversation in my manager's office... or something to that effect. Definitely don't be rude back, but you are not his subordinate... you are both part of a team, so don't let him think that he has the authority to treat you that way.

Yes, yes! Don't take that from anyone, please. We had a CV surgeon that would scream, yell, threaten to have nurses kicked off the heart team, and so on. He was stripped of his OR priviledges until he sought and completed mandatory anger management. After that, he was as sweet as pie. He later appologized to the ENTIRE NURSING and MANAGEMENT STAFF, saying he though he had to do this to get good care for his patients. No, respectful, collaborative, and pt focused discussion is the way to get quality care- and make for good colleagues too. He still works here, and he's still nice after 3 years!:yeah:Go to your administration and urge them to develop a 'zero tolerance policy' for hostile working conditions.

[AmyCardsNP, RN, NP]

I think the last 2 posts were great advice... stand up for yourself and don't let someone determine what you do with your career. But, everyone has a different personality and if you're not the type of person to stand up for yourself and the dread of communicating with this physician is making you feel this bad, then maybe CV isn't for you. Most CV surgeons have ego issues, although not all of them yell... they are very protective over their patients and thrive on trusting the nurses who they FEEL they are "entrusting" with THEIR patient's care.

I'm not saying what he's doing is right, but chances are you're not going to change him- we have had several MDs like this. They will eventually lighten up on you once you show them what a strong, capable nurse you are. But, if you can't take the fire, get out of the kitchen. (I hope you can... be strong)

[Bella RN, BSN, MSN]

I can DEFINITELY relate to what you are saying.

I trained for hearts and it was just a 3 month orientation where they wanted you to study and then you would get cases daily. I didn't like that. I thought their orientation sucked. I had 3 years of MS ICU experience at that time.

And the preceptor I had was condescending and was obviously let it be known that she didn't feel that I wasn't trying my hardest. Which I was but in CSU those nurses I worked with were very,very, very competitive.

For instance A fairly new CSU nurse would brag about a patient being on 8 drips and how critical the patient was and how many fresh hearts they had and everyone was so impressed with them. At that time I wasn't taking fresh hearts nor did I have much exposure to IABPs so I can understand how you feel about being insecure because of taking the less acuity assignments and how you may or may not be treated in your unit.

I think since it is apparent that you are not happy there; so go where you feel lead to go and that makes you feel more comfortable. Neuro ICU is a fascinating and you will grow and hopefully like it. You said that the team there seemed great and that is very conducive to your well being while on a team. :nuke:

If you are this stressed and becoming depressed and having insomnia due to this current position--it is not for you.

Just because you are not doing "fresh hearts" doesn't make you less than.

You are a very good nurse and take your knowledge where you will feel welcomed. Go were you are celebrated and not tolerated. That is what I did and i am happy with my move.