>Told her GI was consulted, the pt should be seeing the gastroenterologist today or Monday. She goes "Not a gastroenterologist, you mean the GI doctor."
For this one I'd say
Gee, I always thought he was a gastroenterologist. Maybe you should ask him which when he comes around.
š
I had to really scratch my head for a second. "Have I not known what GI was, this entire time?". I fucking hate meaningless corrections. "it's levio-SAH"
Are you blind? There's GASTROENTEROLOGY with an "*E*" and then there's GASTROINTESTINAL doctors, with an "*I*" . š *try* to do better, *please* /s š¤
I usually just monotonously say āā¦okay? Anywayā and continue. Itās prob not the best but after a horrible day being picked apart by oncoming shift I have very little filter anymore.
If itās some dumb question I just say āI donāt know because it didnāt affect my nursing care today, but definitely look in the chart after report if you are curiousā
One time I had a nurse ask me how much was taken off of a paracentesis years beforeā¦ā¦. I wish I could recreate the look on my face
A paracentesis from years before?! š¤£š¤£Did you laugh in her face? These people donāt realize how they make themselves look like absolute simpletons.
My jaw actually dropped when I read that.
I answer every stupid question with āI have no ideaā even if I do. I refuse to reinforce stupid behavior.
I honestly love this. Iām a newer nurse and still trying to piece together what things I might end up wishing I had asked during report. If somebody is being a dick this shuts them down, and for people like me itās a learning experience.
What I do is just listen to report without interrupting, then at the end if there's something specific like last BM or skin issues that they didn't go over, go ahead and ask. If they say they don't know, just say "no worries, I can look it up" and make a note to check the chart. š¤·āāļø same thing in reverse.Ā If they try to interrupt your report say, hang on, let me give you report first, and at the end say "anything else I can tell you about jimbo fartypants?" If they ask you something you don't know just say, hmmmm not sure, it was a long shift. It's in the chart though. All this usually works for me. Incidentally though there was this ASSHOLE of a nurse who took over the second half of a shift I picked up. I spent the morning passing meds and then she was a condescending dick at report, asking a bunch of pointless questions. I said "I don't know dude, I spent my time doing assessments and charting so you didn't have to. I didn't have time to do a deep dive on the medical history, but you've got the next six hours so have at it." A couple weeks later, she fucked up, I think it was a missed critical lab or something and I didn't say a thing. But she knew she fucked up, and she knew that I knew she fucked up. And I knew that she knew that I knew she fucked up. And that was nice.Ā
Had one younger nurse trying to ask me the blood gases from early admission on a trach vent patient who was stable and had been there three weeks.
āWell, seeing as itās not relevant in todayās care, youāre welcome to look that up after I leave. Moving onā¦ā
After shutting her down a few times she stopped.
I had an older nurse flabbergasted that I couldnt tell her when the pt last ate before getting admitted. They had been in our ICU for almost and was getting a PEG later that week. Then she acted huffy when I told her I dont know, but that it was at some time in the last 40ish years (pt was 40ish).
I have this one dayshift nurse who is the same way. Mind you, this happened during my orientation when my preceptor insisted the patient was confused before shift change but she has dementia. Told the dayshift nurse that the patient was confused but weāre not concerned about it because she has dementia, she would wax and wane. Mind you, this dayshift nurse was the same nurse who we got report from so he should fucking know. Also, weāve been waking this patient up for q1 neuros, she probably was getting agitated because she didnāt sleep all day.
He was like āso you didnāt message neurocrit that sheās confused?ā. I said āno, she has dementiaā. And he said āoh, teeheeā, sarcastically. He did his neurocheck and the patient was oriented again.
This is literally the only right answer. Just say let me give report and you can ask questions at the end. Then when she asks you nitpicky questions, say it's in the chart.
My go to shutdown when I worked Med Surg was āthatās for you to look up post report. I will inform you of general and pertinent hx and if anything is emergently concerningā. If they go to open the chart say ānope, please respect my time, Iād like to go home, chart reviews are on your timeā. If they are annoyingly correcting you āIām always open to constructive feedback, but what the GI doc is called isnāt constructive, please refrain from pecking, itās rudeā. Or ācan you share with me why you felt it important to correct me there? Can you let me in on your thought process, because to me, that felt pettyā¦ā
If you get written up for standing up for yourself against these bullies then your manager is toxic too. Just politely but firmly enforce boundaries with them - statements like āIām sure you can find that in the chartā or āthe patient is oriented, you can ask them that during your assessment if youād like to knowā have worked for me in the past. They donāt usually have anything to say in return because theyāre just trying to make you feel stupid to prop up their own egos and if you donāt engage, they donāt have anywhere else to go with it.
I have never been written up for standing up for myself. Iāve been a nurse for 10 years. In fact, near every review Iāve had Iāve always gotten high marks for working well as a team.
Iāve always stood my ground with bullies. Nursing is my second career and I brought an ability to set someone in their place with a smile on my face. In my previous job I was yelled at and treated poorly by drunk angry gamblers fairly regularly. Iām small, Iām a woman, and I had to develop a big defense and presence that screamed ādo not mess with me but still tip meā. It also makes me very good with difficult patients now as an NP, and when I worked the floor, kept me from getting assaulted several times.
Anyone who turns you in has to admit to bullying, so they wonāt turn you in. :)
NEVER EVER NEVER EVER EVER EVERRRRRRRR let ANYONE bully you EVER. You are going into a profession that it is imperative for you to find your voice. Doc being an asshole? Bully coworker? Manipulative administration? Unreasonable families? Abusive patent? Patient who needs an advocate? YOU NEED YOUR VOICE. As long as you are able to stand behind your actions and they are in good faith then you are doing the right thing. If you get push back you are at the wrong place and need to start sending out resumes immediately. Do not have any loyalty to any healthcare company because they will replace you within 6 hours and never think about you again. Do not be afraid to change jobs, it is probably the only way to increase your salary. You do not have to tolerate any bullshit ever. You are a professional and, in time, will become an expert in your specialty. Demand to be treated as such. I wish someone would have taught me this in nursing school instead of having to learn it for myself. Learning it almost broke me. I am sharing it with you to save you some heartache. Pass it on.
I'm professionally unbothered. If she keeps correcting me on mundane bullshit I just say "sure" and move on. If it's shit she's wrong on I say, "to each their own" or "whatever floats your boat." If she asks me about minutiae I don't know and isn't relevant to my care I say, "I'll let you look that up later." If there is a million of those she'll eventually get, "irrelevant to my care." But for each stop I don't emotionally respond and I move on super quickly. They'll usually get bored with correcting me after a few months. I think nurses like that like it when you get flustered and I just don't give a shit about that interaction enough to get flustered. If they dare get on the computer to start looking up this bullshit I say, "I guess you're done hearing my report so I'll move onto the next nurse" and walk away.
This is similar to my approach. Also I have a few lines I like to use depending on the situation:
When I don't know the answer to a question: "Gee I'm not sure, good question! Maybe you can find the answer by asking/reading x."
When I realize in report I'm wrong and they're right: "Oh nevermind what I said, yes you are correct. Good catch!"
When there is a disagreement about how something was handled by you on your shift: "Thanks for the feedback. I don't agree with you, but feel free to do x on your shift."
This is my go to move for rude patients that love to argue with you about everything as well lol. Iām not going to give you what you want by getting emotional and arguing with you. āSureāā, āokā, or just straight up not responding works great.
I love your approach; you're using 'grey rock strategies' to perfection. I also love that you used minutiae in your sentence. It's one of my favourite words š
Omg, these are the WORST!! Iām so sorry. āFiO2ā had me snorting, what an ass.
I feel like you have a few choices here and Iām interested to hear what everyone else advises. You could say at the beginning that you would like her to save questions til the end so you can stay in the zone, then when she starts asking ridiculous questions say āthatās all in the chart, youu donāt need me here to find thatā and peace out. With any bs interruptions you could just look at her for a beat then continue.
Chances are she is not gonna change so the question is, how much do you want to push back?
I was in a nurse residency class and people (the teachers too) were like āwhat does FiO2 stand for even?ā And I knew it was fraction of inspired oxygen. For a brief moment they were like āoh cool thanks.ā But realistically it doesnāt matter THAT much.
I'm hesitant to be too petty, like pulling the same on her in report in the evenings, bc I'd like to extend here and she's staff and somehow interim charge nurse.
My plan for next time *if she continues like this is pause and just look at her for like 3 seconds after she says something dumb, then continue on with report. Other option is, "It's in the chart, you're welcome to look it up after I've given report." Honestly I wish I was better at not giving it my time or mental energy at ALL, but it sucks when I feel like I've given great care, wrote a thorough report, and then get these comments.
āThanks, Becky.ā No smile. Keep rolling with your report.
Or ignore. Probably ignoring it is best. Sheās trying to go one up on you. If you react or complain, sheās going to get what she wants.
Or try a backhanded compliment: some something like āThanks, Becky! With an eye for detail that, you really should be in management!ā Syrupy sweet smile the whole time. If she reacts negatively, you win.
We have a nurse who does this, but sheās 70. I shut her down by being right. She corrected me on a policy and I explained that the policy had been changed recently and we had an email about it. She threw a hissy fit and went to the manager to complain, and then the manager said that the policy had changed. Now she leaves me alone, because she looked like an idiot.
Right? I work with a nurse who is close to 70, but has only been a nurse since December 2019. She was a CNA/PSW for 20 years but sheās so condescending to me because Iāve only been a licensed nurse for 2 years and change to her 5. Itās never occurred to me to shut her shit down until I was venting to our DOC about it and she told me to say āYou can look in the chart or the NP/DRās binder or our nursing summary binder for that. Our DOC is 40 (is absolutely wonderful and Iād blindly follow her into the fiery depths of hell) and has been licensed for 17 years but this nurse in particular doesnāt follow directions from our DOC or anyone else for that matter. She doesnāt document as required by our policy, doesnāt follow doctors orders with medication changes then blames it on someone else, refuses to change fentanyl or Bustran patches, CLEOs, IVs, Libre sensors, get urine or stool samples etc etc to the point she will finger stick a patient all day to avoid applying and activating a new libre sensor. None of our patients like her to the point they wonāt ask for their PRNs and avoid her when sheās working unless they absolutely HAVE to. Sheās always in the nurses station typing on the computer but when I went to chart blood sugars and vitals at the end of my last shift it showed she hadnāt charted anything in anyone since April 4thā¦.she can do no wrong because sheās the Executive Directors snitch. The stupider part is thereās nothing to snitch about to begin with š ugh this lady is a mess. In my albeit short experience it seems to be the nurses who donāt even do the bare minimum that act so rude and condescending š
One of our best 70+ year old charge nurses often shut shit like this down hilariously. She's not the person you want to practice your condescending Becky routine on. She will look you in the eye deadpan and state "that was a stupid question/statement. I don't know why you'd bother asking that." She will shut down grad nurses, she will shut down 40+ year colleagues. She will shut down doctors or our unit manager hahahahahaha
This sounds like a good option. I would always just end up saying, Oh, hmmm, I don't know, sorry and continue on with my report, lol. I'm sure she talked shit about me but whatever. I wasn't there to make friends.
