When enough is enough - attitudes on the floor

[amarilla, RN]

Hi all,

I graduated last May and have worked per diem for the last year on the same surg floor where I was a tech throughout nursing school. I tried to work through the learning curve and ignored most of the nonsense on the various shifts. I've been dumped on, run ragged, ignored and teased; I've stood up for myself, called people out for their behavior, kept copies of our assignments when in doubt, refused admissions when unsafe, and thought I lasted through it as it seems my shift has finally accepted me. They include me now, help if I need them, and offer opinions when they see I'm stuck with something difficult. I never went to the boss because I thought I could handle it myself.

That's great....

until I was moved to another shift to cover a hole in the schedule. Cue two new blow ups with others. One nurse flipped out on me after a doc complained to the charge that she never set up the wound vac, (I found the order confirmed but undone on the noc shift and applied the vac in the AM per confirmation from doc.) She asked me why it took me two hours to chart check and find the missing order; I asked her why, in that case, she signed the order off but didn't get to it in the remaining 10 hours of her shift? Full-on hysteria ensued. I interrupted her eye-rolling, swearing and yelling and told her that I'd heard enough, walked away. Supposedly this was the talk of the subsequent shift because three people have already asked me what happened.

Another: I got an admit ten minutes before shift change. I settled her, changed tubing, hung the new fluid on the pump, did some teaching and scanned her orders. I told the oncoming what I had done and explained that pt was likely going home, (i.e., observation status, not inpatient admit.) On our floor, you do not do the admit paperwork if pt is staying

My question: I've had my fill of eye-rolling, backtalk, insults, silent treatment and having to hash out blow-ups at the station in front of everyone. I see this happen to others but they just duck their head and walk away. They tell me if you can avoid the confrontation, I'll be better off, but that's not true. They come in to blown IVs, meds not given, orders not entered and are walked on all the more for not calling the offgoing out on it. I am looking for another job, but is there anything else I can or should do? Should I write people up? Go to the boss? Complain to HR?

My thinking is that the culture of this unit accepts this behavior, as it isn't limited to a few individuals or even one shift vs. another. Any advice to help me keep sane in the meantime is appreciated. I don't mind standing up for myself but this is really getting to be too much.

[Mulan]

There's nothing wrong with holding people accountable.

[Jerrysdogmommy]

I am fairly new to nursing and have already seen this and have been selected by an insecure bully as a target...best thing for you is to do your job, do it well (which it already sounds like you are doing a great one!!), offer to help, be kind to others and let the grouchy ones implode. In the end, they'll be all alone.

[Nurse Mentor Nancy, MSN, RN, NP]

Good for you for standing up for yourself! You cannot change this kind of toxic environment alone. You need help. Your supervisor either doesn't realize this kind of behavior is going on or more likely doesn't know how to fix it.

You mention two issues:

1. Nurses are not doing their jobs.

2. Behavior of the nurses on when there is a conflict. (especially when # 1 happens)

I suggest you ask for an appointment with your immediate supervisor. Tell her/him you will need about 20 minutes to discuss some issues you are concerned about on the unit. Prepare ahead of time by writing these down. When you meet with your supervisor, remain cool and calm.

First and best case scenario:

Your supervisor is appaulled by what you say and asks you to let her/him know when either of these situations occur in the future. Thank your supervisor for her/his time and attention to your concerns. Confirm that you would really like to continue working there, however this negative environment makes work very difficult. (or something like that. In other words, hinting that you may not be around much longer if action is not taken to turn this around.) Then see if your supervisor is true to her/his word. If so, and you see real change taking place in the next few weeks, you may be able to stay.

Second and not as good scenario:

You get a lukewarm answer, excuses for the other nurses or why no action has been taken. Ask for you and your fellow nurses to have some conflict resolution training. Let your supervisor know that you will be writing down any problems you see with nurses not completing their assignments in a timely fashion or any negative behavior directed at you and giving this to her on a daily or weekly basis(whatever is easiest for you.) You will ask for her/his help with any conflicts that you are having difficulty resolving.(in other words, when your discussion with another nurse gets to the yelling stage, you will continue to walk away.) Meanwhile, look in your employee handbook to see if there are any grievance policies or if anything is said about violence in the workplace.

