There was a midlevel provider that made a very rude comment to me in public and I'm wondering if I should report it or say something to the person. This is what happened. I was coming on to my shift and taking care of a chest pain patient. This person had been given nitrox3 with no effect. The resident taking care of the patient was also in and said the patient isn't responding to nitro, but hadn't told the cardiologist yet. They were going to take the patient for an angiogram that morning anyway to investigate. Anyway, the patient also had bradycardia so the last shift nurse said she was reluctant to give morphine or more nitro because she didn't want to decrease heart rate. The midlevel calls me in to the nursing station at the start of my shift and I've never worked with this person before. They ask why I haven't given nitro (I said because the patient hasn't had relief from nitro and I didn't want to decrease HR). I also said the patient was going for a cath today. I didn't know the midlevel was on the cardiology team. The midlevel looked at me and asked in front of everyone if it was my first day with a snide look on their face. I said does it seem that way and they said yes. They told me nitro doesn't affect HR (I should have know that and not taken the last nurses word for it, mistake) I probably should have known this person was on the team. The resident could have also called cardiology and said the patient wasn't responding to nitro. Anyway, the midlevel scolded me and ordered a nitro drip. Before this I had called the attending and asked about giving morphine regardless, and I gave the patient morphine with some relief. I start the nitro and they take the patient for the angio, they turn off the drip because the patient is not responding to nitro and it turns out the patient has no blockage. The chest pain isn't cardiac. Ever since then, I get nasty looks from this midlevel. Also, I've noticed I haven't been assigned many chest pain patients and that I've had very few of this midlevels patients. Do you think this midlevel told charge nurses they didn't want me on their cases? Also, should I talk to this person about the comment? I don't think I was that wrong in what I did, except not knowing nitro doesn't affect HR.
Specializes in ED, Cardiac-step down, tele, med surg.
The person's cardiac enzymes (trops, CK, CKMB) and ekg were all negative (except for bradycardia, no ST elevation or depression) and the patient had been given 3 sprays of nitro in ER. The last nurse was afraid to give more because #1 she had not responded to the first 3 sprays and #2 she thought nitro would drop heart rate (the HR was in the 40s). The patient also had a 6/10 headache. The patient was going for a cath ASAP. The patient was the first patient I saw and there was a physician at his bedside assessing him when I arrived. This physician did not inform cardiology the patient was not responding to nitro. I should have known nitro does not worsen bradycardia (in fact it can cause tachycardia) but I was always respectful of this provider (PA-C) and was trying to act on the best interest of my patient. The Midlevel provider (PA-C) could have taken me aside and spoke with me, but they chose to try to embarrass me in front of my peers. It was rude and unhelpful and the comment made me feel like crap the rest of the day. The PA-C ended up ordering a nitro drip that was turned off after 10 minutes because the patient wasn't responding, developed a worsening headache and it turned out the patient's chest pain wasn't cardiac. I talked to someone about it and they said to talk to the (PA-C) first before doing anything else, but that I should follow through so it doesn't happen to someone else. I can admit I probably didn't communicate effectively and should have known about the nitro (that it wouldn't have decreased HR) but I don't believe in public humiliation either especially if people aren't going to hear the whole story. Starting a nitro drip after the patient wasn't responding to nitro in the first place and having them turn it off after 10 minutes doesn't look too good either. There was no evidence of heart damage in the first place, what was more nitro going to do for the patient especially if they weren't responding?
*** Uh, no. It doesn't make the slightest difference what the nurse did, didn't, or should have known. There is no excuse for any provider to treat a nurse like that. The provider should be severely disciplined and, if they make a habit of creating a hostile work environment by bullying nurses, fired.
Gross overstatement. If everyone who was a jerk now and then got fired, the whole country would be out of work. I weary of the NETY, perpetual victimhood trope in nursing.
You want to solve the biggest problem of our profession? Promote maturity and do what can be one to extinguish all vestiges of perpetual victimhood. There's plenty of literature to indicate that bullies back down when confronted. But that takes self-confidence and maturity; promote that at the learner level. Save the big guns and resources for the real thing: genuine workplace violence (not the oh-so-trendy "lateral violence," either).
Specializes in ED, Cardiac-step down, tele, med surg.
I'm going to talk to this person in private about what happened and ask them respectfully to not make rude comments to me, especially in front of other people and that the comment hurt my feelings and it sank my confidence for a while. We will see what happens. I'm definitely going to make sure I'm more cautious about report I get from other nurses and to review meds I'm giving.
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
Gross overstatement. If everyone who was a jerk now and then got fired, the whole country would be out of work.
*** Hmm, my statement was:
" if they make a habit of creating a hostile work environment by bullying nurses"
I didn't say ANYTHING at all about anyone who is a jerk now and then. I stand by my statement that people who make a habit of creating hostile work environments and bully nurses should be fired.
I weary of the NETY, perpetual victimhood trope in nursing.
*** I am happy you see it my way.
You want to solve the biggest problem of our profession?
*** Yes! Of course I do. However your solutions don't even address the biggest problem in nursing.
Promote maturity and do what can be one to extinguish all vestiges of perpetual victimhood. There's plenty of literature to indicate that bullies back down when confronted.
*** Yes of course they do. I don't need any literature to know that. Exactly why I suggested in my first reply to the OP that she should have immediately confronted the abuser.
amzyRN
1,142 Posts
The person's cardiac enzymes (trops, CK, CKMB) and ekg were all negative (except for bradycardia, no ST elevation or depression) and the patient had been given 3 sprays of nitro in ER. The last nurse was afraid to give more because #1 she had not responded to the first 3 sprays and #2 she thought nitro would drop heart rate (the HR was in the 40s). The patient also had a 6/10 headache. The patient was going for a cath ASAP. The patient was the first patient I saw and there was a physician at his bedside assessing him when I arrived. This physician did not inform cardiology the patient was not responding to nitro. I should have known nitro does not worsen bradycardia (in fact it can cause tachycardia) but I was always respectful of this provider (PA-C) and was trying to act on the best interest of my patient. The Midlevel provider (PA-C) could have taken me aside and spoke with me, but they chose to try to embarrass me in front of my peers. It was rude and unhelpful and the comment made me feel like crap the rest of the day. The PA-C ended up ordering a nitro drip that was turned off after 10 minutes because the patient wasn't responding, developed a worsening headache and it turned out the patient's chest pain wasn't cardiac. I talked to someone about it and they said to talk to the (PA-C) first before doing anything else, but that I should follow through so it doesn't happen to someone else. I can admit I probably didn't communicate effectively and should have known about the nitro (that it wouldn't have decreased HR) but I don't believe in public humiliation either especially if people aren't going to hear the whole story. Starting a nitro drip after the patient wasn't responding to nitro in the first place and having them turn it off after 10 minutes doesn't look too good either. There was no evidence of heart damage in the first place, what was more nitro going to do for the patient especially if they weren't responding?