Write ups and feeling bulling by staff

[Elan84]

Hello Nurses, I need some words of hope and some inputs from some good experience Nurses now that at work I really can't trust anyone.

I have been having a really tough time at work, I work at night and I am in total control of this charge Nurses that don't do nothing but report everything you do to make you drawn. I recently receive my first write up on December 30th blaming me that I discharge a patient and in the papers given there were other peoples papers in it, I work in the ED.

In the ED sometimes the charge Nurses discharge the patients and then ask you to chart the discharge for them, well as a rookie first lesson learn I won't never do it again. As an addendum the write up included that lab wrote me up for sending the Urine and vial of blood together in the same bag, blame I took with pride I won't never do it again. The lack of techs and the help provided because I am a new nurse is minimal and I screw up. This is my first write up and I took it as a learning experience, after all I hope it would be the worst of my mistakes and I did not kill anyone.

Then February 2nd another phone call from management, I am always so afraid, because really not having a good time and I don't feel comfortable with the staff any question I ask or movement I do gets reported by charge nurse and is very very intimidating. Well this second write up is what I want guidance from you experience nurses. I really feel they are picking on me to get me fire just because I don't know why they just don't like me.

The situations presented to me are the following:

- On January 29th, 2015 at 0645 (6:45am) I received a patient complaining of chest pain and complications.

- At 6:45am I received the patient and placed her in a room, initiated triage and placed her in a gown.

- Although my shift ended at 0700(7:00am), I finalized caring for the patient by ensuring protocol was met and placing the patient on a cardiac monitor at 0704 (7:04am) as documented in the chart.

- After placing her on the monitor and based on her condition, she was complaining about chest pain and palpitations, for that reason I delegated the ED technician to perform an Electrocardiogram on the patient and followed up with him to make sure it was done.

- At 0715 (7:15am) I handed off Report at bedside to the day Nurse on duty. At this point my duty ended and the respective patient was in a stable condition. There was no complaint presented to me at this time.

Based on the given facts above, I believe that I have completed my duties as an RN in full and with a professional and timely manner towards the respective patient.

Then on February 2nd, I received a phone call from my Manager, asking me to come to her office to discuss the presented scenario with me. Manager and (Chief Director of the ER) said the patient in question presented to the ER on January 29th at 0645 is a RN and is claiming that I did not place her on a monitor in timely manner. I explained with facts, based on my chart that I performed all my duties on timely manner, even though my shift already ended. I also explained that I handed off the report at bedside. If the monitor wasn't placed in a timely manner, then it would have been corrected at this time.

I still were forced to sign this write up that in top of that had the issue with the urine and the blood one more time and as explained by the manager was because at the time of the first write up the ESRM report was not ready and because now is it needed to be address again and really makes it sound like I did it twice when I just did it once.

Now I texted my manager this morning telling her I want the copy of this disciplinary actions I sign and she very mean reply check with HR you can have those copies but you are not allowed to take any patient information outside the hospital big big accusation ;-/ very very scared I have been crying and feeling very sad thinking I chose the wrong profession after working so hard to get here... any thought experience nurses ???

[roser13, ASN, RN]

I'm guessing that English is not your first language. Do you work in an English-speaking facility? Are you certain that there are no language barriers working against you either in your reading/comprehension of orders or in your writing/charting?

[ScrappytheCoco]

I can only go off of what you wrote, but I agree, why did it take 15 mins to get this pt on the monitor? Also, a tech should have been in the room upon the pt's arrival to do the EKG. It should be done within 10 min of the initial complaint of cp. if there isn't a tech, do it yourself. You aren't a horrible nurse, these things are learning experiences. If this pt had a bad outcome you wouldn't have a leg to stand on in court.

[ICURN3020]

For future reference, you cannot be "forced" to sign anything. You may feel intimidated, coerced or pressured....but you always have a choice.

By signing, you are agreeing that you have been notified of and counseled on your error. If, after being presented the facts, it is not proven that you did in fact make an error, don't sign anything.

