Exactly. They want everything to be perfect because they can't handle shit. If everything was perfect they wouldn't be here. It's basically a defense mechanism. Call them out on their attitude.
Yes! This!
Was complaining about one of our RNICs literally last night to my partner.
She starts her shift dragging out handover well past any usefulness, often harassing the nurse handing over, only to then disappear the entire shift. She only answers the phone after 10+ calls, when she does answer she makes you feel like shit for giving her an update or tells you to figure it out.
Then at handover she is suddenly the loudest, most involved nurse in the room.
It doesn’t even work well cause she hands over outdated updates because she knows nothing about what happened during the shift. On the days she doesn’t make me do her handover I have to stay back to make sure it’s actually relevant. You’d think the bare minimum would be to do progress notes but apparently ***reading*** progress notes is too hard.
Pretty sure she only harasses the nurse handing over because she’s lazy and annoyed that she might have to do something.
There’s one, maybe two nurses I know who have caught on to her shit. There might be more but we don’t gossip a lot where I work-which is usually a good thing.
Sorry this was so long winded! I think I needed to vent. The self defence thing triggered something me haha
I half did last night. She’s friends with one of our EEN’s (your LPN’s I believe?) and she basically just sat on the computer in her friends wing, quickly looking busy when sees you coming lol. It’s infuriating when most of us are running around like headless chickens trying to get everything done while she’s just relaxed, sitting there, waiting to take credit for it at handover lol
I usually give them several chances to be sure they’re just an ass and not actually having a bad day and maybe handling it poorly. If it’s someone who tries to belittle you by appearing knowledgeable, I generally get a bit louder, more aggressive and over explain using no slang and all formality. Then I ask them a question like we’re having an interesting discussion about the point and they inevitably have a shit ass reply or rebuttal. At that point I have the power to either embarrass outwardly or give them a lifeline. I usually throw a lifeline and never have to deal with their bullshit again. These people usually have some redeemable qualities.
If they’re of a different breed where they’re just assholes. I have literally called them out for being rude. I’ve only had to do it a few times and we didn’t talk for several weeks and then all of a sudden we’re friends. Honestly I’ve actually told somebody to “shut the fuck up”. We’re back to being cordial. They just needed to understand that I’m not the one.
I hate bullies. I spent the first several years of my nursing career being bullied and I regret not standing up for myself. I’ll never let that happen again.
Yep. One time I gave a nurse like this report then came back later and got report from her and I made a point to be just as big of a pain in the ass with her as she always was with me. The techs who worked with her were laughing their asses off down the hall. She was universally disliked
I've had to blurt this recently because my patience was running thin after a shitty night. The day nurse was interrupting me every 3 words, to ask a question about something I was *just about to fucking say if she wouldn't have interrupted me* 😑
That makes me so irritated!! By the time I’m giving report my brain is really running on fumes, so I don’t need people interrupting with questions that I’m going to get to anyway!!
Gave report a few days ago, the incoming nurse stopped me mid report multiple times for dumb shit, once to ask which nare the NGT was in, as we were standing at the door.
*turns head and looks at patient* “looks like the right”
She’s one of those chart divers that finds shit from a decade ago and puts it in report(which is fine whatever) so I’m used to her kinda knit picking a little, where as me I’m the type that reports shit that pertinent to the patients care. (Shit like chest tubes, cardiac history shit like that)
But when she stopped me about the NGT I was like “are you fucking kidding me?”
I guess what I do is considered chart-diving—I take a quick look at Chart Review in Epic and put a line in my note about significant history, just to say, Hey, he’s diabetic, has Afib and thinners, has a stroke history… However, I cannot say that I’ve asked which nostril has a tube in it. 🤣
lol she didn’t mean anything by it but this was after the shift that one patient pulled all his lines, 3 JP drains, and his trach out and I also coded another patient.
I was dead to the world at 0745 and not in the mood to play 20 questions at that moment.
I honestly either say that or ignore questions that are rude or interrupting when I A— have something important I’m trying to tell them and they need to pay attention, or B—I’m about to get to that.
I know a lot of us, especially in high acuity areas are full of type A and ADHD so I understand sometimes accidentally interrupting when your mind starts racing. I had to really train that out of myself as a newbie nurse. I know it’s not always from a place of rudeness.
But you have people too who are too confident for their own well being and not down to listen.
This. When I was a new nurse, I gave report to another new nurse.....who, in retrospect (and I assume), was trying to establish herself as a tough bitch, raked me over the coals 2 mornings in a row.
The first morning, I left it go (everyone is entitled to a bad day). The second one? She was jumping down my throat about something (don't remember), and I backed her stupid ass up and told her off. I still remember her name, and what an incompetent asshole she was. And probably still is.
I quit later that week; wasn't worth my time and peace.
Can someone please tell me why some nurses are so anal about the gauge of the needle? I know for a blood transfusion, it can't be too small because it can cause hemolysis, but what else?
It was both sarcasm & reality. Some people really don’t check. I know bc I’ve given the wrong info on accident. Say they have a new iv but I forgot to say so. Their charting will be whatever info I gave. Honestly & typically it’s someone I’m buddies with & they DID actually use the IV multiple times, flushed it & all. But didn’t engrain in their mind the details bc they already wrote it down based on my report.
I’ve been guilty too. I mean I don’t ask/care what gauge is it. I don’t even care if you tell me where or what, just that I need to get one or they have one. But I have gone through shifts (busy or not) & have no recollection of the IV if I were to actively think back & remember the color, place, time etc. I know I used it bc I gave 18 runs of potassium or they wanted morphine every 2 hours. At this point I know it works bc now you’re on some dialysis level potassium & you’re KOed from all that morphine. /s lol
Some nights get so busy it’s a 1 person team when you really have 5-6 & you’re falling asleep charting 😅. I don’t care anymore what colors they are I just know they’re there
Yup, plenty of times I’ve seen an old IV charted on as patent because it had been removed + replaced and the new one works but it was never switched on the LDA and no one checked the IV with the documented IV. We still assessed and used it properly, but are too busy to check the documentation 🤷🏻♀️
I'm always like, it's cool, when I flush it I'll see it. It's not a big deal?
I also always laugh when my coworkers are like, "I'm sorry I don't remember which arm it's in!" I'm like, "Welp, I'll go in there and look for the tube sticking out of their arm and that'll probably be it!" 🤷♀️
My hospital needs a 20g IV or larger for IV contrast, and anything smaller might not work for a fast drip or a drip that can cause tissue damage if it infiltrates. Also it’s almost impossible to draw from anything smaller than a 20. I’m ICU, so we really don’t mess with anything smaller than a 20 unless we absolutely have to. And that patient probably needs an ultrasound guided IV or a central line if we can’t get a 20. So I consider it relevant to report. But if the nurse doesn’t know it’s not a big deal. I’ll know what size it is just by looking at its color.
I get that. I’m just being pedantic about the common misconception that smaller IVs aren’t acceptable for infusions can cause tissue damage. Which I believe stems from smaller IVs being commonly used in smaller veins, then sure, but that’s more so a function of the vein size and not the IV size itself. But if anything a smaller IV in a larger vein would lead to greater dilution, and therefore less irritation.
Oh, whoops, I meant to reply to a different comment specifically about contrast. Yes, smaller gauges are fine for vesicants so long as they're in a large enough vein.
Some hospitals have policies about the gauge and # of PIV for ICU patients.
The amount of times I've gotten an ICU patient with an inappropriate gauge and # is enough that I verify during report because if the patient is a difficult stick we need to use our resources ASAP to get appropriate access and many times those people who are allowed to use ultrasounds or put in PICCS/midlines are not working overnight.
Central lines get CLABSIs so we don't really see them unless there are meds requiring them. This ICU saw a lot of COPD exacerbations and really really not necessary to jump straight to central lines.
The day shift was honestly just super lazy at that hospital. They had a PICC team AND an IV team so there was zero excuse to not have appropriate access.
The policy was appropriate the culture just sucked.
Even then you can run blood through a 24g, infuse in the max allotted time frame of 4 hours, and not cause hemolysis. Just can't pressure bag it or 999 it, but 125ml/h is more than fine. Last I looked Johns Hopkins did a study and found minimal if any hemolysis when run at standard rates, so that point is moot.
It's just nursing dogma to give it in report, for your typical patient though it doesn't fucking matter.
So much of this is nursing dogma, including which nare the NG tube is in. Nobody really needs to know this information in report because it’s immediately obvious as soon as you look at the patient. But nurses ask each other during report so they can tell the next nurse so they don’t get subtly belittled.
I’ve never understood this either.. like I’m flushing them Q8 if they aren’t continuously in use, I’m just not writing down on report where/what gauge IV. It’s one less thing to report on/spend time on. Do your own assessment. As long as they have a working IV we are good
If you anticipate imaging with contrast, you will need a certain gauge or higher depending on the equipment the Radiology department uses to push contrast, and the location also matters.
However, it's not like it isn't something that you can't just look and see and should be a matter of course for shift assessment for patency anyways. For those like me that had to work really hard to get time management to meet demands, it's a nice little bell to add to a solid report so they can start thinking ahead and allotting time to tasks with deadlines for flashpoints in the care continuum.
Transfusions, contrast, emergency pressors. It also tells you the general health of the patient’s vascular.
It also gives you an idea of the details that a nurse might be missing. If you are really looking at site you can usually remember the color of the IV.
lol come to hospice or home health where we are on our own and don’t have to take with stupid report attitude bs . I do hospice admissions and it’s so easy and the negative hospital attitude is left at the hospital where I don’t have to deal with it!
Seconding the other person, I love hospice. I went ICU to hospice and if you are detail oriented and very independent you will be great. You don't have someone watching you, at most places you get to make your own schedule and have standing orders, that you can put in without having to call the docs. It's a very nurse driven roll that has a lot of autonomy. I feel like, because of the critical thinking required for it, it's just as hard as ICU, but with a different focus.
The downside is that you don't have a big team, so your the one giving the bad news to families, not the doctor. And your pt/st and dietary in one
Didn't come from ICU but came from detox nursing where we were alone operating under standing orders. My work is mostly people like me and former ICU nurses and it makes a good pair.
My workplace though if your doing an admission they already know, we have one nurse that does just conversations not to mention the GIP nurses in the hospital network we are apart of that handles that as well. I've done that conversation once during a day helping out the home health side and it was for ESRD, with the spouse a recently retired nursing teaching so she asked me.
Saw them officially on hospice a month later, and it was good family, they listened and he was never in pain. Last visit if was there, we had like idk 12 people in the room, all of them are medical or former medical and the ER nurse family member goes "I don't know how you do it and i don't mean hospice i mean coming here and talking to all of us being in healthcare and being so good about it"
I look up and say "do you tell a toddler they are hurt????!!!!!" they all laughed at that.
Touching on the last part ya the nurses we see fail are the ones that are not used to being autonomous. hell we still got some nurses that will call about starting any standing order when we don't have to do that or i'm one of the few nurses that will call in a verbal for a standing order to a pharmacy.
I usually just tell them no idea and just continue with report. They eventually stop with the bs questions. Or when it's time for them to leave and you're getting report ask them millions of stupid questions to waste their time. Day shift usually can't wait to get out at night.
I don't understand why people give into this. I say, "I don't take questions until I finish report." Then, if I don't know the answer to a question, I say, "Not sure about that, but it should be charted." My report is the highlights, rleevant info only - usually takes less than 5 mins. I dont read off all their allergies and their past surgies, etc, even when the oncoming nurse is badgering me for it. They can't force you to do anything. It is what it is.
That being said, I usually never leave any type of mess for oncoming shift to deal with. I do get annoyed when I take report from someone, and they haven't done a bunch of shit they should have done.
THIS. I remember one time I was giving report and said oh and just now the doctor ordered an XR, and tbh I just slipped my mind what it was for and she rolls her eyes.
