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 do expect my coworker to stay over. The patient technically was reported to this coworker, and she should at least start the database. This is my opinion & it may not reflect the general views of other nurses.
But, if you have a more thorough report of the patient & I am to pass meds, do assessments, etc. I believe the nurse who received primary report should at least pitch in to assist.
I disagree 100%. Nursing is a 24/7 job, and I am not staying late to assist with routine non-emergent matters. If someone is coding at shift change, sure, I will be staying, but, no, I am not staying to do admission charting on a new pt that literally just arrived. My hospital has a policy that you have 24hrs to complete the nursing admission database so it really is not my problem if you think I should stay late to do it
Specializes in Labor/Delivery, Pediatrics, Peds ER.
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.
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.
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.
Our floors would generally refuse to take patients during report time. If the ED would call near report time saying they were coming with a patient, we would ask them to either bring the patient 15 minutes before report, or wait till the end of report time. It was very much frowned upon for them to try to shuffle patients around at report time, unless, of course, there was pressing need to do so because of the patient's condition or need. The supervisors supported us in this. It seems like there needs to be some communication with the higher-ups to stop this sort of practice as a routine thing. It's not fair to the patients when you can't communicate to the next shift what is up with them because you are distracted by several new patients.
Sometimes there would be an exception to the practice of discouraging report-time patients if those bringing them stated there was no urgent need to attend to them, and if they would agree to use their own staff to get the patient into bed and settled in. (Not including arrival vitals, which would of course still be our responsibility.) Oftentimes, they were less busy than those on the floor, so they would readily agree, just so they would be able to discharge the patient from their area. Of course, at that time, we were not dealing with any Medicare rules such as 45 minute time limits, either.
Specializes in Labor/Delivery, Pediatrics, Peds ER.
It is almost impossible to always equally distribute new admissions among nurses. Suppose the hall way is 200 ft, is it reasonable to expect a nurse at the end of the hall to admit a new patient in room 1 just to equally divide the new admissions? Again, there is no reason to be upset when you get two admissions at the same time. It happens this time to you, it can happen next time to another nurse.
Maybe I am not clear, but I think I can tell the difference between asking questions and being hostile. ok, she went to verify the IV site and fluids, that's fine, but she starts to lift the pt's gown and listen to her lung sounds, bowel sounds, to empty the 30cc from pt's colostomy and to have a five minutes conversation with the pt when I am waiting to finish my report, that is rude.
I'm a little puzzled, because I wonder why the dividing line between being reasonable and becoming "hostile" is when the incoming nurse goes beyond checking the IV site and goes on to further assessment? I understand that it makes the process longer for you and you think it's rude, but it's not necessarily hostile nor passive aggressive.
I can identify with you, however. At one of the hospitals I worked for, we had a night shift nurse who was genuinely hostile and difficult to get along with. She could also be very funny, once she stopped trying to intimidate us. She had a couple of moods - cranky and superbly cranky. The patients would say she had no compassion for them. If they complained about the pain of labor, she would tell them they should have thought of that before they became pregnant! At that point, I knew for certain it was not about me, so I gave her as wide a berth as possible when she was extremely cranky, and genuinely appreciated her humor when she was having a "good" day. She really had no business being a nurse, because her idea of a good shift was one in which no patient succeeded in getting any more out of her than the bare minimum she intended. Putting things into perspective, I felt fortunate to only be the outgoing nurse and not the patient.
To understand passive-aggressiveness in woman I suggest that you invest $1 + a few $ postage from half.com or check addall.com and search for the book: Odd Girl Out : The Hidden Culture of Aggression in Girls by Rachel Simmons (2003, Paperback)
It's a real eye-opener. And if you understand the origin you'll start to understand how to deal with it. At its worst, passive-aggressive games are very destructive.
Usually, the ED is wanting to get the patient's admitted to the floor before they go home. Sometimes it is the floor that will not accept a patient at (or close to) shift change.
It is really hard to get 2 or 3 admissions at once. If it is that close to shift change, why couldn't the ER nurse just give report to the oncoming nurse? then you can help with setting up orders, or whatever else you can do.
Well, when the ED calls us at 5 with report on a new pt and the pt doesnt hit our floor until 6:45, it sure seems like they held onto them as long as they could. And it does happen all the time. I would ask that the nurse please do a quick safety check of the room with you as part of report but you dont have time to do her assessment with her thats her job on her time they dont pay both of you to do it! And say it before you start report. We had a travel nurse do this to us, she would drag everyone in the rooms and fully assess the pts! It held us up an hour. She was gone before the week was over.
I think it is hostile of the on-coming nurse to keep you in a room to assess a pt beyond checking their safety, IV, and ID because it is saying, "I dont trust you", it is saying " oh, you're not leaving just yet, I have to find some more work for you to do so that I dont have to do it" Nurses that usually do this always find something to nitpick about. We all know the other shift wants to just go home at the end of the night, why would you prolong it? Because they are being mean. when they question you about every. little. thing during report, things they could easily look in the computer about is part of this " i dont trust you, i want you to make my job easier on me so I will put you through the wringer". It is hostile. We have older night nurses doing it to the younger nurses on day shift and Ive had many nurses discuss it with me, it happens.
ChristineN, BSN, RN
3,465 Posts
I disagree 100%. Nursing is a 24/7 job, and I am not staying late to assist with routine non-emergent matters. If someone is coding at shift change, sure, I will be staying, but, no, I am not staying to do admission charting on a new pt that literally just arrived. My hospital has a policy that you have 24hrs to complete the nursing admission database so it really is not my problem if you think I should stay late to do it