Unprofessional Behavior

[peds4now]

How do you deal with, or plan to deal with, unprofessional behavior on the part of other nurses on your unit? I know many of us come to nursing as a second career, and I've read many comments about how nurses do not act as professionally as people in other industries.

I've seen lots of nurses who just keep their head down. That might be okay to avoid stupid gossip. But what about the stuff that borders on malpractice, like not doing ROM on comatose patients but charting that you did, or not taking pain seriously and ridiculing a patient DXed with a bonafide extremely painful condition as "just drug-seeking". Or privacy violations, or racist labelling of certain groups as inappropriately demonstrative in their grief or pain?

I so don't want to become a lousy, unprofessional nurse. But I also have to survive socially. Maybe being quiet and not sitting in the break room/nurse station is the only answer? What are your thoughts?

[Heloisea3]

I encountered similar problems with unprofessional behavior when I was teaching school. My husband is a teacher and this is apparent to him as well. I think it is because both fields are kind of dominated by women. For some reason, many women love to gossip, tattle, back-stab, etc. Many women also tend to feel threatened by other women for various reasons. Yes, I know this is generalizing and doesn't apply to every every single woman, but "if the shoe fits".... Maybe this takes place in fields where men make up the majority of employees and I just haven't noticed it, but I have not heard as many complaints about those fields. I would like to hear what men who have entered nursing as a second career think about this, especially if you worked in a prior field where most of your peers were men.

When I started my first year teaching, one of my professors gave me some of the best advice that I could have ever received. "Stay out of the teacher's lounge." The point was to not put yourself in a situation where you are privy to gossip or more of a target for the gossipers. Some people just make it their mission in life to find little things to use against you. Of course, some people will do this anyway, but try to avoid it if possible. I tend to do the same thing once I start nursing. Gossiping and talking badly about others is really my pet peeve because you never know what another person has experienced or is having to go through in their lives. I try to be nice to everyone, but my main priority is my job. I have friends outside of work, so I don't have to worry about developing my social life on the job.

Also, when it comes to tattling and back-stabbing, I tend to be very direct. I don't believe in running to management for the purpose of tattling if you are having a problem with someone. I always try to speak directly to the person involved. Sometimes a small miscommunication can be blown out of proportion because some people lack the skills to communicate with their peers. I always appreciate it when people are honest with me and speak to me directly (even if it is something I don't want to hear), and I try to show this same courtesy to others. This doesn't mean that there are not times when you have to go management, especially if it involves a safety or privacy issue, but it shouldn't be for petty reasons.

Overall, I think the others hit the nail on the head when they said that we can only be responsible for our own behavior and professionalism. Maybe those who tend to lead by example and act professionally will rub off on others. I can also see where it would be a good idea to have some professional development on appropriate behavior in the workplace. I wonder how many businesses do this.

[Soup Turtle]

We have a new grad RN that on 3-11 shift is doing cartwheels in the hallway and no shes not a 20 something! I told the LPN who was orienting her she needs to let her know this is so unprofessional! How will the other nurses and STNAs ever take her as a superior with her actions!:uhoh21:

Wow...she sounds like fun, although a bit misguided.

[nursinguy]

I encountered similar problems with unprofessional behavior when I was teaching school. My husband is a teacher and this is apparent to him as well. I think it is because both fields are kind of dominated by women. For some reason, many women love to gossip, tattle, back-stab, etc. Many women also tend to feel threatened by other women for various reasons. Yes, I know this is generalizing and doesn't apply to every every single woman, but "if the shoe fits".... Maybe this takes place in fields where men make up the majority of employees and I just haven't noticed it, but I have not heard as many complaints about those fields. I would like to hear what men who have entered nursing as a second career think about this, especially if you worked in a prior field where most of your peers were men.

I hate to say it but you are right. I worked in several jobs and all the guys cared about was doing their jobs and getting paid. We talked about sports most the time and never about each other. Personal feelings about co-workers were never discussed, it would be considered unmanly and unprofessional to do so, so no one ever did it. Many of the guys wouldn't listen to it if it did happen simply because guys don't care about that kind of stuff.