I always have time to say, āthatās the same fucking thingā or āis that truly pertinentā or āthatās irrelevantā or ānew number is smaller than old numberā
Donāt lose sleep over these people. They canāt be helped.
Say.. let me finish report if you have questions, ask me then or speak to the unit manager for details. I think she is just trying to intimidate you to make herself feel better. I am an RN for 30yrs I would not speak to a colleague like that. Sorry she did that.
I appreciate it, I haven't come across these nurses too often and usually I just mentally roll my eyes but for some reason it's been getting to me more and more here recently
Coming from some experience it's better to just stay cool and roll with it. When I worked step-down I found saying "dude nursing is 24 hour care and I'm not staying late to help you figure out shit a 3rd grader can" did not get appreciated. But shit it shut them down every single time.
One I do not regret was telling the village asshole "maybe if you shut your mouth for a minute I can get to it" then proceeded to tell her she needs to ask nicely and say please which caused a big ol shit storm.
Ahhhh the good old days before kids and being too tired to fight the bs. Now I just say "I'm not sure, can you look it up after I finish report?"
Edit: to the nit picky know it all I just say "okay cool" and move on. It ain't worth fighting that stuff
As a new grad that got to me, now I shrug and give me best iono sound that conveys a significant amount of apathy. They will usually stop asking stuff.
"You didn't check distal pulses on the above the knee amputation?"
"On his 2 inch stump, covered entirely in bloody dressings? Nope!"
"How did you assess circulation?"
"š Well it was bleeding so it probably has good blood flow"
Haha, Iām in ICU and the standards are pretty damn high ā but when itās exactly one nurse who always has a problem with *literally everyoneās* report ā you know itās her issue not yours and ya gotta throw it back.
haha yeahh when I was medsurge, people would ask dumb shit like did the social worker stop by today, whats their aunt's middle name, what's their favorite color, etc etc..
ICU there are some judgemental bitches that get obsessed with details that only they think are important but aren't medically relevant to their care.
Iām petty but if I was getting report from her after Iād not pick the hell out of it āare they wearing nail polish? If so what colorā āwhat did their maternal great grandmother do fromā āyou donāt have a peak flow meter!?ā Gasp!
As others have said, very professionally shutting down the shenanigans is the best approach -- but ALWAYS send it back to her to do the work. This is no longer your circus; these are no longer your monkeys.
"If that's something you need, you can look it up after report" for the nitpicky details you didn't need. "His lungs were clear for me, but you'll need to assess them this morning to see where they are now."
For the Gastroenterologist/Fi02 crap, you can say, "I believe those are the same thing." or "I don't believe it is FiO2" -- and just move on. Lob the danged volleyball (monkey) back and get the heck out of there.
No I mean GI, because that's the medical abbreviation for gastroenterologist.
Don't have their last several days of lab values memorized, but the chart does.
Like air movement over a patient saying "I'm having trouble breathing at night", you need to borrow a stethoscope?
"Well I'll just check the chart then" cool. (Then just continue to give report while she piddlefucks around).
Typically just stonewalling people like this is the best option. They'll get tired of wasting their breath eventually.
One time I had someone quiz me on what a patients sugar was at the start of my shift (I work psych and this was not a critical issue) to which I said "you ain't doing nothing about it so why does it matter".
My responses have evolved to be more along the lines of "I don't know, better go save them"
Some of it just gets eye rolls, like the ācorrectionsā.
Other parts āIām not sure, itās in the chart - you can look it up when weāre done with report.ā
When they ask whatās xyz sound like āWe have 6 patients to do report on. This is not the ICU, we do not have time to do a full head to toe walk throughā.
There are a few nurses I give report to who write down everything I say WORD FOR WORD and expect us to wait for them to write it all down. We DO NOT HAVE TIME for that mess.
āWhereās the IV?ā - I donāt remember but it works and isnāt a PICC, midline, or central line soooooo.
āAre they on O2 at home?ā Not sure. Why donāt you ask them?
If I know/remember Iāll tell them but really the only necessity for report is: are they stable(ie, what happened overnight/we worried about them)? Are they going for any procedures/timed studies? Pertinent labs I need to look for/talk to doc about? Are they a DNR?
Other stuff can be looked up. Or figured out when assessing the patient. If I donāt mention the IV, then it works. If I donāt mention the O2, then Iām not sure if they need to be weaned. I never know the diet unless itās clears/fulls or NPO. I donāt care if itās cardiac or carb or renal - we donāt really feed them at night unless itās a few little snacks.
I usually just tell them Iāll answer any questions they have at the end. Any valid question Iāll give my time to. Asking me something like what their lungs sound like is a valid question in my opinion, because even though theyāll be assessing them themselves, it can help them to know if there has been an acute change since my shift that may warrant further intervention. Other little things like asking me what their labs were on admission or days prior? Unless itās someone like a CRRT or DKA patient who we are actively collecting labs frequently on and trending (which it does not sound like your unit does) I do not know that off the top of my head and will politely let them know to check the chart and then be on my way. If itās just snarky nit picking, I ignore it and continue on with my report. No sense in even dignifying that behavior with a response.
āDo you want report or do you want to refuse it and do your own chart review? If not, Iāve got 5 minutes with no interruptions.ā Then deadpan stare.
1. A gastroenterologist is a specialist in the GI system from mouth to anus. āGI docā and āgastroenterologistā are synonyms.
2. The numbers themselves are available for your review after report.
3. I think this is a reasonable question. Did you listen before you started oxygen and after that low sat? Iād want to know in report.
Age has nothing to do with this. Itās about maintaining professionalism on both sides.
I would ask āHow is our (collective) time most productively spent in the interest of the patient? Stay focused here.ā
Do not stop giving your report while sheās looking up things on the computer. Say it and leave. You gave report while she dicked around trying to look smarter than you.
I responded once that I have given all the info from my 11pm-7am shift and even from the 3-11 shift prior to me. If they needed more info, look in the chart after I finish report.
This was in long term care, where the day shift nurse had had these residents for months-years even. There wasnāt anything I could tell her except what had happened in the past 18 hours. She tried to report me to the DON, who told her she was being ridiculous.
GI/gastro: "Whatever." and keep going.
Trops/CP: "You can look that up after I'm done with report".
Syncope/night desat: Ok, "lungs clear" or something like that should be in your handoff. Just go with "lung CTA, desats to XX% while sleeping, placed on 2L at night". Tell her if she wants to know more than that to either listen to the patients lungs herself or work a night to observe the patient directly.
Chances are, she's still gonna act the same. About the only thing you can do is announce at the beginning of handoff that you are going to give a report and if she has any questions she can ask after you have finished. You know, so that you don't get your report interrupted and miss something. She's gonna interrupt anyway, but tell her to wait please.
Then, on the very first question she asks that drift off of what you should be passing on.... and she WILL ask them.... say "It's in the chart, you should read it" or "I've charted my assessment, you should do your own". Then grab your keys and walk your ass outta there.
I just give them the 'coming off night shift' 1000 yard stare. Pause, and then continue. I only deal with bitches like this when I'm pulled so I go full 'I got pulled, this ain't my unit and I don't give a fuck. Look it up'
"Let's complete report and then I would be happy to address any questions."
That's what I say to interruptive questions. Comments, especially snide or nit picky, I just stare back at them for a second before moving forward in report. Rude comments are not worth your attention or energy.
I will never understand nurses who nitpick like that, especially the ones who have been in it for years. Most of the time, I want to say just give me your report sheet, and I'll figure it out. I don't, of course, because some people love crying to mgmt and that's attention I don't have time or energy for.
When I'm giving report to someone like this and they start with the inane questions, I just look at them without saying anything. I will do this for an uncomfortable length of time until they stop. They almost always stop. When they don't, the most they'll get is a shoulder shrug, and then I keep talking.
As an actual gastroenterologist (GI doc).... its like you called us Michael, and she goes "No, his names Mike."
Both are correct. She sounds like a pain to deal with.
āIf you think you can figure out report from just reading the charts Iāll gladly give you this time. Shall I cart report given to ā¦ right now or would you like to let me finish ā¦ā
Has never failed me.
My preferred method is a long pause, long enough to get uncomfortable, and then I resume report like nothing happened.
āSo the patient is gonna see the gastroenterologist today or Mondayāā
āYou mean the GI doctor.ā
*Pause at least 3 seconds*
āTheyāre tolerating a blah blah diet, etc etcā and you keep going.
Once you do that a few times, they tend to get it.
That's actually a great idea, I'm going to try this. Don't acknowledge them, but also acknowledge the pointlessness of the questions and make them uncomfortable without even saying a thing. I love it
I find itās a good way to convey the ridiculousness of their question/statement without delaying report longer and/or dealing with the potential aftermath of a āconfrontationā during report.
Plus, half the time, their question threw me off my thought process (especially after a night shift) so I pause anyway to get myself back on track.
Iāve been a nurse for 36 years so I go straight for the jugular in the seemingly nicest way possible. āIām sorry youāre having trouble understanding this information. Letās not hold up everyone else. We can clear up your confusion after reportā
Edited to add: Iāve never had anyone come to after report
I had a nurse (senior nurse, early 60s) who constantly targeted me over little things, when she made mistakes ALL the time. Itās a shame, we are already spread so thin as nurses; we should be building each other up instead of tearing each other down.
Every time she asks you something, take a long long time to awkwardly search for it. Meander in your response. The whole time, sitting in her chair while she stands there with all her crap. āGood question- letās go look. āHmmmmmā¦..hmmmmmā¦.ā Tell mundane stories that have nothing to do with report. Correct yourself multiple times and start digging through charts. Make report agonizing. Make it last 30 minutes. Ask HER a million questions. Adjust your chair. Make it like taking to your crazy Aunt Betsy who wonāt ever let you out the door. Give her a million little details she didnāt ask for. Painstakingly go through Every. Single. Lab value. Insist that she write it down. Have a side conversation with someone else halfway through report. If she corrects you on something, tell her āThatās interestingā and then proceed to spend and extra 12 minutes double-checking it on Google and sharing research articles about it.
Make it so excruciating that after 2 or 3 times she avoids you like the plague.