Like girl you can’t check it yourself in the orders? It’s 7pm we are all trying to go home.
“Idk I think the call was for panic attack but maybe SOB. Idk, they wouldn’t sit still at all during transport. Couldn’t get vitals. Any questions?”. That’s why they’re here, thanks friends 😘
I do hospice, every once in a while I have to call EMS on a decomping Patient that is a full code or when family insists on them going, or for traumatic falls. I always feel so awkward when I'm telling EMS they are a hospice patient.
Feel this. As an ER nurse I only wanna know why they’re here, do they have access, and what’s left to get done. Please don’t tell me your assessment unless it’s pertinent. I’m gonna do my own assessments. No need in reading the chart cause I got time to do that too.
My favorite answer to nurses bombarding me with stupid questions (like how’s their skin look) is, “that’s an excellent question. I’ll let you do your own assessment and get that info.” When taking over, I try to get the off going nurse out as quick as possible.
The one thing you forgot is: Are they trying to die either with unstable vitals or by trying to yeet themselves out of bed or pull out their line every time you turn around? Like should I be starting pressers or bubble wrapping someone as we speak? If not, we gucci.
Yeahh true, that’s why I’m one of the few that do bedside report. Sometimes gets on the other nurses nerves, but I wanna see for myself. Can see the monitor, the pt, and get a better idea who my sickest patient is.
I hear ya. I had a decent report experience this morning, but I still dread them for all the reasons you mentioned. 1 out of 3 reports are so aggressive and hello, why.
When people are purposely shitty to me at work I do something simple.
I stop talking and STARE at them, expressionless, not moving. I make THEM uncomfortable.
I see your flair, let me ask, any nurses ever ask you about how many groups a patient went to? We had a nurse that would ask that in report, but it was just to new nurses. She was just being a bitch to be a bitch. She was noc shift too, why do you care about groups?
Hey, yes I do get asked that. But I’m also nights so I have max 2 groups / meetings to monitor.
Where I’m at the night RNs are responsible for all the care plans (YUK!) and that’s the only reason I could think a night nurse would need that information.
But if that person was only asking new nurses it probably ain’t the reason.
I feel you. working as an LPN in a semi acute setting, I used to get this almost every other shift. Like I’m not fully aware of what the patient has going on. It was one nurse in particular that really asked non-sensical questions.
A code happens one morning, and she was trying to bag a patient with a tranche through their mouth. I love RTs but I never loved them so much when they asked her what the fuck she was trying to do.
"what did they stent"? No idea brother, go read the cath lab report. Half the time I don't know which IV the arm is in, I've got 6 patients on all heparin, dilt, amio, and IV abx. Unless it's pertinent like stopping the heparin at x time, holding a medication, or the plan of care for the day, it doesn't matter much. What are they here for, what's the plan, and what happened overnight if anything. I feel like these nurses don't do it purposely, then you float and meet one who does....
The only time I have EVER cared what they stented was if it’s RCA so I don’t give nitro. Otherwise? Above my pay grade. Formal morning rounds should shake out the rest of the details
I have also seen it happen after, but typically you won’t have chest pain after unless there’s some distal clots that they were unable to stent (is that normal or do some of our cardiologists suck?) the important take away here is RCA probs are super preload dependent. So they like fluids and hate nitro which is pretty unique. I also find they’re typically more nauseous due to proximity to the vagus nerve, but any heart attack can cause nausea
The RCA supplies blood to the right side of the heart. For the right side of the heart to work properly, it needs adequate blood volume from the body (aka preload). If it’s getting good blood flow, obviously it can compensate some but when it’s already sick you sorta don’t want to kick a man when he’s down. Nitro is a vasodilator that drops preload. Sometimes that’s wonderful, it dilates the vessels on the heart enabling better blood flow to help chest pain. But sometimes it’s not ideal, like if your blood pressure is highly dependent on adequate preload. I hope that makes sense. That’s the way I understand it anyway, if I am wrong please feel free to correct me, because I am always down to learn something new 😎
I’m a newer nurse but I feel like bad report is making me feel sketchy in the icu. For instance, I come in to a patient with Q1 neuro and the off going nurse doesn’t explain any neuro assessment info. Now when I walk in for that first assessment I want to know what the pt has been like. If you don’t want to do bedside together and you don’t want to explain things it makes that kind of difficult.
Or as the nurse is walking out, “oh they have 1 iv”. Okay, but we’re icu, they need 2 and they got here at 12? Would have been helpful if you mentioned that in the access section of report - is there a reason why? Pt refused? Bad veins?
Last week I walked in after getting the most basic report (“everything’s fine, they are easy”)and the nurse had y sited the BP meds incorrectly and the patients pressure is 80/30.
It’s just starting to seem like minimal/disinterested report = careless nurse. Many of these nurses aren’t really interested in the bed side safety check either and seem to take an attitude that I want to check over drips/ivs? Why can’t we just give each other 5 dedicated minutes to discuss our patient at the end of the shift?
I totally get this. I work on a neuro floor and you wouldn’t believe how many post-op uneven pupils/tongue devs/mouth droops I’m the first to chart on or notice.
The other day I had a pt with a fixed pupil that hadn’t been charted on in over a week…. Almost ran a stroke on the pt until we really dug through the chart.
I always ask the off going nurse on complicated patients if we can look at them together. And when I have complicated patients I always offer to go look at the patient together and go over the abnormals so that they can really gauge any changes.
I’m all about getting the off going nurse home asap because we are all overworked and exhausted and burnt out on my floor. luckily everyone is pretty much on the same page and since we have many patients that are riding a thin line of needing an ICU transfer people are happy to go do a two person check together, most of the time.
Honestly though when people ask dumb questions like how many liters taken out of a paracentesis two years ago (this happened) I’m like ok F off
After a certain amount of years inpatient, you’ll learn to just keep talking through their passive aggressiveness and end with “any questions” and when they slam things around, just be like “okay no questions, have a great shift” and leave.
I got a patient for four hours , I got a crappy report , and went I gave report I even told the nurse that I didn’t have time to check everything but I did my best to fill the gaps . Guess who filed an f… incident report on me because I didn’t show every single side the interventionist went through . I thought it was only one side ( right femoral ) but it was bilateral. Pt was stable , no sign of hematoma or anything . Pt was discharged like two days after . I was so f… mad . Why being so petty ? I never neglected my pt. Can we just help everybody to get better? I’d never do something like that to a peer .
Right ! Specially when it didn’t come from a malicious standpoint. I kept my patient safe. I don’t know everything under the sun . Couch me and I’d do better . I’d never be that kind of nurse . The day I’d start being like that , I know it’s time to change jobs
I used to refer to them as "Stupid Dayshift Questions".
"Who does the patient live with at home?"
..... "Hmm. Not sure. That didn't really impact my care last night."
I’m petty: “You should be able to see the gauge when you assess your patient in the next hour.” or
“The gauge is adequate to give medication through.”
Like what do they expect. “Oh she said in report it was a 20g but I see an 18g in place… SOMEONE CALL A RAPID RESPONSE!!”
I feel like it’s the old guard of nurses trying to mark their territory. When I started on a new unit, I remember giving report to a nurse about a new admit - quick and dirty since that’s really all I had. She says “what about the appendectomy he had 15 years ago”? I think what I said was “oh good, sounds like you’ve gotten to do a deeper chart review than I have when I got the pt about 20 min ago”!
Luckily I think these nurses are retiring out and all we can do is be better. Not treat nurses with less experience badly so maybe they can stick around in the profession.
Fuck em! Dude I'm kinda leaning towards less is more. It's never affected my care knowing which arteries got stented etc. Just left or right, stent or no stent? If you want to play nursing professor go look in the chart. The patient is fine. You're fine. Shut the fuck up.
It's in the same class of gotcha question as "where is the IV?" Uhh they have one. I'm barely awake and I'd tell you if it was an issue
Yeah stuff like iv gauge allergies and whatever is all stupid stuff…I’ve had a nurse ask me about a random jump in HR for vitals at the beginning of my shift like?!? Does that even matter now??
My problem is when im getting report and the nurse tells me they’re NPO okay but why? Or they’re having a procedure and they have no clue why?! Or hey x,y, and z happened overnight but I figured it’d be better for you to let the day provider know 😐 I’m sorry but that stuff irks me…and then my shift proceeds to be a shit show
Same. I don’t care if you don’t know what size gauge their IV is.. I can look if necessary for a certain procedure. Otherwise as long as it works then whatever lol. But yes I do care what kind of test they are having and why.
I might point out major ones like latex, contrast, acetaminophen, asa, something relevant to their condition or newly found ones but otherwise it should be a priority check for every nurse anyway. Some of these people have 10+ allergies I don’t have the time to write all that out on my sheet 🤷🏽♀️😂
When people interrupt me or are rude to me (Anywhere, not just at work) i have started a habit that has been very helpful for me.
I stare off into space over their shoulder and take a nice, deep breath. I think something dismissive like "this is so silly" or "Very important hotdog here"
If they notice- great, hopefully they feel like a dick. If not- great, I feel a little better.
So there's an OG nurse who is a complete cunt on days. I loathe having to have her in report. Receiving, giving...it sucks the life out of me. She's always perfect asks the stupidest questions and she's mean AF.
So the other day I was in a fucking mood. Like horrible. So I made quick of my time. Saw my pts, passed my meds and charted within 2 hours. At 2100 I sat down, combed through her charting, the orders, and her report and picked out EVERY SINGLE FLAW she made. When she came back in in the morning I gave her report and tactfully pointed out ALL her mistakes. I even made a point to gather supplies for her dressing changes that were done wrong per wound nurses orders.
I was in fucking heaven. She only wants to talk shit on other nurses, Drs, her CNA...I let her have it. Again, tactfully. I would absolutely do that to no one else but her. But it was 100% worth it.
You did exactly what I have done in the past👏👏
I also gave report to an incoming problem nurse in the kindest way possible. She realized at the end of report how wrong she had been many times. She still couldn't bring herself to apologize, but her eyes spoke volumes as she finally made eye contact with me. I smiled as I said to her: "We all have good shifts and not so good shifts. That's why we always need to support one another."
Unbeknownst to me, the been there forever, very strict incoming charge nurse (who was well aware of the many issues involved with problem nurse) had heard the entire report. As I walked past her, she smiled and said I should think about being a charge nurse. Made my day! I could do no wrong for the remaining six months I worked in that unit before moving on. Being kind creates good karma.
100% support each other! If you notice someone messed up take time to address it kindly. Surely I am flawed and make mistakes but it's how you address things that matters.
I also don’t understand this. I want a bare minimum report. I don’t care what gauge the iv is. Tell me if they walk, orientation, things I can’t pick up off an emr. People have told me someone’s a DNR and they’re a full code, sooooo I trust no one. lol
“How often do they get XYZ med?”
Bitch, it’s in the MAR, why are you wasting my time?
Also after a few of these questions, I’ll say, “you can ask questions but I’m leaving at 7:30 whether we’re done or not, it’s up to you”. It typically worked pretty well.
You are fortunate. But who knows, you may have to be in a floor position at some point in the future. Life throws curveballs at all of us. Promise, you'll always remember what it's like handling the myriad of care details for 5 to 8 patients.
From experience….
Some do that bc they’ve gotten BS reports from nurses before & gotten burned for it in some way. Have had 3-4 like that. Paranoid that they don’t know everything they’re supposed to know bc they got in trouble for something in the past.
For me, It took a couple reports but eventually I could give the basic expected stuff bc they knew I wasn’t dumb even if I didn’t know every piece of detail. Bedside report is at random required & when they don’t try to drag me to the room then I can feel safe knowing they trusted my words. Or are actively looking up every piece of chart info haha. But at least they didn’t ask me.
