passive aggressive nurses

generalRN2008 · Jan 30, 2014

Tell her to be more positive and the shift goes faster that way

HouTx, BSN, MSN, EdD · Jan 30, 2014

I'm confused - why would an ED "hold" patients to avoid getting new ones?? Their census has no impact upon the arrival of new patients unless they are so stuffed that it has forced them into 'divert' status. Just didn't make sense to me.

Dealing with passive aggressive folks is a real pain. Best approach is to confront PA behaviors - not in an evil, snarky way, but just be matter-of-fact. But your description of her response didn't sound PA to me... just kinda normal ticked-off because of the way the shift started. Very understandable because when you're slammed from the get-go, you know that the entire shift is going to be a doozy.

Always assume good intentions unless you have concrete evidence to the contrary. When people have a negative reaction to a situation, it's not about you just because you happen to be there.

TheCommuter, BSN, RN · Jan 30, 2014

I know maybe the best way is to ignore this type of passive aggressive nurse. They make the work place like hell.

Your coworker is not passive-aggressive in any way whatsoever, based on your description. She is downright aggressive! She is rude, always in a nasty mood and tells you exactly what she thinks of you, whereas the typical passive-aggressive nurse would smile in your presence and pretend to be in a pleasant mood while secretly plotting to sabotage you.

Passive-aggressive nurses indirectly express their hard feelings instead of addressing them out in the open. Passive-aggressive coworkers retaliate using subtle, roundabout, sneaky techniques rather than speaking their minds. These people:

Purposely forget to complete tasks
Blame others for their personal issues
Constantly whine and sulk
Purposely procrastinate when asked to so something
Complain all their coworkers are 'out to get them'
Approach their work inefficiently and sloppily
Secretly resent those with authority over them
Sabotage other peoples' hard work
Lose important papers on purpose
Insist they are overworked

Always remember that passive-aggressive nurses never openly disagree or express their displeasure with you. In fact, they're going to to lie and insist everything is going beautifully. However, they express their dislike of certain people through manipulative actions.

LadyFree28, BSN, LPN, RN · Jan 30, 2014

If anything, the nurse was reasonably upset, and was honest about her feelings.

The Commuter gave great example of what a TRUE passive aggressive person entails.

Next time that happens, don't go in with a chip...go in with a bat, use it when only necessary.

Christy1019, ASN, RN · Jan 30, 2014

I'm confused - why would an ED "hold" patients to avoid getting new ones?? Their census has no impact upon the arrival of new patients unless they are so stuffed that it has forced them into 'divert' status. Just didn't make sense to me.
Dealing with passive aggressive folks is a real pain. Best approach is to confront PA behaviors - not in an evil, snarky way, but just be matter-of-fact. But your description of her response didn't sound PA to me... just kinda normal ticked-off because of the way the shift started. Very understandable because when you're slammed from the get-go, you know that the entire shift is going to be a doozy.
Always assume good intentions unless you have concrete evidence to the contrary. When people have a negative reaction to a situation, it's not about you just because you happen to be there.

^^^ This!

I am an ED nurse and we don't have the option to hold on to our patients because there are always more in the waiting room that need to be seen. Not to mention that with the new Medicare/Medicaid reimbursement laws we literally have 45minutes from the time an admission was put in, until we have to get a patient upstairs or else we don't get paid. Trust me when I say that we don't like having to send patients at shift change, we aren't out to make anyone's job harder, but we have no control when patients get bed assignments.

I also agree that this nurse sounded more frustrated than passive aggressive. Perhaps she is starting her assesments during report because she knows she won't have a chance to get back in to that patient any time soon due to multiple new admissions.

If you feel upset with this nurse try having an honest heart to heart with her. If you never tell her how you feel how can you expect her to change her behavior?

Esme12, ASN, BSN, RN · Jan 30, 2014

I worked 7a to 7p yesterday and three of my five patients are discharged. The ED usually hold their patients till shift change time so they don't need to get new patients, it happens all the time. Two of my three new admissions all came in at 7:15pm during the shift report and the night shift nurse was upset that she has to do the admission stuff. I tried to give her report and help with the new admission as much as possible.
The night shift nurse has a foul mood and is so nasty. She questions every single thing I said in report. She starts to assess her pt during the report so I have to stay. I asked her that she seems upset, did I do something wrong. She said "oh no, it's not your fault. They give me so many damn admissions at the same time". I don't understand why she is giving me hard time.
I know maybe the best way is to ignore this type of passive aggressive nurse. They make the work place like hell.

I know everyone this the ED nurses hold patients to avoid more patient but that simply isn't true. The mass exodus in the ED at shift change is physician driven. Their peers are coming in to relieve them and they don't want them to have to do another assessment H&P and deal with the oncoming MD. So they finally get the lead out and make deposition on the patients all at one time.

I think you are taking it too personally....she told you it isn't you....

"oh no, it's not your fault. They give me so many damn admissions at the same time".

RNGriffin · Jan 30, 2014

I too would be upset if I came onto the shift to three new admission at the same time. Why is your ED holding patients and taking up valuable space to avoid inconveniencing the floor nurses?