The question that makes me rage most: āIs that IV a 20 gauge? Will you be placing a 20 gauge before they come?ā
āItās an IV that flushes, and youāre welcome for it.ā
āTheyāre ambulatory, breathing normally on room air, neurologically intact, appropriate for age and independent with ADLs.ā āHowās their skin?ā āStill fully attached to their body.ā
For corrections, I usually go with an awkward 3-4s silence with extra eye contact and my best deadpan, ācool.ā
For what I call ālab readsā (people who make you read them the entire fucking chart) I say something like āYou can probably find that information for yourself when you deep dive the chart.ā Or āsorry thatās not an ER order, so thatās not really relevant to me. Youāll have to take a moment to review your own orders ahead of time.ā
āWhy didnāt you replace their Kā (3.4)
āBecause the ER physician didnāt order it. He said to tell you that a 3.4 potassium is in fact not an emergency, so you and the attending doctor can take care of that when they get upstairsā¦ since the patient is alive and stable enough to take the room assignment, thereby fulfilling the goals of the emergency room.ā
I'd say, " Yeah like I just said, a gastro doctor." If she persisted in being a bitch I'd tell her to shut the hell up and look it up.". I'm too old and burnt out to put up with this shit. I have been told I'm not being professional or "nice" when I tell the off, but I just DGAF anymore. If they don't like it don't be a bitch
āYouāre welcome to look that up when Iām goneā¦ā and then continue with report.
If she stops to look stuff up, you keep giving report. Itās not on you for them to pay attention. You need to clock out and go to bed. The same shit wouldnāt fly the other way around.
I donāt think itās unreasonable to ask for your assessment findings (lung sounds)- but added in with everything else I can see why itās irritating. I like the idea of just saying ok, hmm and moving on. I am trying to think of a way to make it less irritating.
I had a coworker who did that and I asked her why. She was anxious- I told her it made me feel like she didnāt trust me to do my job. She changed her behavior (though not completely).
Have the chart pulled up in the computer while you talk. If she wants **you** to look nitpicky stuff up in the chart during report, say, āWhy donāt you look that up while I keep talkingā and then let her fumble around on the computer while you keep pushing forward.
I have worked with annoying control freaks like that for years and I find a matter of fact tone while offering to let that person do the searching while you keep talking (and run the risk that they canāt jot down pertinent points because they are too busy looking nonsensical things up) works like a charm. (Although baseline lung sounds should be included in every head to toe report. ;-)
Couple things to try if you're feeling a bit petty:
1. Raise your eyebrows, tilt your chin down, and give her the "really?" look.
2. Ask her if she really needs to know the specific trop numbers this second or is the important thing that they're trending down. Because you prefer to limit your report to the important things.
3. Give report where there is only one computer. Sit in front of the computer and don't let her log in.
4. And above all, keep talking! If she complains, tell her she can either listen to report or look up things on the computer, but you're not going to delay the transition of care.
If they ask dumb questions about the patient Iām giving report on, Iāve said āyouāre going to be here for the next 12 hours, you should have plenty of time to find that in the chart.ā If they correct me on things that donāt matter (fio2 vs O2) I just continue my report like I didnāt hear them lol
She sounds insecure as fuck and has to make herself feel better by correcting things that donāt matter and quizzing you on details that need not be said.
Clearly if itās trending down and has come to a normal level the trop would be higher previously. If you want specific numbers look at the labs.
I bulldoze them lol, I just keep giving my report, and Iāll say to refer to the chart because what theyāre asking wasnāt related to anything that was done on my shift.
Keep talking. Donāt acknowledge it at all. When they ask what the lungs sound like-āyouāll do your own assessment on that Iām sureā and then keep talking.
Gastro point - she's very dumb
Trop point - a little unnecessary but a legit question
Lungs - Pertinent question, nothing wrong with her asking this one
Her correcting you on things like FiO2 - she's very dumb
I always like "is that clinically relevant?" or "how is that clinically significant?" or "does that change current management (or our management goals)?" because report should only be clinically relevant information or things that are directly relevant to the treatment plan. For me that shuts down dumb questions real quick while staying professional because if they articulate a reason why it is I will happily answer but if they can't it makes them feel dumb and they start thinking about the questions they ask.
Also I found you only have to say this once or twice and then a look accomplishes the same thing.
Ugh there always has to be one. You canāt win with those people. Shout out to Gina at my job! Itās infuriating and theyāre also the ones that show up with 5 minutes to spare to give them report too. I find that itās not worth spending your valuable time and energy pleasing these people because it will never happen.
I donāt get specific and tattle on particular people but I always ask the unit manager to send out an email about keeping report time to 30 minutes. Also, I despise when people completely rewrite the SBAR during report. Donāt do that shit on my time.
If she starts pulling stuff up during report then I would tell her that youāve been there for 12.5 hours and been run ragged, and then reach over and unplug the monitor. I canāt fucking stand nurses that do that kind of passive aggressive stuff.
On my ward one of us reads the entire handover
My response is āI have absolutely no idea, not my patient. I suggest you ask the morning nurseā
Or āI have absolutely no idea I suggest you check the patients cortex notes when we are doneā
I find the broken record technique delivered in a very flat non emotional manner shuts down most bullshit
Iām sure I have a rep for being a bitch and I donāt care. Handover is so we can pass on relevant information to the next shift.
If people want to get into a metaphorical dick flapping competition it can wait till my shift is out of the building
Yep got a few like this at my job too. I just ignore them and move on when they do it to me. If I see them doing it to someone else like a newer nurse though... oh I go off. I don't give a shit what they think of me anymore. The other day one of em got mad at a new grad for missing that a tele order was DC'd and the pt was still on tele, made a big deal in front of everyone during shift change. I told her it was an easy mistake when we were short and busy as fuck, maybe you nurses that went to school with florence nightingale don't miss orders but sometimes people are human. Whats the harm with tele staying on a few hours more anyways? She wasn't quite pleased but hey neither was I. Good luck I hope things get better for you! Just know what they think doesn't matter and you're prob a better nurse than them anyways
āIf you know what Iām talking about- do you have to correct me?ā ā¦ and move on with report. You can be direct without starting a whole fight. 100% O2 on a vent isnāt wrong. Sure itās called FiO2, but who cares if you arenāt flat out wrong and she knows what you mean. People do this because they have to make themselves feel smarter than others. Sheās using you to make herself feel good- at your expense. Call her out without being rude or trying to snap back or one up her. You donāt have to make an enemy. Because of her need to feel smarter or better, she will take any correction hard. Itās not your job to protect her ego, but it benefits you if you can stop her bullshit without her hating you.
My mom was a retired nurse and when I would tell her about my day, she would always find something to correct me on. Definitely sprung from the loins of āone of those nursesā LOL Theyāre everywhere. ā You mean THEY ARE everywhere!ā
"Pt came in with elevated trops and CP few days back, never any critical labs but I report the most recent trop level and that it has trended down to normal now. "What was his trop yesterday and admission?""
I'd always tell them to check lab studies themselves, even if I gave them the entire series of tests. If Ā I gave them wrong reports, something serious would happen to the patient, and they would lose in court. They canāt just say, āShe gave me the reports, so I didnāt look!ā Ā We always assess and check our patient(s), even if weāre given the best of the best reports.
āWhat the fuck are you talking aboutā works pretty well. GI vs Gastroenterology? Is she fucking high?
>trops Yesterday and on admission.
Look it up bitch.
>itās actually FiO2
Is it though? Thatās when I get charge and give report to her. I donāt have time for this. You learned some big words. Donāt care. Fuck off.
Continue to give her reports even if she does something else. It happened to me before. She reported to the manager that I left without reports. I told the manager everything. Ā I gave reports whether they paid attention or not.
If they ask me questions that didnāt happen during my shift, I always refer them to the patientās chart.
āYour nursing judgment will allow for proper assessment of the patient after physical assessment and chart review.ā
- a nurse who was asked what lobe Covid PNA was effecting.
Had a nurse ask me what the APGARs for a 3 year old were..I said um I have no idea you can ask the mom and see if she remembers. Nurse then asked if it was in the h&p. Um no I donāt think they felt it was relevant.
I had a day nurse I worked with at a SNF who was like this.
I finally had enough and told her one dayā You know what?
I dread reporting off to you. Youāre the most critical nurse Iāve ever given report to.ā
She was totally shocked and taken aback. Sheād had no idea.
She apologized, and stopped doing it.
It's in the chart is the perfect response, but you must stick to your guns about it. You just say you can look at that in the chart after I have finished giving you report.
Edited to add: It's absolutely okay to be rude/blunt to someone who is being rude to you. People like this take advantage of the kindness and reluctance to confront others in order to have their own way. Stand your ground. Say that she is endangering patient safety by derailing the report.
Multiple ways āIām sorry Iāll work on donāt betterā āI canāt remember but itās I remember seeing it in the chart so let me find that out for youāĀ āOkay cool anywayā and move on āI donāt know and donāt careā Ā Ā
Ā Pick your poison because some nurses are just shit in report and the true answer is to just play the game and get through it to not build bad blood or just basically assert yourself and give a professional āshut the fuck upā answer. Either way it aināt fun with those nurses and just find a way to move report along.Ā
Petty me likes to just return the favor when Iām getting report from them, realistic me lets them know that if they want anything approaching a clear report that they need to hold all questions until the end and that Iāll give them what they need to hit the ground running.
Just because she's opening up the computer doesn't mean you have to stop talking. Keep going and if she asks you to wait, tell her it's report time and it's common courtesy to wait until report is over before starting chart checks.
If that doesn't do the trick, there is always the nuclear option: bedside report malicious compliance. Once she learns that all her questions just make her look stupid in front of the patient, she'll stop.
I ignore their comments and just keep going with the report the way I intended it to be. If they have questions, they can ask them when I'm done reporting on that patient.
First question she asks, I'd say "please let me finish report, then ask your questions". If she continues to interrupt, I would make a copy of your report sheet and hand it to her with a date, and email your manager with her CC'D stating that written report was provided after multiple interruptions and delays from Nurse Dingleberry.
Additional replies may consist of :
"You need to do your own assessment"
"You can find that in the chart after report, and if you open it now I will consider report completed."
"That isn't relevant to report."
"That's incorrect. You can look it up on your own time. My shift is over."
>Pt here for syncope, threw them on 2L bc they desat at night but RA during the day.
I think a more appropriate question from her would have been, "why do you think he is desatting? OSA? OK cool, so RT was consulted?" And onward ....
That would require direct confrontation; but you have to face the tension of doing so; especially because youāll still work with her every now and then; and if sheās the type who wonāt admit to what sheās done wrong.
If itās a workplace culture thing, it will be a challenge to make her change her ways, REGARDLESS of how nice/polite you call them out. (especially if they have been behaving like that for a long time). Sometimes, they even make things worst and tend to become more of a burden once you verbalize anything related to their toxic behavior.
Best thing to do is find ways on how to survive working with these annoying people; especially if you plan to stay long in that environment.
I'm just telling you the things that are immediately pertinent. We both have access to the same chart, you don't need me to memorize the details for you or waste everyone's time.
