So, I have been an RN for a few years, with both hospital and home health experience. Let's just say I am well aware of my strengths and weaknesses by now. Currently, I am a private duty nurse at night, and only have one other nurse to give report to during the day. Since I have started, this LVN (not that the title matters to me, as I see us both as equal in the nursing world) has made condescending remarks towards RNs (even after acknowledging that I'm one of them), such as "yeah, I thought she was an RN, so I ASSUMED she would have her s*** together, but apparently not!", and "As an RN, [insert numerous insults here]". Anywho, her background is a few years in private duty nursing and a short time in psych. We seemed to get along ok at first, even after she made the first RN comment, but then I soon felt as though she started bullying me. She has been with our patient (her only current patient) for about 2 years. I don't know if it's bc this is her only pt that she chooses to nit-pick every aspect of this patient's care in a very derogatory manner, or if she feels some hatred toward me as an RN, but she loves to leave me little "love notes" almost every shift, basically pointing out every. Single. Thing. That she thinks I did wrong. Not only will she point it out and write a novel about how it NEEDS to be from now on, but she always includes a whole paragraph attempting to teach me why it needs to be done that way....
I'm sorry, not only do I find this annoying, but I feel insulted that she feels the urge to teach me something I already know, as a nurse. Perhaps I left something not exactly perfect or to her liking by the end of my 10 hr shift, but I have never done anything to jeopardize the patient or to constitute a written lecture on how to be a nurse. I honestly don't know if she means well or if she is trying to bring an RN down to make herself feel superior as an LVN. I normally would never think that (as I have respect for ALL nurses alike), but the way she has exuded such a negative perspective of RNs, she makes me feel so bad for being a peasant RN, like I don't deserve the title, since I can't meet her ridiculous OCD standards.
Specializes in Mental Health, Gerontology, Palliative.
II had a similar experience recently. The nurse was an enrolled nurse (NZ equivalent of an LPN). She started out nice enough, however I found myself going waking up each morning stressed to the max before I even started. I was doubting myself thinking it was something that I'd been doing wrong.
I then happened to talk to another RN and I found out that this nurse had actually done it to every single other registered nurse in the facility. She had even made other RNs cry.
I just kept doing the best job I could for my patients. Also learned to work around her because she could be down right obstructive and I was determined what ever her problem was, I would not be letting her problem have an adverse impact on my patients. It got so bad however she was putting my written handover for management into the shredding bin
Specializes in Peds/outpatient FP,derm,allergy/private duty.
Thank you for responding! :) I mostly just needed to vent, but I certainly appreciate your two cents. This nurse and I definitely don't mesh well personality-wise, as she is very meticulous and serious, as I am more relaxed and have kind of a "hey, I'm just glad we didn't have a crazy emergency" attitude. Maybe our backgrounds have made us so different, as well. I feel like having hospital/floor nursing experience makes you more focused on clinically critical aspects of patient care, as opposed to having all your undivided attention on one single patient for years and noticing when even one hair is out of place.
Everything is magnified in PDN. The same person in a hospital/floor environment is annoying, move them to PDN and they're really, really annoying. The nurse in question may not realize the disproportionate focus on less important details because she has no job experience to compare it to.
Most of the time boundary-setting in a direct but non-confrontational way works well, but the way you describe the cozy relationship between the Case Manager and the LVN, it raises flags that could cause concern beyond a personality conflict.
Before I worked in PDN I had no idea there were people who would go out of their way to sabotage someone, but I've seen it and more than once.
Anyway, thought I'd add my to the already great advice here.
I have worked in PDN nursing off and on over the years and I will tell you that this kind of behavior is very common. The communication book is where I have seen the majority of it. Tit for tat nit picking and finger pointing at one another, yeah, real professional. I wonder if the nurses writing this stuff to each other realize that the client's POA is most likely reading that book since it's left onsite (and many have read them and written their own comments in response to the ones written by the staff). The note leaving is not professional and uncalled for. Anyone could read it and it only tells one side of the story (opposite your own). Making comments in front of the POA, very unprofessional.
I don't think it's an attack on you because you are an RN. She would probably do it to anyone who doesn't do things exactly the way that she sees appropriate, even though there are a million right ways to do the same task. I've been on cases where there is no RN for shift work, only LPNs and the culture is the same. It's usually someone who has a lot of self doubt and insecurities, trying to make themselves feel superior to their coworkers (And you did mention that her time in psych was brief...there may be a good reason for this).
