I am a dietary assistant in a long-term care setting. This means I am responsible for preparing and serving meals daily. During lunch today I was treated very rudely by a registered nurse who visits some of our residents on a regular basis. I have not held this job for a long time, but it is giving my family some extra income during the summer breaks between nursing school semesters.
To the nurse who treated me as though I am incompetent because I was unaware that a certain resident needs to have prune juice with every meal. This had not been communicated to me.
I know, I work in a kitchen, so I must be incompetent.
Little did you know, I work, take care of two kids and just got an A in Medical Surgical Nursing II last semester.
Little did you know, I've earned A's in nearly every core nursing class I have taken.
I must be so stupid and incompetent --because there is poor communication where I work. It must be all the stupid cook's fault.
/End Rant
Thank you for listening.
Please treat all staff and support staff with dignity and respect. Please do not be condescending and rude. Most of us are really trying to do a good job.
Unless things have changed recently in LTC, I'd bet there was communication that the prune juice WAS indeed ordered and that OP just missed it. Used to be that the pt meal cards were individualized with special directions but they were NOT read, so special directions got missed.
Kind of like when a nurse tries to pass meds by MEMORY and NOT following the MAR. Changes occur - meds get added, changed or deleted. But nurses try passing meds by memory. And med errors happen. I've known diet cards to NOT have been updated - just previous ones being used - so again the possibility for error.
TRUE, OP did not deserve to be treated rudely, but I'll bet again that the nurse prob has to sign off that prune juice was given for the meal and OP's omission would have resulted in a dietary error that nurse would have had to take a hit for. (It wouldn't have been OP filing out an incident report.)
Sounds trivial but prune juice was prob a written order and in LTC, written orders get transcribed and are signed off. Op's omission would have had a trickle-down effect for which nsg gets nailed.
I'd be more interested in learning how OP missed the order and how better communication within her dept could be better effected.
It sounds like this might have been a one time thing. The nurse overreacted, and perhaps OP overreacted to the nurse's overreaction.
OP I am sorry that you had a bad day at work. Keep in mind, however, that it gets no better when you have RN after your name. Some doctors look down on RNs and will chew us out for trivial things. See this as a learning opportunity. I truly sympathize however, and am totally okay with you venting here. I just want to set you up with realistic expectations for the future.
Nurses get called incompetent all the time, and by incompetent people. Just the way it is. Whether it's thick skin or telling them off with inner dialogue, we all find a way to move on. She's a dime a dozen, not worth your energy.
So, what did you say to the rude nurse? You need to start standing up for yourself.. NOW. As a nurse you will be required to be assertive for yourself and your patient.
In this case, eye to eye contact and say, where is that documented in the patient's dietary orders?
I am sorry that you had a bad day at work. What have your past interactions been with this nurse? Maybe the nurse was having a bad day and the prune juice just tipped them over the edge. It is possible that you were not aware that having this prune juice had been a patient satisfaction killer. I am not trying to excuse the behavior or that it came across as condescending and mean, but something may have happened just prior to your arrival.
What was your response to the nurse? How did she responds back?
This seems to be a problem in every LTC I've been to. When you have orders for a diabetic, cardiac, mechanical soft, diet... and the tray comes out with wrong for the 3rd or 4th time, it gets a bit frustrating. If dietary is gone for the day, you're fighting the kitchen staff to make it right. I get along with the kitchen staff so it's not a problem.
I'm not saying you dropped the ball on this one but its dietary's responsibility is to make sure this doesn't happen. It may seem like it isn't a big deal but when you add tray inspection to ensure the appropriate diet to a very lengthy list of nursing duties, it becomes a problem. If this nurse is anything like me, she probably knows the requirements for all 30 of her patients.
I like to think of nursing as the hub on the wheel of patient care. Each spoke of the wheel represents a specific profession such as dietary, physical therapy, dialysis, etc. If one of these professions don't perform as expected, it ultimately falls on the nurse, whose job is to keep the wheel turning. No other healthcare profession holds this much accountability across the spectrum of care. This doesn't excuse rude or unprofessional behavior but I hope it provides some insight into what this nurse may have been dealing with at the time.
I'm sorry that you were treated rudely. You do not deserve it.