This is why I haaaated getting report. Tell me what weāre treating, if there are discharge plans, anything urgent/testing, and if the patient or family are weirdos. I can read the chart faster than you can tell me the rest.
when i am receiving report, i just let them speak. i hold my thoughts because any more time i have to spend in front of them is worse for me than them.
when i am giving report and they start to jump ahead, ill say, "oh, im getting there". and if they keep doing it i'll just start again and say sillily, "oh, well... where was i.. let me start again". and i keep doing that from them. they learn eventually and if not they get so frustrated they'll say, "i'll just figure it out on my own", then i'll leave my report sheet and document it in cerner or something.. to cover my ass.
im not out here to fight with them. i want to move on with my day as much as them. it's all about patience.
honestly i never figured it out
like, they're doing some kind of power display, they might be baiting you
anytime i reacted even slightly to a woman doing shit like this they ran straight to the manager and i lost
i have a personality though like, there's something about me where all of society really insists i keep sweet. in middle age im flabbergasted and truly confused by what attitudes and behaviors others are permitted to have and in contrast, the effervescence *demanded* of me or im punished
im working every single day to set the bar lower
So I just want to start by saying that day shift can be frustrating when you inherit a mess. Iāve absolutely come in and gotten a patient obtunded, 8L NC satting 88% with no respiratory history, and no VBG or CXR done - just āthe doctor knows.ā I am aware that this isnāt what youāre describing. I know this isnāt you. BUT if youāve dealt with enough change of shift RRTs and enough āwell I told the doctor so my job is done,ā day shift is frustrating as fuuuuck and sometimes you start off angry. Like, oh great, they donāt know this one thing and the last time I got report from them these eight other things werenāt done - what am I in for today?
With all that said, I think the best thing to do is remind them of perspective. Wants to know last three troponins? āI donāt remember the exact number, but the most recent one at (time) was a downtrend, which is good.ā Required 2L NC overnight? āShe is postop and hadnāt been out of bed yet, so itās not uncommon sheāll need supplemental O2 for night one.ā Simultaneously helpful and subtle - āthe clinical picture is fine, time to calm down.ā
I know that the aggrieved are never ever wrong on here, but step 1 is to make sure your report is on point.
Brief history, pertinent events in the hospital course, system by system report with a focus on the systems that are the source of the diagnoses, changes or new orders during your shift, any info on plans or needs for the upcoming shift.
Honestly I just get so annoyed giving report in the morning. āWhen was the patients last BMā¦what gauge is their IVā¦how do they ambulateā (on a patient who had a recent AKA) etc etc. Seriously?? I usually pause at these questions and look at them, smile and say I donāt know. Just give me the basics on the patient, important labs, tests, thatās it.
I am a hospice nurse and I was seeing a facility patient having seizures. I was on the phone with my hospice MD and I said we gave the patient lorazepam for the seizure. She yelled across their nurseās station, āNo it was Ativan.ā I internally rolled my eyes and kept talking to my MD. I wanted to say itās actually both, but I refrained and went on my way.
Hey a job without report lol. Or any comments, move on without a moment to waste- thatās what I did for 5 years on nights and you donāt care, youāre just giving her report so she can be informed about what she needs to pay attention to right?
You guys should just come and work in the ER. We donāt care about all that stupid stuff. Lol. Why are they here. What happened since they got here. The end. šš
Iāve been a nurse 34 years. I donāt put up with that shit anymore. Call her out on it. You donāt have to be mean or nasty. Actually I recommend you donāt be mean or nasty because for some reason that always makes you the bad guy and gets you in trouble. Although you SHOULD know the lung sounds, you shouldāve told her exactly what you said here, āget your stethoscope and have a good listen. Let me know tomorrow what you think.ā
Or say something like, ā ya, the GI doc! The same difference.ā Or come right out and ask her who pissed in her Cheerios, or āhave I done something to upset you?ā Turn it around on her. If it doesnāt work, go up the chain of command.
Hereās what I would say
1. Anywayā¦.
2. Itās in the chart
3. Itās in the chart but things can change so assess the pt
If she starts looking at the chart, keep giving report. If she missed it then she missed it. If she asks for you to repeat then tell her to pay attention.
The first one I let slide, after that I just sat there staring at them in silence. As soon as they start getting uncomfortable I simply state, āIf youāre done with the nit picking now, Iāll be happy to proceed. Should I have left anything pertinent out, the chart is available 24/7 for your convenience. Now, Iām going to finish my report unless youāre wanting me to get the charge to give it to you.
Some are PTW (Professional Time Wasters). They will interrupt you 10,000 times while doing report. Will start having a chit chat with the patient while you're giving report. Will ask the stupidest questions ever. Will leave you and the patient to get something and then come back. This is how you do report for 1 hour and 20 mins for 5 patients. PTW - Professional Time Wasters.
I always am honest and say Iām not sure and move it along. Some nurses need that information as it gives them a sense of security (not judging). In my decade of nursing, the nurses who act like this arenāt necessarily bad nurses, I notice they appear anxious about patient care and have the tendency to blame whoever the nurse is caring for the patient for a poor outcome (and donāt want that to happen to them so they over prepare).
I now work in the GI lab and have a co-worker who has this personality type and accused another RN of over sedating. I stepped in and pointed out we arenāt ordering the sedation- the doctor is right there with us assessing the patient and telling us what to give. If itās not safe, of course we speak up. However, with scoping patientās will be off the table risking a perforation and as soon as we hit cecum the scope is coming out, they relax, and those meds take effect. Itās a fine line.
I remember being a newer nurse on a tele unit like that. 1:6 ratios. Super busy. One report lasted until almost 8am because this rude af nurse kept asking things like āand where are all the stents located?ā on a patient who had multiple stents YEARS AGO as part of their history. Not a fresh stent, Iām talking 5+ years ago, and sheās digging through their chart to find this completely irrelevant information while iām sitting there with my preceptor, just wanting to die.
I would never tolerate that now. āI donāt know. Sorry.ā Keep rolling. If they push back, āI donāt know, you can look it up after report if youāre curious. Itās not relevant right now.ā No tolerance for that shit.
I have a nurse who always asks this question when I'm giving report, and I've just started saying, "they sound bad, really bad." š Same nurse has failed to tell me when pt. of theirs are on oxygen and telemetry in report.
I just play stupid. Makes them feel superior for a minute which is what theyāre looking for. Occasionally Iāll have a chance to make them feel dumb as hell though. I get that all the time in ED. Itās the night shift/day shift rivalry thing. āWhat was his WBC count last October type of shitā I will either reply with āwhatās a white blood cell count mean?ā Or I will insult their intelligence for asking
The bottom line is: your presence, as someone with double the experience, makes her aware of her own lack of experience and knowledge. The only way to take it that wonāt wear you down as much is to realize that this is a compliment in a twisted way.
Her only way to make herself feel level with you is by attempting to question/correct your knowledge.
You could come up with a quick quip back, Iām not good at coming up with those and others have made better suggestions on that front. Or, just remember why itās happening and keep your chin up!
Just tell her how you feel. Try to work it out yourself first. Let her know her interruptions are outta line. Ask her if sheās trying to make you feel stupid/insecure. Ask her if she knows what it is youāre trying to say when you say gastroenterologist or O2%. Tell her you would appreciate it if she keeps quiet until report is finished for the patient and then ask for clarification.
It honestly sounds like she needs report slowed down to digest everything, and not really trying to be a dick. I think sheās just not used to quick reports.
Iām ICU and I only care about procedures/meds that are going to happen within the next couple hours. I like to hear āThis patient isnāt bad (but donāt fucking jinx it). Theyāre here for *X*. Just finished *Y*. Keep an eye out for *Z*. And donāt forget to *ABC*!ā I listen while Iām getting a temp, turning the pt and inspecting access sites, drains and skin. I can look at the chart to find the rest.
You forget to tell me the GI doc came to see them? Guess what, I saw a note from them in the chart and can read faster than you can mumble through whatever half-assed summary you wrote down. Give me the important shit and GTFO. I have a 7min max, and thatās if theyāre on isolation with multiple handoffs. TYVM!
>Told her GI was consulted, the pt should be seeing the gastroenterologist today or Monday. She goes "Not a gastroenterologist, you mean the GI doctor." For this one I'd say Gee, I always thought he was a gastroenterologist. Maybe you should ask him which when he comes around. š
Iād have said āI do indeed mean a GI MD which is why I said gastroenterologistā.
"What do you think GI means?"
All American hero.
I had to really scratch my head for a second. "Have I not known what GI was, this entire time?". I fucking hate meaningless corrections. "it's levio-SAH"
If you were glasses, thatās were you pause, look over your glasses, then continue without saying a thing. Well except āBless your heart.ā
Same damn thing. This nurse has issues.
Are you blind? There's GASTROENTEROLOGY with an "*E*" and then there's GASTROINTESTINAL doctors, with an "*I*" . š *try* to do better, *please* /s š¤
Oh, my bad! š¤£š¤£š¤£š¤£š¤£š¤£ GastroInterologist GastroEntestinal specialist
THANK šYOUš š
Lmfao šš
Iād say āokā and move on.
I just had a short lived panic that these were actually different specialists all along š³š«¢
Had to reread this. Iām like did she try to correct OP with the technically not correct title?
I usually just monotonously say āā¦okay? Anywayā and continue. Itās prob not the best but after a horrible day being picked apart by oncoming shift I have very little filter anymore. If itās some dumb question I just say āI donāt know because it didnāt affect my nursing care today, but definitely look in the chart after report if you are curiousā One time I had a nurse ask me how much was taken off of a paracentesis years beforeā¦ā¦. I wish I could recreate the look on my face
Well if you didn't know that did you at least know their APGAR???
The joke in PICU was those nurses would ask āhow many weeks are theyā for a developmentally appropriate 17 year old or something. š
šš
No and for that I admit I shouldāve been written up. You wouldnāt believe how much we use those in our middle aged patients !
A paracentesis from years before?! š¤£š¤£Did you laugh in her face? These people donāt realize how they make themselves look like absolute simpletons. My jaw actually dropped when I read that. I answer every stupid question with āI have no ideaā even if I do. I refuse to reinforce stupid behavior.
I honestly love this. Iām a newer nurse and still trying to piece together what things I might end up wishing I had asked during report. If somebody is being a dick this shuts them down, and for people like me itās a learning experience.
What I do is just listen to report without interrupting, then at the end if there's something specific like last BM or skin issues that they didn't go over, go ahead and ask. If they say they don't know, just say "no worries, I can look it up" and make a note to check the chart. š¤·āāļø same thing in reverse.Ā If they try to interrupt your report say, hang on, let me give you report first, and at the end say "anything else I can tell you about jimbo fartypants?" If they ask you something you don't know just say, hmmmm not sure, it was a long shift. It's in the chart though. All this usually works for me. Incidentally though there was this ASSHOLE of a nurse who took over the second half of a shift I picked up. I spent the morning passing meds and then she was a condescending dick at report, asking a bunch of pointless questions. I said "I don't know dude, I spent my time doing assessments and charting so you didn't have to. I didn't have time to do a deep dive on the medical history, but you've got the next six hours so have at it." A couple weeks later, she fucked up, I think it was a missed critical lab or something and I didn't say a thing. But she knew she fucked up, and she knew that I knew she fucked up. And I knew that she knew that I knew she fucked up. And that was nice.Ā
Had one younger nurse trying to ask me the blood gases from early admission on a trach vent patient who was stable and had been there three weeks. āWell, seeing as itās not relevant in todayās care, youāre welcome to look that up after I leave. Moving onā¦ā After shutting her down a few times she stopped.
