I dealt with a new nurse the other night (she volunteered that she's only been a nurse since December) and I could tell that she'd been on the receiving end of some aggressive behavior from other nurses on the unit (not my unit, I'm agency.) She gave an excessively detailed report, reminded me repeatedly of how she had checked drains, pulses, neuro statuses, pain medicated all of the patients RIGHT before shift change (so you don't have to do it) and "fluffed and buffed" (her words) everyone within the past hour. She reminded me twice that everyone's labs were done and sent, and nervously asked me 3-4 times if I had any other questions about each patient.
When I assured her that she was fine, go home, get some sleep, if there's anything she missed, I would take care of it, her eyes filled with tears, and she told me that so many of the nurses on the unit had "yelled" at her, reported her to management, told her that she was a slacker, because of things that were missed during her shift. She said, "I am a worker! I run my ass off all night! They always find something I did wrong and report me!"
I stopped her with a hand. Look, here's the thing - if you show me a PATTERN of slacking - like, lying to me and telling me you tried to draw blood, and patients REPEATEDLY tell me nope, no one came in all night, or I catch you on your phone when I come in (30-45 min early every morning) but then you give me a list of things you just "didn't have the time to get to," then, damn straight I'm going to call you out on it.
But if you try your best, and a few things get missed (you're new! You don't know everything when you're new!) there are a couple labs or meds you didn't get to...no problem! This is a 24 hour job! And it would take something UNBELIEVABLY awful for me to go to management - you can bet you will have a heads up, cause anything I say to them, I will have said to you first. That's called professional courtesy and being a grown up...
I have no problem saying, sorry, I missed that K+ replacement order, for the pt with a K of 3.3. Sorry, thanks for taking care of that for me! Or, sorry, I couldn't get that UA, she didn't feel like she had to pee, but the stuff's in there. Thanks! Or, my personal fav: Nope, I have absolutely no idea when the last BM was. BMs are literally the last thing on my priority list. But he's right there, you can ask him if it's important to you!
With confidence comes the ability to say, nope, I don't know, didn't get to that, didn't care about that...but I took care of the important stuff - your Cardizem is titrated properly, I got US to come up b/c i suspected a DVT next to the PICC, and I stopped your pt in 4 from leaving cause Case Management had transport on the way when I found out she has 10 steps to get to the bathroom and two casted legs. And lives alone. And no friends or family. And no home health set up.
But sorry, I absolutely forgot to give the 6pm Colace. Thanks for taking care of that for me! See you in the morning!