This person outranks me?!

[Aunt Slappy]

Since I started working in health care as a CNA nearly six years ago, I've had many experiences that have left me wondering how some people get into the positions they hold. I was not a youngin when I started this, I was nearly 20 years on from earning a bachelor's degree in political science and had spent more than a decade raising children at home before I began my health care career. I've worked enough to know that promoting people into leadership who shouldn't be there is not unique to health care by any means.

Lately I've a had a few interactions with a RN coworker that leave me again thinking, "How in the world does this person outrank me?"

#1 He's collecting an induced sputum sample in clinic. (I work in a public health clinic dedicated to TB testing, detection, treatment, and prevention.) He comes to me with the sputum sample tube, thankfully in a sealed specimen bag, holds it up, and says, "She vomited a little food when she coughed. Can we still use this sample?"

#2 He comes to me and says that the biohazard trash near the sputum collection rooms is full, and then asks what he should do. He's worked in this building longer than I have and knows exactly where the biohazard room is.

#3 During a case study presentation in a clinical staff meeting, in which the patient has been described as being 50 years old and 17 weeks pregnant via IVF, he asked what IVF stands for.

I just.......really?! This guy has, when you count RN prereqs I haven't taken yet, two more years of education than I do. He makes at least ten dollars more an hour than I do based on that fact. It's getting to the point where it takes all I have not to be extremely rude when he asks me these stupid questions (yes, there is such a thing).

Share your best "I can't believe s/he outranks me" stories!

[Tenebrae, BSN, RN]

...I guess you had to be there. Since this thread has become all about attacking me, I hope it dies soon. .

Persecution complex much?

No ones attacking you, what people have been saying is that the several examples you have shared in this thread do not necessarily indicate a deficiency of knowledge.

If you have an issue with being outranked by people whom you feel have a knowledge deficit, seize the day and go back and get your RN

[del28]

Your story kind of reminds me of my son...he is not in medical, but IT...however, the "experience" vs. "education," is starting to bite him. He is 26 and went to school for chemical engineering and has a huge knack for computer coding and anything computer related. However, he quit school when he had the opportunity to work for a scientist as an understudy-- he worked with him for about 6 months, but the funding for the project fell through. My son then had school loans and an unsteady academic background. However, with his background of knowledge, he got into the ground floor of some 3-D computer imaging for a large supplier of car parts. It didn't take long for the staff to find out that he was smarter than some of the degree carrying IT guys, and much of the higher personal pass the IT department to find my son to work on a difficult computer problems.

The problem with this is that my son was seeing that he was only receiving a small portion of income, as this field requires the degrees- as does nursing. He was becoming agitated with the IT department and higher personal asking him to do the difficult work! HE QUIT! And right after he gave them the news, they told him that they were planning on giving him his own office and a raise (although until he got that degree- it would still be lower than others in the department) But, now he realizes he should have stayed and just got back into school- living very low for a while and getting the degree that would give him the pay he deserved. I know that is a frustrating feeling! But instead of being discouraged? You should be thankful for what YOU know. Even if you can't go back to school and get that degree- YOU CAN be recognized as a valuable asset in the company you work for and they will want to keep you! Don't let someone's higher pay and lesser knowledge drive you crazy. Be the best you can for your whole company and the patients- and make yourself a valuable asset. I'm sorry, but like my son, the bad attitude will make you the opposite, and possibly replaceable....despite your great knowledge. Good luck!

[Bumex, DNP, NP]

This sounds like personal issues. Get over it, or move to another job.

[Orion81RN]

Let's use a little critical thinking here. If you need a sample of pulmonary sputum for testing, and it now includes gastric contents, is that a valid sample?

For TB? What critical thinking should we know if we are NOT in this area of expertise? I like to think my critical thinking skills are pretty good, with some duh moments like everyone. But I have zero clue how gastric contents would affect this spwcific test. For that matter Ive never heard of sputum culture for TB, so because that is not my area, I should give my degree back. Boy am I dumb for not knowing this.

Now, can you give me an in depth lecture on multi-system organ failure and nursing implications? Because that's an example of extra knowledge you gain going from LPN to RN. Not the silly examples you gave.

[Lunah, MSN, RN]

I try really hard to not make people feel stupid for asking questions. I have actually had people thank me for just answering and not making them feel like idiots for not knowing stuff. That is part of my role as an educator. I believe in freely sharing knowledge, no judgment. I've been an RN for almost 10 years and I wondered about the sputum sample in the original post too, haha! I mean, there is still sputum in there, right? lol. Totally would have critically thought, "Hmmmm, I'd better call the lab." I am surely not going to ask someone who makes me feel small for asking a question. I prefer to be supportive of my peeps, no matter their experience level or ability to figure things out. It's all about helping each other to help the patients, right?

I answered this nurse's questions politely at work, as is required of professionals. However, we all have thoughts that cross our minds privately and this board is advertised as a safe place to share those.

I am glad you answered politely; that wasn't expressed initially. But what if he reads allnurses too?

[macawake, MSN]

I should give my degree back. Boy am I dumb for not knowing this.

Yes, yes... you're a cretin, an imbecile. You're clearly an embarrassment to all all things nursing.

(Of course I'm kidding here, but this being the internet and all with a complete lack of facial expressions and intonation, perhaps it's best I clarify :) )

And as to the expressed concern for my workplace attitude, I'm well-liked and have been told many times that I'm a good teammate by people who have no motivation or investment in telling me things that aren't true. I answered this nurse's questions politely at work, as is required of professionals.