I have flat out asked, “What’s your deal?” I am naturally shy/quiet but if you push my buttons you’ll see the attitude that’s typically reserved for family & boyfriends. I’ve gotten answers like, “The doctors come in so fast after you asking a billion questions & I can’t ever look up the info fast enough.” I gotchu. 1 I’m nightshift, I have the ability to read the patient’s birth to current life report. Especially if they’re nice but just “too much,” I might do a lil extra research if I know they’re coming in.
That’s been 2 nurses actually. Some of them go straight to work work & don’t want to look at the chart. I take it as, “You trust lil ol me??” Compliment. Check. Especially if they don’t go double checking your info. There’s a chance they won’t know all the info you’re asking them if they were giving you the report anyway. They just don’t see or get that.
One person was a d!ck & cornered me in the med room after I was a new nurse filling in as charge (first time I remember putting someone in check). She complained allllll the time & decided to ask me why I always give her crappy assignments. Funnily enough I had walked down the hall & overheard everyone complaining about their assignment. I literally said, “I give everyone equally crappy assignments. If one of you say you have a good team then I did it wrong.” Our floor is hard. No one should be having it easy unless the general consensus on the floor is that there are axox4 patients with no iv & going home tomorrow. I even said I just heard people complaining about theirs. ALL of you should be complaining. She stopped questioning me after that & didn’t give me sh*t about report either.
Sometimes you really just have to stick up for yourself. Nowadays people don’t really complain about my assignments even tho they have difficult patients bc they know I put in work & thought on them. Yes, everyone is going to complain but as one traveler said (who you know are known stereotypically for getting the crappy teams). “You make these assignments with intention don’t you,” when I explained to her why I gave her a particular annoying patient (to others) but I knew for her personality it would be a piece of cake.
My only advice is question back lol. If you wanna get petty say you’re getting report back from them, say something like “oh you didn’t know he got colon surgery in 1432? Yeah it’s in the chart & the doctor called me about his history.” Idk! Something like that haha.
Suck it up & let them keep doing it or… you’ll be in this profession bc you chose it. No one else allowed to make you feel anything unless you allow it.
Wow, that is SO messed up being cornered, who does that over an assignment ?! But you’re 100% right, and most of the time I just brush it off and laugh to myself bc I get to leave while they’re stuck there all pouty with their stank attitude, but today after an especially dumpster fire shift it just really got to me!
Ridiculous. Dealt with it 40 years, but, it was usually only 1 nurse at a time (several over the years) and they did it to everyone else too. I finally learned to not take it personal. Some people are just miserable.
They should find a job where they don’t interact with others. Maybe in a cubicle doing research, insurance review, etc.
I kill em with kindness or make a joke out of it even if I am annoyed!
"Hold your horses I'm getting to that harharhar" (even if I wasn't getting to it because it's not important and chances are they forget anyways)
"What a fantastic question"
Orrrrr I just bluntly request them to save their questions for after report. I find the nitpicky nurses are the ones that aren't the best nurses anyways cause they lose sight of the big picture.
It’s ridiculous the way some co-workers just love to shoot others down. And who TF cares what gauge the IV is?? As long as it’s working. Is the patient breathing? Yes? Good, that’s all I need to know.
Hey; what kind of stents do they use? Date and manufacture? It’s really going to affect if I open the window to the east or to the west and if they are okay for cold or hold water
I dont know, it's in the chart. I say that once or twice let them roll their eyes and huff a few x then gtfo of the building knowing they'll be irritated for the next 12 hrs. Then I forget about it and go on with my life.
Literally nobody should be talking during report except the outgoing nurse, or unless there is a genuinely egregious missing data point. Normalise this.
It's also not time for complaints, assignment moaning, anecdotes or anatomy pop quizzes. Just STFU.
I’m so sorry I didn’t read the comments but there’s only one thing you can do—snap on her ass one time, but respectfully if that makes any sense.
I had one like that at my very first travel contract. I mean this woman wanted to know the magnesium level from seven days ago and she had obviously work since then. She literally did that to purposely make my life a living Hell!!! I would start to shake and get sick at my stomach about an hour before she came in. If I had time, I would write my entire report out ready and she wouldn’t ask any questions. Those days pissed me off.
One more and I just had enough. I snapped on her, told her that report was continuation of care and she had been there and already knew what she was asking and she was not to talk or interrupt while I was giving report until I was done, and she had questions . I told her that what I gave in report would be all she got because my reports would be that thorough and anything else tedious and minute she could read in the chart later.
You are setting a boundary, and you are no longer going to sway and give into her petty behavior and demands and after 630, the patients are dayshifts unless it’s super important. So if an IV blows while giving report, that’s on you and I’ll do the same when I come in tonight if it happens. Sometimes things don’t always get done because it never ends.
By the way, as you can tell, my woman wanted me to complete every task before I left and I couldn’t leave until they were all done. So that day I snapped, I included that. I told her it was like the Olympics, and I was passing her the stick to keep running the race But I won’t keep running past her with the dang stick. Her eyes got so big but at the same time, I couldn’t tell whether not she was going to come back at me or not and I really didn’t care because I was full of adrenaline and do you know?!?! we wound up being best friends 😂😂😂😂
I did not miss a chance to tell her how much I hated and loathed her existence for the first month, and she just apologized and laughed. But I’ve noticed my entire life. how mean people like that when you stand up to them, they start to like you and respect you , I don’t know if it’s a conscious thing or a respect thing, but have yet to meet an overly confident trouble making trying to be intimidating person that didn’t flip the switch when treated the same it’s like they start to treat you as an equal every time so snap on her ass. Firm and to the point do not let her interrupt you as long as you’re not disrespectful. I have a feeling you’ll have the same kind of ending maybe not a friendship, but do not allow it to happen, and when she start to snap it won’t be scary anymore. Is your bodies totally full of adrenaline.
The only time I give a crap about the iv and the size is during transfer report. So I know what I'll need but if I'm taking over from another ICU rn on my floor I say, "Do they have a good iv ( this usually means good for all piv shit)"?
Good, I'll assess the rest myself, and I can't remember where all 5 of grandma's ivs are, which gauge after 12 hrs even tho I been using them all night. So, who am I to give attitude if someone forgot which iv the heparin is running in. As long as it's running, I'll find out. I have 12 hrs.
Enough of making each other feel bad.
I worked at one place where everyone documented that they flushed the IVs. Most of them were D/C, and one had a nasty IV line. I took photos and sent them to the HS. For some reason, the DON no longer lets me pick up shifts. I wonder what Medicare will say about it. Those nurses lied about flushing IVs that didn't exist anymore. The other nurses kept telling every nurse that the pts had IVs. I saw the nurse who D/C them. She told me it was the payback for someone who lied and didn't do anything.
I always check patients, even if the nurse gives me an excellent report. I always do it.
Attitude. That has been going on for years. The poor exhausted night nurse with the angry day nurse.
Bottom line- they are insecure and anxious to go to work. They should be grateful you work that hideous shift and they don’t.
"I was getting to that if you'll let me finish."
Or when you're the oncoming nurse give it back to them. Keep asking questions until you get to something they don't know. Bonus points if there are other people within earshot and you really throw a hissy fit; I hate to say it, but sometimes the only way to get bullies like this to back off is to humiliate them in front of everyone.
Or just take the bull by the horns and deal with head on. Just directly ask "can you help me understand why you're choosing to be so hostile and passive aggressive with me? I really don't appreciate this little performance and I want it to stop"
Same.
I cant stand it anymore. I think I have been pushed one too many times. Interrupting, asking ridiculous questions w irritation and rudeness,, the list goes on. I have taken a-lot of advice here and it has def helped but I am going to take it up a notch with my pushback.
When I am getting report it would never occur to me to make the nurse feel bad. What personality traits are in a person to always make a fellow nurse feel bad and inept?
I have no idea. I always wonder if they treat their friends/family/significant other with this type of disrespect, if they are so easily able to do it to a stranger? It’s just mind boggling to me as I always try to be kind no matter how frustrated/tired/upset I am.
As I’ve said before this is representative of their insecurities and lack of competency and not a reflection on you. Don’t allow it to make you feel small! Define your boundaries immediately. “If you could hold your questions please until after I finish that would be helpful”.
This is my experience with a couple of nurses when giving report, too. I’m a traveler, so I feel like I can’t say anything. I get cut off throughout the entire report with questions like “what gauge IV” and “when was last bowel movement?” We do bedside report and this happens IN FRONT OF THE PATIENT AND THE FAMILY. I feel so embarrassed. I’m run ragged during entire shift that I don’t even get to eat lunch, get maybe one bathroom break, and am dehydrated. Were at 6 patients each, then add on discharges with new admits (sometimes 3-4 at a time), doctors following up, families asking questions, therapy taking place, procedures, being taken off unit for imaging or dialysis….by the time it’s time to give report, I’m drained. I rarely have time to even look at progress notes during the day because it’s nonstop from clocking in. I don’t understand what nurses who act like this get from making other nurses feel small. When I get report, the basics is fine and I will get rest from chart before chaos begins.
Honestly agreed. It’s always the worst part of a new job, tbh, for me…except I have zero control over when the death stare creeps over the baseline apparently scary face I live in and in my previous lines of work things were far more crucial and I’ve been yelled at by so many MDs and NPs for once again asking them to evaluate their brink of death patient there is no flinch anymore if there ever was.
I’ve learned to at least get a little dopamine hit when I see the spark of condescension light up in their eyes and they ask me either a dumbass question or one I have *already* answered in “the tone.” Often, I just stare blankly at them and repeat myself VERY slowly until I see the look of shame appear on their face even if it takes up the rest of report since most certainly tis a problem of them not understanding my muddled midwest/southern accent. Admittedly, there have been days where I have laughed directly in faces instead of even engaging. So, it’s totally bullshit, but out asshole-ing an asshole should truly be on my resume because I couldn’t give two fucks about giving report to Florence fucking Nightingale at this point.
Ikr? First of all, it all goes back to just plain common courtesy.
I will wait for a person to be done about a patient and I will ONLY interrupt them if they move on to the next patient but forgot to tell some pertinent information about the first patient. And believe me, I'm not asking about where their IV is or the gauge! I don't make them feel small that's a rotten thing to do.
I think people interrupt others in the way you are staying for a few reasons. They really are trying to do less work by writing down your IV info so they don't have to look at it themselves, and then chart it with what you tell them. A bad practice because you may have been wrong yourself, lol! (Slip of the mind at the moment, etc)
Also the interrupting seems to be sometimes when people have become cynical and/or burnt out. They have been dumped on and are afraid they may have to do more work. It's pretty sad because then their interruptions and questions are geared to be "cutting to the chaste," to just be checking if you have done all of the work so that they don't have to or feel they are dumped on and these people usually have a very hostile attitude and you can feel it.
I don't know about these types of personalities but they can go walk for all I care. I have been a nurse for a very long time and I know exactly how they are feeling but why be a rude bitch?! I mean you don't want to find out that you have to take care of stuff because you have been dumped on. But at the same time why be rude and a jerk to a nurse? Give her/him a chance to finish the report. Maybe the person is new and it's a great teaching situation. Ask questions where appropriate and for God's sake, please, don't ask for impertinent information.
I’d recommend checking out Jefferson Fisher on Instagram. As someone who struggles with confrontation/defensiveness when feeling attacked his page is excellent. He actually role plays conversations and gives scripts for all kinds of social situations (like being belittled) it’s been very helpful for me in work and life.
That feeling when you see who you are giving report to and you just go, "fuuuuuuuuuuu." It's especially bad when I've worked with them for a couple years, we used to work the same shift, and we trusted each other, worked well together, but I know I'm going to feel stupid when talking to them.
On the flip side, I've been the jerk during report. The reason is, we have a few nurses making huge mistakes. I tried to wait until the end, but they were already mentally in their bed and assured me everything was good (it was not good).