I would suggest asking to be reassigned as most agencies that I have worked for staff based on a few criteria, number one being who the family wants assigned to them. If she's been working with this case for a long time the family probably likes her and the agency is most likely going to continue sending her there without any issues because its filling the shift and the family is satisfied. I have noticed that they really don't care if one nurse gets along with the next, just as long as the shifts are filled. Another option is to go with a different agency. I don't know how much home care opportunities are available in your area, but where I am from the opportunities are endless. I could probably list at least a dozen agencies that are looking for PDN, some so desperate that they will hire nurses straight out of school. You don't have to tolerate the harassment.
Me personally, I'd start keeping her notes, somewhere in a very safe place. Then, when I got ready to leave the case, and management asked my reason as to why, I'd mention the notes. Perhaps given them copies/advise them where the notebook is in the PDN home where I've been saving them (just beware of our favorite friend HIPAA). Then I'd tell management exactly all the reasons why I'm leaving - her constant critiquing of someone above her scope of practice, her inappropriate closeness to the pt/transference issues, her friendship with the CM seeming to affect how others are perceived/treated, as well as any other tidbits you feel are relevant. Kind of dropping the ball in their court and walking out of the game. You win.
Specializes in Psych, Corrections, Med-Surg, Ambulatory.
When I read about all the notes, my first thought was to get a scrapbook and a glue stick. Carefully paste each note in the scrapbook. Tell the LPN that you value ALL her input and don't want to lose a single note. Show her all her notes proudly displayed in your scrapbook. When she notices the sheer volume accumulating, maybe she'll realize how ridiculous she is being. At least you'll have a tangible record to show management.
I didn't read all the posts, so I don't know if this has been mentioned: it's called "leveling" behaviour. This person clearly feels inferior to RNs (for reasons you may never discover) and your egalitarian attitude is making no difference. She seems to need to cut people down to her level, whatever she perceives that to be.
Sounds like she is insecure and very possessive of that pt. Also sounds like to the CM & the parents, she's the coolest thing since popsicles.
Bottom line, she is the one with the problem. I'd just agree with her to shut her up, then forget about it. She probably also takes great pride in the number of RNs she's run off the case. Personally, I think I might have to quietly stand my ground just to blow that for her.
Good luck to you. People like that can really be sickening.
Specializes in M/S, Pulmonary, Travel, Homecare, Psych..
So, I have been an RN for a few years, with both hospital and home health experience. Let's just say I am well aware of my strengths and weaknesses by now. Currently, I am a private duty nurse at night, and only have one other nurse to give report to during the day. Since I have started, this LVN (not that the title matters to me, as I see us both as equal in the nursing world) has made condescending remarks towards RNs (even after acknowledging that I'm one of them), such as "yeah, I thought she was an RN, so I ASSUMED she would have her s*** together, but apparently not!", and "As an RN, [insert numerous insults here]". Anywho, her background is a few years in private duty nursing and a short time in psych. We seemed to get along ok at first, even after she made the first RN comment, but then I soon felt as though she started bullying me. She has been with our patient (her only current patient) for about 2 years. I don't know if it's bc this is her only pt that she chooses to nit-pick every aspect of this patient's care in a very derogatory manner, or if she feels some hatred toward me as an RN, but she loves to leave me little "love notes" almost every shift, basically pointing out every. Single. Thing. That she thinks I did wrong. Not only will she point it out and write a novel about how it NEEDS to be from now on, but she always includes a whole paragraph attempting to teach me why it needs to be done that way....
I'm sorry, not only do I find this annoying, but I feel insulted that she feels the urge to teach me something I already know, as a nurse. Perhaps I left something not exactly perfect or to her liking by the end of my 10 hr shift, but I have never done anything to jeopardize the patient or to constitute a written lecture on how to be a nurse. I honestly don't know if she means well or if she is trying to bring an RN down to make herself feel superior as an LVN. I normally would never think that (as I have respect for ALL nurses alike), but the way she has exuded such a negative perspective of RNs, she makes me feel so bad for being a peasant RN, like I don't deserve the title, since I can't meet her ridiculous OCD standards.
Am I overreacting or being hypersensitive?