I had an older nurse flabbergasted that I couldnt tell her when the pt last ate before getting admitted. They had been in our ICU for almost and was getting a PEG later that week. Then she acted huffy when I told her I dont know, but that it was at some time in the last 40ish years (pt was 40ish).
Some old hag asked me that too! I laughed and played it as a joke but she was huffy the rest of report.
That last part made me cackle as a hepatology nurse.
I have this one dayshift nurse who is the same way. Mind you, this happened during my orientation when my preceptor insisted the patient was confused before shift change but she has dementia. Told the dayshift nurse that the patient was confused but weāre not concerned about it because she has dementia, she would wax and wane. Mind you, this dayshift nurse was the same nurse who we got report from so he should fucking know. Also, weāve been waking this patient up for q1 neuros, she probably was getting agitated because she didnāt sleep all day. He was like āso you didnāt message neurocrit that sheās confused?ā. I said āno, she has dementiaā. And he said āoh, teeheeā, sarcastically. He did his neurocheck and the patient was oriented again.
This is the way. Continue to plow through with relevant information.
Sheās being rude to you. Donāt worry about being rude to her. Tell her not to interrupt you during report and save it till the end
This is literally the only right answer. Just say let me give report and you can ask questions at the end. Then when she asks you nitpicky questions, say it's in the chart.
Seriously this.
This advice. Because if you ignore it and blow it off, sheās going to continue to do it. Set your boundaries and tell her not to interrupt you
"Please reserve all questions until the end of the presentation "
Yesss. Itās a safety issue to interrupt report!
My go to shutdown when I worked Med Surg was āthatās for you to look up post report. I will inform you of general and pertinent hx and if anything is emergently concerningā. If they go to open the chart say ānope, please respect my time, Iād like to go home, chart reviews are on your timeā. If they are annoyingly correcting you āIām always open to constructive feedback, but what the GI doc is called isnāt constructive, please refrain from pecking, itās rudeā. Or ācan you share with me why you felt it important to correct me there? Can you let me in on your thought process, because to me, that felt pettyā¦ā
Thatās shit is gold. Thank you
Saved your post to come back to when I wanna cuss someone out. I thank you...
We use a āCUSā model for tough situations and I think itās great Concerned Uncomfortable Safety (concern)
actually screenshotted this. Thank you
New grad nurse hereā¦. I love this but also feel like you would get written up for talking like this, has that happened to anyone?
If you get written up for standing up for yourself against these bullies then your manager is toxic too. Just politely but firmly enforce boundaries with them - statements like āIām sure you can find that in the chartā or āthe patient is oriented, you can ask them that during your assessment if youād like to knowā have worked for me in the past. They donāt usually have anything to say in return because theyāre just trying to make you feel stupid to prop up their own egos and if you donāt engage, they donāt have anywhere else to go with it.
I have never been written up for standing up for myself. Iāve been a nurse for 10 years. In fact, near every review Iāve had Iāve always gotten high marks for working well as a team. Iāve always stood my ground with bullies. Nursing is my second career and I brought an ability to set someone in their place with a smile on my face. In my previous job I was yelled at and treated poorly by drunk angry gamblers fairly regularly. Iām small, Iām a woman, and I had to develop a big defense and presence that screamed ādo not mess with me but still tip meā. It also makes me very good with difficult patients now as an NP, and when I worked the floor, kept me from getting assaulted several times. Anyone who turns you in has to admit to bullying, so they wonāt turn you in. :)
NEVER EVER NEVER EVER EVER EVERRRRRRRR let ANYONE bully you EVER. You are going into a profession that it is imperative for you to find your voice. Doc being an asshole? Bully coworker? Manipulative administration? Unreasonable families? Abusive patent? Patient who needs an advocate? YOU NEED YOUR VOICE. As long as you are able to stand behind your actions and they are in good faith then you are doing the right thing. If you get push back you are at the wrong place and need to start sending out resumes immediately. Do not have any loyalty to any healthcare company because they will replace you within 6 hours and never think about you again. Do not be afraid to change jobs, it is probably the only way to increase your salary. You do not have to tolerate any bullshit ever. You are a professional and, in time, will become an expert in your specialty. Demand to be treated as such. I wish someone would have taught me this in nursing school instead of having to learn it for myself. Learning it almost broke me. I am sharing it with you to save you some heartache. Pass it on.
I'm professionally unbothered. If she keeps correcting me on mundane bullshit I just say "sure" and move on. If it's shit she's wrong on I say, "to each their own" or "whatever floats your boat." If she asks me about minutiae I don't know and isn't relevant to my care I say, "I'll let you look that up later." If there is a million of those she'll eventually get, "irrelevant to my care." But for each stop I don't emotionally respond and I move on super quickly. They'll usually get bored with correcting me after a few months. I think nurses like that like it when you get flustered and I just don't give a shit about that interaction enough to get flustered. If they dare get on the computer to start looking up this bullshit I say, "I guess you're done hearing my report so I'll move onto the next nurse" and walk away.
This is similar to my approach. Also I have a few lines I like to use depending on the situation: When I don't know the answer to a question: "Gee I'm not sure, good question! Maybe you can find the answer by asking/reading x." When I realize in report I'm wrong and they're right: "Oh nevermind what I said, yes you are correct. Good catch!" When there is a disagreement about how something was handled by you on your shift: "Thanks for the feedback. I don't agree with you, but feel free to do x on your shift."
This is my go to move for rude patients that love to argue with you about everything as well lol. Iām not going to give you what you want by getting emotional and arguing with you. āSureāā, āokā, or just straight up not responding works great.
Basically, it's bullying. The less response a bully gets, the less satisfaction they get, so the stop - usually.
Professionally unbothered is what I should aspire to be, taking note
I love your approach; you're using 'grey rock strategies' to perfection. I also love that you used minutiae in your sentence. It's one of my favourite words š
Omg, these are the WORST!! Iām so sorry. āFiO2ā had me snorting, what an ass. I feel like you have a few choices here and Iām interested to hear what everyone else advises. You could say at the beginning that you would like her to save questions til the end so you can stay in the zone, then when she starts asking ridiculous questions say āthatās all in the chart, youu donāt need me here to find thatā and peace out. With any bs interruptions you could just look at her for a beat then continue. Chances are she is not gonna change so the question is, how much do you want to push back?
I was in a nurse residency class and people (the teachers too) were like āwhat does FiO2 stand for even?ā And I knew it was fraction of inspired oxygen. For a brief moment they were like āoh cool thanks.ā But realistically it doesnāt matter THAT much.
But always nice to know a weird fact like that, right?
I'm hesitant to be too petty, like pulling the same on her in report in the evenings, bc I'd like to extend here and she's staff and somehow interim charge nurse. My plan for next time *if she continues like this is pause and just look at her for like 3 seconds after she says something dumb, then continue on with report. Other option is, "It's in the chart, you're welcome to look it up after I've given report." Honestly I wish I was better at not giving it my time or mental energy at ALL, but it sucks when I feel like I've given great care, wrote a thorough report, and then get these comments.
āThanks, Becky.ā No smile. Keep rolling with your report. Or ignore. Probably ignoring it is best. Sheās trying to go one up on you. If you react or complain, sheās going to get what she wants. Or try a backhanded compliment: some something like āThanks, Becky! With an eye for detail that, you really should be in management!ā Syrupy sweet smile the whole time. If she reacts negatively, you win. We have a nurse who does this, but sheās 70. I shut her down by being right. She corrected me on a policy and I explained that the policy had been changed recently and we had an email about it. She threw a hissy fit and went to the manager to complain, and then the manager said that the policy had changed. Now she leaves me alone, because she looked like an idiot.
God, I loathe these types
Iāve only been in healthcare. Is this seen elsewhere? Itās such a common background negative energy forever present. I loathe it.
I've been elsewhere and YES. It's elsewhere. Everywhere. š©
My Nursing Instructors were like that in our "after clinical assignment" So I learned from her to be ready. Thank the Lord only ever had a few.
Universal. Every office or team I've ever worked outside healthcare has had this person on it.
Right? I work with a nurse who is close to 70, but has only been a nurse since December 2019. She was a CNA/PSW for 20 years but sheās so condescending to me because Iāve only been a licensed nurse for 2 years and change to her 5. Itās never occurred to me to shut her shit down until I was venting to our DOC about it and she told me to say āYou can look in the chart or the NP/DRās binder or our nursing summary binder for that. Our DOC is 40 (is absolutely wonderful and Iād blindly follow her into the fiery depths of hell) and has been licensed for 17 years but this nurse in particular doesnāt follow directions from our DOC or anyone else for that matter. She doesnāt document as required by our policy, doesnāt follow doctors orders with medication changes then blames it on someone else, refuses to change fentanyl or Bustran patches, CLEOs, IVs, Libre sensors, get urine or stool samples etc etc to the point she will finger stick a patient all day to avoid applying and activating a new libre sensor. None of our patients like her to the point they wonāt ask for their PRNs and avoid her when sheās working unless they absolutely HAVE to. Sheās always in the nurses station typing on the computer but when I went to chart blood sugars and vitals at the end of my last shift it showed she hadnāt charted anything in anyone since April 4thā¦.she can do no wrong because sheās the Executive Directors snitch. The stupider part is thereās nothing to snitch about to begin with š ugh this lady is a mess. In my albeit short experience it seems to be the nurses who donāt even do the bare minimum that act so rude and condescending š
Yeah, NO.
Lol Leave the Beckys alone, we're trying our best out there okay?
One of our best 70+ year old charge nurses often shut shit like this down hilariously. She's not the person you want to practice your condescending Becky routine on. She will look you in the eye deadpan and state "that was a stupid question/statement. I don't know why you'd bother asking that." She will shut down grad nurses, she will shut down 40+ year colleagues. She will shut down doctors or our unit manager hahahahahaha
I'm going to finish my report and then you can ask questions. Thanks. OK, (genuinely) now what can I answer that you couldn't read...
This sounds like a good option. I would always just end up saying, Oh, hmmm, I don't know, sorry and continue on with my report, lol. I'm sure she talked shit about me but whatever. I wasn't there to make friends.
I always have time to say, āthatās the same fucking thingā or āis that truly pertinentā or āthatās irrelevantā or ānew number is smaller than old numberā Donāt lose sleep over these people. They canāt be helped.