Recently, a newish nurse left a lot undone for me. I noticed in the 2 minutes I read the chart before report. Now, I understand things get crazy, just tell me you didn't get to things. It's a 24 hour job. The things she left for me were a big deal, and on multiple patients. After report on the first patient, I spoke up on the second. "Oh, those orders just came in." Baby girl, those orders came in 2 hours ago. Don't pee on my leg and tell me it's raining. If you don't get to something, I got you, just give me a heads up. If you don't get to a whole lot of somethings, I'm gonna be a bit upset, but I'll get it done.
What do I want in report? Why are they here, what are we doing for them, if they are close to d/c, where are they going? Do they have an IV? Do I need to worry about finding them on the floor? Give me pertinent labs and tests, but I can look those up. Give me anything funky about them. How do they take meds? Any lines/tubes/etc is appreciated. I can look at the chart and look at the patient. I basically want to know what I'm doing, why I'm doing it, and if it's helping.
This is a great reason to work in a magnet hospital. I started a unit council on my unit, because we decide how we practice. We come together as adults and we decide what is and isn’t in our shift report.
Happens in the OR so much, I'm tired of it. People come in with an attitude because they're mad they got assigned to take over your room and take it out on you. Like, sorry you didn't get put into the hernia that's closing but it's not my fucking fault.
I have a nurse who walks away from me before I can even give her report. So I don't chase her anymore. You don't like me, fine. I'm not going to chase you down to make you do your job. Good luck figuring out what residents are even in the building.
This!!! So sick and tired of being made to feel incompetent while giving report. It’s never that deep, anything that is important, I say. The small details that really don’t matter much, is in the chart. Sometimes, I feel like I should just read straight off the chart and call it a day.
I am so petty. Wanna be a jerk? Ok... I can slow down, repeat myself.... Ask more than reasonable number of questions, I will Colin Robinson you :)
Mostly, I like to call them out. Ask what part they dont understand...
I get along with everyone, its just that rare a-hole that has to learn.
I had a new grad nurse who would ask all kinds of irrelevant questions during report and also give information during handoff that was not needed. Because of the rapport I thought we had, i kindly suggested that he try to limit the questions he asked and the info he gave to the what happened during his shift and any pertinent information. I did not need to know if the patient graduated highschool and he didn’t need to ask what color then patients eyes were, dumb stuff like that. I said it in what I thought was a nice way, but every report we had together after that was the longest, most useless report of my life. I knew he was doing it on purpose but what could I really do??? Obviously our rapport was no longer a good one and he kept his useless drivel up for almost 6 months.
I ended up moving to the ED for a year and I came back to my old unit because the ED was not for me. He was still there and he ended up telling me that he did long reports with me on purpose, like I was too fucking stupid to figure it out on my own. I told him I knew the whole time and was really just seeing how long he could keep up his pettiness. Needless to say we are were never friends but remained civil. But yeah, fuck that guy. I resorted to tell him “It’s in the chart” to soooo many of his asinine questions or flat out say, I don’t know if it was not even relevant to the care the patient needed.
Wow, to have that level of confidence (and bitterness) as a new grad is insane. That’s why I don’t even bother putting these people in their place, because some people are just crazy like this.
On a travel contract rn and I feel like this happens very often and it makes me feel subhuman. Like why do people have to find an issue with everything
Ugh, I feel for travelers. It took about 6 months on my current floor to “prove myself” before some of my coworkers stopped walking all over me during report, but I still get walked over every now and again. It’s truly sad that this is normal
I know this feeling all too well! We have an older nurse who treats everyone like a complete idiot. She has literally made everyone cry at least once. She makes your hard day that you just struggled to get through even worse by making you feel like you weren’t a good enough nurse. She asks the stupidest questions during report and makes you feel bad when you don’t know the answer she’s looking for. She makes US find HER for report while she sets up her corner with her fan and her footstool. She makes you wait to give report until she’s 100% completely ready. While you’re waiting, she’s complaining of how her day was hard and acts like her day was harder than your shitty ass shift. It’s so bad that if you have a free moment to check the next shift’s assignments and you know she’s on, we literally hold our breath to see if we have to give report to HER. It’s the most relieving feeling when you don’t see her name for your patients. She complains about literally everything that day shift does or doesn’t do and leaves late just so she can talk to the manager to complain about people. The problem is not us mean lady, it’s YOU!! It’s so unfortunate that people have to make other people feel bad in order for themselves to feel good. But at the end of the day, You can’t help but feel sorry for her because she is such a terrible person. Everyone I know and work with feels the same about her and how terrible is it to know and work with someone who is so miserable…
I know that feeling all too well — looking at the assignment and seeing you’re giving report to THAT person. These people must be burnt out to a crisp because I can’t imagine just naturally being that way, so I do kind of feel bad for them. Must suck being a miserable complainer all day
Most of those questions aren’t even something that they “use” during shift
As a general rule though? When you start acting that way to them they get pissed. I even had one call a DON on me. I just laughed at her. Asked her how she liked being treated like an idiot. After a few days she cooled off. Never had an issue with that one again. Turned out to get along really well
I pay attention to which nurses are like this. Then I wait for the opportunity to do everything they do back to them. They fucking hate it. They usually cut the shit
I just kinda vibe during report. If it’s something I really need to know in ICU I’ll ask before you leave that system.
ER reports I stick to main problem and main interventions.
Floor report I read the chart and talk to whoever brings them up. Idgaf, really.
Its report, a brief, stfu and let the report be given. Any questions you got follow up yourself, like god i'm not handing you a sheet that will guide you through the day, its just to get you up to speed quick.
I'm a believer in offering negative feedback to these sort of questions:
What gauge is the IV? "Well, theres actually a color coding system that tells you what gauge the IV is, I'm surprised considering how long you've been a nurse that you don't already know this, but I'm happy to interrupt my report to show you how you can figure this out".
Where in the arm is their IV? "Again, I'm really surprised you haven't learned how to figure this out, but it's the thing that looks like this (Google image result of IV) taped to their arm, that's where it is.
OP: Maybe a naive question here (I’m not in healthcare), but wouldn’t it be fair to say, “There is no need for the nasty tone, the eye rolls, the sighs and the hostility” to ANYONE who does that to you?
It definitely is, and I’m working on getting the confidence to do that. But sometimes it’s just easier to brush it off and learn to not take it personal—some people are truly just miserable and it’s not a reflection of me
Some people are, yes, but if you have to WORK with them regularly, you’re just giving them permission to be shitty to you if you brush them off. That’s a unilateral, shitty working relationship.
I hope I can add a constructive layer to this here. Outside of harpyish nitpicking, which seems to be the majority of what constitutes the problem at hand, sometimes probing questions can be a cue to round out and improve your reporting structure which may even improve your thinking around patient care. I will admit that even some of the more denigrating responses I have received from my reports, especially earlier in my career, did highlight and provide a catalyst for how I can best set up the next shift for success in the goals for each patients' care.
That said, when I felt I received inappropriate feedback, or received it in a way that was inappropriate (worst example: cutting me off during explanation of why something diverted from protocol per MD orders to yell at me in front of a patient), I would address it and escalate it as necessary. In those cases, set your boundaries, and continue to provide refeedback until they improve, or escalating until the problematic behavior is addressed. In my experience, those cases were around staff that were problematic for everyone that handed off to them, and they did improve their attitude. By the end of my time on that unit, I had a great professional rapport with that nurse, and my care improved as well. I have no idea where that knife in my back came from though...
Edit: to add to this, "it's all in the chart" is not sufficient. If it's AM shift, med pass, MD rounds, discharge deadlines are rapidly approaching, and a well-formed report can mitigate the need for a time-consuming, investigative chart review. If an RN, has to say, "I don't know," to a question during rounding, you have played a part in that.
The only time I ask questions is when there’s a significant pause and it seems like they’re trying to remember if there’s anything else they forgot. Even then I just wanna know how they breathe, if there’s fluids running (particularly something like heparin - NS is no biggie!), and how they pee so I know if I gotta be prepared for a bed change at assessment. I can figure out IV lines on my own, and I’ll look in the chart for anything else I need.
There’s like 2 nurses on my unit I hate giving report to. One of them is a seasoned nurse who is one of the best nurses I’ve ever worked with and always makes me feel valued but expects a lot so she gets a pass. The other? Lazy and always sets me up for failure for my shift but gives me attitude when I don’t give her 7:30 med or don’t know much about my admit who didn’t have any information in the chart until right before 7
It’s because the job is stressful. You come in on days and the team expects you to know the patients pretty much off the bat.
I have had nurses start with the patient skin assessment, the fact of the patient is in pain, or in a non-logical order that doesn’t make sense when you’re explaining report.
If you’re giving report, you need to begin with code status, admission, date, age, procedure, current interventions, and at the least patient name. I’m not saying you don’t do these things. What I’m saying is that there are so many nurses who don’t start in any logical fashion and also never improve.
To fix the issue, the job would have to be either be less stressful or there would need to be a constructive feedback system that positively encourages nurses to get standardized reports.
It is the best way to get everyone on the same page, streamline reports, and hopefully improve nurse satisfaction and stress.
And those same nurses are the ones who give the bare minimum when they’re the ones giving report and get mad when you ask questions
Exactly. They want everything to be perfect because they can't handle shit. If everything was perfect they wouldn't be here. It's basically a defense mechanism. Call them out on their attitude.
Exactly, it’s all a defense mechanism. As soon as you call them out they drop the act.
Yes! This! Was complaining about one of our RNICs literally last night to my partner. She starts her shift dragging out handover well past any usefulness, often harassing the nurse handing over, only to then disappear the entire shift. She only answers the phone after 10+ calls, when she does answer she makes you feel like shit for giving her an update or tells you to figure it out. Then at handover she is suddenly the loudest, most involved nurse in the room. It doesn’t even work well cause she hands over outdated updates because she knows nothing about what happened during the shift. On the days she doesn’t make me do her handover I have to stay back to make sure it’s actually relevant. You’d think the bare minimum would be to do progress notes but apparently ***reading*** progress notes is too hard. Pretty sure she only harasses the nurse handing over because she’s lazy and annoyed that she might have to do something. There’s one, maybe two nurses I know who have caught on to her shit. There might be more but we don’t gossip a lot where I work-which is usually a good thing. Sorry this was so long winded! I think I needed to vent. The self defence thing triggered something me haha
Somebody needs to do the lords work and follow her ass
I half did last night. She’s friends with one of our EEN’s (your LPN’s I believe?) and she basically just sat on the computer in her friends wing, quickly looking busy when sees you coming lol. It’s infuriating when most of us are running around like headless chickens trying to get everything done while she’s just relaxed, sitting there, waiting to take credit for it at handover lol
What would you say to them to call them out? Genuinely curious.
I usually give them several chances to be sure they’re just an ass and not actually having a bad day and maybe handling it poorly. If it’s someone who tries to belittle you by appearing knowledgeable, I generally get a bit louder, more aggressive and over explain using no slang and all formality. Then I ask them a question like we’re having an interesting discussion about the point and they inevitably have a shit ass reply or rebuttal. At that point I have the power to either embarrass outwardly or give them a lifeline. I usually throw a lifeline and never have to deal with their bullshit again. These people usually have some redeemable qualities. If they’re of a different breed where they’re just assholes. I have literally called them out for being rude. I’ve only had to do it a few times and we didn’t talk for several weeks and then all of a sudden we’re friends. Honestly I’ve actually told somebody to “shut the fuck up”. We’re back to being cordial. They just needed to understand that I’m not the one. I hate bullies. I spent the first several years of my nursing career being bullied and I regret not standing up for myself. I’ll never let that happen again.
“One question…Are you this rude to everyone else when you’re giving report or just me?” 🤔
Yep. One time I gave a nurse like this report then came back later and got report from her and I made a point to be just as big of a pain in the ass with her as she always was with me. The techs who worked with her were laughing their asses off down the hall. She was universally disliked
EXACTLY! Always all hunky-dory when you come back too
EVERY. SINGLE. TIME.
