Traumamama02

I guess I did this to myself, but I don’t see how or why when we are over ratio and worked to exhaustion that this was a priority for discipline... how about teaching, guiding , giving tools for success? Isn’t that what managers are suppose to do at lease some of the time? I didn’t communicate assertively...you’re right ... assertive communication gets us in even more trouble, yelled at in front of colleagues which adds to the low self esteem which leads to less respect which leads to less teamwork and adds room for clinical judgement errors because we begin to not trust ourselves and our intuition ... because we become dumb nurses in our own minds. I can’t agree with my lack of assertive communication being my downfall. Nothing you can do pleases this manager. Nothing you say, no amount of kindness or distance from her keeps you safe from sabotage. This kind of psychology damage is criminal when our mental health is already spread thin... Thank you for your response. It means so much to be acknowledged when it feels like the world is falling apart around you. I appreciate you!

suppose I do rub people the wrong way, would that excuse the manager behavior to deny my request for help and risk putting a patient’s safety at risk ? Patient care is the bottom line with every assignment I get. Compassion is my number one compliment by colleagues and family members. I’m not a jerk to work with ... I love my job and I know what I do best, trauma. I know I can be an asset in that specific unit. Inside I’m annoyed and was venting with my post but I will absolutely work wherever I’m needed and give 110% to any and all assignments. I’m a happy nurse, friendly and smile everyday I walk in to work. I can’t stress enough that I’m not one to ruffle feathers and openly complain all day, I’m don’t walk around talking negatively about things .. I’m quite the opposite. I’m a team player and would never talk down to anyone.

I’ll clarify a few things now that I’m not as emotional. Clearly I did elaborate as to how my ICU’s are delineated. There are 4 trauma, neuro, cardiac and med surg. There are core staff in each specially and the surgeons have a say in who they would like to see become core staff. They don’t get involved passed a request ... if it doesn’t happen, it doesn’t happen except for the cardiothorasic surgeon, he gets who he wants. That’s just the way it is. Next, I will say that when I mentioned retaliation, I had a scenario in my mind of being singled out by my manager if I went to my director for guidance. Yes, there have been several (hearsay) complaints in regards to her disruptive behavior by other nursing staff and this was not our first interaction. I’m just at my wits end with the disrespect, the constant ridicule and nit picking ... I mean, last month she sternly told me to take down my comfort care sign on patient with a new diagnosis of brain death. Her exact words were “I’m going to need you to take down that comfort care sign, it’s not comfort care anymore, he’s brain dead”. My mind was blown as she said this to me in the door way of the room and I’m certain that comfort care continues on with such a sensitive dynamic as brain death, it’s multi faceted with grief. My response to her was that it’s a gentle reminder to our colleagues that there is a sensitive situation in this room and she just demanded I take it down. I just don’t see the benefits of being so mean, no compassionate and interfering with teamwork. Shouldn’t a manager have walked into any of my mentioned situations and acknowledged each situation even slightly as to carry out my simple request to call secretary to delegate tasks to in my first scenario and maybe introduce herself to the patient’s family, offer her her card and her support in my second scenario instead of displaying disruptive behavior? Maybe I am rubbing the wrong way, but I can’t see how. I appreciate any and all responses, advice and opinions.

you nailed it...I'm one of those who are just in awe over crappy behavior....it blows my mind; i can't fathom the audacity, thus I am having a difficult time maintaining my composure when the subject is brought up (which isn't often). btw, the attending pulled me aside today and apologized, gave me the preceding 24 hrs of the plan of care of this patient and again ...mind=blown at the lack of ....oh I'm gonna shut up.... I refuse to become a "Bitter Betty"... but learn, learn, share, teach and learn some more... don't be mean, take accountability, practice team work, give constructive criticism, show each other compassion, empowerment is my favorite, support emotional health, hug it out often...be the nurse you'd want to work with... that is all and hope y'all had a great day and if not, hope you know that I believe in you and your passion for nursing.

you need to be cloned! you're the only one that gets it...

i should have used quotes that the attending said to RT, "stop sx so we can get an accurate bp before we hang the propofol..." its hard to get everything out in regards to facial expressions noding of heads, etc. i had orders people and pharmacy, my director and the medical director and also the resident program director are backing me up... no disciplinary actions, an absolute learning experience. this resident does not get the concept yet and neither do many of you. its ok I'm ok you're all ok...thanks again. as for as this thread is concerned, case is now closed with no further updates.