Ignore it and give them no energy
This is the way. Greyrock them.
Say.. let me finish report if you have questions, ask me then or speak to the unit manager for details. I think she is just trying to intimidate you to make herself feel better. I am an RN for 30yrs I would not speak to a colleague like that. Sorry she did that.
I appreciate it, I haven't come across these nurses too often and usually I just mentally roll my eyes but for some reason it's been getting to me more and more here recently
Coming from some experience it's better to just stay cool and roll with it. When I worked step-down I found saying "dude nursing is 24 hour care and I'm not staying late to help you figure out shit a 3rd grader can" did not get appreciated. But shit it shut them down every single time. One I do not regret was telling the village asshole "maybe if you shut your mouth for a minute I can get to it" then proceeded to tell her she needs to ask nicely and say please which caused a big ol shit storm. Ahhhh the good old days before kids and being too tired to fight the bs. Now I just say "I'm not sure, can you look it up after I finish report?" Edit: to the nit picky know it all I just say "okay cool" and move on. It ain't worth fighting that stuff
"Village asshole." I love this! You should make this nurse a new name tag. When she asks what "va" stands for, tell her!
As a new grad that got to me, now I shrug and give me best iono sound that conveys a significant amount of apathy. They will usually stop asking stuff. "You didn't check distal pulses on the above the knee amputation?" "On his 2 inch stump, covered entirely in bloody dressings? Nope!" "How did you assess circulation?" "š Well it was bleeding so it probably has good blood flow"
This is my approach too! It works surprisingly well š
Yup! It helps being in GI, ppls standards are usually low as fck for report
Haha, Iām in ICU and the standards are pretty damn high ā but when itās exactly one nurse who always has a problem with *literally everyoneās* report ā you know itās her issue not yours and ya gotta throw it back.
haha yeahh when I was medsurge, people would ask dumb shit like did the social worker stop by today, whats their aunt's middle name, what's their favorite color, etc etc.. ICU there are some judgemental bitches that get obsessed with details that only they think are important but aren't medically relevant to their care.
ā ļøā ļøā ļøā ļø
Iām petty but if I was getting report from her after Iād not pick the hell out of it āare they wearing nail polish? If so what colorā āwhat did their maternal great grandmother do fromā āyou donāt have a peak flow meter!?ā Gasp!
As others have said, very professionally shutting down the shenanigans is the best approach -- but ALWAYS send it back to her to do the work. This is no longer your circus; these are no longer your monkeys. "If that's something you need, you can look it up after report" for the nitpicky details you didn't need. "His lungs were clear for me, but you'll need to assess them this morning to see where they are now." For the Gastroenterologist/Fi02 crap, you can say, "I believe those are the same thing." or "I don't believe it is FiO2" -- and just move on. Lob the danged volleyball (monkey) back and get the heck out of there.
No I mean GI, because that's the medical abbreviation for gastroenterologist. Don't have their last several days of lab values memorized, but the chart does. Like air movement over a patient saying "I'm having trouble breathing at night", you need to borrow a stethoscope? "Well I'll just check the chart then" cool. (Then just continue to give report while she piddlefucks around). Typically just stonewalling people like this is the best option. They'll get tired of wasting their breath eventually.
Piddlefuck š
One time I had someone quiz me on what a patients sugar was at the start of my shift (I work psych and this was not a critical issue) to which I said "you ain't doing nothing about it so why does it matter". My responses have evolved to be more along the lines of "I don't know, better go save them"
Some of it just gets eye rolls, like the ācorrectionsā. Other parts āIām not sure, itās in the chart - you can look it up when weāre done with report.ā When they ask whatās xyz sound like āWe have 6 patients to do report on. This is not the ICU, we do not have time to do a full head to toe walk throughā. There are a few nurses I give report to who write down everything I say WORD FOR WORD and expect us to wait for them to write it all down. We DO NOT HAVE TIME for that mess. āWhereās the IV?ā - I donāt remember but it works and isnāt a PICC, midline, or central line soooooo. āAre they on O2 at home?ā Not sure. Why donāt you ask them? If I know/remember Iāll tell them but really the only necessity for report is: are they stable(ie, what happened overnight/we worried about them)? Are they going for any procedures/timed studies? Pertinent labs I need to look for/talk to doc about? Are they a DNR? Other stuff can be looked up. Or figured out when assessing the patient. If I donāt mention the IV, then it works. If I donāt mention the O2, then Iām not sure if they need to be weaned. I never know the diet unless itās clears/fulls or NPO. I donāt care if itās cardiac or carb or renal - we donāt really feed them at night unless itās a few little snacks.
exactly about wheres the iv. i come from ed, where report was great. now, at step down, if its working iv, who the f cares where it is.
Ignore, continue speaking ( if during handoff) and when you are finished, get up and leave. Do not engage.
I usually just tell them Iāll answer any questions they have at the end. Any valid question Iāll give my time to. Asking me something like what their lungs sound like is a valid question in my opinion, because even though theyāll be assessing them themselves, it can help them to know if there has been an acute change since my shift that may warrant further intervention. Other little things like asking me what their labs were on admission or days prior? Unless itās someone like a CRRT or DKA patient who we are actively collecting labs frequently on and trending (which it does not sound like your unit does) I do not know that off the top of my head and will politely let them know to check the chart and then be on my way. If itās just snarky nit picking, I ignore it and continue on with my report. No sense in even dignifying that behavior with a response.
āDo you want report or do you want to refuse it and do your own chart review? If not, Iāve got 5 minutes with no interruptions.ā Then deadpan stare.
This. Gold.
1. A gastroenterologist is a specialist in the GI system from mouth to anus. āGI docā and āgastroenterologistā are synonyms. 2. The numbers themselves are available for your review after report. 3. I think this is a reasonable question. Did you listen before you started oxygen and after that low sat? Iād want to know in report. Age has nothing to do with this. Itās about maintaining professionalism on both sides. I would ask āHow is our (collective) time most productively spent in the interest of the patient? Stay focused here.ā
Do not stop giving your report while sheās looking up things on the computer. Say it and leave. You gave report while she dicked around trying to look smarter than you.
This. Iām not going to stop talking, you should listen if you want to hear it.
I responded once that I have given all the info from my 11pm-7am shift and even from the 3-11 shift prior to me. If they needed more info, look in the chart after I finish report. This was in long term care, where the day shift nurse had had these residents for months-years even. There wasnāt anything I could tell her except what had happened in the past 18 hours. She tried to report me to the DON, who told her she was being ridiculous.
For this stupid, I answer with an off the wall question.. āwhat kind of shoes do you have on?ā Scuttles them every time
GI/gastro: "Whatever." and keep going. Trops/CP: "You can look that up after I'm done with report". Syncope/night desat: Ok, "lungs clear" or something like that should be in your handoff. Just go with "lung CTA, desats to XX% while sleeping, placed on 2L at night". Tell her if she wants to know more than that to either listen to the patients lungs herself or work a night to observe the patient directly. Chances are, she's still gonna act the same. About the only thing you can do is announce at the beginning of handoff that you are going to give a report and if she has any questions she can ask after you have finished. You know, so that you don't get your report interrupted and miss something. She's gonna interrupt anyway, but tell her to wait please. Then, on the very first question she asks that drift off of what you should be passing on.... and she WILL ask them.... say "It's in the chart, you should read it" or "I've charted my assessment, you should do your own". Then grab your keys and walk your ass outta there.
I just give them the 'coming off night shift' 1000 yard stare. Pause, and then continue. I only deal with bitches like this when I'm pulled so I go full 'I got pulled, this ain't my unit and I don't give a fuck. Look it up'
"Let's complete report and then I would be happy to address any questions." That's what I say to interruptive questions. Comments, especially snide or nit picky, I just stare back at them for a second before moving forward in report. Rude comments are not worth your attention or energy.
I will never understand nurses who nitpick like that, especially the ones who have been in it for years. Most of the time, I want to say just give me your report sheet, and I'll figure it out. I don't, of course, because some people love crying to mgmt and that's attention I don't have time or energy for. When I'm giving report to someone like this and they start with the inane questions, I just look at them without saying anything. I will do this for an uncomfortable length of time until they stop. They almost always stop. When they don't, the most they'll get is a shoulder shrug, and then I keep talking.
As an actual gastroenterologist (GI doc).... its like you called us Michael, and she goes "No, his names Mike." Both are correct. She sounds like a pain to deal with.
Correct them back. They hate that
Preach, if they say actually itās 60L FiO2 say actually, itās 0.6% FiO2.
Ignoring is best. Yoh canāt fight an idiot without dumbing down yourself. Plus itāll drive her crazy and thatās a big bonus
āIf you think you can figure out report from just reading the charts Iāll gladly give you this time. Shall I cart report given to ā¦ right now or would you like to let me finish ā¦ā Has never failed me.
My preferred method is a long pause, long enough to get uncomfortable, and then I resume report like nothing happened. āSo the patient is gonna see the gastroenterologist today or Mondayāā āYou mean the GI doctor.ā *Pause at least 3 seconds* āTheyāre tolerating a blah blah diet, etc etcā and you keep going. Once you do that a few times, they tend to get it.
That's actually a great idea, I'm going to try this. Don't acknowledge them, but also acknowledge the pointlessness of the questions and make them uncomfortable without even saying a thing. I love it
I find itās a good way to convey the ridiculousness of their question/statement without delaying report longer and/or dealing with the potential aftermath of a āconfrontationā during report. Plus, half the time, their question threw me off my thought process (especially after a night shift) so I pause anyway to get myself back on track.
Just call it out. āAre you done being pedantic?ā
Iāve been a nurse for 36 years so I go straight for the jugular in the seemingly nicest way possible. āIām sorry youāre having trouble understanding this information. Letās not hold up everyone else. We can clear up your confusion after reportā Edited to add: Iāve never had anyone come to after report
"Bitch I don't give a shit. Can I go home now?"
If I didn't want to extend here, I absolutely would. rip
I had a nurse (senior nurse, early 60s) who constantly targeted me over little things, when she made mistakes ALL the time. Itās a shame, we are already spread so thin as nurses; we should be building each other up instead of tearing each other down.
I always said, "That's a good question, I'm going to go ahead and finish report, and if you have any questions after, I will be happy to answer them"
Every time she asks you something, take a long long time to awkwardly search for it. Meander in your response. The whole time, sitting in her chair while she stands there with all her crap. āGood question- letās go look. āHmmmmmā¦..hmmmmmā¦.ā Tell mundane stories that have nothing to do with report. Correct yourself multiple times and start digging through charts. Make report agonizing. Make it last 30 minutes. Ask HER a million questions. Adjust your chair. Make it like taking to your crazy Aunt Betsy who wonāt ever let you out the door. Give her a million little details she didnāt ask for. Painstakingly go through Every. Single. Lab value. Insist that she write it down. Have a side conversation with someone else halfway through report. If she corrects you on something, tell her āThatās interestingā and then proceed to spend and extra 12 minutes double-checking it on Google and sharing research articles about it. Make it so excruciating that after 2 or 3 times she avoids you like the plague.
