"the 3rd degree" with report and other rude behavior

[amzyRN]

I recently started a new job at another hospital. I've been off orientation about 3 weeks now. I had 6 shifts on the floor, plus general orientation. I'm going from computer charting to paper. And that's been a really pain in the you know what. Anyway, I've been interrogated during report three times, by three different nurses. I give the same report with everyone and don't always get interrogated. Most of the time it's an easy hand off. I have missed things, yes, but I am new to the facility and the error prone paper charting, things get missed. Does this mean I need to be treated rudely and delayed to leave? I don't think so, in my opinion.

My facility looks at time sheets and I don't want anyone thinking I'm lagging behind. Considering that I'm new to the facility, I think I'm doing pretty well, my patients remain safe and I am providing high quality compassionate care. I've missed some non critical things, doesn't everyone make mistakes, especially when they are new to a place?

I think part of it is the culture of the state I moved to, more rude people in general, so I'm trying to let it go, but I'm starting to get really annoyed by it. I may look younger than I actually AM, but I don't want to be treated like a 5 year old. Should I write out an SBAR or something? Reviewing orders is important at then end with a paper system, because things do get missed. At my last job, people were so friendly and helpful. There was no interrogation sessions during report. It was a way to ensure continuity of care, nothing more.

I'm considering talking to my manager about it. Not to name names, because I'm not trying to get anyone in trouble or cause drama, but really just want a standardized list of things that need to be communicated and that's it. I want to be able to say, I've told you the pertinent facts to the best of my ability, we have reviewed the orders and I am done and am clocking out.

Any thoughts? By the way, thanks for listening and any responses.

[calivianya, BSN, RN]

It could just be the culture of your particular unit. Not all units are created equal... some have teamwork and some don't, some are nice during report and some aren't. It could also be the individual nurses. Whichever it is, airing your concerns with anyone at all is likely just going to make you look like you're incapable of getting along with others and a troublemaker. I wouldn't stick my neck out and make myself a target if I were you.

Besides, you're a new employee - they are also probably testing you out and deciding if they can trust you or not. This behavior may go away entirely a few months down the road once you've given report to these people a few times and they realize you're competent and not going to leave them in a mess. Some places are hard to break into, culture-wise.

[jadelpn, LPN, EMT-B]

There are many examples of SBAR report sheets. (or "brain sheets") a number here of AN. The search bar at the top of the page can help you.

OR search engine "SBAR report sheets" and get a couple of examples.

Everyone should be using SBAR to report off.

Meanwhile, really make sure that with paper charting, all your i's are dotted and t's crossed. Yes, it is a pain to look at 900 sheets of paper, however, by using a brain sheet, getting into the habit of being sure that you are reviewing orders and meds when you come on, after the MD rounds, around meal time (when any number of MD's come in to write orders) and before you leave to double check, it should get better.

You could also suggest a general "brain" sheet that has all of every patient's information on it. I fold it so that I can write notes. You an also assume that patients have meds at 9 and 9, 8 and 8.....BUT there are those patients who have oddly timed meds--write them in red on your brain. Refer to your brain.

Good luck, and get your groove before you go to management. Should people be giving you the 3rd degree, stop and say "this is the SBAR reporting that I have for you. Any other questions, you can review the chart. In my review prior to report all of the information contained in it was up to date and correct." Straying for a moment, you could say "room 44 does have an antibiotic to be hung in an hour" or some other heads up that the patient may not have timed meds that are usual times. Or labs or any other heads up that can easily be missed.

Best wishes!

[Pangea Reunited, ASN, RN]

You sound a bit defensive. It might be better to focus on what's being communicated rather than how it makes you feel. I wouldn't go running to management just yet ...give yourself time to adjust to your new co-workers' reporting styles and time for them to adjust to yours.

[klone, MSN, RN]

Every unit has its own culture, and often its own way of giving shift report. I would recommend listening in on other people's shift reports (or take mental notes when report is given to YOU) and try to model it after the other nurses.

[TakeTwoAspirin, MSN, RN, APRN]

It might help you to deal with these people better if you focus on the fact that they too want to provide their patients with safe, high quality, compassionate care, which is probably why they are getting the information they believe to be essential for that objective from you.

[RNperdiem, RN]

Unless "rude" means personal attacks on you, give it time.