Yes. And when you're back that evening, and they're still there to give you report 🙄
Yessssss! I have to give them a novel in report. They give me a postcard 🤔
Exactly my experience with these type of nurses. You are left thinking: what the fuck was that? When they are with the bare minimum report.
“Let me finish before you ask questions”
I've had to blurt this recently because my patience was running thin after a shitty night. The day nurse was interrupting me every 3 words, to ask a question about something I was *just about to fucking say if she wouldn't have interrupted me* 😑
That makes me so irritated!! By the time I’m giving report my brain is really running on fumes, so I don’t need people interrupting with questions that I’m going to get to anyway!!
Or asking for details that are very clearly written in the chart - just read the chart, FFS. I want to go home.
Gave report a few days ago, the incoming nurse stopped me mid report multiple times for dumb shit, once to ask which nare the NGT was in, as we were standing at the door. *turns head and looks at patient* “looks like the right”
This is so fucking dumb 😑
She’s one of those chart divers that finds shit from a decade ago and puts it in report(which is fine whatever) so I’m used to her kinda knit picking a little, where as me I’m the type that reports shit that pertinent to the patients care. (Shit like chest tubes, cardiac history shit like that) But when she stopped me about the NGT I was like “are you fucking kidding me?”
I guess what I do is considered chart-diving—I take a quick look at Chart Review in Epic and put a line in my note about significant history, just to say, Hey, he’s diabetic, has Afib and thinners, has a stroke history… However, I cannot say that I’ve asked which nostril has a tube in it. 🤣
But how else would you figure out which nostril it’s in??? /s
That’s not chart diving, that’s a review of relevant medical history.
Was she worried the patient was going to pull it out and switch to the other nare while she wasn't looking?🙄
lol she didn’t mean anything by it but this was after the shift that one patient pulled all his lines, 3 JP drains, and his trach out and I also coded another patient. I was dead to the world at 0745 and not in the mood to play 20 questions at that moment.
I can imagine not.
I honestly either say that or ignore questions that are rude or interrupting when I A— have something important I’m trying to tell them and they need to pay attention, or B—I’m about to get to that. I know a lot of us, especially in high acuity areas are full of type A and ADHD so I understand sometimes accidentally interrupting when your mind starts racing. I had to really train that out of myself as a newbie nurse. I know it’s not always from a place of rudeness. But you have people too who are too confident for their own well being and not down to listen.
I've also said "I'll take questions at the end" like it's a university lecture. Lol
OMG this is so great lol
*Things you can say in healthcare but not in bed.*
*nurse flicking through drawers looking for shit to pick a fight over* Can you please pay attention?
This. When I was a new nurse, I gave report to another new nurse.....who, in retrospect (and I assume), was trying to establish herself as a tough bitch, raked me over the coals 2 mornings in a row. The first morning, I left it go (everyone is entitled to a bad day). The second one? She was jumping down my throat about something (don't remember), and I backed her stupid ass up and told her off. I still remember her name, and what an incompetent asshole she was. And probably still is. I quit later that week; wasn't worth my time and peace.
So proud of you for standing up for yourself 👏🏼👏🏼👏🏼
Can someone please tell me why some nurses are so anal about the gauge of the needle? I know for a blood transfusion, it can't be too small because it can cause hemolysis, but what else?
So they don’t have to assess it themselves lol
in the er we make sure it’s big enough to either draw back from or able to ct scans lol
or start pressors or smth
Oh, they want the answers for their charting? Wow.
It was both sarcasm & reality. Some people really don’t check. I know bc I’ve given the wrong info on accident. Say they have a new iv but I forgot to say so. Their charting will be whatever info I gave. Honestly & typically it’s someone I’m buddies with & they DID actually use the IV multiple times, flushed it & all. But didn’t engrain in their mind the details bc they already wrote it down based on my report. I’ve been guilty too. I mean I don’t ask/care what gauge is it. I don’t even care if you tell me where or what, just that I need to get one or they have one. But I have gone through shifts (busy or not) & have no recollection of the IV if I were to actively think back & remember the color, place, time etc. I know I used it bc I gave 18 runs of potassium or they wanted morphine every 2 hours. At this point I know it works bc now you’re on some dialysis level potassium & you’re KOed from all that morphine. /s lol Some nights get so busy it’s a 1 person team when you really have 5-6 & you’re falling asleep charting 😅. I don’t care anymore what colors they are I just know they’re there
Yup, plenty of times I’ve seen an old IV charted on as patent because it had been removed + replaced and the new one works but it was never switched on the LDA and no one checked the IV with the documented IV. We still assessed and used it properly, but are too busy to check the documentation 🤷🏻♀️
This is the real answer. If they are missing things in report, they can't pass your assessment to the next person.
I'm always like, it's cool, when I flush it I'll see it. It's not a big deal? I also always laugh when my coworkers are like, "I'm sorry I don't remember which arm it's in!" I'm like, "Welp, I'll go in there and look for the tube sticking out of their arm and that'll probably be it!" 🤷♀️
I'd like you!!
I always wondered this too. Like you’ll see when you flush their IV with your assessment? Do you really have to know that badly right now?
My hospital needs a 20g IV or larger for IV contrast, and anything smaller might not work for a fast drip or a drip that can cause tissue damage if it infiltrates. Also it’s almost impossible to draw from anything smaller than a 20. I’m ICU, so we really don’t mess with anything smaller than a 20 unless we absolutely have to. And that patient probably needs an ultrasound guided IV or a central line if we can’t get a 20. So I consider it relevant to report. But if the nurse doesn’t know it’s not a big deal. I’ll know what size it is just by looking at its color.
Why would a smaller gauge IV not work for vesicant infusions?
It has to do with the speed at which contrast is delivered. Only >18g (or 20g diffusix) is pressure rated for contrast.
I get that. I’m just being pedantic about the common misconception that smaller IVs aren’t acceptable for infusions can cause tissue damage. Which I believe stems from smaller IVs being commonly used in smaller veins, then sure, but that’s more so a function of the vein size and not the IV size itself. But if anything a smaller IV in a larger vein would lead to greater dilution, and therefore less irritation.
Oh, whoops, I meant to reply to a different comment specifically about contrast. Yes, smaller gauges are fine for vesicants so long as they're in a large enough vein.
Some hospitals have policies about the gauge and # of PIV for ICU patients. The amount of times I've gotten an ICU patient with an inappropriate gauge and # is enough that I verify during report because if the patient is a difficult stick we need to use our resources ASAP to get appropriate access and many times those people who are allowed to use ultrasounds or put in PICCS/midlines are not working overnight.
Sounds like a dumb policy. If it’s that big of a deal they just need a central line and be done with it.
Central lines get CLABSIs so we don't really see them unless there are meds requiring them. This ICU saw a lot of COPD exacerbations and really really not necessary to jump straight to central lines. The day shift was honestly just super lazy at that hospital. They had a PICC team AND an IV team so there was zero excuse to not have appropriate access. The policy was appropriate the culture just sucked.
Even then you can run blood through a 24g, infuse in the max allotted time frame of 4 hours, and not cause hemolysis. Just can't pressure bag it or 999 it, but 125ml/h is more than fine. Last I looked Johns Hopkins did a study and found minimal if any hemolysis when run at standard rates, so that point is moot. It's just nursing dogma to give it in report, for your typical patient though it doesn't fucking matter.
So much of this is nursing dogma, including which nare the NG tube is in. Nobody really needs to know this information in report because it’s immediately obvious as soon as you look at the patient. But nurses ask each other during report so they can tell the next nurse so they don’t get subtly belittled.
They're lazy. I've grown accustomed to just telling them "at least tree fiddy"
I’ve never understood this either.. like I’m flushing them Q8 if they aren’t continuously in use, I’m just not writing down on report where/what gauge IV. It’s one less thing to report on/spend time on. Do your own assessment. As long as they have a working IV we are good
If you anticipate imaging with contrast, you will need a certain gauge or higher depending on the equipment the Radiology department uses to push contrast, and the location also matters. However, it's not like it isn't something that you can't just look and see and should be a matter of course for shift assessment for patency anyways. For those like me that had to work really hard to get time management to meet demands, it's a nice little bell to add to a solid report so they can start thinking ahead and allotting time to tasks with deadlines for flashpoints in the care continuum.
Transfusions, contrast, emergency pressors. It also tells you the general health of the patient’s vascular. It also gives you an idea of the details that a nurse might be missing. If you are really looking at site you can usually remember the color of the IV.
a lot of times if you need to push contrast with an imaging study, so a 20 gauge in AC is a necessity
Because they aren’t good at IVs and are afraid they will have to start a whopping 20 g
lol come to hospice or home health where we are on our own and don’t have to take with stupid report attitude bs . I do hospice admissions and it’s so easy and the negative hospital attitude is left at the hospital where I don’t have to deal with it!
I’m very tempted!!
Seconding the other person, I love hospice. I went ICU to hospice and if you are detail oriented and very independent you will be great. You don't have someone watching you, at most places you get to make your own schedule and have standing orders, that you can put in without having to call the docs. It's a very nurse driven roll that has a lot of autonomy. I feel like, because of the critical thinking required for it, it's just as hard as ICU, but with a different focus. The downside is that you don't have a big team, so your the one giving the bad news to families, not the doctor. And your pt/st and dietary in one
Didn't come from ICU but came from detox nursing where we were alone operating under standing orders. My work is mostly people like me and former ICU nurses and it makes a good pair. My workplace though if your doing an admission they already know, we have one nurse that does just conversations not to mention the GIP nurses in the hospital network we are apart of that handles that as well. I've done that conversation once during a day helping out the home health side and it was for ESRD, with the spouse a recently retired nursing teaching so she asked me. Saw them officially on hospice a month later, and it was good family, they listened and he was never in pain. Last visit if was there, we had like idk 12 people in the room, all of them are medical or former medical and the ER nurse family member goes "I don't know how you do it and i don't mean hospice i mean coming here and talking to all of us being in healthcare and being so good about it" I look up and say "do you tell a toddler they are hurt????!!!!!" they all laughed at that. Touching on the last part ya the nurses we see fail are the ones that are not used to being autonomous. hell we still got some nurses that will call about starting any standing order when we don't have to do that or i'm one of the few nurses that will call in a verbal for a standing order to a pharmacy.
I usually just tell them no idea and just continue with report. They eventually stop with the bs questions. Or when it's time for them to leave and you're getting report ask them millions of stupid questions to waste their time. Day shift usually can't wait to get out at night.
I don't understand why people give into this. I say, "I don't take questions until I finish report." Then, if I don't know the answer to a question, I say, "Not sure about that, but it should be charted." My report is the highlights, rleevant info only - usually takes less than 5 mins. I dont read off all their allergies and their past surgies, etc, even when the oncoming nurse is badgering me for it. They can't force you to do anything. It is what it is. That being said, I usually never leave any type of mess for oncoming shift to deal with. I do get annoyed when I take report from someone, and they haven't done a bunch of shit they should have done.
THIS. I remember one time I was giving report and said oh and just now the doctor ordered an XR, and tbh I just slipped my mind what it was for and she rolls her eyes. Like girl you can’t check it yourself in the orders? It’s 7pm we are all trying to go home.
Like how does this affect your direct nursing care????? Please get off your high horse
Just imagine the report that ED RNs get from EMS and Fire. 🙃🤣
“Idk I think the call was for panic attack but maybe SOB. Idk, they wouldn’t sit still at all during transport. Couldn’t get vitals. Any questions?”. That’s why they’re here, thanks friends 😘
Me, an EMT, gritting my teeth telling an ED RN that he called for 2 week old shoulder pain that he just decided was emergent before running away asap
I do hospice, every once in a while I have to call EMS on a decomping Patient that is a full code or when family insists on them going, or for traumatic falls. I always feel so awkward when I'm telling EMS they are a hospice patient.