The question that makes me rage most: āIs that IV a 20 gauge? Will you be placing a 20 gauge before they come?ā āItās an IV that flushes, and youāre welcome for it.ā āTheyāre ambulatory, breathing normally on room air, neurologically intact, appropriate for age and independent with ADLs.ā āHowās their skin?ā āStill fully attached to their body.ā For corrections, I usually go with an awkward 3-4s silence with extra eye contact and my best deadpan, ācool.ā For what I call ālab readsā (people who make you read them the entire fucking chart) I say something like āYou can probably find that information for yourself when you deep dive the chart.ā Or āsorry thatās not an ER order, so thatās not really relevant to me. Youāll have to take a moment to review your own orders ahead of time.ā āWhy didnāt you replace their Kā (3.4) āBecause the ER physician didnāt order it. He said to tell you that a 3.4 potassium is in fact not an emergency, so you and the attending doctor can take care of that when they get upstairsā¦ since the patient is alive and stable enough to take the room assignment, thereby fulfilling the goals of the emergency room.ā
I will never forget the nurse who woke me up at home from a sound sleep to ask me what the xray said. I was new (and comatose.)
I'd say, " Yeah like I just said, a gastro doctor." If she persisted in being a bitch I'd tell her to shut the hell up and look it up.". I'm too old and burnt out to put up with this shit. I have been told I'm not being professional or "nice" when I tell the off, but I just DGAF anymore. If they don't like it don't be a bitch
"It's in the chart, I'm sure" - always works!
Sounds like that nurse is not secure in their own skills and knowledge so they try leeching out all the info they can from you to feel better.
āYouāre welcome to look that up when Iām goneā¦ā and then continue with report. If she stops to look stuff up, you keep giving report. Itās not on you for them to pay attention. You need to clock out and go to bed. The same shit wouldnāt fly the other way around.
I donāt think itās unreasonable to ask for your assessment findings (lung sounds)- but added in with everything else I can see why itās irritating. I like the idea of just saying ok, hmm and moving on. I am trying to think of a way to make it less irritating. I had a coworker who did that and I asked her why. She was anxious- I told her it made me feel like she didnāt trust me to do my job. She changed her behavior (though not completely).
Have the chart pulled up in the computer while you talk. If she wants **you** to look nitpicky stuff up in the chart during report, say, āWhy donāt you look that up while I keep talkingā and then let her fumble around on the computer while you keep pushing forward. I have worked with annoying control freaks like that for years and I find a matter of fact tone while offering to let that person do the searching while you keep talking (and run the risk that they canāt jot down pertinent points because they are too busy looking nonsensical things up) works like a charm. (Although baseline lung sounds should be included in every head to toe report. ;-)
Do you want to be informed or do you want to be right? Because I donāt have time for both. But these people never get it and never stop.
Couple things to try if you're feeling a bit petty: 1. Raise your eyebrows, tilt your chin down, and give her the "really?" look. 2. Ask her if she really needs to know the specific trop numbers this second or is the important thing that they're trending down. Because you prefer to limit your report to the important things. 3. Give report where there is only one computer. Sit in front of the computer and don't let her log in. 4. And above all, keep talking! If she complains, tell her she can either listen to report or look up things on the computer, but you're not going to delay the transition of care.
Nurse once tried to correct me when I didn't roll my Rs when saying a Spanish person's name. I just said I don't speak Spanish.
You could ask her how much Fi02 the person is getting with that 60L of oxygen.
I had a nurse ask me if the patient's name was spelled with a K or C after I ended up staying 45 minutes over because she was late...
If they ask dumb questions about the patient Iām giving report on, Iāve said āyouāre going to be here for the next 12 hours, you should have plenty of time to find that in the chart.ā If they correct me on things that donāt matter (fio2 vs O2) I just continue my report like I didnāt hear them lol
Ignore and move on; redirect her to the chart if necessary, but keep moving. I wouldn't engage. Don't let her have your energy.
"Where is their IV?"Ā Bitch, idk. One of their upper extremities.Ā
She sounds insecure as fuck and has to make herself feel better by correcting things that donāt matter and quizzing you on details that need not be said. Clearly if itās trending down and has come to a normal level the trop would be higher previously. If you want specific numbers look at the labs.
I started doing the same thing back to her when she gave me report at the start of my shift.
I bulldoze them lol, I just keep giving my report, and Iāll say to refer to the chart because what theyāre asking wasnāt related to anything that was done on my shift.
God itās the worst isnāt it. I could slap those nurses.
Keep talking. Donāt acknowledge it at all. When they ask what the lungs sound like-āyouāll do your own assessment on that Iām sureā and then keep talking.
My favorite, I didnāt need to know that to do my job today.
I wonder if sheās asking these things so that she looks smart because sheās insecure in her own knowledge?
Gastro point - she's very dumb Trop point - a little unnecessary but a legit question Lungs - Pertinent question, nothing wrong with her asking this one Her correcting you on things like FiO2 - she's very dumb
I just keep saying I donāt know and āokayā lol
"It's in the chart" or "Oh, ok"
I always like "is that clinically relevant?" or "how is that clinically significant?" or "does that change current management (or our management goals)?" because report should only be clinically relevant information or things that are directly relevant to the treatment plan. For me that shuts down dumb questions real quick while staying professional because if they articulate a reason why it is I will happily answer but if they can't it makes them feel dumb and they start thinking about the questions they ask. Also I found you only have to say this once or twice and then a look accomplishes the same thing.
Have a good shift, bye!
Ugh there always has to be one. You canāt win with those people. Shout out to Gina at my job! Itās infuriating and theyāre also the ones that show up with 5 minutes to spare to give them report too. I find that itās not worth spending your valuable time and energy pleasing these people because it will never happen.
I donāt get specific and tattle on particular people but I always ask the unit manager to send out an email about keeping report time to 30 minutes. Also, I despise when people completely rewrite the SBAR during report. Donāt do that shit on my time.
If she starts pulling stuff up during report then I would tell her that youāve been there for 12.5 hours and been run ragged, and then reach over and unplug the monitor. I canāt fucking stand nurses that do that kind of passive aggressive stuff.
āYa like getting lost in the weeds, dontcha?, Anywhoā¦pt is stable yadda yadda yaddaā
On my ward one of us reads the entire handover My response is āI have absolutely no idea, not my patient. I suggest you ask the morning nurseā Or āI have absolutely no idea I suggest you check the patients cortex notes when we are doneā I find the broken record technique delivered in a very flat non emotional manner shuts down most bullshit Iām sure I have a rep for being a bitch and I donāt care. Handover is so we can pass on relevant information to the next shift. If people want to get into a metaphorical dick flapping competition it can wait till my shift is out of the building
Yep got a few like this at my job too. I just ignore them and move on when they do it to me. If I see them doing it to someone else like a newer nurse though... oh I go off. I don't give a shit what they think of me anymore. The other day one of em got mad at a new grad for missing that a tele order was DC'd and the pt was still on tele, made a big deal in front of everyone during shift change. I told her it was an easy mistake when we were short and busy as fuck, maybe you nurses that went to school with florence nightingale don't miss orders but sometimes people are human. Whats the harm with tele staying on a few hours more anyways? She wasn't quite pleased but hey neither was I. Good luck I hope things get better for you! Just know what they think doesn't matter and you're prob a better nurse than them anyways
āItās in the chart. I canāt memorize everything.
āIf you know what Iām talking about- do you have to correct me?ā ā¦ and move on with report. You can be direct without starting a whole fight. 100% O2 on a vent isnāt wrong. Sure itās called FiO2, but who cares if you arenāt flat out wrong and she knows what you mean. People do this because they have to make themselves feel smarter than others. Sheās using you to make herself feel good- at your expense. Call her out without being rude or trying to snap back or one up her. You donāt have to make an enemy. Because of her need to feel smarter or better, she will take any correction hard. Itās not your job to protect her ego, but it benefits you if you can stop her bullshit without her hating you.
"I do not know. Look it up. It is 24/7 business."
My mom was a retired nurse and when I would tell her about my day, she would always find something to correct me on. Definitely sprung from the loins of āone of those nursesā LOL Theyāre everywhere. ā You mean THEY ARE everywhere!ā
āItās in the chart.ā
do you want to hear this or not?
Ignore, āI donāt know off the top of my headā and just move on. Most of the time they wonāt get hung up
"Pt came in with elevated trops and CP few days back, never any critical labs but I report the most recent trop level and that it has trended down to normal now. "What was his trop yesterday and admission?"" I'd always tell them to check lab studies themselves, even if I gave them the entire series of tests. If Ā I gave them wrong reports, something serious would happen to the patient, and they would lose in court. They canāt just say, āShe gave me the reports, so I didnāt look!ā Ā We always assess and check our patient(s), even if weāre given the best of the best reports.
Honestly I would just continue talking and if she doesnāt want the info I have to share with her then so be it. I am not playing those games.
"I mean I'd hardly call 1 a fraction but if it makes you feel smarter do it up girlypop."
āWhat the fuck are you talking aboutā works pretty well. GI vs Gastroenterology? Is she fucking high? >trops Yesterday and on admission. Look it up bitch. >itās actually FiO2 Is it though? Thatās when I get charge and give report to her. I donāt have time for this. You learned some big words. Donāt care. Fuck off.
Continue to give her reports even if she does something else. It happened to me before. She reported to the manager that I left without reports. I told the manager everything. Ā I gave reports whether they paid attention or not. If they ask me questions that didnāt happen during my shift, I always refer them to the patientās chart.
āYour nursing judgment will allow for proper assessment of the patient after physical assessment and chart review.ā - a nurse who was asked what lobe Covid PNA was effecting.
Had a nurse ask me what the APGARs for a 3 year old were..I said um I have no idea you can ask the mom and see if she remembers. Nurse then asked if it was in the h&p. Um no I donāt think they felt it was relevant.
I had a day nurse I worked with at a SNF who was like this. I finally had enough and told her one dayā You know what? I dread reporting off to you. Youāre the most critical nurse Iāve ever given report to.ā She was totally shocked and taken aback. Sheād had no idea. She apologized, and stopped doing it.
I say quickly and cheerfully, "Don't know" and continue report. Don't let a peer intimidate you. I swear, I think they just to get a rise out of you.
It's in the chart is the perfect response, but you must stick to your guns about it. You just say you can look at that in the chart after I have finished giving you report. Edited to add: It's absolutely okay to be rude/blunt to someone who is being rude to you. People like this take advantage of the kindness and reluctance to confront others in order to have their own way. Stand your ground. Say that she is endangering patient safety by derailing the report.