I don't think her responses were passive aggressive by your write up. She stated, "it's not your fault they gave me so many patients". If she would have stated this and then went to the manager to report you or complained about you all night to colleagues, this would be passive aggressiveness. Seems as though you feel guilty for leaving her such a messy workload, which isn't your fault, unless you told ED to hold patients until the oncoming shift( I've seen this happen).

Nothing to see or discuss here.

dudette10, MSN, RN · Jan 30, 2014

I worked 7a to 7p yesterday and three of my five patients are discharged. The ED usually hold their patients till shift change time so they don't need to get new patients, it happens all the time. Two of my three new admissions all came in at 7:15pm during the shift report and the night shift nurse was upset that she has to do the admission stuff. I tried to give her report and help with the new admission as much as possible.
The night shift nurse has a foul mood and is so nasty. She questions every single thing I said in report. She starts to assess her pt during the report so I have to stay. I asked her that she seems upset, did I do something wrong. She said "oh no, it's not your fault. They give me so many damn admissions at the same time". I don't understand why she is giving me hard time.
I know maybe the best way is to ignore this type of passive aggressive nurse. They make the work place like hell.

Based on your description, I'm not convinced the nurse is nasty. I don't think she was upset at you at all. If, as you say, many admissions come in at shift change from days to nights, she was probably annoyed that it happened again to her, as she pointed out to you when you asked her if you did something wrong. Coming onto shift already behind is not fun.

As for questioning what you say in report, sometimes those questions come rapid fire because she is not receiving report with the same organization as she expects it. I have given report to certain nurses who keep interrupting me and asking questions because my way of organizing it isn't the way they want it organized. I give a big picture report; they want a task-based report. When I get a task-based report, I also ask questions to get a big picture report. It goes both ways, and we both just need to deal with it. Nothing personal about it.

As for assessing when getting report, I too find that frustrating because I just wanna get the hell outta there. Checking lines and set ups (IVs, drains, chest tubes, etc.) is one thing, but whipping out the steth to check lung, heart, and abdomen sounds when the patient is in no distress is another. You just have to be firm and say, "Let's finish with report so that we both can continue with our evening."

All this is to say that, based on the minimal information you've given, what you're experiencing is not unusual; however, the way you are perceiving it may be the issue.

treeye · Jan 30, 2014

So I may perceive the reasons wrong but it is true that a lot of our admissions on med-surg come on shift change time.

Second, med-surg floor is such a fast paced floor where patient turn over is one or two days. I do not understand why it is justified to be upset that you get two admissions when you come on shifts. The charge nurse have helped her with one admission already. No one intentionally does it to her, it is just the nature of the work.

Do you want to work with someone who is upset and hostile?

I think it could be an expectation issue. so Just curious, your coworker is supposed to leave at 730 and the admissions come at 715, do you expect the coworker to stay and do the admission stuff?

Twinmom06, ASN, APN · Jan 30, 2014

I'm confused - why would an ED "hold" patients to avoid getting new ones?? Their census has no impact upon the arrival of new patients unless they are so stuffed that it has forced them into 'divert' status. Just didn't make sense to me.
Dealing with passive aggressive folks is a real pain. Best approach is to confront PA behaviors - not in an evil, snarky way, but just be matter-of-fact. But your description of her response didn't sound PA to me... just kinda normal ticked-off because of the way the shift started. Very understandable because when you're slammed from the get-go, you know that the entire shift is going to be a doozy.
Always assume good intentions unless you have concrete evidence to the contrary. When people have a negative reaction to a situation, it's not about you just because you happen to be there.

our ED does this all the time! They get travel orders to the floor by 9 pm and then send EVERYONE up at 10:30 pm. Then the nurses that have these patients send them to the floor (2 and 3 at a time - its not uncommon to get 4-5 admissions at shift change) and then the ED nurses walk out at 11 pm without having to assess or report off.

dudette10, MSN, RN · Jan 30, 2014

Second, med-surg floor is such a fast paced floor where patient turn over is one or two days. I do not understand why it is justified to be upset that you get two admissions when you come on shifts.

That depends. Does every nurse on her shift have at least one admission when they come on shift? If so, someone needs to talk to the ED about their patient flow. If not, and she is getting two admissions while other nurses have none, she needs to talk to your shift's charge about more equitable patient assignments.

Do you want to work with someone who is upset and hostile?

Again, you haven't said anything to show this nurse is hostile. You've just said she asks questions during your report. She is upset about the admissions, but you haven't given a bigger picture about admission assignment on your floor.

I think it could be an expectation issue. so Just curious, your coworker is supposed to leave at 730 and the admissions come at 715, do you expect the coworker to stay and do the admission stuff?

Oh, absolutely not. At 7:15 is during report time! If I knew the patient was coming prior to the other shift clocking in, the only thing I would do is put toiletries in the room, grab a VS machine, and move furniture so that the patient can get settled. Question to you: does she ask you to stay and do the admission or do you do it because you feel you "have to" because she's annoyed? I had to learn to put my foot down on very late-in-shift orders that take considerable time to do, although I usually try to gather supplies and educate the patient on them.