As a new employee you are in a vulnerable position. Running to the manager too soon with anything less than a true patient safety issue will make you look like you are "not a good fit" for the unit or that you "do not work well with others" or anything else that can get you dismissed during the probationary period.

Some nurses like detailed reports and others like a basic sketch. It is like this everywhere.

Give it time, work on your paper charting and try not to take it personally. It is hard to be the new person.

[SmilingBluEyes]

SBAR. that's the ticket. If they are still interrupting you, I would do what I have done; tell them to kindly hold questions til report is over, THEN ASK.

[jojo489]

I had a similar problem when I first started at my current facility. I felt like it was a police interrogation every morning (I work nights) and I didn't have some of the answers because charting isn't the best at this facility and 3-11 wasn't always the best with report.

It really upset me because I was an asset at my last job and felt very comfortable in my role and also confident in my skills. They managed to tear me down every morning and make me feel like I was a complete idiot.

I let it roll for about 3 1/2 months until I finally spoke to management because I was at my wits end and afraid I was going to freak out and make enemies (if they weren't enemies already). When I did speak to my manager, I found out that this was a recurring problem with a particular set of nurses and aids. She spoke to them for what she said was the umpteenth time. Things were better after that. They started asking questions and not drilling me and one of the nurses actually apologized to me for her behavior.

I also look much younger than I am but it also doesn't help that even with that said, all the nurses I work with are old enough to be my mother, so I still get looked at as the kid. I've been there about 6 months now and since I've gotten to know everyone, I'm able to tell when someone is in a bad mood or when they're actually unhappy, and whether it's with me or not. I do think that they were feeling me out for a while there to see if I was good enough though, and I think I passed their test.

Best of luck to you. Just know, it hasn't only happened to you. :)

[psu_213, BSN, RN]

At my first job, we had cards (not really a cardex) that served as our brain sheets. The card was passed from shift to shift. It included spaces for name, dx, procedures, diet, relevant labs, most common areas of assessment, chest tube sites/suction, etc. Each nurse wrote in pencil on the sheet and erased and added things as needed. As so, most reports went well and there was very little nitpicking during report.

At my second job, there was no standardized report/brain sheets. Each nurse could make their own, if they saw fit (IMHO, it is a very good idea to have one). Some nurses were very laid back with report--you would give them the basic report and they would say "that's good, I've got it from here." Others wanted all the nitty gritty details. You think you would give a complete report and then it was Q and A time. "When was their last BM? Was it formed? What color was it? Is the stat lock on their Foley on the right thigh or the left thigh? Is his Alaris pump plugged in? How much battery time is left? Is his pacemaker Boston Scientific or Medtronic? Etc, etc." They would do this to new nurses, they would do it to nurses with 25 years experience. In their minds it was not rude. In my mind it was not rude…just incredibly annoying.

Don't immediately jump to "they are just being rude to me because I am new." Some nurses just want a very detailed report, and it does not necessarily mean they are picking on you. Personally, I wouldn't talk to the manager yet…certainly not in the context of nurses being rude. If you do talk to the NM, start with "I just want to clean up and make my reports more efficient…" That way it is about you getting better and does not seem like a b***h session about nurses who you think are rude to you.

[cayenne06, MSN, CNM]

Report can be tricky, because unit culture does play a large part. We use designated report sheets which help standardize things. I have one coworker who is like that sometimes. If she asks me stuff that is not pertinent to the handoff, I just say "I can't recall but it is in the chart so have a look!"

Don't go to management. Is there another nurse you are friendly with that you could ask for pointers?

[amzyRN]

Every unit has its own culture, and often its own way of giving shift report. I would recommend listening in on other people's shift reports (or take mental notes when report is given to YOU) and try to model it after the other nurses.

I have done this and do state everything everyone else is reporting in their report. My reports contain the essential facts that are required in any hand off. For example, I have stated that certain labs have been completed and then the nurse will check the chart and make sure they are done. That's fine, but do it after I am done speaking. Like you said it's the unit culture. I am used to a very team oriented welcoming environment. And some people have been very welcoming, just a few that are frankly kind of nasty. I am just getting too old for tolerating rudeness (often communicated in tone of voice and the way things are stated).

I am well over 30 now do expect basic respect from nurses and physicians. I think what I'll do is write an SBAR, review orders and a brief bedside check on my patients and then be out the door. If they think my nursing care is lacking, they can take it up with management, because I am confident my care will stand up to any investigation.