"know it all"

CEN35 · May 10, 2002

usually that type of person, will have a few humbling experiences that put them back in the right frame of mind................at least temporarily anyways!

me :)

zumalong · May 10, 2002

I have worked with several of this type of personality. I think most of it is to cover up with their inadequacies. (Psychobabble)

The worst I ever worked with was about 13 yrs. ago. Madelyn was new to our unit. She was an RN, I was an LPN. I worked nights while I was going to school for my RN one summer. This chick (my pet name for people who pis# me off) starts telling me what to do. Only everytime she opens her mouth something else screwy comes out. Ex: She was watching me change a dressing. (now mind you--I had been working on this unit for 4 yrs by now) and she started to criticize my technique. She tried to tell me that you put the moist dressing on the intact skin, and the dry dsg on the wound!!!! Well then and there I knew she was swimming in the shallow end of the gene pool.

One night several weeks later, I again had the pleasure of working with this ditz again. I had pretty much stayed away from her. She was busy, so I answered one of her call lights. The frail gentlemen that was in the bed was very apologetic. He had spilled his water pitcher and wondered if I could change his wet sheets. I knew that his family had brought him in for abx treatment for resp. inf. He had terminal Ca, but there was no indication that he was going to hit the eternal road on this admission.

So anyway, flighty nurse comes in, turns all the LIGHTS on. Then proceeds to take over my changing of the bed. Fine--but then I hear her say to this tired gentlemen (who only had spilled water), "OK let's give you a bath." He stated he did not want a bath. She told him he did not know what was best for him. I was very angry by now. I pulled her aside as she was getting towels, washclothes, razors etc. I very calmly explained that all he had done was spill his water pitcher.

She looked at me and said that he needed to be clean for when he leaves. :confused: I thought, hey maybe he is going to be discharged in morning--and she knew something I didn't. So I continued on my rounds.

Not 3 minutes later I hear "So Mr. Soandso what do you want to do before you die???" Then to make matters worse I hear him say, "Why, am I going to die?"

I did not hang around for more of the "theraputic' talk she was giving him. I went directly to my DON--I did not pass go or collect 200$ (which incidently was my full time pay for a week). Madelyn lasted about 2 more weeks on our floor, when she made a nasty drug error. She quit and went into home care. :eek:

Sorry this became so long. Anyway--I haven't run into anyone as bad as her since, but when I do work with that type of "I know it all" personality, most times I steer clear. If that is not possible I will politely smile and walk away--then do my own thing. THese people like to get under your skin--they are like animals they can smell uncertainty and lack of assertiveness. All I can say to you is explain that you went to school and that you were so intelligent that you passed your boards. So thank you for your advice I will take it into consideration. (Even If you were a CNA you still had to take a class and pass it).

Don't know if this will help--but hopefully this person does not practice nursing with the lack of ability that Madelyn did.

:kiss

fedupnurse · May 10, 2002

A couple of years ago I was precepting a new RN. She would ask a question and then tell you why she thought you were wrong. So I started to take a different approach by saying "How would you handle this situation?" or "what do you think is going on here and how would you adress the patient's issue?" She still does it to this day but I use my technique and after she says how she would do something, if it wouuldn't harm the patient I said "sounds good to me".

There are some people you just can't deal with. So don't. Help them to benefit a paient but otherwise stear clear!!

Good luck.

Stormy · May 10, 2002

I agree, sometimes you just have to steer clear. It isn't worth the effort of arguing unless it compromises patient care. Then I stand firm.

hoolahan, ASN, RN · May 10, 2002

fedup, I also had to precept a know it all. Everytime I discussed a policy, she would roll her eyes. I was a fairly new precptor, so I went to the best preceptor in our unit and said, how do you deal with this? She said, throw her to the dogs and let her feel herself sinking, be sure to rub it in when you have to bail her out!

I did exactly that. I gave her an unstable post-op open heart, and I sat in a chair at the foot of the bed, and just rode her a$$! Did you get those ABG's that were due yet? Did you treat that K+ yet? When are you going to hang that blood? What was the CT drainage the last half hour? I mean I busted her a$$ like I've never busted anyone's a$$ (what fun!!) At the end of the day, she came to me, and said, OK, I get it, and thanks for finally helping me!!! (which of course I did, b/c I would never do this at the expense of the pt.)

However, precepting is a unique situation, and I think for your "everyday" know-it-all, zum is right, they can smell fear. When they tell you how to do something, the trick is to ask why. They usually can't tell you. I had one nurse who tried to make me feel like a turd repeatedly in a new position. She kept saying things like "we" do it this way. "We use this king of tape..." etc. Finally, one day I just lost it when we were deciding what stock to order for the unit we were going to open, I asked to have 14 Fr. NG tubes. She says "We use 16 Fr." I asked "Why??" She said, that the way we always do it. NEVER say that to ME!! LOL!! I asked her if she good give me a scientific rationale for determining the proper size for a NG tube for insertion. Please explain your thought process. She couldn't, just kept hedging. She says, Well, when we start tube feedings, we need to be able to check residuals." I don't have any problems doing that w a 14Fr tube I said, next? Well, turns out there really was no reason a 14 FR tube could not be used. So, we ordered them (Probably just to shut me up!)

Make them explain the scientific rationale and watch them squirm!!

susanmary · May 11, 2002

Truly believe that know-it-alls have low self esteem & believe that they "elevate" themselves by bringing others down. Everyone knows that only teenagers know EVERYTHING (spoken by a mother of THREE teenagers!)

NurseDennie, BSN, RN · May 11, 2002

I'm really laid back about that kind of thing. I started nursing when I was pretty old, so a lot of really experienced nurses are younger than I am. One of them once asked me if I had problems because she was telling me how to do stuff (this was NOT a know-it-all nurse - a know-it-all nurse would not have asked that!) and I pointed out that she had 10 years of experience, and I had no (count them, zero) years of experience. How stupid would *I* have to be to resent her giving me tips.

But!!!! a few years go by and I'm working with another nurse. By now I'm a role model nurse, and the whole nine yards. I'm not stupid enough to think that I won't learn from the people I work with, but please!!

Finally, after another butt-in-ski episode, I just told her sometimes I wondered why I even bothered to dress up like a nurse anymore. It started a conversation and things got better. But it really was a smart-a$$ way to start a conversation that was eventually very helpful. I was just irritated and snapped at her, but she deserves the credit for the way it worked out.

Love

Dennie

eagleRN · May 11, 2002

Even "know it all" nurses can be coped with. They don't know it all, but they do study and read and you can learn from them. Just don't discredit that kind of personality, if you're in a bind, just ask them to take care of it, and ask them in front of other nurses, and soon you'll find (hopefully) they don't want to come across as a "know it all" because it mean extra work.