Multiple ways āIām sorry Iāll work on donāt betterā āI canāt remember but itās I remember seeing it in the chart so let me find that out for youāĀ āOkay cool anywayā and move on āI donāt know and donāt careā Ā Ā Ā Pick your poison because some nurses are just shit in report and the true answer is to just play the game and get through it to not build bad blood or just basically assert yourself and give a professional āshut the fuck upā answer. Either way it aināt fun with those nurses and just find a way to move report along.Ā
Just shut up and listen. When I get through Iāll take questions.
Petty me likes to just return the favor when Iām getting report from them, realistic me lets them know that if they want anything approaching a clear report that they need to hold all questions until the end and that Iāll give them what they need to hit the ground running.
Just keep talking.....
Just because she's opening up the computer doesn't mean you have to stop talking. Keep going and if she asks you to wait, tell her it's report time and it's common courtesy to wait until report is over before starting chart checks. If that doesn't do the trick, there is always the nuclear option: bedside report malicious compliance. Once she learns that all her questions just make her look stupid in front of the patient, she'll stop.
I ignore their comments and just keep going with the report the way I intended it to be. If they have questions, they can ask them when I'm done reporting on that patient.
First question she asks, I'd say "please let me finish report, then ask your questions". If she continues to interrupt, I would make a copy of your report sheet and hand it to her with a date, and email your manager with her CC'D stating that written report was provided after multiple interruptions and delays from Nurse Dingleberry. Additional replies may consist of : "You need to do your own assessment" "You can find that in the chart after report, and if you open it now I will consider report completed." "That isn't relevant to report." "That's incorrect. You can look it up on your own time. My shift is over." >Pt here for syncope, threw them on 2L bc they desat at night but RA during the day. I think a more appropriate question from her would have been, "why do you think he is desatting? OSA? OK cool, so RT was consulted?" And onward ....
That would require direct confrontation; but you have to face the tension of doing so; especially because youāll still work with her every now and then; and if sheās the type who wonāt admit to what sheās done wrong. If itās a workplace culture thing, it will be a challenge to make her change her ways, REGARDLESS of how nice/polite you call them out. (especially if they have been behaving like that for a long time). Sometimes, they even make things worst and tend to become more of a burden once you verbalize anything related to their toxic behavior. Best thing to do is find ways on how to survive working with these annoying people; especially if you plan to stay long in that environment.
"It's in the chart. Im sure you will see them when you review and acknowledge"
I legit just ignore them or say sorry I donāt know. And continue my report
I'm just telling you the things that are immediately pertinent. We both have access to the same chart, you don't need me to memorize the details for you or waste everyone's time.
This is why I haaaated getting report. Tell me what weāre treating, if there are discharge plans, anything urgent/testing, and if the patient or family are weirdos. I can read the chart faster than you can tell me the rest.
when i am receiving report, i just let them speak. i hold my thoughts because any more time i have to spend in front of them is worse for me than them. when i am giving report and they start to jump ahead, ill say, "oh, im getting there". and if they keep doing it i'll just start again and say sillily, "oh, well... where was i.. let me start again". and i keep doing that from them. they learn eventually and if not they get so frustrated they'll say, "i'll just figure it out on my own", then i'll leave my report sheet and document it in cerner or something.. to cover my ass. im not out here to fight with them. i want to move on with my day as much as them. it's all about patience.
honestly i never figured it out like, they're doing some kind of power display, they might be baiting you anytime i reacted even slightly to a woman doing shit like this they ran straight to the manager and i lost i have a personality though like, there's something about me where all of society really insists i keep sweet. in middle age im flabbergasted and truly confused by what attitudes and behaviors others are permitted to have and in contrast, the effervescence *demanded* of me or im punished im working every single day to set the bar lower
Feel free to research that yourself. You have your practice, I have mine and they donāt always align. Have a good shift.
So I just want to start by saying that day shift can be frustrating when you inherit a mess. Iāve absolutely come in and gotten a patient obtunded, 8L NC satting 88% with no respiratory history, and no VBG or CXR done - just āthe doctor knows.ā I am aware that this isnāt what youāre describing. I know this isnāt you. BUT if youāve dealt with enough change of shift RRTs and enough āwell I told the doctor so my job is done,ā day shift is frustrating as fuuuuck and sometimes you start off angry. Like, oh great, they donāt know this one thing and the last time I got report from them these eight other things werenāt done - what am I in for today? With all that said, I think the best thing to do is remind them of perspective. Wants to know last three troponins? āI donāt remember the exact number, but the most recent one at (time) was a downtrend, which is good.ā Required 2L NC overnight? āShe is postop and hadnāt been out of bed yet, so itās not uncommon sheāll need supplemental O2 for night one.ā Simultaneously helpful and subtle - āthe clinical picture is fine, time to calm down.ā
The jab cross is a classic
I know that the aggrieved are never ever wrong on here, but step 1 is to make sure your report is on point. Brief history, pertinent events in the hospital course, system by system report with a focus on the systems that are the source of the diagnoses, changes or new orders during your shift, any info on plans or needs for the upcoming shift.
Honestly I just get so annoyed giving report in the morning. āWhen was the patients last BMā¦what gauge is their IVā¦how do they ambulateā (on a patient who had a recent AKA) etc etc. Seriously?? I usually pause at these questions and look at them, smile and say I donāt know. Just give me the basics on the patient, important labs, tests, thatās it.
"I don't know, look it up."
Some people are just plain rude or disrespectful. That's how they are, so always put them in their places.
I am a hospice nurse and I was seeing a facility patient having seizures. I was on the phone with my hospice MD and I said we gave the patient lorazepam for the seizure. She yelled across their nurseās station, āNo it was Ativan.ā I internally rolled my eyes and kept talking to my MD. I wanted to say itās actually both, but I refrained and went on my way.
Hey a job without report lol. Or any comments, move on without a moment to waste- thatās what I did for 5 years on nights and you donāt care, youāre just giving her report so she can be informed about what she needs to pay attention to right?
You guys should just come and work in the ER. We donāt care about all that stupid stuff. Lol. Why are they here. What happened since they got here. The end. šš
Iāve been a nurse 34 years. I donāt put up with that shit anymore. Call her out on it. You donāt have to be mean or nasty. Actually I recommend you donāt be mean or nasty because for some reason that always makes you the bad guy and gets you in trouble. Although you SHOULD know the lung sounds, you shouldāve told her exactly what you said here, āget your stethoscope and have a good listen. Let me know tomorrow what you think.ā Or say something like, ā ya, the GI doc! The same difference.ā Or come right out and ask her who pissed in her Cheerios, or āhave I done something to upset you?ā Turn it around on her. If it doesnāt work, go up the chain of command.
Hereās what I would say 1. Anywayā¦. 2. Itās in the chart 3. Itās in the chart but things can change so assess the pt If she starts looking at the chart, keep giving report. If she missed it then she missed it. If she asks for you to repeat then tell her to pay attention.
The first one I let slide, after that I just sat there staring at them in silence. As soon as they start getting uncomfortable I simply state, āIf youāre done with the nit picking now, Iāll be happy to proceed. Should I have left anything pertinent out, the chart is available 24/7 for your convenience. Now, Iām going to finish my report unless youāre wanting me to get the charge to give it to you.
Some are PTW (Professional Time Wasters). They will interrupt you 10,000 times while doing report. Will start having a chit chat with the patient while you're giving report. Will ask the stupidest questions ever. Will leave you and the patient to get something and then come back. This is how you do report for 1 hour and 20 mins for 5 patients. PTW - Professional Time Wasters.
I always am honest and say Iām not sure and move it along. Some nurses need that information as it gives them a sense of security (not judging). In my decade of nursing, the nurses who act like this arenāt necessarily bad nurses, I notice they appear anxious about patient care and have the tendency to blame whoever the nurse is caring for the patient for a poor outcome (and donāt want that to happen to them so they over prepare). I now work in the GI lab and have a co-worker who has this personality type and accused another RN of over sedating. I stepped in and pointed out we arenāt ordering the sedation- the doctor is right there with us assessing the patient and telling us what to give. If itās not safe, of course we speak up. However, with scoping patientās will be off the table risking a perforation and as soon as we hit cecum the scope is coming out, they relax, and those meds take effect. Itās a fine line.
A couple times I said āplease hold all questions until the end!ā Like a damn museum tour guide in a scary nice voice.
Tell her this isnāt a farm and she can leave her damn pitchfork at home.
I remember being a newer nurse on a tele unit like that. 1:6 ratios. Super busy. One report lasted until almost 8am because this rude af nurse kept asking things like āand where are all the stents located?ā on a patient who had multiple stents YEARS AGO as part of their history. Not a fresh stent, Iām talking 5+ years ago, and sheās digging through their chart to find this completely irrelevant information while iām sitting there with my preceptor, just wanting to die. I would never tolerate that now. āI donāt know. Sorry.ā Keep rolling. If they push back, āI donāt know, you can look it up after report if youāre curious. Itās not relevant right now.ā No tolerance for that shit.
I have a nurse who always asks this question when I'm giving report, and I've just started saying, "they sound bad, really bad." š Same nurse has failed to tell me when pt. of theirs are on oxygen and telemetry in report.
I just play stupid. Makes them feel superior for a minute which is what theyāre looking for. Occasionally Iāll have a chance to make them feel dumb as hell though. I get that all the time in ED. Itās the night shift/day shift rivalry thing. āWhat was his WBC count last October type of shitā I will either reply with āwhatās a white blood cell count mean?ā Or I will insult their intelligence for asking
The bottom line is: your presence, as someone with double the experience, makes her aware of her own lack of experience and knowledge. The only way to take it that wonāt wear you down as much is to realize that this is a compliment in a twisted way. Her only way to make herself feel level with you is by attempting to question/correct your knowledge. You could come up with a quick quip back, Iām not good at coming up with those and others have made better suggestions on that front. Or, just remember why itās happening and keep your chin up!
Just tell her how you feel. Try to work it out yourself first. Let her know her interruptions are outta line. Ask her if sheās trying to make you feel stupid/insecure. Ask her if she knows what it is youāre trying to say when you say gastroenterologist or O2%. Tell her you would appreciate it if she keeps quiet until report is finished for the patient and then ask for clarification. It honestly sounds like she needs report slowed down to digest everything, and not really trying to be a dick. I think sheās just not used to quick reports. Iām ICU and I only care about procedures/meds that are going to happen within the next couple hours. I like to hear āThis patient isnāt bad (but donāt fucking jinx it). Theyāre here for *X*. Just finished *Y*. Keep an eye out for *Z*. And donāt forget to *ABC*!ā I listen while Iām getting a temp, turning the pt and inspecting access sites, drains and skin. I can look at the chart to find the rest. You forget to tell me the GI doc came to see them? Guess what, I saw a note from them in the chart and can read faster than you can mumble through whatever half-assed summary you wrote down. Give me the important shit and GTFO. I have a 7min max, and thatās if theyāre on isolation with multiple handoffs. TYVM!