What to do about disruptive behavior?

Pistachio · Jul 25, 2012

There's is no excuse for that behavior. It really doesn't matter what you did, it's never appropriate to handle anything by screaming at somebody.

LadysSolo · Jul 25, 2012

Things like this should ALWAYS be handled in private - I told an MD once that when he could address me politely we would talk. He was shocked into silence. I don't think anyone had ever called him on his behavior before, but he never did that again.

MahzieLPN, LPN · Jul 26, 2012

How courageous of you, Mudwoman! You do not need to tolerate this abuse by anyone, especially a co-worker. After all, we're in nursing to help others. If anything, the nasty nurse should be written up and taken to task. There is never any excuse for this type of aggressive hostility.

Keep your chin up; you can come through this and will certainly, most assuredly be the better person - and ultimately, the better-best nurse.

gypsyd8 · Jul 26, 2012

edited for brevity:

I gave report first to the nurse taking my older patient. She had him on the night of 7/19-7/20. I have never met or worked with this nurse prior to this.
The nurse for my older patient comes out of his room and started screaming at me in my face in front of everyone "You didn't turn this patient all day....he is in the same position he was when I left this morning...." She was right. I had not turned him. I had assumed that he had been turned by the nurses that were so generous to help me.
The next 15 minutes, I spent with her yelling and calling me names and telling me what a pathetic nurse I was and how the care I gave this patient was totally unacceptable and would not be tolerated in ICU. "We give excellent care around here, not poor, substandard care around here, and you are NOT up to our standard for a nurse"...."They say nurses eat their young, well I guess we do to weed out the undesirables".
So, we have an "EVENT REPORTER" that we are supposed to fill out if there is a nursing error, or disruptive behavior etc. I have already reported that I did not turn the patient all shift and I did not follow up and make sure someone else did when I could not.
Should I also write a complaint of disruptive behavior on this nurse?
Write a short note to my unit manager about what happened?....,or
I don't consider leaving an option. It is a wonderful unit. I'm learning lots. I have been at this hospital many years. There are lots of other nurses that do not agree with this particular nurse's opion.
Thanks for any input....good or bad.
Charlee

#1: that nurse is full of feces. after working in the ICU, I can tell you, A LOT of patients do not get turned. Sometimes there are other priorities.

#2: Report this behavior ASAP. It is unacceptable.

#3: I am sorry you had to deal with this unspayed female canine in heat. Every ICU (I am sure) has at least one holier than thou bully with too much time on her/his hands. I have been written up for mixing "butt cream" * for use after hygiene. The person who wrote me up is a stupid old orifice who is upset about her sagging bottom. She does have a lot of experience and knowledge, but that is overshadowed by her two faced gossip, backstabbing and desire to feel superior to her peers. Lets just say she has not aged gracefully. Instead of a fine wine, she is all vinegar and EVERYONE on the unit knows this. We are all nice to her face because she makes our lives hell if we are not.

Hope this helps.....

*its basically the thick stuff (whatever you have on the unit that is mostly zinc oxide) thinned with the thin stuff (whatever you have on the unit that is mostly dimethicone) and some triple abx or mupirocin. It works, will eliminate pressure ulcers (obviously not stage IV but you get my drift). I have personally seen this and have used the stuff for over 8 years. Old CNA trick, but its not standard procedure.

gypsyd8 · Jul 26, 2012

Yes, you need to inform someone of this nurses behavior. This is unacceptable in a professional environment (or should be). How embarrassing for you. I really hope family/visitors were not around to hear this nurses tirade. You did the best you could. That is absolutely all anyone can do. You had a challenging assignment and you had to PRIORITIZE your care. A good nurse knows how to do that. You asked for help when you needed it and you made sure the most important interventions for your patient's were completed. I say good job!
Admitting that "you're right" probably made this person feel justified in their anger and fueled the fire. This nurse was not "right." You are not an "undesirable" or a nurse who provides "substandard" care. You are a nurse who is new in an area where rushing around to check off tasks can kill people. It is o.k. to not be perfect and you need time and experience to grow into your role.
You need to set boundaries for yourself on how you allow others to treat you. Should you ever experience an angry coworker screeching at you again it is perfectly acceptable to say something along the lines of "We can have a professional and private discussion regarding this matter when you regain control of your emotions" Then WALK away! Or you can just walk away. Much easier said then done I know! It took me a long time to learn to be more assertive but the payoff in the end is soo worth it!

