Nurses aggravating my patients.

[WittySarcasm, BSN]

Maybe rant-y but I need to get this out there. Sorry if it annoys you.

So, this has happened several times by the same nurse and I need ideas now. Going to the manager doesn't work- several have tried to no avail.

Anyways this one nurse tends to say/do stuff to purposefully make patients mad or annoyed or complain. I, along with others, tend to keep her out of our patient rooms- even rushing to lights to get there before she does. Normally it works, but sometimes something happens and you're unable to. Today was that day, I was busy labeling blood that I had drawn and marking the IV blood pressure med I had given when a patient's call light went off. She jumped up to get the light. I had casually said that if it was pain meds she still had longer.

I guess this nurse proceeded to tell the patient that I had told her she couldn't have pain meds and that she needed to wait- instead of asking the patient what she needed. The patient proceeded to cry when I later got her light, explaining she needed the meds- that she isn't drug seeking, and so on. She's upset to know that we are talking about her like that. And now refuses the pain meds she needs. Normally I would suggest she talks to the manager. But I know my name will come up. It'll be me that did wrong. And it frustrates me that I work so hard to keep them safe and happy and healthy just for 5 minutes to ruin it.

The problem is there's no confrontating the nurse. Again others have tried- multiple times and result is always the same; she will lie, turn it around to where she is the innocent victim. I bend over backwards to make my patients happy for the 12 hours I have them. And it annoys me that I have to deal with this constantly.

Any ideas on what can be done about this, besides shaking her and screaming endlessly. Or if nothing else thanks for the rant.

[LovingLife123]

I would have just explained to the patient that you weren't talking about her. You were in another room, this nurse was helping you with a call light and you mentioned that her next pain meds weren't due yet.

That is why the patient put on her call light, correct. I would have said sorry if there was a misunderstanding but nobody thinks she's a drug seeker.

Two things. One, of her pain is not being controlled in the time frame of your orders, you need to call the physician and get that adjusted. Many times when people clock watch and are calling early, it's because what they are getting is not adequate.

Maybe the nurse in question could have a better approach with patients, but why do you immediately refer them to the manager instead of trying to fix the issue yourself? Either smooth things over with the patient or approach the nurse in a respectful way. There are ways on going about it.

[WittySarcasm, BSN]

Ususally I don't have them immediately talk to the manager, I've never actually suggested it to a patient but have had others do that. But if it becomes too big of a problem then I tend to pass it up the line- charge (though most of our charges don't want to be charge and tend to ignore that) and continue up the line. I did try to explain and I'm hoping that as the day progresses she'll kind of see it and maybe tonight will be better (especially since said nurse won't be back again).

[JKL33]

Go to manager and use your professional business demeanor to concisely and factually report this example of the coworker undermining care by lying to patients in order to destroy their trust in assigned nurses. Hear your manager's suggestions for how this should be handled. Main ways this could play out:

1. Manager suggests not doing much/ignoring it/not giving it undue attention: State "that isn't an acceptable solution because it is causing patients to distrust us and affecting their care." If mgr states this might just be your perception, state, "I considered that, but most of us have the same perception and therefore I know it isn't primarily a problem with my view of things."

2. Manager suggests professionally confronting these instances privately in real-time (during shift): Ensure that you have manager's support and then do it. If at all possible, give her some rope and catch her in the act - - let her answer a light of yours and immediately follow her so you are present to hear her interaction and in the doorway as she exits the room. Inform her that you need to speak with her privately and recount what you have witnessed ("you lied to that patient," "you are attempting to cause distrust by lying to patients," etc.)

3. Manager suggests formally confronting the coworker (via a proctored meeting with the three of you): Do it! Many times managers can't easily do much to help because everyone wants to complain indirectly and therefore evidence of the problem is always hear-say. Go to the meeting and confront the coworker with unemotional, objective FACTS that she knows you witnessed first-hand, just as suggested in #2.

Above all else, you have to be calm and pleasant but concerned. Unemotional. In every interaction.

BTDT!!

Best of luck~

[WittySarcasm, BSN]

Thank you so much for your reply. I'm gonna try to do that and hope for the best. I know everyone is tired of this and I hope through these ideas maybe something will help calm it down some.