Last and worst case scenario:

Your supervisor gives you the impression this behavior is tolerated. Nothing is going to be done to change what is happening. Or even worse, that you are the problem. If this is the case, get another job as soon as possible. Meanwhile, let the supervisor know you are going to HR to bring your case to them.

Best of luck to you! And thanks for discussing this important problem among nurses. I will blog about it!

[caliotter3]

Continue to do your job as you understand it needs to be done and work on your job search. That is about all you can do.

[obenfermera1]

Once you've talked to your supervisor as discussed above, think long and hard using the info you gathered in the meeting. How much do you love/like/hate this job? Your co-workers? Management? The environment? The patients themselves? Do you have any support in other co-workers that might be willing to be proactive in addressing the situation? How supportive was your supervisor and do you truly believe what they told you? What does your gut tell you?

THEN decide if this workplace is worth the time, trouble, and heartache it's going to take to improve things. If not, move on in peace! Good luck!

[MKS8806]

I had a ... somewhat similar incident where I work. Except, on my unit, we had a nurse that was not competent, and no one understood why she was still employed on the unit. She made mistake after mistake, and we would write her up and notify our supervisor, but the reality was she was a liability and no one enjoyed working with her. Everyone felt like they had to watch what she was doing and how her patients were tolerating the care they received. Our manager would just keep saying "keep reporting to me and writing things down." People were getting very frustrated. It was not until a doctor put his foot down, that she finally got fired.

I encourage you to continue doing the great job that you are. Bring the issue up to your manager and report as necessary. My point was that, unfortunately, sometimes things don't happen until a physician has problems with these nurses.

[Bruin's Mom]

It disappoints me that the nursing profession has come to this. I have been in the same boat. I have been berated, information told to the supervisor that wasn't true, etc. I have decided to take some time off from nursing to regroup and try and understand why people are the way they are. I am sorry that this has happened to you. The other post was correct that people do need to be held accountable and responsible for their actions.:)

[country mom]

I think you just described my first job following graduation- somehow, I made it 6 years there. I wonder if life would be better if everyone got a lifetime antidepressant order when they got their nursing license. Or, maybe Paxil, Zoloft, or some such thing by aerosol and filtered through the whole building through the vents? ;)Years of reflection have led me to believe that this kind of goings-on is due to poor leadership, or more precisely, people in leadership positions who have not been properly trained to lead, or lack a natural affinity for leadership. It seems few places have formal training in place for their front-line managers. So, unless that manager has a natural talent for leadership, their opportunities for developing the skills for leading people are sadly lacking. Good luck to you- it's no fun working somewhere when you have to watch your back every minute, make copies and notations of everything and can't trust your team.

[traumaRUs, MSN, APRN]

Moved to Nursing Colleague/Pt Relations forum.

[xtxrn, ASN, RN]

I graduated in 1985. I've been lucky- I spent the VAST majority of my working years in TX. Then I moved back to the midwest, and noticed the change immediately.... I know it't not strictly regional, but I think there is some of that from what I saw. I'm on disability now, and am frequently a patient, and nurses are really lacking insight if they think patients can't tell they're generally nasty-- but of course, the worst ones would never think to look at themselves.... It's sad. Yes, in TX there were a few duds... but for the most part, we worked together. There is always shift bashing (I've worked them all, days, evenings, nights, 8s, 12s, weekends, M-F...everybody has stuff to do!!).

[MKS8806]

I was voted by my fellow night shifters to be a part of the nursing council on our unit. We have been discussing this issue since May. We have had a terrible time with turnover on the night shift, and this has included some of the new hires for those positions! I work with the unit educator with new hire orientation, especially those new hires for the night shift. It seems like we've had a lot of problems with attitudes toward new hires recently as well. It doens't matter if they are experienced or not, we have some nurses that pick them apart and just dwell on their mistakes.

Since May, we have been trying to boost morale with different activities. We have started having an activity or quote at the staff meeting that has something to do with teamwork or comradery, then we also are recognizing anniversaries and years of service at our meetings. We have our staff meetings once every other month.

Does anyone else have other suggestions of things that may boost morale i the work place?