Ok i graduated three years ago. But was working for an md who helped pay for my ed and was extremely comfy with. i worked for her over 10years. But i woke up one day and decide to try bedside nursing since that is what i went to school for and always wanted to do....or so i thought! I am on a tele unit and have had a ruff time now that i am on my own. I Guess this would be my third week on my own after 12 weeks of orientation.
Well 2 nights ago i got a patient from the er adm dx dehydration. no Cardaic issue what so ever, and questioned when i was getting report ...like no cardiac enzymes? nothing on a ekg...why are they coming here? so i went to my charge and told her i wasnt sure if i should take this patient and we talked and she said might be because she just needs a private room since she will need a private room for contact for mrsa in norifice. All i saw was a order that said admit to med surg/ or possible step down. no telemetry order what so ever. I asked again and my charge looked at the order also. So i think at this point the idea is to get her in the room and keep her till am so she can be transferred when med/ surg opens up .so i get the patient s took v/s and her bp was 87/47 .....so i go to her chart and see who the adm dr was? call and let her know and we bolus her. Other wise her vitals were good , sat at 98% on room air and a&O x3 but forgetful and sleepy ..but it is 2am!
Anyway i give report to the day nurse, and leave. When i came back that night i was chewed out from another nurse who was saying how could i not put her on tele? or o2? this is a critical care floor? use common sense! ...i started to tear up and think omg what did i do i am soo stupid....... and she went on and on ..you did go to nursing schoool? use your judgement, call the dr and ask for these orders! OMG so at 2am that night ....i look up and i am so angry how could you talk to me like that!!!!!!!!!!!!!!!! I did what i thought i could for this patient, i didnt just throw her in the room and forget her, i called and spoke to the dr myself about her b/p and obv this dr was not concerned about tele or she would have sent her strait to my floor and not wrote an order for MED SURG!!!! I also checked with my charge that night, now i didnt say i am not going to put a monitor on her specifically and maybe i should have. BUt i just soooooooooooooooooo frustrated!
I AM NOT sure i can continue this way, i am doing my best everyday. I am exhausted from working nights and i am started to regret my decision on becoming a nurse. This is the second time i have have run into trouble asking questions and getting answer that I still end up in trouble for!
Now if i had been a nurse for a while and had some confidence and new what my scope is i would have done something more, but i am scared and nervous and depend on other more experience nurses to guide me. And if there are not...then how do i win this battle. And how to deal with insults like that from other nurses. I am extremely smart, well educated and over 30! I can not stand for being spoke to like a 5yr old. I can not work like this. What can i do? Do I hunt down this nurse and have a talk with her and how wrong it was to throw insults? Please help, am I just not cut out to be a nurse? Am i missing something here?
The 3 of you should sit down and get things out in the open. It may feel awkward but will be worth it! The "bully" may back off a bit knowing that the boss is on to her ways.
Also, who cares about putting a patient with dehydration on a monitor....really!!!! What about using those assessment skills....you did nothing wrong.
If you have three years of nursing experience it's time to stand up and take up for yourself.
You know what I would have said to that nurse?
"Sats were 98%...since when do we put someone on O2 that has Sats at 98% on room air that has no s/sx of chest pain or having trouble breathing???"
You went to the charge nurse you called the doctor.
End of story.
That is when you tell her what you did and say, "This was MY patient last night and I treated them the way I felt that they were to be treated infull collaboration with the physician along with my nursing judgement. If you have any issues or concerns with how the PHYSICIAN chose to treat the patient, here is the number of the physician...I suggest you call take it up with them. Have a great shift!"
THEN GET UP AND FREAKING CLOCK OUT!
That is how you deal with workplace bullies. You don't play into it.
A pt with a low bp and no cardiac history does not necessarily need tele if their BP responds to the bolus. We bolus patients all the time on my floor without tele, and even patients who do have a cardiac history without sending them to tele. We get EKGs as needed and send them to higher levels of care only as appropriate. You will find your voice as your confidence grows. You did nothing wrong. Did the patient's bp respond to the bolus?
her b/p continued to be low and during the day they got orders to keep it up above 90systolic. I went to my manger and discussed the situation and she agreed that i did nothing wrong. I chose not to tell who it was who made comments. I am not sure that i am going to respond to the comments but all i know is it will NEVER EVER HAPPEN AGAIN! I need to start believing in myself a bit more at work. Sometimes i have to stop and say wait I am smart why am i over thinking this. Its sooo hard not to respond to her. but i dont want to give her the satisfaction of knowing it bothered me. All i should care about is if the care i gave was safe and appropriate! Not how another rn feels it was. I am going to try to move on from this and learn more lessons for this horrible experience.
The other RN was a witch and clearly is not interested in 'offering' her wisdom and guidance to you as a relative newbie. She's toxic--you've been served---make a mental note of those you can count on for guidance in the furture. Also, glad all turned out well and manager/charge agreed w/assessment and actions.
BUT.....go ahead 'n hate me all....
Truthfully, w/out info on patient's age, hx or basic labs, I can't honestly say that I wouldn't have done things a bit differently. If someone is actually being admitted for dehydration, my exp. goes to PT is probably elderly and their lytes were likely pretty out of whack to get upstairs and not just corrected downstairs in the first place and plus the low BP on arrival....I don't know. Could be doc assumed was already on tele at that point...ie.e, Tele RN calling me?
I don't know--wasn't there. All I'm saying is clearly what you did was fine and even if I may have done differently--doesn't necessarily make one of us VERY WRONG!
I also come from an ED and not floor perspective while you had the benefit of actual information and #'s(chem panel, UA, geez, even HR for that matter)so...whatever.
Just a tiny other way to think about it but that nurse was a snot and that ain't cool. Plenty more where she comes from, unfortunately.
ok so if this nurse was so concerned all it would have taken was to initiate tele and all the other things? So, what was wrong with her arms were they broke is she that incompetent herself? Did the pt suffer any harm did the pt's health decline d/t this? if not tell the other know it all to bite you!
gofast!
23 Posts
How about getting the manager involved?
The 3 of you should sit down and get things out in the open. It may feel awkward but will be worth it! The "bully" may back off a bit knowing that the boss is on to her ways.
Also, who cares about putting a patient with dehydration on a monitor....really!!!! What about using those assessment skills....you did nothing wrong.