Ah, but it does matter to you. It's a part of your thread title even. That's not coincidence. Not saying I think you attempt to bully her with titles or anything, but I don't agree that it doesn't matter to you. It comes up too often not too. But I do think the titles are clouding things for you and causing you too, hmmm........not see the forest through the tree.
Truth is, the titles don't matter what so ever in your situation. And it shouldn't, people are people and we all deserve respect and civility. But, the truth of the matter is, this woman would be bullying you regardless of what the titles are. If she were the RN and you the LPN, she'd still take jabs at you (although they'd be more of the "Oh, you LVN's don't know this but......" style). If you were both RNs, she'd still be critical of you: "Gee, how many times did you have to take boards? You should know better than to........".
Point is, a bully is a bully and your title isn't going to deflect them one ounce. That's why the titles don't matter. I think there may be some resentment on your side that the titles aren't keeping her from being the bully, hence they came up a lot in your original post.
Why would you resent that? It's simple, because you're dealing with a bully in the workplace and it's a very difficult thing to have to manage. Your hopes of the titles making her afraid to be the bully left you disappointed. Now you have to gear up to face her. And that's the part I think is the forest you're not seeing through the tree. It's not a matter or RN vs. LPN or new person on the job vs. the long standing employee or anything else. This is a classic recreation of the schoolyard bully problem many of us face when we're youths. The problem is, you've gotta punch that bully in the nose (metaphor, please don't really do that).
I've had to deal with it. I was a travel nurse, and let me tell you, every single job title in the hospital likes to bully the travel RN. Had a security personnel once tell me to leave my unit and "watch this hallway" for them, then throw a fit when I declined to do so. Once, while transporting a patient to the ICU who was stroking, I had a housekeeper who was blocking the hallway with their cart tell me I'd have to wait, cause they deserve to be there as much as me. A CT operator once tried to give me a long list of phone calls to make before they'd take my STAT CT order, because they were understaffed and weren't taking anymore STAT orders from "You travel RNs who constantly want to be first."
So what do you do with these types:
1. Don't become the bad guy. Bullies flourish on that. They'll break rules, be rude, take jabs and be outright disrespectful. But, the second they catch a whiff of their own medicine, they're on the floor in a fetal position as if you struck their soul with a deadly blade of some sort. Most of the time, we have done that though. We try to ignore them, then we boil over and respond finally with aggression. This makes us the bad guy, no matter how much poking and taunting lead to the boil over.
2. Don't let things boil over. My rule is, I deal with things as they happen. If I don't, then it's gone from my memory. If you deal with things "on the spot", while our reactions may be a bit off, they won't be done out of anger and you'll avoid boiling over.
3. Be consistent. Bullies cross "the line in the sand" and test us constantly. Once they get across the line, it's very hard to put them back on their side. When she makes a snug remark, respond simply with "Don't talk to me that way." Doesn't have to be any more complicated than that. But, you must do it every time.
4. Avoid letting them drag you into emotional debates or discussions. Say what you mean, mean what you say, and leave it at that. Don't be an audience to their excuse making for their behavior. They may tell you a sad story about being tired lately because of some stress in their life, but don't humor it. The implication by them is, it's alright to behave that way when we're stressed. And once they have gotten you believing that, every day will be a stressed day. So, in their mind, their well withing their rights to take it out on you, cause they've already made it clear that is how they act when they're stressed. If they start story telling and excuse making, cut it off: "I don't need to know the details of your personal life, it's just a matter of not talking to me like that, nothing more." To make staying out of emotional debates and chats easier, also inform them that the "notes" are no longer necessary and won't be read by you. Anything they need to say needs to be formally written into report, on the company's documentation system or paper. If it's not formally documented, it wasn't said.
5. Don't be afraid to report that there is an issue to whoever is above you. State the facts simply, like documentation on the job is: no emotion, no assumptions, only say what what transpired. It's not "telling on" someone. Tell the manager of the problem, how it affects your work, and what you've done about it. This too helps you avoid boiling over. It also can help you gauge if your'e going to be supported or not.
6. Last but not least, don't hold it in. Even if you manage to avoid boiling over, you'll end up taking the stress home with you. You may even start becoming ill. This is no good for you, as you're attendance will suffer and you may end up making an error on the job. No one is going to believe you either if your explanation is "I was stressed and my coworker was bullying me, I lost my focus." It's on you to deal with it before it gets to that point. If it's not possible to correct the situation, even after being assertive with the bully, consider moving on (if management doesn't support you).