I agree... worked hard, with positive attitude and motivated with an open mind for 10 years... numerous kudos and peer nominations plus admin chosen awards ... not floating but for Christ's sake.. I'm not an idiot, and I am definitely not a know it all... I am humbled every day.... (to the resident and attending) so please don't flat out lie. What kind of crap í ½í²© does that to a team whose barely holding it together in the first place... we are all better than that, than this... it's not suppose to be a pissing contest... I've offered my mistakes to students and colleagues so they are mindful, I've turned myself in for giving phenergan IV when it was ordered IM and that was just last month... the point is ... I'm not a physician, I'm not even a mid level, I'm an ADN, BUT I'm a critical thinker and I put the pt first always, I look at my orders, I put in orders, I ask for help when I need it and I always offer help when I can afford to.. even when I can't I will stop and help. I'm a crappy ED nurse.. I've never given up on something I set my heart and soul out to do but I'm getting out ... neonatal air Transport is my second career goal, I've already completed my first goal which was HEMS....reason I went to the ground is bc I had a baby and jumping out of a helicopter 7 months pregnant in the dunes at glamis prooved not safe for anyone ...and going back to 48 hour shifts was not desired. Trauma center nursing was a passion, I'm sad that this happened... defending yourself is never fun especially when the focus goes south instead of on what the moral question is that's being asked... I'm smart, I'm the cheerleader of any Dept I work in, im a happy person, I smile a lot, im focused, I'm detail oriented ... IM compassionate I'm humble, I still learn every day ... I'm a good nurse... and I've been told all of these things... as well as a lot of other not so nice things... The culture has to change, we need to be tight with each other ... not tighten the noose ... Please close this thread... thanks to everyone for participating. I'm exhausted and I go back to work tomorrow for the first time since the incident... be safe everyone...

I love you Ruby Vee!!!

I kid you not , most all that happened .ive never restrained a pt before intubation unless they were flailing but this was the case until I was delayed on starting the prop bc of half ass order changed and riffles physician feathers. the physicians never left the dept except the resident did go the cafeteria.. the things that came out of the attendings mouth were incredibley inaccurate as far as medication properties.. but I'm not a doctor nor do I pretend to know more, with that said the prop was going to be started immediately but she immediately wanted a bp first which are set to q 5 min so it's not like we didn't have a Trend already ... uhh I just want to go back to icu where our pts are safe and our autonomy is honored and we are educated as to why and what with accurate, best practice literature... even in a code situation. In the icu, a team member never tries to be a jerk, it's always an order with education if needed or even if not needed, reminders are always cool I'm considering writing a grievance to the resident school admin for misconduct .. even if I did do everything wrong and my thought process is in outer space. That fact is he's lyig and that my friends is more dangerous than me starting propofol Emergently

The bottom line is the integrity of the resident ... he has none and he's dishonest. And I hope that in sharing my experience that anyone can take home a learned experience from mine .. "use your power to empower others" don't eat your colleagues ... teach them if they mess up ... keep lateral violence out of the pt care setting..out of nursing altogether

I did take was was easy and in front of me bc I had orders to do so.. you should know not to leave the or bedside with an at risk airway as the only Rn in the iso room...to get a detailed titration order, figure out how to place it (joint commission in on our ass about titration orders and we get reprimanded if not perfect ) and then to have to call pharmacy and wait for validation bc you can't override **** in this ER except for haldol, Benadryl' and Ativan (the B-52).. that's just dumb .. to even consider leaving the bedside when you have safe hemodynamics and a capable medication.. it's called pt safety

The attending trumps the resident and we discuss used starting the prop to get him over to the crit care are of the Er safely then transitioning to the combo. The receiving Rn didn't follow through.. then levophed was started and they flipped out on me an hour later ... makes percfet sense .. not .. we even cycled the no which ended 125/88 ‘before we start the prop' and RT was there as a witness and submitted what she hears come out of everyone's mouth. We were all on the same page ... start the prop bc bp is wnl and get him moved and then bridge to combo sed orders. Keep in mind we had to bag him and sx him and restrain him during this 30 sec conversation.. infection control and pt/employee safety.. why the bus treatment .. there is no need for this drama ... in my opinion

Exactly... bridging ...get the pt under control. give them a bolus, a little bit of vasoactive medication is not uncommon in critical care patient who are sick AF

He practiced nursing before medical school. And with that said why would he give me starting dose of 30 mcg if he and the attending were so focused on the blood pressure and potentially having some hypotensive rebound on this patient who has more Comorbidities than I care to dictate in this thread ..The acute issue was his combative behavior, airway security, hypoxia, acidosis, VQ mismatching, R/o TB, 5150 hold and I can go on... the priority was not a bp but def a critical care component but getting the hell out of a room with no camera no window, no help, no sitter, dealing with a know it all trauma RN who looked at me like an idiot when I gave her report and the follow up bridging sedation orders and encouraged analgesia at a higher gtt rate vs versed bc of md concerns and obvious ones like better pt outcomes.no one wants to go in there to help bc of the TB, the pt needs an iso icu room in icu, but none avail so ID says bc he's a ‘closed circuit' he can go into general pt population, an area where there's actually 2 to 1 ratio to properly care for the sick man. But how safe if that when he's at risk for self extubation.. I'm sorry but ER knows code blue yes. They are trauma experts but that's where it stops... they don't know what do s/p code blue... in my hospital .. in my opinion.

No they don't have access, he asked a floating RN to access the pt profile and get the gtt. She has already written and submitted this information to our director and for quality ...