I've been a new nurse for almost a year now. I had an incident that still rattles me. There was a patient who had an elevated blood pressure, around in the 170's/90. The doc said to just re-check it in an hour, then she'd figure out if she'd give the pt anything to lower it. I re-checked it, and when I did, it was I think 159/80's range. When I was on the phone talking to the doctor, one nurse, who has worked at my hospital for years, was listening to my conversation with the doc. Then she all of a sudden said something along the lines of "now don't take me the wrong way, but should you really be reporting that blood pressure? That is pre-hypertensive and the patient is old." That is NOT pre-hypertensive value and the patient was simply in her late 50's. She knew that. Just because an elevated BP tends to happen amongst people who are middle-aged and older does not mean it is healthy to not treat an elevated blood pressure.
My question is, was this nurse trying to mess with my mind? I did my job and reported the abnormal value, which is our responsibility at this facility and as a nurse in general. This nurse has had a history of making comments to me like "hah, you're a young nurse" and would try to make fun of me for always documenting things extensively. I think that she is a bit twisted and for some reason is trying to hate on me. I have always been nothing but courteous. When with saying hello and goodbye, and most of the times when I say hello or "have a good night," she never responds back.
What do you think this was?
The whole incident got me very angry. Though I stayed calm and ignored her because she was giving me incorrect information and perhaps encouraging me to work towards losing my license by not reporting an elevated blood pressure (if a patient strokes out...it will be my fault because I did not report it).
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
After I got done cleaning off my computer from the coffee I spit on it when I read.....
"now don't take me the wrong way, but should you really be reporting that blood pressure? That is pre-hypertensive and the patient is old." That is NOT pre-hypertensive value and the patient was simply in her late50's.
OLD?? I am NOT OLD.......I am still considered middle aged!! I want to remind everyone that...
According to CollinsDictionary, this is "... usually considered to occur approximately between the ages of 40 and 60".The current edition of the Oxford English Dictionary gives a similar definition but with a shorter span: "The period of life between young adulthood and old age, now usually regarded as between about forty-five and sixty." The US Census lists middle age as including both the age categories 35 to 44 and 45 to 54, while prominent psychologist Erik Erikson (Erikson Growth and Development) saw it ending a little later and defines middle adulthood as between 40 and 65. The Diagnostic and Statistical Manual of Mental Disorders, the standard diagnostic manual of the American Psychiatric Association, used to define middle age as 40–60, but as of Edition IV (1994) revised the definition upwards to 45–65.
I think you did the right thing calling the MD and in calling him back. According to the NIH (National Institution of Health)
A blood pressure level of 140/90 mmHg or higher is considered high. About two-thirds of people over age 65 have high blood pressure. If your blood pressure is between 120/80 mmHg and 139/89 mmHg, then you have prehypertension.
You showed maturity and professionalism with your response
The whole incident got me very angry. Though I stayed calm and ignored her because she was giving me incorrect information
Do NOT let someone's negativity or petty jealousies dictate your actions. Don't spend anytime trying to discern what her motivations are....continue to be pleasant and move forward. You don't have to like and be friendly with everyone you work with you just need to be mature and get along with them at work.
You will find rude know-it-alls throughout your career. Try to not let them get the best of you. Remain professional and do what you know is right. You don't owe her an explanation, but you can always offer one.
One thing that I learned to say to people like that is, "You might be right." Not, "I agree with you," and not "I'll do what you say." Just, "You might be right," smile, and do whatever you were going to do in the first place. It really frosts their buns but they can't complain about it.
It's the same as in grade school! There are BULLY'S EVERYWHERE. and I hate to say it, but females EXCELL at being mean and making it seem like it COULD be innocent when you know it's not. Though there are those guys that can do it well also.
What I try to remember is Bully's somehow feel bad abt themselves, that is why they do this, and go on abt my business.
I try to "TEACH" others if there is something I know or "LEARN" if it is something I don't, and neither of those are done in a rude mean manner.
BUT you'd previously called about a higher one and the instructions were to monitor and recheck. You're not reporting a random value, you're following up. If you hadn't called, the doctor could be left wondering if the blood pressure was now ok or if you had forgotten to recheck it.
I'd just ignore that nurse. She was butting in without knowing the full situation. And if she has a habit of smug comments and stuff, waste as little energy as possible on her.
Maybe she was ignorant to the immediate dangers of blood pressure that high... maybe she never learned that medications should be checked for effectiveness... hmmm yeah ignore her and do what you know how to do. Good luck in your career.
Specializes in Medical Oncology, Alzheimer/dementia.
If I am given parameters to call the doctor, guess what? I'm calling the doctor. If the VS are just outside the parameters and the patient is symptomatic, I'm calling. If something doesn't seem right, I'm using my best nursing judgement. 170's/90's might not be life threatening for some, but I'm there and the doctor isn't. This is your nursing practice, not hers. To hell with what a smug co-worker has to say.
It's not about a new nurse having to earn respect, its about the other nurse being respectful toward the new nurse, and treating her with decency and common courtesy.
Nurses eating their young is shameful. It's bullying behavior and will be perpetuated for as long as there are those that condone it!
I have 20 plus years experience helping people deal with the effects of bullying and I was shocked to find that it is the greatest hurdle many nursing students and new nurses have to face.
As with everyone else, ignore her. You're doing a great job.
I am a little worried that this is making you so angry. So what if she made the comment or doesn't respond to your friendliness? You know you are doing the right thing. Don't let it get to you so much, that is why she is doing it. I hope she is not purposely trying to sabotage you...just be careful, and let it go, and certainly avoid asking her for advise!
I really like the response above "You might be right". I use it all the time with my mother-in-law!
Specializes in Pain, critical care, administration, med.
Who cares what that nurse thinks. Always do the right thing by your patient, document as you need to. Never let anyone sway your got or what you think I'd the right thing to do because you are the one responsible and need to answer if there is a problem.
Along the same lines as what everyone is saying, but don't allow this person to make camp in your headspace. Likely she never thinks of you unless you are right in front of her. Do what you know is right, go about your business and don't spend another minute worrying about it. This is a lesson I wish I had learned way sooner than I did!
Esme12, ASN, BSN, RN
20,908 Posts
After I got done cleaning off my computer from the coffee I spit on it when I read.....
OLD?? I am NOT OLD..Good Job!!!!