I sense you're a little afraid to deal with this person. Don't be. Bullies push and push until they're stopped. While you may feel mean for being so firm with them, there are unfortunately those types who you will never get along with until you show you can be. Then they'll move onto someone else to bully.
We have a personal responsibility to maintain self preservation for ourselves. No one else will. If you find yourself afraid to be firm with her, perhaps role play will help. Find a friend who will role play as the bully, and enact scenes of you answering her back: Firmly yet with tact, nothing but the point that needs made, simple and sweet.
First off, you are not equals and you should not look at that way. you have more experience, education and training than the LVN. If she belittles you in front of a client again I would simply say "You are an LVN, you don't have the education and training to understand why I do .... this way. If you would like to learn I would be happy to teach you or perhaps you would like some information on becoming an RN so you can understand why I do things a certain way."
Here's my 10c. I work with somebody similar and it's caused me a huge amount of stress too, but here's what I've learned.
1) It's not about you. It sounds like she has a personality disorder and she can't help herself. You've done nothing wrong but she needs someone to reflect off and you're it. Don't take it personally.
2) You THINK she's friends with management but in reality these kind of people love to create the illusion that they are best pals with the higher ups because it makes them feel important, but really management can't stand them and are merely being friendly to keep them off their back.
3) People can only bully you if you let them, and the greatest power you have is to smile, agree with whatever they say, and then turn around and do exactly as you want. Make her feel like she has the upper hand, but in your mind know that you are in control of you, not her. However, set boundaries, politely and firmly, smiling all the while.
4) You'd be amazed how observant people are, and no matter how bad someone tries to make you look, people will make up their own minds and have already probably made up their mind about her and not in a good way. The more she puts you down, the better you look and the worse she makes herself look. People notice more than you imagine. Let her dig her own grave.
5) Document, document, document. Keep notes of every single thing she does wrong, date it and store it in a safe place. Keep her notes in a file. Create a dossier. This tool is not to use to punish her, but as a way of protecting yourself. One day you might need it. When you are pulled in to answer to management, you have it all there in writing....how many times you were undermined, talked to disrespectfully, and belittled in front of patients.
6) Being confrontational with somebody like this makes them worse. Complaining about them may be like throwing gasoline on a fire. As soon as they feel threatened, the big guns come out. Never let them know how you feel about them.
You can't play someone like this at their own game. You have to put boundaries on their behavior without being confrontational, and make a pact with yourself that you are going to do what YOU think is right in every situation. You are a professional and get to make your own decisions, and as long as they're clinically sound and all is documented, you are fine.
When I read about all the notes, my first thought was to get a scrapbook and a glue stick. Carefully paste each note in the scrapbook. Tell the LPN that you value ALL her input and don't want to lose a single note. Show her all her notes proudly displayed in your scrapbook. When she notices the sheer volume accumulating, maybe she'll realize how ridiculous she is being. At least you'll have a tangible record to show management.
I sense you're a little afraid to deal with this person. Don't be. Bullies push and push until they're stopped. While you may feel mean for being so firm with them, there are unfortunately those types who you will never get along with until you show you can be. Then they'll move onto someone else to bully.
We have a personal responsibility to maintain self preservation for ourselves. No one else will. If you find yourself afraid to be firm with her, perhaps role play will help. Find a friend who will role play as the bully, and enact scenes of you answering her back: Firmly yet with tact, nothing but the point that needs made, simple and sweet.
AutumnApple, I don't know if you are a writer for this site, or any other site, or in an advisory position in your professional life, but what you wrote is superb, on point, clear, powerful, and excellent advice. I quoted the last part just to have something to reference, but your entire post is outstanding. Excellent advice, thanks for sharing it.
to the already great advice here.
Tenebrae, BSN, RN
2,021 Posts
II had a similar experience recently. The nurse was an enrolled nurse (NZ equivalent of an LPN). She started out nice enough, however I found myself going waking up each morning stressed to the max before I even started. I was doubting myself thinking it was something that I'd been doing wrong.
I then happened to talk to another RN and I found out that this nurse had actually done it to every single other registered nurse in the facility. She had even made other RNs cry.
I just kept doing the best job I could for my patients. Also learned to work around her because she could be down right obstructive and I was determined what ever her problem was, I would not be letting her problem have an adverse impact on my patients. It got so bad however she was putting my written handover for management into the shredding bin