Ugh... ER bullies.

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Chanandler Bong

That's "MISS"
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So, tonight I actually had a nurse tell me, "Don't check on my patients anymore." Flat out, just told me not to do the biggest portion of my job (a tech actually introduced me to another nurse as "the best volunteer we've had so far" BECAUSE I "actually check in on patients").Told the chief nurse and he put her in her place, but I foresee drama in the future... ARGH. :mad:

How about you guys? Anyone else have to deal with this kind of BS? Does it go away? Right now I'm of the mind that I will not avoid this person and her patients and thus let her "win," but correct me if this is somehow wrong.

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Tread lightly my friend. Someone once told me that "nurses are the only species who will eat their young to save themselves". They can make or break you. They can have more power than you think.

If the chief nurse if on your side, cool, but I would not as a volunteer engage or go out of your way to make this person totally hate you. Do what you are there to do, let the chief nurse take care of her, and do your best not to make anymore waves than you have.

Trust me, even as an attending I still have my run ins with nurses who totally hate me for no reason. Gotta pick your battles and when they are taking care of your patients, many times it's easier to bend for the sake of the those at their mercy than fight every day.

Just my two cents
 
I appreciate your advice, and (thankfully) none of the other nurses seem to feel this way about me and are glad to have someone to check in on patients so they don't have to.

Unfortunately, I'm required to talk to this particular person if I check in on her patients and they want something: I'm not allowed to give them anything without permission. Head nurse said to avoid her just for the night, but made a point of telling her "that's what volunteers do." It's either make waves or ignore all of her patients (which was half of the ER today)...
 
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Just do your best, she is probably threatened by you in some way because you are trying to get into medical school. I got that type of flack from nurses at work as soon as they found out I was trying to be a doctor. You will find this all along your journey, it is only the beginning.
 
I appreciate your advice, and (thankfully) none of the other nurses seem to feel this way about me and are glad to have someone to check in on patients so they don't have to.

Unfortunately, I'm required to talk to this particular person if I check in on her patients and they want something: I'm not allowed to give them anything without permission. Head nurse said to avoid her just for the night, but made a point of telling her "that's what volunteers do." It's either make waves or ignore all of her patients (which was half of the ER today)...

You're a volunteer. She's a nurse. Do what she tells you. I'm sure you can work this situation into an interview question answer somehow.
 
If the chief nurse put her in her place, I'm assuming that means you can visit her patients again, correct? Well, at this point you have what you want so I'd let this battle stop there. just keep everything on the straight and narrow around her in the future because she sounds like the type to carry a grudge. She didn't happen to give you a reason why she wanted you to stop seeing her patients did she?
 
What she said to me was, "There are too many people checking in on them. They're confused." I've had people ask me to leave people alone before and give reasons ("Pssssssst, stay out of 14, she's not very nice right now," that sort of thing) but this was just confrontational.

What she said to the head nurse was something about pain meds. Honestly, looking back, I think she was annoyed at her med-seeking patients or something which made her annoyed that I was asking her things -- but this is conjecture, not something that was actually said outright.

I can technically see her patients, yes, because you are not "allowed" to tell a volunteer not to do their job for no reason. But it is something she doesn't want, and would require me to constantly ask her permission to do, and could result in her being petty at every opportunity and encouraging others to do the same, regardless of what is "allowed."

Apologies if this seems obvious. It's not to me. I'm not good with playing people's ridiculous games, and it is frustrating to have TWO higher-ups request entirely different things.
 
Well if your job is to visit patients, and the patients enjoy and/or benefit from your visits then I'd continue to visit them regardless of whether or not you're bruising someone's ego. Its not about you, its not about some woman's pride or problem with you. It's about the people in the beds. Just keep doing right by them and I'd be willing to bet you'll end up on the better side of any problem this banshee of a nurse cooks up.

cj8
 
You do realize that as a volunteer, you are at the bottom of the org. chart, right?

If the nurse is asking you to leave his/her patients be, then obviously it is causing more trouble that it is worth. If you are truly there seeking to help, then find other ways to help. If someone tells you that something you are doing is not helping, and in fact confusing patients, then stop.

Also, the part about "not wanting her to win" and forcing a confrontation by checking on that particular nurse's patients, simply to prove a point, doesn't exactly scream "team player."

You are a hospital volunteer with a primary motivation of building experience towards getting into medical school. Consider yourself lucky that you are there and don't rock the boat. Seek out staff that are more willing to let you be involved, and avoid staff that are more adversarial. Getting into disagreements and confrontations serves nobody's better interests.
 
Tread lightly my friend. Someone once told me that "nurses are the only species who will eat their young to save themselves". They can make or break you. They can have more power than you think.

If the chief nurse if on your side, cool, but I would not as a volunteer engage or go out of your way to make this person totally hate you. Do what you are there to do, let the chief nurse take care of her, and do your best not to make anymore waves than you have.

Trust me, even as an attending I still have my run ins with nurses who totally hate me for no reason. Gotta pick your battles and when they are taking care of your patients, many times it's easier to bend for the sake of the those at their mercy than fight every day.