I'm somewhat confused....is it just the patient's word against your charting? And your employer believes the patient because she is an RN?

[NightNurseRN13]

It took you 15 minutes + to start an EKG and then you only spent another 15 minutes with the patient before handing them off to someone else.

[Libby1987]

Crap, I've put urine and blood in the same bag, I guess the lab staff have been too polite to say anything.

I don't know ER protocols and nurses hands down can be the toughest as far as critiquing your every move but I'm missing the bullying in your description of events.

How are you being bullied? With the language barrier maybe it's not the right choice of word.

[jadelpn, LPN, EMT-B]

For future reference, the tech should come in with you to help undress/gown the patient, get on the monitor and do EKG immediately. Once you get a CC of chest pain on arrival to the ED, and you take them into the room to triage, you need to be sure this is done before all of the rest of the triage is complete.

Make sure you are aware and look at the different protocols in your department. The chest pain protocol and standing orders will give you an indication of not only time limits, but what each step is you need to take.

Also, you can sign off on any paperwork, however, be sure to note "for acknowledgement of receipt only". Please speak with a union rep regarding this, don't ever go into a meeting without a rep. And if you do not have your own malpractice insurance, get it. If you do, look to them for guidance.

Best wishes!

[Elan84]

No! I have no writing nor reading comprehension problems. I was may be frustrated earlier and I used my phone to write this blog, but what being a second language has to do with anything? yes I do speak and write three other languages but is been a big plus in my life never a barrier. The bullying comes with techs helping all the older nurses and not me, mean and rough comments from more experience nurses, including the charge nurse. I totally belive that my patient that day was helped fast enough from the door to EKG 15 min is not bad, not counting that patients BP was 125/72 and HR 71 and 100% O2 sat total stable patient finally sent home with some xanax ...

[Elan84]

And i did had patient on the monitor since she Got undressed7:04 was both EKg and monitor both going same time, still can't see where I failed so bad to the point of being judged of being a horrible Nurse?

[roser13, ASN, RN]

No! I have no writing nor reading comprehension problems. I was may be frustrated earlier and I used my phone to write this blog, but what being a second language has to do with anything? yes I do speak and write three other languages but is been a big plus in my life never a barrier. The bullying comes with techs helping all the older nurses and not me, mean and rough comments from more experience nurses, including the charge nurse. I totally belive that my patient that day was helped fast enough from the door to EKG 15 min is not bad, not counting that patients BP was 125/72 and HR 71 and 100% O2 sat total stable patient finally sent home with some xanax ...

Well, even you will admit that this post is so much more comprehensible than the first. I struggled to make sense out of your initial post and thus wondered if others at your workplace struggle as well. Or if you yourself struggle with reading comprehension in English.

My apologies.

[whofan, ADN, BSN, RN]

Are you a new grad? Sometimes critical care departments can be super overwhelming. Did you have a good orientation/internship to the ED. I know the hospital I work at has a short one for the ED but a much longer one for ICU, and the ICU nurses have better retention because of this. If you truly feel bullied then you need to speak to your HR and possibly transfer out of that department. Sometimes there are just bad matches when it comes to units. Personality clashes and all.

[Esme12, ASN, BSN, RN]

And i did had patient on the monitor since she Got undressed7:04 was both EKg and monitor both going same time, still can't see where I failed so bad to the point of being judged of being a horrible Nurse?

As an emergency department nurse if that patient was in the room at 0645 the patient should have had an EKG, B/P in both arms, and on the monitor before 0700.....this patient should have also had labs drawn and a heploc in, MD aware of the chest pain documentation complete by 0715.

Did you allow the patient to undress herself? What if this patient was having an acute MI and needed thrombolytics? What if they were having an arrhythmia and letting them get undressed themselves and going back you found them on the floor in cardiac arrest? Sounds extreme, I know, but it has happened.

Try not thinking about being a horrible nurse or being bullied. Think of it as an improvement process. Are you a new grad or just new to the ED?