What should I do? Nursing Supervisor intercepting and playing doctor

My pt sitting in chair, HR 151, BP 87/46. no distress. Fresh knee post-op with morphine pca. MD called. wants pt to go to telemetry. Another MD evaluated pt & says he is in rapid afib get him back in bed "Transfer to ICU." I call the supervisor to explain everything and that's when she starts yelling at me. "Why didn't you call me first, he does not need to go anywhere!"

Then she arrives on the floor "You didn't medicate him well enough that's why he's like this." along with more additional replies about pain medication use. I said "I just started my shift. He's on a PCA, and he's denying pain!" She rolls her eyes. Then the pt suddenly had a brief moment of syncope while PT is getting him to bed.

Supervisor spats at me "Don't you know what a vasovagal is? Have you seen one before?" I said "Yes, once, when my patient was on a bedside commode." She says "You should have called me before calling those doctors! Don't you know how to assess properly?" She goes on and on. It was getting personal.

But I was more focused on getting orders completed & my pt to the unit rather than getting involved in her self-generating arguments. I doubt she listened to me. She just kept yelling. She would be more of a use if she helped carry orders out instead of trying to find a blame for his condition. I asked her 3 times what room is my pt being transfered to? She finally spat out the room number as she was walking away from me.

What the heck?? Then a few hours later she tells me smiling "That was a good call"

I did not even want to pursue an apology or defend myself.

With her type of personality, my words would only be blowing in the wind.

My resignation was already turned in. I can't imagine working here any longer. I need to work with teamplayers who want to seriously save lives.

Should I complain? The nurse manager on my floor is already aware of how the supervisors are. This is not the first. I was told that a pt coded and died because the nursing supervisor intercepted a transfer. I learned something new: Seems to me that there is some "administration vs the nurses" problem that has been existing long before I started.

[JB2007, ASN, RN]

Like you said this has been an ongoing problem that upper management was aware of before you started. You have already turned in your resignation, so I would not say anything at this time. Be sure to follow what the doctors orders (not what supervisor says) and call the doctor when it is needed. However, during your exit interview you could mention this incident as one of the reasons why you are quitting. JMO

[Whispera, MSN, RN]

sounds like she was having a VERY bad day (or recent career) and you got to be the target! in any case it surely wasn't a pleasant experience! I empathize with you!

[Purple_Scrubs, BSN, RN]

That sure sounds like verbal abuse, personally I would not tolerate it. If it were me I would file a complaint using whatever chain of command is laid out in your employee handbook. It is irrelevant that you already turned in your resignation. No one should have to deal with that.

That said, I am fortunate that my family can survive on just my husband's income. If I were not in that position, I might be less apt to file a complaint. But, since you are leaving anyway I don't see how they could retaliate.

[FireStarterRN, BSN, RN]

This is utterly unsafe and I think you have an obligation to report this to outside regulatory bodies. Just my

[LisaDNP]

WOW! ITA with Firestarter.

Kudos to you for thinking of your patient first and not reacting to the supervisor's unprofessionalism.

Now that your patient is taken care of, you have to make this situation known to someone who can do something about correcting it.

[Batman24]

I would absolutely report it. She's a danger to patients. Put it in writing because it's harder for them to ignore when there is a paper trail in place.

[RN1982]

That supervisor is an idiot. Follow the doctor's orders, ignore her's. Document, document, document. I would have wrote an incident report also. More importantly, YOU are an advocate for your patient. You are well within your rights to tell that supervisor that YOU are doing as the doctor ordered. Sometimes you need to fight like hell to do whats right for your patient.

[glasgow3]

What should you do? In my humble opinion, you have already done what you should do---leave that hell hole!!!

Your house supervisor is an idiot. Incompetent AND abusive..nice combo for someone who's supposed to be a leader. You did exactly what you should have done: You recognized a significant change in the patient's condition and you reported it to someone who could address it.

Obviously someone in administration has decided to make the house supervisors the gatekeepers for the units. This "strategy" often results from patient flow problems where the ER can't move patients out to the ICU because the beds are filled..... so the powers that be decide the answer is to limit in-house ICU transfers.

You have already told us that the managers are well aware of how the supervisors are and that there is an administration vs nursing struggle going on. Things will not change under those circumstances, at least in the short or intermediate term, trust me on that.

I'd probably state the reasons why I was leaving on my way out the door...but even if your story is well received, don't think the underlying practices will change until I was going to say someone dies; Unfortunately, however, I see someone already HAS, so let me amend that to say until someone dies and sues and/or brings their story to the media.

[Virgo_RN, BSN, RN]

Vasovagal my behind. He was syncopal because he was in a nonperfusing rhythm. He needed to be on tele (not neccessarily ICU, but a floor where they can administer a diltiazem gtt). I see this a lot when surgical patients are not given their antiarrhthmics perioperatively, then end up in AF with RVR. I'm sorry she was so horrible to you. Good luck with your next job!

[Vito Andolini]

I'm glad you have already resigned but I think you owe it to the patients to let Admin know what it going on.

Since they already know and allow it to keep happening, you should inform the doctors that their orders are being countermanded and intercepted. The docs are in more of a position to get that Supervisor the heck out of there than you or Admin are, apparently.

I hope you have a little talk with the Sup, too, for what that might be worth.

Or just stay there and ignore her, basically. Tense, I know, but I don't usually advocate nurses just running away from trouble, always starting new jobs, losing their benefits and all because of some intolerable condition on their present job. I usually say to stay and fight but I guess I'm tired right now.