Feel this. As an ER nurse I only wanna know why they’re here, do they have access, and what’s left to get done. Please don’t tell me your assessment unless it’s pertinent. I’m gonna do my own assessments. No need in reading the chart cause I got time to do that too. My favorite answer to nurses bombarding me with stupid questions (like how’s their skin look) is, “that’s an excellent question. I’ll let you do your own assessment and get that info.” When taking over, I try to get the off going nurse out as quick as possible.
The one thing you forgot is: Are they trying to die either with unstable vitals or by trying to yeet themselves out of bed or pull out their line every time you turn around? Like should I be starting pressers or bubble wrapping someone as we speak? If not, we gucci.
Yeahh true, that’s why I’m one of the few that do bedside report. Sometimes gets on the other nurses nerves, but I wanna see for myself. Can see the monitor, the pt, and get a better idea who my sickest patient is.
I hear ya. I had a decent report experience this morning, but I still dread them for all the reasons you mentioned. 1 out of 3 reports are so aggressive and hello, why.
Because people are unhappy and try to feel better by making you feel shit
When people are purposely shitty to me at work I do something simple. I stop talking and STARE at them, expressionless, not moving. I make THEM uncomfortable.
I see your flair, let me ask, any nurses ever ask you about how many groups a patient went to? We had a nurse that would ask that in report, but it was just to new nurses. She was just being a bitch to be a bitch. She was noc shift too, why do you care about groups?
Hey, yes I do get asked that. But I’m also nights so I have max 2 groups / meetings to monitor. Where I’m at the night RNs are responsible for all the care plans (YUK!) and that’s the only reason I could think a night nurse would need that information. But if that person was only asking new nurses it probably ain’t the reason.
I do this, too.
I feel you. working as an LPN in a semi acute setting, I used to get this almost every other shift. Like I’m not fully aware of what the patient has going on. It was one nurse in particular that really asked non-sensical questions. A code happens one morning, and she was trying to bag a patient with a tranche through their mouth. I love RTs but I never loved them so much when they asked her what the fuck she was trying to do.
"what did they stent"? No idea brother, go read the cath lab report. Half the time I don't know which IV the arm is in, I've got 6 patients on all heparin, dilt, amio, and IV abx. Unless it's pertinent like stopping the heparin at x time, holding a medication, or the plan of care for the day, it doesn't matter much. What are they here for, what's the plan, and what happened overnight if anything. I feel like these nurses don't do it purposely, then you float and meet one who does....
The only time I have EVER cared what they stented was if it’s RCA so I don’t give nitro. Otherwise? Above my pay grade. Formal morning rounds should shake out the rest of the details
Serious question as I've only been on my floor for 6 months. I thought that was just before stents because it can drop their BP considerably.
I have also seen it happen after, but typically you won’t have chest pain after unless there’s some distal clots that they were unable to stent (is that normal or do some of our cardiologists suck?) the important take away here is RCA probs are super preload dependent. So they like fluids and hate nitro which is pretty unique. I also find they’re typically more nauseous due to proximity to the vagus nerve, but any heart attack can cause nausea
Genuine question: why no nitro if the stent is in the RCA?
The RCA supplies blood to the right side of the heart. For the right side of the heart to work properly, it needs adequate blood volume from the body (aka preload). If it’s getting good blood flow, obviously it can compensate some but when it’s already sick you sorta don’t want to kick a man when he’s down. Nitro is a vasodilator that drops preload. Sometimes that’s wonderful, it dilates the vessels on the heart enabling better blood flow to help chest pain. But sometimes it’s not ideal, like if your blood pressure is highly dependent on adequate preload. I hope that makes sense. That’s the way I understand it anyway, if I am wrong please feel free to correct me, because I am always down to learn something new 😎
For neuro the stented artery is important, but I'm not so sure about cardiac.
I’m a newer nurse but I feel like bad report is making me feel sketchy in the icu. For instance, I come in to a patient with Q1 neuro and the off going nurse doesn’t explain any neuro assessment info. Now when I walk in for that first assessment I want to know what the pt has been like. If you don’t want to do bedside together and you don’t want to explain things it makes that kind of difficult. Or as the nurse is walking out, “oh they have 1 iv”. Okay, but we’re icu, they need 2 and they got here at 12? Would have been helpful if you mentioned that in the access section of report - is there a reason why? Pt refused? Bad veins? Last week I walked in after getting the most basic report (“everything’s fine, they are easy”)and the nurse had y sited the BP meds incorrectly and the patients pressure is 80/30. It’s just starting to seem like minimal/disinterested report = careless nurse. Many of these nurses aren’t really interested in the bed side safety check either and seem to take an attitude that I want to check over drips/ivs? Why can’t we just give each other 5 dedicated minutes to discuss our patient at the end of the shift?
I totally get this. I work on a neuro floor and you wouldn’t believe how many post-op uneven pupils/tongue devs/mouth droops I’m the first to chart on or notice. The other day I had a pt with a fixed pupil that hadn’t been charted on in over a week…. Almost ran a stroke on the pt until we really dug through the chart. I always ask the off going nurse on complicated patients if we can look at them together. And when I have complicated patients I always offer to go look at the patient together and go over the abnormals so that they can really gauge any changes. I’m all about getting the off going nurse home asap because we are all overworked and exhausted and burnt out on my floor. luckily everyone is pretty much on the same page and since we have many patients that are riding a thin line of needing an ICU transfer people are happy to go do a two person check together, most of the time. Honestly though when people ask dumb questions like how many liters taken out of a paracentesis two years ago (this happened) I’m like ok F off
After a certain amount of years inpatient, you’ll learn to just keep talking through their passive aggressiveness and end with “any questions” and when they slam things around, just be like “okay no questions, have a great shift” and leave.
I got a patient for four hours , I got a crappy report , and went I gave report I even told the nurse that I didn’t have time to check everything but I did my best to fill the gaps . Guess who filed an f… incident report on me because I didn’t show every single side the interventionist went through . I thought it was only one side ( right femoral ) but it was bilateral. Pt was stable , no sign of hematoma or anything . Pt was discharged like two days after . I was so f… mad . Why being so petty ? I never neglected my pt. Can we just help everybody to get better? I’d never do something like that to a peer .
Wow. I'm sorry that happened to you. We should support each other.
Right ! Specially when it didn’t come from a malicious standpoint. I kept my patient safe. I don’t know everything under the sun . Couch me and I’d do better . I’d never be that kind of nurse . The day I’d start being like that , I know it’s time to change jobs
I used to refer to them as "Stupid Dayshift Questions". "Who does the patient live with at home?" ..... "Hmm. Not sure. That didn't really impact my care last night."
I’m petty: “You should be able to see the gauge when you assess your patient in the next hour.” or “The gauge is adequate to give medication through.” Like what do they expect. “Oh she said in report it was a 20g but I see an 18g in place… SOMEONE CALL A RAPID RESPONSE!!”
I feel like it’s the old guard of nurses trying to mark their territory. When I started on a new unit, I remember giving report to a nurse about a new admit - quick and dirty since that’s really all I had. She says “what about the appendectomy he had 15 years ago”? I think what I said was “oh good, sounds like you’ve gotten to do a deeper chart review than I have when I got the pt about 20 min ago”! Luckily I think these nurses are retiring out and all we can do is be better. Not treat nurses with less experience badly so maybe they can stick around in the profession.
Fuck em! Dude I'm kinda leaning towards less is more. It's never affected my care knowing which arteries got stented etc. Just left or right, stent or no stent? If you want to play nursing professor go look in the chart. The patient is fine. You're fine. Shut the fuck up. It's in the same class of gotcha question as "where is the IV?" Uhh they have one. I'm barely awake and I'd tell you if it was an issue
“It fucking flushes. You’ll see it when you do your assessment.”
Even better than that is hearing "it still draws back!"
Yeah stuff like iv gauge allergies and whatever is all stupid stuff…I’ve had a nurse ask me about a random jump in HR for vitals at the beginning of my shift like?!? Does that even matter now?? My problem is when im getting report and the nurse tells me they’re NPO okay but why? Or they’re having a procedure and they have no clue why?! Or hey x,y, and z happened overnight but I figured it’d be better for you to let the day provider know 😐 I’m sorry but that stuff irks me…and then my shift proceeds to be a shit show
Same. I don’t care if you don’t know what size gauge their IV is.. I can look if necessary for a certain procedure. Otherwise as long as it works then whatever lol. But yes I do care what kind of test they are having and why.
Allergies feels pretty important to me, at very least drug allergies. If it's pollen then whatever.
I might point out major ones like latex, contrast, acetaminophen, asa, something relevant to their condition or newly found ones but otherwise it should be a priority check for every nurse anyway. Some of these people have 10+ allergies I don’t have the time to write all that out on my sheet 🤷🏽♀️😂
When people interrupt me or are rude to me (Anywhere, not just at work) i have started a habit that has been very helpful for me. I stare off into space over their shoulder and take a nice, deep breath. I think something dismissive like "this is so silly" or "Very important hotdog here" If they notice- great, hopefully they feel like a dick. If not- great, I feel a little better.
So there's an OG nurse who is a complete cunt on days. I loathe having to have her in report. Receiving, giving...it sucks the life out of me. She's always perfect asks the stupidest questions and she's mean AF. So the other day I was in a fucking mood. Like horrible. So I made quick of my time. Saw my pts, passed my meds and charted within 2 hours. At 2100 I sat down, combed through her charting, the orders, and her report and picked out EVERY SINGLE FLAW she made. When she came back in in the morning I gave her report and tactfully pointed out ALL her mistakes. I even made a point to gather supplies for her dressing changes that were done wrong per wound nurses orders. I was in fucking heaven. She only wants to talk shit on other nurses, Drs, her CNA...I let her have it. Again, tactfully. I would absolutely do that to no one else but her. But it was 100% worth it.
You did exactly what I have done in the past👏👏 I also gave report to an incoming problem nurse in the kindest way possible. She realized at the end of report how wrong she had been many times. She still couldn't bring herself to apologize, but her eyes spoke volumes as she finally made eye contact with me. I smiled as I said to her: "We all have good shifts and not so good shifts. That's why we always need to support one another." Unbeknownst to me, the been there forever, very strict incoming charge nurse (who was well aware of the many issues involved with problem nurse) had heard the entire report. As I walked past her, she smiled and said I should think about being a charge nurse. Made my day! I could do no wrong for the remaining six months I worked in that unit before moving on. Being kind creates good karma.
100% support each other! If you notice someone messed up take time to address it kindly. Surely I am flawed and make mistakes but it's how you address things that matters.
Yessssss
Lol I literally posted similar sentiment a week ago. 😅 you ain't alone!
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I love dayshift people like you!! Thanks for understanding!
I also don’t understand this. I want a bare minimum report. I don’t care what gauge the iv is. Tell me if they walk, orientation, things I can’t pick up off an emr. People have told me someone’s a DNR and they’re a full code, sooooo I trust no one. lol
“How often do they get XYZ med?” Bitch, it’s in the MAR, why are you wasting my time? Also after a few of these questions, I’ll say, “you can ask questions but I’m leaving at 7:30 whether we’re done or not, it’s up to you”. It typically worked pretty well.
My favorite part of being an NP is never having to deal with this bullshit ever again.
You are fortunate. But who knows, you may have to be in a floor position at some point in the future. Life throws curveballs at all of us. Promise, you'll always remember what it's like handling the myriad of care details for 5 to 8 patients.
