Nothing is worse than having to work with a person or persons that are all drama. That one person when you get to work and you immediately think to yourself, "ugh, I am working with her/him". Working with a bunch of women is notorious for drama in the work place. Personally, I would love to work with a bunch of men because they are little to no drama. Nursing is still a predominately female profession that is slowly starting to change and I love it.
Today was a great example for me of why I love working with men. At the end of the shift we do shift report where the day nurse gives report to the night nurse about the patients that he/she took care of that day. When I get report from night shift in the morning ALL I want to hear is the pertinent information! I don't need you to tell me what fluids are running, what they are running at, allergies, code status ect. That is all stuff I can find out myself by ONE glance at the electronic medical record (EMR). I want to know things that have changed, things I need to look out for, that the patient likes to take their pills with chocolate milk, that they like one light on not all of them on, that they use a walker to ambulate, that they are a stand by assist patient, that kind of stuff. Why? Because that is the kind of stuff I can't find out on my own looking in the EMR. All the other stuff is "task" type things. The task type things are all in the EMR. I don't consider myself a task oriented nurse. I like to put the big picture together. Making sure I know how my patient likes to take their pills is JUST as important to me as making sure my insulin drip is programmed correctly.
Male nurses or murses tend to be this way, which is why I love giving them report. Because by the end of my 12 hours the last thing I want to do is spend an extra 45 minutes giving report on information you can find out yourself in the next 12 hours. Some people don't grasp that concept very well. The male nurses almost always have my same philosophy on report. Just give me the highlights and I'm good.
Then there is the female nurses...they ask 101 questions about the patient. I know some of you might be thinking, "evidence based practice says that one of the best ways to reduce errors is good hand off reporting". I completely agree. A good hand off report consists of the things that can be missed and are pertinent to the situation. Things like double checking drips, discussing medication reactions, any dressing changes or missed doses that need to be followed up on or significant lab results. Things of that sort. I shouldn't have to list all the allergies and tell you that the patient is running D5 1/2 with 20K at 50 mls/hr. Things of that sort are in the EMR and are things you will be looking at anyway right at the start of your shift when planning your day/night out. Some nurses want that type of report so they don't have to go look in the EMR for that information. THAT is bad nursing. How can u be sure that the nurse gave you the correct settings for the PCA if you never took 3 seconds to double check it in the EMR and just trusted the day shift/night shift nurses report. Understand where I am going with this? It's not that I am lazy or a "bad nurse". I just don't rely on people giving me the information I need. I can get it myself and be sure that it's accurate.
Also, change of shift is not the time for the on coming nurse to start assessing their patients when we go into a patient's room to introduce the next shifts nurse. That is just bad etiquette. Furthermore, if in that time when you go and introduce yourself you notice something is wrong like the IV is infiltrated or the amiodarone drip is programmed wrong this is NOT the time to confront the nurse who missed the error. DISCRETELY correct the error and then when you are OUT of the patients room approach the nurse privately and tell him/her.
I have seen many nurses argue in front of patients over errors. I am horrified in those situations and usually end up walking out because I want nothing to do with that. That is extremely unprofessional. Especially when nurses or managers drag patients into the argument. Many nurses especially female nurses feel that need to prove their competence by putting other nurses down. Everyone makes mistakes regardless of how big or small the mistake. You maybe extremely competent, but no one will ever want to hear what you have to say if it's always in a condescending manner.
This happened to me today. My patient's IV infiltrated during a blood transfusion within the first hour. It was a brand new IV that I personally placed specifically for the transfusion. I was closely monitoring the IV because I just had a feeling it would infiltrate because this patient did not have the best veins in the world. Sure enough an hour into the transfusion it infiltrated and it was 30 minutes before I was getting off shift. So of course I needed to start a new IV again to continue to transfusion but I only had one arm to work with because the other arm was off limits due to an AV fistula. I notified my charge nurse of the infiltration and her response to me was, "you didn't check to see if the IV was patent (working) before you started the transfusion?!" in a very condescending manner. Clearly, she wasn't listening to me when I told her I had started a brand new IV just for the transfusion. So, I repeated myself when she asked me that question. Her reply was, "oh", in which I politely replied telling her I was just coming to inform her and that I would be starting another IV on the patient before I left. Tone of voice is everything. Watch your tone and be careful of your facial expressions. Make sure they match.
At the end of the day being a nurse can be stressful and the last thing that is needed is extra drama on the floor or unit you work on. Save the drama for somewhere else. Learn to be a team player. Don't put your coworkers down to other coworkers and especially not patients. It's not a good look. You are only hurting yourself by doing it.
Be considerate at change of shift. If you know you want all the nitty gritty details, get to work early, find out your assignment, and go sit in front of a computer and get all the minute details you want. Put a smile on your face and keep it positive.
Until next time.
-Norah
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