I would have just "liked" this but this really is such fabulous advice I have to comment (and thank the poster). Sugarcoma brings up a VITAL point. This nurses behavior, if overheard, could lead to liability for the hospital. Be sure to describe any onlookers in your incident report.

Nccity2002, MSN, RN · Jul 26, 2012

I do agree that nobody should be treated that way, under no circunstances.

However, as an ICU nurse, I can't get past the fact that you did not turn/touch an ICU patient under your care for 12 hrs!!

I am curious, how did you completed your documetation/charting if you did not assess/touch your patient??

kindaquazie · Jul 26, 2012

One: Learn from this and NEVER do it to another nurse.

Option A: Go to the offending nurse, state that her behavior was against policy and inconsistent with professional behavior, however, let her know you understand and appreciate her passion for the role of an ICU nurse in the protection of vulnerable patients. Do not try to describe or defend what happened, but rather let her know you "wrote yourself up" for the incident and that you want to learn from it and move on. Let her know that she is welcome to mentor your, offer constructive advice, but that if she ever displays that kind of aggressive behavior towards you again that you will take action in accordance with company policy. If she is amenable, forgive and move on.

Option B: Go straight to reporting her behavior. If everyone already agrees that this person is a witch that needs to be fired, you might not suffer too much backlash. However, if for some odd reason she is well-liked you risk alienation.

You are in a tough spot, but ask yourself, what can I learn from this? There is no excuse for the behavior, but if you handle it right, the nurse will respect you and hopefully learn that you are formidable.

PrayeRNurse, ASN, RN · Jul 26, 2012

That was how I thought it should be handled, would have been scared to say that to a doc. Did you have reprocussions from doing it that way? Thanks for posting how you handled this.

gypsyd8 · Jul 26, 2012

As I am sure you already know, sometimes there are patients so unstable every nurse on the unit is in one room. How do you think they turn their patients then?

I do agree that nobody should be treated that way, under no circunstances.However, as an ICU nurse, I can't get past the fact that you did not turn/touch an ICU patient under your care for 12 hrs!!I am curious, how did you completed your documetation/charting if you did not assess/touch your patient??