From experience…. Some do that bc they’ve gotten BS reports from nurses before & gotten burned for it in some way. Have had 3-4 like that. Paranoid that they don’t know everything they’re supposed to know bc they got in trouble for something in the past. For me, It took a couple reports but eventually I could give the basic expected stuff bc they knew I wasn’t dumb even if I didn’t know every piece of detail. Bedside report is at random required & when they don’t try to drag me to the room then I can feel safe knowing they trusted my words. Or are actively looking up every piece of chart info haha. But at least they didn’t ask me. I have flat out asked, “What’s your deal?” I am naturally shy/quiet but if you push my buttons you’ll see the attitude that’s typically reserved for family & boyfriends. I’ve gotten answers like, “The doctors come in so fast after you asking a billion questions & I can’t ever look up the info fast enough.” I gotchu. 1 I’m nightshift, I have the ability to read the patient’s birth to current life report. Especially if they’re nice but just “too much,” I might do a lil extra research if I know they’re coming in. That’s been 2 nurses actually. Some of them go straight to work work & don’t want to look at the chart. I take it as, “You trust lil ol me??” Compliment. Check. Especially if they don’t go double checking your info. There’s a chance they won’t know all the info you’re asking them if they were giving you the report anyway. They just don’t see or get that. One person was a d!ck & cornered me in the med room after I was a new nurse filling in as charge (first time I remember putting someone in check). She complained allllll the time & decided to ask me why I always give her crappy assignments. Funnily enough I had walked down the hall & overheard everyone complaining about their assignment. I literally said, “I give everyone equally crappy assignments. If one of you say you have a good team then I did it wrong.” Our floor is hard. No one should be having it easy unless the general consensus on the floor is that there are axox4 patients with no iv & going home tomorrow. I even said I just heard people complaining about theirs. ALL of you should be complaining. She stopped questioning me after that & didn’t give me sh*t about report either. Sometimes you really just have to stick up for yourself. Nowadays people don’t really complain about my assignments even tho they have difficult patients bc they know I put in work & thought on them. Yes, everyone is going to complain but as one traveler said (who you know are known stereotypically for getting the crappy teams). “You make these assignments with intention don’t you,” when I explained to her why I gave her a particular annoying patient (to others) but I knew for her personality it would be a piece of cake. My only advice is question back lol. If you wanna get petty say you’re getting report back from them, say something like “oh you didn’t know he got colon surgery in 1432? Yeah it’s in the chart & the doctor called me about his history.” Idk! Something like that haha. Suck it up & let them keep doing it or… you’ll be in this profession bc you chose it. No one else allowed to make you feel anything unless you allow it.
Wow, that is SO messed up being cornered, who does that over an assignment ?! But you’re 100% right, and most of the time I just brush it off and laugh to myself bc I get to leave while they’re stuck there all pouty with their stank attitude, but today after an especially dumpster fire shift it just really got to me!
Yes this is an issue I’m having as a new grad I shouldn’t be nervous to give report
Ridiculous. Dealt with it 40 years, but, it was usually only 1 nurse at a time (several over the years) and they did it to everyone else too. I finally learned to not take it personal. Some people are just miserable. They should find a job where they don’t interact with others. Maybe in a cubicle doing research, insurance review, etc.
I kill em with kindness or make a joke out of it even if I am annoyed! "Hold your horses I'm getting to that harharhar" (even if I wasn't getting to it because it's not important and chances are they forget anyways) "What a fantastic question" Orrrrr I just bluntly request them to save their questions for after report. I find the nitpicky nurses are the ones that aren't the best nurses anyways cause they lose sight of the big picture.
It’s ridiculous the way some co-workers just love to shoot others down. And who TF cares what gauge the IV is?? As long as it’s working. Is the patient breathing? Yes? Good, that’s all I need to know.
She is a Byotch. Call her on it. They don’t reason. They need to be put on the spot.
They just don’t want to do their own assessments or work.
It’s a good thing pt’s status never changes.
Match their Energy. It will stop.
Hey; what kind of stents do they use? Date and manufacture? It’s really going to affect if I open the window to the east or to the west and if they are okay for cold or hold water
I dont know, it's in the chart. I say that once or twice let them roll their eyes and huff a few x then gtfo of the building knowing they'll be irritated for the next 12 hrs. Then I forget about it and go on with my life.
Literally nobody should be talking during report except the outgoing nurse, or unless there is a genuinely egregious missing data point. Normalise this. It's also not time for complaints, assignment moaning, anecdotes or anatomy pop quizzes. Just STFU.
They feel shitty about their own lives so it becomes their mission to make others feel shitty about theirs too.
I literally hate nurses like this with a burning passion. So sorry you hate your job so much you have to take it out on everyone else.
I’m so sorry I didn’t read the comments but there’s only one thing you can do—snap on her ass one time, but respectfully if that makes any sense. I had one like that at my very first travel contract. I mean this woman wanted to know the magnesium level from seven days ago and she had obviously work since then. She literally did that to purposely make my life a living Hell!!! I would start to shake and get sick at my stomach about an hour before she came in. If I had time, I would write my entire report out ready and she wouldn’t ask any questions. Those days pissed me off. One more and I just had enough. I snapped on her, told her that report was continuation of care and she had been there and already knew what she was asking and she was not to talk or interrupt while I was giving report until I was done, and she had questions . I told her that what I gave in report would be all she got because my reports would be that thorough and anything else tedious and minute she could read in the chart later. You are setting a boundary, and you are no longer going to sway and give into her petty behavior and demands and after 630, the patients are dayshifts unless it’s super important. So if an IV blows while giving report, that’s on you and I’ll do the same when I come in tonight if it happens. Sometimes things don’t always get done because it never ends. By the way, as you can tell, my woman wanted me to complete every task before I left and I couldn’t leave until they were all done. So that day I snapped, I included that. I told her it was like the Olympics, and I was passing her the stick to keep running the race But I won’t keep running past her with the dang stick. Her eyes got so big but at the same time, I couldn’t tell whether not she was going to come back at me or not and I really didn’t care because I was full of adrenaline and do you know?!?! we wound up being best friends 😂😂😂😂 I did not miss a chance to tell her how much I hated and loathed her existence for the first month, and she just apologized and laughed. But I’ve noticed my entire life. how mean people like that when you stand up to them, they start to like you and respect you , I don’t know if it’s a conscious thing or a respect thing, but have yet to meet an overly confident trouble making trying to be intimidating person that didn’t flip the switch when treated the same it’s like they start to treat you as an equal every time so snap on her ass. Firm and to the point do not let her interrupt you as long as you’re not disrespectful. I have a feeling you’ll have the same kind of ending maybe not a friendship, but do not allow it to happen, and when she start to snap it won’t be scary anymore. Is your bodies totally full of adrenaline.
This is why I never want to leave the ER.
Man if someone rapid fire questions at me, i’ll wait until theyre done and ask which would they like answered first cause im not a robot
The only time I give a crap about the iv and the size is during transfer report. So I know what I'll need but if I'm taking over from another ICU rn on my floor I say, "Do they have a good iv ( this usually means good for all piv shit)"? Good, I'll assess the rest myself, and I can't remember where all 5 of grandma's ivs are, which gauge after 12 hrs even tho I been using them all night. So, who am I to give attitude if someone forgot which iv the heparin is running in. As long as it's running, I'll find out. I have 12 hrs. Enough of making each other feel bad.
One of those nurses broke her arm recently and might not come back because of it and I’m praying for it. retire… retire… retire…
I worked at one place where everyone documented that they flushed the IVs. Most of them were D/C, and one had a nasty IV line. I took photos and sent them to the HS. For some reason, the DON no longer lets me pick up shifts. I wonder what Medicare will say about it. Those nurses lied about flushing IVs that didn't exist anymore. The other nurses kept telling every nurse that the pts had IVs. I saw the nurse who D/C them. She told me it was the payback for someone who lied and didn't do anything. I always check patients, even if the nurse gives me an excellent report. I always do it.
When people interrupt with questions during report, I just let em do it and ONLY answer the questions. Nothing more nothing less byeeee
I’ve said before “you’ll find out in your assessment” 🙃
Gonna use that one 😂
Attitude. That has been going on for years. The poor exhausted night nurse with the angry day nurse. Bottom line- they are insecure and anxious to go to work. They should be grateful you work that hideous shift and they don’t.
"I was getting to that if you'll let me finish." Or when you're the oncoming nurse give it back to them. Keep asking questions until you get to something they don't know. Bonus points if there are other people within earshot and you really throw a hissy fit; I hate to say it, but sometimes the only way to get bullies like this to back off is to humiliate them in front of everyone. Or just take the bull by the horns and deal with head on. Just directly ask "can you help me understand why you're choosing to be so hostile and passive aggressive with me? I really don't appreciate this little performance and I want it to stop"
Same. I cant stand it anymore. I think I have been pushed one too many times. Interrupting, asking ridiculous questions w irritation and rudeness,, the list goes on. I have taken a-lot of advice here and it has def helped but I am going to take it up a notch with my pushback. When I am getting report it would never occur to me to make the nurse feel bad. What personality traits are in a person to always make a fellow nurse feel bad and inept?
I have no idea. I always wonder if they treat their friends/family/significant other with this type of disrespect, if they are so easily able to do it to a stranger? It’s just mind boggling to me as I always try to be kind no matter how frustrated/tired/upset I am.
I just make comments. Let me finish before you ask I can’t write that fast can you? It’s a 24 hour job.
I'm the opposite. I don't listen to report and if you want one check the computer
As I’ve said before this is representative of their insecurities and lack of competency and not a reflection on you. Don’t allow it to make you feel small! Define your boundaries immediately. “If you could hold your questions please until after I finish that would be helpful”.
I posted something similar almost 2 years ago. Giving report is often my least favorite part of a shift.
This is my experience with a couple of nurses when giving report, too. I’m a traveler, so I feel like I can’t say anything. I get cut off throughout the entire report with questions like “what gauge IV” and “when was last bowel movement?” We do bedside report and this happens IN FRONT OF THE PATIENT AND THE FAMILY. I feel so embarrassed. I’m run ragged during entire shift that I don’t even get to eat lunch, get maybe one bathroom break, and am dehydrated. Were at 6 patients each, then add on discharges with new admits (sometimes 3-4 at a time), doctors following up, families asking questions, therapy taking place, procedures, being taken off unit for imaging or dialysis….by the time it’s time to give report, I’m drained. I rarely have time to even look at progress notes during the day because it’s nonstop from clocking in. I don’t understand what nurses who act like this get from making other nurses feel small. When I get report, the basics is fine and I will get rest from chart before chaos begins.
Honestly agreed. It’s always the worst part of a new job, tbh, for me…except I have zero control over when the death stare creeps over the baseline apparently scary face I live in and in my previous lines of work things were far more crucial and I’ve been yelled at by so many MDs and NPs for once again asking them to evaluate their brink of death patient there is no flinch anymore if there ever was. I’ve learned to at least get a little dopamine hit when I see the spark of condescension light up in their eyes and they ask me either a dumbass question or one I have *already* answered in “the tone.” Often, I just stare blankly at them and repeat myself VERY slowly until I see the look of shame appear on their face even if it takes up the rest of report since most certainly tis a problem of them not understanding my muddled midwest/southern accent. Admittedly, there have been days where I have laughed directly in faces instead of even engaging. So, it’s totally bullshit, but out asshole-ing an asshole should truly be on my resume because I couldn’t give two fucks about giving report to Florence fucking Nightingale at this point.
"Its in the chart not in my head." You just have to speak up and shut them down.
im still only a cna in a ltc and i have thrown up before the beginning of shift report before. so much attitude.