[Been there,done that, ASN, RN]

I am not clear as to what constitutes "say/do stuff to purposefully make patients mad or annoyed or complain." You would need clear examples when presenting the problem to the manager. If fellow nurses are also seeing the issue... remember, there is strength in numbers. Call a meeting with the NM and nurses that you know will support you.

You also gave her ammunition with your remark about the pain meds not being due. No patient needs to hear that from any nurse. If they are in pain, call the doctor for an additional order. Time is not the issue, pain is the issue.

[JKL33]

^ That's a good point.

OP, if you are going to address this in the manner I described, it has to be about someone purposely causing trouble, not just someone with less-than-perfect communication skills. And you can't have contributed to it like you inadvertently kind of did in the example you gave.

If you said something like "she still has longer" - then how would you have honestly responded to the patient? Probably with a discussion that might end in both of you deciding to wait until the next meds were able to be given, or might have resulted in you calling the physician. Also, I didn't get into it previously because it does sound like this nurse has more than her fair share of problematic interactions with patients, but the fact is that your opinion of what went on was also influenced by the patient's...sort of off-kilter...reaction.

My first response is for a known absolutely problematic coworker. Not for someone who doesn't finesse things very well in a situation where a patient may have made some assumptions too (like the fact that you were "talking about" her) and twisted some things slightly for her own reasons.

You can't deal with this unless you have directly witnessed purposeful sabotaging.

[cleback]

If you're going to bring the issue up with the manager, I'd suggest using a different example. The one you gave just sounds like she's being frank with the information you gave her. Lack of communication skills/ social finesse aren't necessarily a sign of malacious intent.

[sweet sunshine]

When I don't like working with specific nurses I wait for them to fill out their schedule and try not to schedule myself on the days they are working.

[NurseSince2014]

While she should have asked the patient what she needed instead of assuming what she wanted, I don't necessarily think that she was saying this to make the patient mad. In this case, based on what you shared, it seems like the information she shared was truthful. This nurse may not have been very tactful in her interaction with the patient, but I'm not sure she was trying to aggravate the person. She was, after all, only providing the patient with information you had given her. In my opinion, this example alone isn't enough to report to the manager, so you may want to keep track of other negative interactions this nurse has with patients. Like other posters have said, if you can get other witnesses, that would be helpful as well. I'm sorry that you are having to deal with a coworker that you perceive to be negatively impacting patient care, but unless you can get other examples, perhaps ones that are more provocative, I don't think you will get anywhere. Managers typically aren't going to get upset with nurses answering call lights unless there is a good reason for this nurse not to be doing so.

[canoehead, BSN, RN]

OP I get what you are saying. You don't have to be overtly inappropriate to wind someone up. Especially if they are sick, on edge and the nurse has all the power.

She's been reported for this before, so I doubt doing it again will have any effect unless you had a very obvious example. Frankly, I'd follow behind her and apologize, explain that she's skilled but not the most tactful person, and what she meant was...whatever you wanted to say. Tell the patient you've got their back, and they can ask for their assigned nurse anytime they think there's been a misunderstanding, you will take on working out those issues for them.

[WittySarcasm, BSN]

I understand this example is not the strongest but it was more the latest moment I've had with her (mainly because I race for the lights).

I had her once answer my call light, while I was in another room. The patient in question was a set up transfer (and truthfully she could have asked him or me) and he needed the bathroom. She proceedes to come to me and tell me the patient is demanding pain medications. Something that surprised me since his last 3 weeks here he never needed pain meds so I 'sped walked' to his room, only to see him half out bed. He tells me that 'I told the nurse that I needed to use the bathroom. She said ok and turned the light off and left.' I'd went back- after helping the patient and apologizing- and had her repeat what the patient needed (again she swore he wanted pain meds) which I had to explain the real reason. This is just another in a huge list of stuff she's done.

Then there was the fiasco of when she was charge RN and refused to call a rapid response for me, refused to have the other nurse call it for me. And proceeded to LIE to me for over 20 minutes saying "they're on the way" when she NEVER called them. While I was with my patient who was on 6 liters of O2 and barely keeping 80%. While I tried to not cry she sat and lied to me multiple times. Which I didn't find out about the lie until I got another nurse to stay with my patient so I could call them.