R. Obias Jr., R.N. · Jul 26, 2012

I have been a med-surg nurse since 1994. In January of this year, I left my beloved med-surg floor and moved over to ICU. Even with my experience, I knew that this would be like starting over. I don't know if the other nurses notice any growth on my part, but I feel the growing pains for sure. That is good! That is a large part of moving to ICU: to grow and be a better nurse.
I will not go into a huge amount of detail, but will be glad to answer specific questions if anyone needs me to, but I need some advice on how to move forward on a particular unpleasant encounter from last night's shift change.
I had 2 patients. One patient had been a 1:1 until my day shift on 7/19. Young (21) and still very critical, on vent. The other patient had been moved from LTAC during the early morning hours of 7/19, but had been cared for by another nurse on 7/19. Pt is older and with a long, long hx of chronic medical problems and on vent. He is also in BIG time isolation (the works). I had both of these patients on 7/20 and they had the highest acuity on the unit. 3 other nurses helped me as their time permitted. I was so, so grateful for their help. I thanked them all over and over, and one of the nurses that is also sometimes the charge nurse made the remark that she didn't know why, but when "L***" is charge nurse, I always get the hardest load.
At one hr prior to shift change, my young, critical patient had a STAT CT of chest ordered, and 30 min prior to shift change, we had her ready to roll to CT. I got back just after report was started. I handed off to 2 different nurses.
I gave report first to the nurse taking my older patient. She had him on the night of 7/19-7/20. I have never met or worked with this nurse prior to this. I then gave report to the nurse coming on for my younger patient, and part of that report was that I had placed a rectal tube for constant diarrhea during the day, but moving her around for the CT had caused some leakage and I planned to get help cleaning her up and getting everything else back in order (monitor, tube feed etc) before I left. I found a float tech that was willing to stay over and help me. This was all accomplished by 1930.
Now comes where I need help. The nurse for my older patient comes out of his room and started screaming at me in my face in front of everyone "You didn't turn this patient all day....he is in the same position he was when I left this morning...." She was right. I had not turned him. I had assumed that he had been turned by the nurses that were so generous to help me. The nurse that offered to give his AM meds was in the room for nearly 2 hours. I was in the room for over an hour catching up on his care while giving him blood. It was on my list of things to do, however, I got called back to my other pt's room by the physician....and time moved forward, but care for this older patient did not. I admitted to her very kindly, that she was right, I had not turned him. A sport bed had been ordered for this patient, but no sport beds were available, so turning him was something that was very important! I also did not follow up and check behind the other nurses that were so kind to help me. It was one of those days where you don't take a break, you don't eat, you just keep moving as fast as possible and at the end of the day, mark it down as one of the worst of your career; even when you did the best you could do.
The next 15 minutes, I spent with her yelling and calling me names and telling me what a pathetic nurse I was and how the care I gave this patient was totally unacceptable and would not be tolerated in ICU. "We give excellent care around here, not poor, substandard care around here, and you are NOT up to our standard for a nurse"...."They say nurses eat their young, well I guess we do to weed out the undesirables". There was so much more said and it was said with cruelty and hatefulness. By this time, I am crying (darn it) and I can't talk for the lump in my throat that hurts so bad I can hardly breathe. The only thing else I could manage to say was "You are right and I'm sorry." The night charge nurse finally had heard all the yelling and got between me and her, and said, "I've got this, you go home Kid-do". The charge nurse is one of those nurses that you find so easy to look up to, consider a mentor and when you grow up as a nurse, you want to be just like him. I clocked out at 1950.
So, we have an "EVENT REPORTER" that we are supposed to fill out if there is a nursing error, or disruptive behavior etc. I have already reported that I did not turn the patient all shift and I did not follow up and make sure someone else did when I could not.
Should I also write a complaint of disruptive behavior on this nurse?
Write a short note to my unit manager about what happened?....,or
Should I just let the extra large bowl of Ben and Jerry's ice cream take care of the collateral damage and move on?
I don't consider leaving an option. It is a wonderful unit. I'm learning lots. I have been at this hospital many years. There are lots of other nurses that do not agree with this particular nurse's opion.
Thanks for any input....good or bad.
Charlee

This nurse was partly right in pointing out something that you neglected to perform on a patient, you may say that it was just turning of a patient but it is critical to an ICU patient, we may say that this badgering from the nurse will be part of your nursing/learning experience while in ICU or any department in a hospital, so try to remember them.

Now on the idea on reporting it to the unit manager, if she did it once, you may let it pass and not to report it but make sure you don't make a lot of mistakes while she is around for you will definitely get another round of that badgering. But is she repeats it more often than needed just to remind evrybody of your previous mistake and it begins to affect your functions as a nurse physically and emotionally then that would be thetime to report her. To tell you the truth this nurse must have experienced the same treatment as a nurse in her early years and this action is just a reflection of the traumatic experience she had during those times, so don't let it get into you andjust do your duties the best you can. Good Day!

Imarisk2 · Jul 27, 2012

To dress down anybody in this fashion is a travesty. To find others trying to laugh it off or downplay it as something somebody can get away with because of who they know and how many years they've been holding their own personal courtmarshalls is no less a travesty.

Nobody heals in a hostile environment, including our patients. We all get sicker together.

Walking on eggshellls is not good for our feet, much less our profession.

Grow on, and spread your seed far and wide.

Nccity2002, MSN, RN · Jul 28, 2012

As I am sure you already know, sometimes there are patients so unstable every nurse on the unit is in one room. How do you think they turn their patients then?

In the future, please read the OP original post, before commenting. There was no reference of that patient being"unstable". She simply did not turrned or "touched" the patient because she became busy with her other patient.