However, being a nurse for a while I have seen a lot of mix ups concerning meals and supplements that are supposed to come with them and repeatedly are missed. This is frustrating on the nurse's end because they are responsible to seeing that these orders are carried out. She may have just been frustrated that she had to AGAIN tell someone about the prune juice. Turn over tends to be high in LTC, and therefore the communication can be quite awful at times. This doesn't excuse the way you were treated, I'm just trying to shed some light on where the nurse may be coming from.
Try not to let things like this get to you. Just take note of what is needed and carry it out. In time you'll gain more experience in your facility and notice places that could use improvement and be able to offer ways to make these changes happen.
Unless things have changed recently in LTC, I'd bet there was communication that the prune juice WAS indeed ordered and that OP just missed it. Used to be that the pt meal cards were individualized with special directions but they were NOT read, so special directions got missed.
Kind of like when a nurse tries to pass meds by MEMORY and NOT following the MAR. Changes occur - meds get added, changed or deleted. But nurses try passing meds by memory. And med errors happen. I've known diet cards to NOT have been updated - just previous ones being used - so again the possibility for error.
TRUE, OP did not deserve to be treated rudely, but I'll bet again that the nurse prob has to sign off that prune juice was given for the meal and OP's omission would have resulted in a dietary error that nurse would have had to take a hit for. (It wouldn't have been OP filing out an incident report.)
Sounds trivial but prune juice was prob a written order and in LTC, written orders get transcribed and are signed off. Op's omission would have had a trickle-down effect for which nsg gets nailed.
I'd be more interested in learning how OP missed the order and how better communication within her dept could be better effected.
I've never worked LTC, so I wouldn't know how this works. But if it's something the nurse could take a hit for, couldn't the nurse ask for another prune juice? And if that prune juice wasn't given, couldn't the nurse document that she/he checked for the juice, requested more, but didn't get it? I can't see how the nurse would get in trouble for this.
I've given meds on my floor super late because they didn't get to me on time, even though I had called pharmacy about it. I simply documented that I did my part in trying to contact pharmacy, but that the med was still given late because it arrived late. Never got even close to be in trouble for that, and it was a pretty important med.
Oh my Lord!!! Rudeness and disrespect over a patient missing prune juice, LOL!!!! Stop the bolder from forming like in the movie, "Indiana Jones and Raiders of the Lost Ark." (yes constipation is a serious problem, just a joke to lighten the situation.)
I am sorry you went through that experience. We appreciate you! We thank you for the hard work you do! We are excited you will be joining our profession! Congratulations on getting an A!
I think that people who forget that to treat others as they would like to be treated, makes it hard for everyone. Everyday I go to work I tell the dietary staff, house keeping, maintenance etc, that I appreciate the work that they do! It feels like crap when you feel like you are taken for granted. Do mistakes happen, yes! I have weeks were I am desperately trying to prevent my suicidal or psychotic patients from getting metal utensils. Do I feel upset when an error occurs, yes. Do I feel like snapping, sure. BUT, I know snapping will not solve anything. Taking three steps back and you usually can see the system errors that occur.
Are individuals, individually responsible, yes! But one can't just assume intent or awareness.
Eh, come on in and vent when you need to. Sometimes a remark just hits you wrong on a day, whereas on another you might not have even noticed.
Vent, forget, move on.
Welcome to AllNurses!
I completely agree. While I agree with the commenters advising to let things roll off your back....we as humans will have days where we need to just let it out. On other days, we can bite our tongue and carry on about our day.
Thanks for the reminder to treat everyone with respect. We don't know other people's situations. Thank you for everything you do.
amoLucia
7,736 Posts
Unless things have changed recently in LTC, I'd bet there was communication that the prune juice WAS indeed ordered and that OP just missed it. Used to be that the pt meal cards were individualized with special directions but they were NOT read, so special directions got missed.
Kind of like when a nurse tries to pass meds by MEMORY and NOT following the MAR. Changes occur - meds get added, changed or deleted. But nurses try passing meds by memory. And med errors happen. I've known diet cards to NOT have been updated - just previous ones being used - so again the possibility for error.
TRUE, OP did not deserve to be treated rudely, but I'll bet again that the nurse prob has to sign off that prune juice was given for the meal and OP's omission would have resulted in a dietary error that nurse would have had to take a hit for. (It wouldn't have been OP filing out an incident report.)
Sounds trivial but prune juice was prob a written order and in LTC, written orders get transcribed and are signed off. Op's omission would have had a trickle-down effect for which nsg gets nailed.
I'd be more interested in learning how OP missed the order and how better communication within her dept could be better effected.