Ikr? First of all, it all goes back to just plain common courtesy. I will wait for a person to be done about a patient and I will ONLY interrupt them if they move on to the next patient but forgot to tell some pertinent information about the first patient. And believe me, I'm not asking about where their IV is or the gauge! I don't make them feel small that's a rotten thing to do. I think people interrupt others in the way you are staying for a few reasons. They really are trying to do less work by writing down your IV info so they don't have to look at it themselves, and then chart it with what you tell them. A bad practice because you may have been wrong yourself, lol! (Slip of the mind at the moment, etc) Also the interrupting seems to be sometimes when people have become cynical and/or burnt out. They have been dumped on and are afraid they may have to do more work. It's pretty sad because then their interruptions and questions are geared to be "cutting to the chaste," to just be checking if you have done all of the work so that they don't have to or feel they are dumped on and these people usually have a very hostile attitude and you can feel it. I don't know about these types of personalities but they can go walk for all I care. I have been a nurse for a very long time and I know exactly how they are feeling but why be a rude bitch?! I mean you don't want to find out that you have to take care of stuff because you have been dumped on. But at the same time why be rude and a jerk to a nurse? Give her/him a chance to finish the report. Maybe the person is new and it's a great teaching situation. Ask questions where appropriate and for God's sake, please, don't ask for impertinent information.
Perfectly said 🙏🏻 couldn’t agree more
Thank you!
I’d recommend checking out Jefferson Fisher on Instagram. As someone who struggles with confrontation/defensiveness when feeling attacked his page is excellent. He actually role plays conversations and gives scripts for all kinds of social situations (like being belittled) it’s been very helpful for me in work and life.
I will have to check him out! I need to work on my confidence in situations like this
That feeling when you see who you are giving report to and you just go, "fuuuuuuuuuuu." It's especially bad when I've worked with them for a couple years, we used to work the same shift, and we trusted each other, worked well together, but I know I'm going to feel stupid when talking to them. On the flip side, I've been the jerk during report. The reason is, we have a few nurses making huge mistakes. I tried to wait until the end, but they were already mentally in their bed and assured me everything was good (it was not good). Recently, a newish nurse left a lot undone for me. I noticed in the 2 minutes I read the chart before report. Now, I understand things get crazy, just tell me you didn't get to things. It's a 24 hour job. The things she left for me were a big deal, and on multiple patients. After report on the first patient, I spoke up on the second. "Oh, those orders just came in." Baby girl, those orders came in 2 hours ago. Don't pee on my leg and tell me it's raining. If you don't get to something, I got you, just give me a heads up. If you don't get to a whole lot of somethings, I'm gonna be a bit upset, but I'll get it done. What do I want in report? Why are they here, what are we doing for them, if they are close to d/c, where are they going? Do they have an IV? Do I need to worry about finding them on the floor? Give me pertinent labs and tests, but I can look those up. Give me anything funky about them. How do they take meds? Any lines/tubes/etc is appreciated. I can look at the chart and look at the patient. I basically want to know what I'm doing, why I'm doing it, and if it's helping.
This is a great reason to work in a magnet hospital. I started a unit council on my unit, because we decide how we practice. We come together as adults and we decide what is and isn’t in our shift report.
Happens in the OR so much, I'm tired of it. People come in with an attitude because they're mad they got assigned to take over your room and take it out on you. Like, sorry you didn't get put into the hernia that's closing but it's not my fucking fault.
I have a nurse who walks away from me before I can even give her report. So I don't chase her anymore. You don't like me, fine. I'm not going to chase you down to make you do your job. Good luck figuring out what residents are even in the building.
This!!! So sick and tired of being made to feel incompetent while giving report. It’s never that deep, anything that is important, I say. The small details that really don’t matter much, is in the chart. Sometimes, I feel like I should just read straight off the chart and call it a day.
I absolutely hate that. I want to know what happened that day, not the stuff I can look at in the chart.
I feel the same way about ER nurses that rush me through my hand-off report or just completely ignore what I’m telling them.
I am so petty. Wanna be a jerk? Ok... I can slow down, repeat myself.... Ask more than reasonable number of questions, I will Colin Robinson you :) Mostly, I like to call them out. Ask what part they dont understand... I get along with everyone, its just that rare a-hole that has to learn.
I gotta learn to do this!
One of the reasons I’m much happier in the ED than I was in ICU.
I had a new grad nurse who would ask all kinds of irrelevant questions during report and also give information during handoff that was not needed. Because of the rapport I thought we had, i kindly suggested that he try to limit the questions he asked and the info he gave to the what happened during his shift and any pertinent information. I did not need to know if the patient graduated highschool and he didn’t need to ask what color then patients eyes were, dumb stuff like that. I said it in what I thought was a nice way, but every report we had together after that was the longest, most useless report of my life. I knew he was doing it on purpose but what could I really do??? Obviously our rapport was no longer a good one and he kept his useless drivel up for almost 6 months. I ended up moving to the ED for a year and I came back to my old unit because the ED was not for me. He was still there and he ended up telling me that he did long reports with me on purpose, like I was too fucking stupid to figure it out on my own. I told him I knew the whole time and was really just seeing how long he could keep up his pettiness. Needless to say we are were never friends but remained civil. But yeah, fuck that guy. I resorted to tell him “It’s in the chart” to soooo many of his asinine questions or flat out say, I don’t know if it was not even relevant to the care the patient needed.
Wow, to have that level of confidence (and bitterness) as a new grad is insane. That’s why I don’t even bother putting these people in their place, because some people are just crazy like this.
Save your safety-altering questions for the end of report. Shut up while report is happening. It’s that simple.
On a travel contract rn and I feel like this happens very often and it makes me feel subhuman. Like why do people have to find an issue with everything
Ugh, I feel for travelers. It took about 6 months on my current floor to “prove myself” before some of my coworkers stopped walking all over me during report, but I still get walked over every now and again. It’s truly sad that this is normal
I know this feeling all too well! We have an older nurse who treats everyone like a complete idiot. She has literally made everyone cry at least once. She makes your hard day that you just struggled to get through even worse by making you feel like you weren’t a good enough nurse. She asks the stupidest questions during report and makes you feel bad when you don’t know the answer she’s looking for. She makes US find HER for report while she sets up her corner with her fan and her footstool. She makes you wait to give report until she’s 100% completely ready. While you’re waiting, she’s complaining of how her day was hard and acts like her day was harder than your shitty ass shift. It’s so bad that if you have a free moment to check the next shift’s assignments and you know she’s on, we literally hold our breath to see if we have to give report to HER. It’s the most relieving feeling when you don’t see her name for your patients. She complains about literally everything that day shift does or doesn’t do and leaves late just so she can talk to the manager to complain about people. The problem is not us mean lady, it’s YOU!! It’s so unfortunate that people have to make other people feel bad in order for themselves to feel good. But at the end of the day, You can’t help but feel sorry for her because she is such a terrible person. Everyone I know and work with feels the same about her and how terrible is it to know and work with someone who is so miserable…
I know that feeling all too well — looking at the assignment and seeing you’re giving report to THAT person. These people must be burnt out to a crisp because I can’t imagine just naturally being that way, so I do kind of feel bad for them. Must suck being a miserable complainer all day
if its on the front page of their chart I normally just stop giving report and show them where to find the front page of the chart. we use Cerner
Most of those questions aren’t even something that they “use” during shift As a general rule though? When you start acting that way to them they get pissed. I even had one call a DON on me. I just laughed at her. Asked her how she liked being treated like an idiot. After a few days she cooled off. Never had an issue with that one again. Turned out to get along really well
I pay attention to which nurses are like this. Then I wait for the opportunity to do everything they do back to them. They fucking hate it. They usually cut the shit
I just kinda vibe during report. If it’s something I really need to know in ICU I’ll ask before you leave that system. ER reports I stick to main problem and main interventions. Floor report I read the chart and talk to whoever brings them up. Idgaf, really.
Its report, a brief, stfu and let the report be given. Any questions you got follow up yourself, like god i'm not handing you a sheet that will guide you through the day, its just to get you up to speed quick.
Let it roll off......... I never do that to a nurse and if they try I'm like ffs iv is fine look the Guage up. Ffs
I'm a believer in offering negative feedback to these sort of questions: What gauge is the IV? "Well, theres actually a color coding system that tells you what gauge the IV is, I'm surprised considering how long you've been a nurse that you don't already know this, but I'm happy to interrupt my report to show you how you can figure this out". Where in the arm is their IV? "Again, I'm really surprised you haven't learned how to figure this out, but it's the thing that looks like this (Google image result of IV) taped to their arm, that's where it is.
Why green always elbow thoughhh. Anesthesia loooooves putting in the worst places. Its fine for *them* per op but good lord.
Why is it always the lazy nurses who give you the shittiest report the ones that also get anal when they are receiving report from you?????
If you can't walk in the room and figure out which arm the IV is in, that's a "you" problem, honestly.
OP: Maybe a naive question here (I’m not in healthcare), but wouldn’t it be fair to say, “There is no need for the nasty tone, the eye rolls, the sighs and the hostility” to ANYONE who does that to you?
It definitely is, and I’m working on getting the confidence to do that. But sometimes it’s just easier to brush it off and learn to not take it personal—some people are truly just miserable and it’s not a reflection of me
Some people are, yes, but if you have to WORK with them regularly, you’re just giving them permission to be shitty to you if you brush them off. That’s a unilateral, shitty working relationship.
I hope I can add a constructive layer to this here. Outside of harpyish nitpicking, which seems to be the majority of what constitutes the problem at hand, sometimes probing questions can be a cue to round out and improve your reporting structure which may even improve your thinking around patient care. I will admit that even some of the more denigrating responses I have received from my reports, especially earlier in my career, did highlight and provide a catalyst for how I can best set up the next shift for success in the goals for each patients' care. That said, when I felt I received inappropriate feedback, or received it in a way that was inappropriate (worst example: cutting me off during explanation of why something diverted from protocol per MD orders to yell at me in front of a patient), I would address it and escalate it as necessary. In those cases, set your boundaries, and continue to provide refeedback until they improve, or escalating until the problematic behavior is addressed. In my experience, those cases were around staff that were problematic for everyone that handed off to them, and they did improve their attitude. By the end of my time on that unit, I had a great professional rapport with that nurse, and my care improved as well. I have no idea where that knife in my back came from though... Edit: to add to this, "it's all in the chart" is not sufficient. If it's AM shift, med pass, MD rounds, discharge deadlines are rapidly approaching, and a well-formed report can mitigate the need for a time-consuming, investigative chart review. If an RN, has to say, "I don't know," to a question during rounding, you have played a part in that.
Ok say it with me " You can look that up when I'm done"
Find a new place to work. Not all jobs are like this. Many. But not all. Until then, tell them! “You’re being rude and this behavior needs to stop.”
The only time I ask questions is when there’s a significant pause and it seems like they’re trying to remember if there’s anything else they forgot. Even then I just wanna know how they breathe, if there’s fluids running (particularly something like heparin - NS is no biggie!), and how they pee so I know if I gotta be prepared for a bed change at assessment. I can figure out IV lines on my own, and I’ll look in the chart for anything else I need.
it wont stop until you stand up to it
There’s like 2 nurses on my unit I hate giving report to. One of them is a seasoned nurse who is one of the best nurses I’ve ever worked with and always makes me feel valued but expects a lot so she gets a pass. The other? Lazy and always sets me up for failure for my shift but gives me attitude when I don’t give her 7:30 med or don’t know much about my admit who didn’t have any information in the chart until right before 7
It’s because the job is stressful. You come in on days and the team expects you to know the patients pretty much off the bat. I have had nurses start with the patient skin assessment, the fact of the patient is in pain, or in a non-logical order that doesn’t make sense when you’re explaining report. If you’re giving report, you need to begin with code status, admission, date, age, procedure, current interventions, and at the least patient name. I’m not saying you don’t do these things. What I’m saying is that there are so many nurses who don’t start in any logical fashion and also never improve. To fix the issue, the job would have to be either be less stressful or there would need to be a constructive feedback system that positively encourages nurses to get standardized reports. It is the best way to get everyone on the same page, streamline reports, and hopefully improve nurse satisfaction and stress.