I'm impressed if you managed to answer your coworker's questions without giving away how you really feel about them/him. I say this completely snark-free. When you described his questions in your OP I perceived a sense of superiority towards him due to the fact that you see him as lacking knowledge, and that's usually really difficult to hide from others in real life. People can often intuitively sense the judgment/that mental eye roll. It's a good thing if you genuinely managed to conceal your feelings, because you don't want to discourage coworkers from asking questions. Feeling that you can ask questions when you're unsure of something, instead of just winging it, is an important part of a healthy safety culture.

Since this thread has become all about attacking me, I hope it dies soon.

So beat this piñata further if it pleases you, but I'm done participating.

I'm not trying to attack you, and I think the same can be said about most other posters in this thread. I don't agree with the basic premise of your OP, but that's not the same thing as attacking you. I disagree with the thoughts you voiced, but I don't know you. Listen, I realize that this thread didn't take the direction that you likely hoped, but I'll try to explain the reason I reacted to it the way I did.

I think that you were nitpicking with the things you seem to think are major knowledge deficits. I don't think that they are a big deal. I think that some of your subsequent posts have had a rather haughty tone. I understand that may be because you are acting defensively because you feel attacked, but communication will break down when everyone is oozing snark. Apart from not feeling that your coworker's ignorance was very serious, I also have a problem with the entire concept of coming up with stories that describe how much better I am than someone who happens to have more formal education than I do. That just strikes me as a odd, wholly unappealing mix of chip on the shoulder and smug superiority. It simply turns me off and likely affects how I react.

I've experienced situations where I was a bit surprised that for example a physician didn't know something that I though was pretty basic, but I wouldn't automatically jump to questioning his or her education or the breadth and depth of their knowledge. I am always very aware of all the knowledge that they likely have, that I don't. I just view those situations as an opportunity to share whatever knowledge I happened to be in possession of. I certainly have learned a lot from physicians, and sometimes they learn from me. It's beneficial for all parties. It certainly benefits our patients.

To macawake - I may have to ask you about half of the abbreviations you dropped.

I would expect that many nurses would and that doesn't in my opinion say anything about their professional capabilities. It certainly doesn't imply that they are less knowledegable than the nurse who happens to know them. The ones I mentioned are just ten out of thousands of abbreviations & acronyms in healthcare and far from the most vital or impressive knowledge we can and need to have. Frankly, I avoid them as far as possible when I chart since I think they are often a source of confusion/unclear communication. I try to use only the ones that are pretty much 100% accepted and known across all different specialties.

[Lunah, MSN, RN]

I try to use only the ones that are pretty much 100% accepted and known across all different specialties.

Being in EMS and the ER, we are masters of appropriate and not-so-appropriate acronyms.

Speaking of - has anyone heard "BID" used for "brought in dead?" I was teaching a bleeding control class to some high school students, and apparently BID is used in that manner in their medical terminology textbook. Never heard of that usage! Weird.

[Ruby Vee, BSN]

Since I started working in health care as a CNA nearly six years ago, I've had many experiences that have left me wondering how some people get into the positions they hold. I was not a youngin when I started this, I was nearly 20 years on from earning a bachelor's degree in political science and had spent more than a decade raising children at home before I began my health care career. I've worked enough to know that promoting people into leadership who shouldn't be there is not unique to health care by any means.

Lately I've a had a few interactions with a RN coworker that leave me again thinking, "How in the world does this person outrank me?"

#1 He's collecting an induced sputum sample in clinic. (I work in a public health clinic dedicated to TB testing, detection, treatment, and prevention.) He comes to me with the sputum sample tube, thankfully in a sealed specimen bag, holds it up, and says, "She vomited a little food when she coughed. Can we still use this sample?"

#2 He comes to me and says that the biohazard trash near the sputum collection rooms is full, and then asks what he should do. He's worked in this building longer than I have and knows exactly where the biohazard room is.

#3 During a case study presentation in a clinical staff meeting, in which the patient has been described as being 50 years old and 17 weeks pregnant via IVF, he asked what IVF stands for.

I just.......really?! This guy has, when you count RN prereqs I haven't taken yet, two more years of education than I do. He makes at least ten dollars more an hour than I do based on that fact. It's getting to the point where it takes all I have not to be extremely rude when he asks me these stupid questions (yes, there is such a thing).

Share your best "I can't believe s/he outranks me" stories!

You're telling us more about yourself than you are about this guy. Sounds like you just don't like him or have some other sort of problem with him.

[Ruby Vee, BSN]

LMAO I challenge you to claim where I said I know as much as a RN. The whole point of this thread is that he *should* know more than me.

And perhaps he does know more than you; you just know different things than him.

[Ruby Vee, BSN]

Let's use a little critical thinking here. If you need a sample of pulmonary sputum for testing, and it now includes gastric contents, is that a valid sample?

I'm beginning to see the problem . . . it isn't in this guy you're disrespecting. It's in your attitude.

[blondy2061h, MSN, RN]

Let's use a little critical thinking here. If you need a sample of pulmonary sputum for testing, and it now includes gastric contents, is that a valid sample?

I would think if you are testing for TB, there's either going to be TB in the sample or not. As long as there's enough sputum, having some gastric content mixed in won't kill the TB, or we could have a new treatment option!

[Pepper The Cat, BSN, RN]

Why do you say your question was stupid? Whoever wrote the order must have used an unauthorized abbreviation. And left out "to".

Nah, the MD wrote the order correctly. It was our air head secretary that put it in the Kardex like that.