When I started my first year teaching, one of my professors gave me some of the best advice that I could have ever received. "Stay out of the teacher's lounge." The point was to not put yourself in a situation where you are privy to gossip or more of a target for the gossipers. Some people just make it their mission in life to find little things to use against you. Of course, some people will do this anyway, but try to avoid it if possible. I tend to do the same thing once I start nursing. Gossiping and talking badly about others is really my pet peeve because you never know what another person has experienced or is having to go through in their lives. I try to be nice to everyone, but my main priority is my job. I have friends outside of work, so I don't have to worry about developing my social life on the job.

Also, when it comes to tattling and back-stabbing, I tend to be very direct. I don't believe in running to management for the purpose of tattling if you are having a problem with someone. I always try to speak directly to the person involved. Sometimes a small miscommunication can be blown out of proportion because some people lack the skills to communicate with their peers. I always appreciate it when people are honest with me and speak to me directly (even if it is something I don't want to hear), and I try to show this same courtesy to others. This doesn't mean that there are not times when you have to go management, especially if it involves a safety or privacy issue, but it shouldn't be for petty reasons.

Overall, I think the others hit the nail on the head when they said that we can only be responsible for our own behavior and professionalism. Maybe those who tend to lead by example and act professionally will rub off on others. I can also see where it would be a good idea to have some professional development on appropriate behavior in the workplace. I wonder how many businesses do this.

From my experiance most of this garbage comes from many women being passive-agressive. They are passive and let someone else step on them and then they get mad and become agressive and hold grudges agaisn't other nurses. Being assertive like the tried to teach us in nursing school would solve most of these problems. Dispite this I'd say 90% of my nursing class are very passive and this will lead to agressive behavior when somone else steps on them.

[Daytonite, BSN, RN]

before i even get revved up here, let me say that no one, no one, is ever forced to become a lousy, unprofessional nurse. they do it by choice. if you decide, as you start your career, that you are going to follow the rules of good practice as you were taught, despite all the excuses you are going to hear from others you come into contact with, then that's what you do. i never let anyone sway me that doing something which i knew to be a wrong way was ever correct. you know, it's kind of like when you are driving all alone on a street with no one else around and you come to a stop sign. are you going to stop? or, are you going to drive through it because no one is looking? i stop. i do it out of habit. if you break a rule once, you're more likely to break it again without hesitation.

new grads and new employees are in a tough spot in relation with the other workers. they are trying to "fit in" and not "make waves". i have to tell you that i've seen all the above situations you've described, but i've been around in nursing for 30+ years now. i don't have a problem reporting people like that, but i've got a lot of experience and confidence behind me in case something goes wrong, and it sometimes does, and i end up being the one who they go after. i merely would move on and get another job.

i did see a charge nurse doing some very unlawful and wrong things in my first ltc job. when i kept reporting it to the don nothing was done, at least that i was aware of. the nurse i reported, however, became nastier to me, so obviously the don did talk to her. she ended up complaining about me to the don every time she could. her problem though was that i was doing things correctly and the don was tolerant. i ended up just leaving after about 8 months because i couldn't stand all the badgering anymore. the overall problem was the don, our manager, just wasn't a good manager or these things would have been stopped long before i came along and she would have stopped this same nurse from constantly complaining about me. but, this particular manager had no backbone.

i do want to clarify something you mentioned. not doing rom on a comatose patient and charting that they did is falsification of a medical record. this is a violation of all nurse practice acts. any nurse who openly admits doing this (i'm not talking about hearing about it through gossip) is absolutely committing career suicide. if you have heard someone admit they did this, then you should write exactly what you were told and give this documentation to your manager. what the manager does with it, is no longer in your hands. when i was a manager myself, i had to deal with two incidences of employees falsifying medical records, both time involving documenting fingerstick blood sugars that they never performed. each were fired on the spot and one reported to the board of nursing.

i've worked with plenty of nurses who had a problem administering pain medication to people. they would not give a prn dose of an opioid when asked for, or drag their feet giving it for a number of reasons, some of them being that the patient just wanted drugs or had been a drug addict in the past and just wanted to feed their newly restarted addiction. and i've heard the snide and disrespectful comments made by others on staff when families and patients of other ethnic and cultural groups expressed their grief in very different ways than we were used to seeing. none of this is malpractice, but it is poor practice. we're supposed to be nonjudgmental and respectful. you can only be responsible for your own behavior. to go back to what i said above, we all make our own choice to follow the rules of good practice or not. i never participated in the snide or disrespectful comments. and if there was pain medication ordered and a patient asked for it i never withheld it despite what i might have thought about any addiction. part of our job is to follow doctor's orders. if the doctor had wanted to restrict a patient's access to pain medication, they would have written different orders. also, if a nurse feels that a patient's request for pain medication is bogus, pick up the phone and report this to the doctor and get the orders changed.

i have a story about a couple of smart alec nurses who consistently denied and withheld giving a patient, who happened to be a former colleague, shots of demerol for abdominal pain because they knew she had a former history as a user. i admitted and assessed the patient for them because i was a new employee in orientation. turns out the patient actually had a deep retroperitoneal malignant tumor that was found by a psychiatrist who they kept bugging her physician to consult! when he was examining her, he did the right thing when the patient told him about her abdominal pain that everyone was ignoring and he palpated and found this mass. she went to surgery a few days later and the extent of her cancer was found to be so bad that they just closed her up. she came back to our nursing unit with doubled doses for her pain medication and a terminal prognosis. do you know those two smart alec nurses were giving her pain medication when she asked for it, but we all had to listen to them rant about it! i sincerely hope they left nursing a long time ago.

[happybunny1970]

My friend who is the nurse floor manager spends 85% of her time dealing with desputes between female nurses and other female personal. After you grad and start working the backstabbing, gosping, holding grudges will began. This comes from a passive-agressive behavior that most nurses have. It can be solved by being assertive and not letting otherx step on you.

Oh, man, if it were only limited to nursing... There are so many catty women out there. I don't think it has anything to do with the field -- I dealt with this not only as a nurse, but also as a receptionist, graphic designer, and other "tame" office positions.

[nursinguy]

Part of our job is to follow doctor's orders. If the doctor had wanted to restrict a patient's access to pain medication, they would have written different orders. Also, if a nurse feels that a patient's request for pain medication is bogus, pick up the phone and report this to the doctor and get the orders changed.

.

I agree as long as the doctor has not made a mistake, if he has then it's our duty to disobey his orders.

[nursinguy]

Oh, man, if it were only limited to nursing... There are so many catty women out there. I don't think it has anything to do with the field -- I dealt with this not only as a nurse, but also as a receptionist, graphic designer, and other "tame" office positions.

You are correct. My mother is a public school teacher and she deals with the same problems with other female teachers ( gosiping, backstabbing, grudges, cat fights, envying, etc).

[TheCommuter, BSN, RN]

My mother is a public school teacher and she deals with the same problems with other female teachers ( gosiping, backstabbing, grudges, cat fights, envying, etc).

Unfortunately, this type of acrimony occurs within all female-dominated professions such as nursing, primary school teaching, librarianship, social work, clerical, etc. Some people might become offended at my assessment of the situation, but the proof is in the pudding. Not all nurses, teachers, librarians, social workers, and secretaries participate in gossiping and backstabbing, but countless female professionals do.

[Daytonite, BSN, RN]

I agree as long as the doctor has not made a mistake, if he has then it's our duty to disobey his orders.

You are wrong! Your profile indicates that you are a nursing student, so I can't expect you to understand the implications of saying and doing something like that. When you become licensed, you cannot summarily disobey a doctor's order if you think he's made a mistake! Where on God's green earth did you learn that? You pick up the phone and notify the doctor as tactfully as you know how that you do not believe that his order is correct, you do not feel comfortable following it and tell him your reasoning. That is his patient and he is in charge of that case, not you. If he still continues to say he wants the order to stay as is, and you still disagree with giving the pain medication, then you get back on the phone and notify your supervisor immediately because the situation needs to be resolved promptly since a patient is waiting for pain medication! To do anything else is no different than the kind of people the OP was talking about--someone who would just ignore the patient's requests! The supervisor should come up to your unit and assess the patient, listen to your reasons for not giving the medication and make a decision to direct you to give the pain medication if warranted or follow up with the physician's supervisor if they agreed with your reasoning. If you still were refusing to follow the doctor's order, the supervisor could either direct another nurse to give the medication or give it themself. In either case, for refusing to follow a supervisor's order you would probably be written up for insubordination.

[nursinguy]

You are wrong! Your profile indicates that you are a nursing student, so I can't expect you to understand the implications of saying and doing something like that. When you become licensed, you cannot summarily disobey a doctor's order if you think he's made a mistake!

Where on God's green earth did you learn that?

Feel free to come and tell my instructors (whome all all have their PhD in nursing) they are wrong then. This is what they teach Bach nursing students. We are taught to protect the patient even if it costs us our job, so I do understand the implication of disobeying a doctors order. The also teach us that nurses are to be automous from physicians.

You pick up the phone and notify the doctor as tactfully as you know how that you do not believe that his order is correct, you do not feel comfortable following it and tell him your reasoning. That is his patient and he is in charge of that case, not you. If he still continues to say he wants the order to stay as is, and you still disagree with giving the pain medication, then you get back on the phone and notify your supervisor immediately because the situation needs to be resolved promptly since a patient is waiting for pain medication! To do anything else is no different than the kind of people the OP was talking about--someone who would just ignore the patient's requests! The supervisor should come up to your unit and assess the patient, listen to your reasons for not giving the medication and make a decision to direct you to give the pain medication if warranted or follow up with the physician's supervisor if they agreed with your reasoning. If you still were refusing to follow the doctor's order, the supervisor could either direct another nurse to give the medication or give it themself. In either case, for refusing to follow a supervisor's order you would probably be written up for insubordination.

If the doctor is giving a dose that will harm the patient nurses always have the responsibility and duty to disobey that order and refuse to administer that medication.

[Daytonite, BSN, RN]

feel free to come and tell my instructors (whome all all have their phd in nursing) they are wrong then. this is what they teach bach nursing students. we are taught to protect the patient even if it costs us our job, so i do understand the implication of disobeying a doctors order. the also teach us that nurses are to be automous from physicians. if the doctor is giving a dose that will harm the patient nurses always have the responsibility and duty to disobey that order and refuse to administer that medication.

i highly doubt that you are correctly interpreting what your professors are telling you. part of it is correct, but you are leaving a big chunk of it out--the followup to the action that you take. i've been a staff nurse, supervisor and manager for many years (32 to be exact) and have a bsn myself. no one can refuse to follow a doctor's order and then do nothing to follow up on that action. that, i believe, would be malpractice. there are consequences to all one's actions. you can't refuse to follow the written orders of staff physicians without following the facility protocols for doing so and expect to stay employed for very long. can i remind you that you are posting to a graduate nurse forum--for students who have graduated from nursing school, getting ready to take the nclex and go out into the working world. i'm really concerned that you are not expressing any empathy and follow up for the patient here either. please! print the posts on this thread and show them to your professors and report back on what they've responded. i doubt that they will say that it's ok to disobey a doctor's order in protection of a patient and then do nothing more with regard to the doctor or the order that's being disobeyed. the doctor will report you and the administration will most likely support him because you didn't follow facility policy on the correct way to question a doctor's order. there's still the issue of what is going to be done for the patient. you continually skirt that issue.

[Imafloat, BSN, RN]

Assertiveness might make you unpopular but its our responsiblity as nurses.

Survival, not popularity is what motivates me. I am not at work to make friends, but I don't want to stand out and become a target. I prefer to stay under the radar, if someone's safety were in question, I would defenitely step in.