Just my two cents



OK. I am a RN. Have been one for quite some time. Not all nurse are like this. . .trust me. But those that are. . . watch out! They can make your time there miserable if they want to do so. It's wrong, and it's sucks, and it does more harm then good on the whole of things, but it is what it is. Nurses do eat their young (even though those in higher up places or in administrative ivory towers hate the use of that expression--I feel it's b/c they don't want to deal with the reality of it.), or whoever they feel is a threat somehow. Seriously. Some will get you for being too attractive or charming. Some will get pissed at you for being too smart. Some will get you for being a patient advocate. And some just like to think they are big crap and push others around when they can get away with it. Again, please do not think all nurses are like this.
Unfortunately there can be enough of them to make it feel that way sometimes. Sometimes these people need to be reminded --if the hospital is a teaching facility. Some need to be reminded that we're all supposed to be on the same team. And some don't give a crap about any of that and are more of a PITA than a number of troubling patients. Be sweet and try not to be resentful. Eventually a good portion of them will come around. But jump in when you can, just be careful about it. It's a hard thing to juggle.

Also, there are some nurses that are just super protective of their patients and their level of accountability. Those folks haven't learned to be flexible yet. They may not be total biatches, but they just can't seem to let go of control or being as overly controlling as possible. And some haven't learned that not everything is worth making a big crap over or battling over.

But yes, the nurses do have to protect their patients, and they can be part of the system of checks and balances. Things do get missed. . .more times that people think or want to admit. An astutue and experienced nurse can save the patient's arse and yours, believe it or not. But that doesn't mean they shouldn't take your volunteering and future goals seriously. I think it's a confidence-building thing. Maybe I'm wrong. IDK. Seriously. I just think people have to be groomed and supported in the role they are growing into, rather than undermined or discouraged. But then again, I have a different approach as an adult educator compared with some that are pleased to treat others as children. These folks know little about supportive learning for adults. But I also just realized something. You posted as a pre-med and not a med student. That's even more of a step from outside of things.

Anyway. Good luck, and don't give up. You don't have to kiss arse. Just try to figure out the dynamics--is he or she really worried and being protective over his/her patients--or are there other issues afoot? How can you soften the relationship for the benefit of everyone--win/win?

Final thought that reflects what others implied. OK, if a patient gets worked up, overstimulated, a ton of things, there are times when more people do make the situation worse, even thought those people aren't trying to make it so. Now, who do you think has to deal with calming that patient--especially when they have a boatload of other patients for which they are responsible? The nurse. You yourself said she had half the ED pts. Don't know what that's about, but people that don't work the role of the nurse is such situations really don't realize how overwhelming and demanding the job can be. Being a nurse is worse than playing educated waitress and politician. You have to deal with and please multiple disciplines, families, and patients all at once. It can be a huge pain in the butt job for more reasons that I have time to discuss.

OK, an overly simplified example would be going in and waking up an irritable baby that took a good chunk of time to sooth and get to sleep--and the nurse still has 10 or more pts to deal with--some of them much sicker than the irritable baby--or the irritable baby may end up being a trainwreck straight out of the blue. On top of that, there is a TON of customer service stuff that nurses have to incorporate nowadays. It may often be a good thing, but it can definitely add extra burdens to the nursing staff. Remember, these nurses are not supposed to be glorified nurse's aides. They have to deal with patients on vents, transvenous pacers, traumas, people on vasoactive drips and drugs--there are many things to deal with for many patients--all of which have to be monitored and documented to the standard of care that is demanded.

I don't know if this person was a bully. I DO know that I've worked with a number of nurse bullies. Their approach and attitude suck, and there is no excuse for it. But as long as a nurse has legal and professional responsibility for her/his patients that are within his/her scope of practice, you have to take that seriously. Some volunteers want to be nice and give and do things that are really medically contraindicated for patients as well. There is no way an ED physician can hang with the patients as much as a good nurse can-- that is, when he or she is not overworked or working with poor nurse-to-pt ratios or major crash scenarios. So, the nurse does have a level of protector/advocate--and he or she also has to deal with the patient's problems--and needlessly adding to them, regardless of how inadvertent or well-intentioned, can be a problem--for the pt, the families, other pts, and the nurse/nurses/docs...etc.

Stand back and look at it again from outside yourself. Yes. Maybe that person is a bully, maybe not, or maybe it's some combination of things and factors. I agree with the other person above. The us versus them mentality is almost always counterproductive.

This is from someone lower on the totem pole--but not weak about it. Everyone knows a good structure involves a sturdy foundation. ;)
 
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So you went over her head to her boss and got her in trouble?

Yes, your problems are all solved and you will face no retaliation, whatsoever.
 
The only reason to be a tryhard volunteer is if you're going to get a LOR from the place. Otherwise, sit back, relax and enjoy your shift/break. You have the rest of your life for real patient contact. Volunteering is just a checkbox you need to tick. Any and all skills you learn in the ER will be worthless when you actually start medical school since the doctor-patient relationship is lightyears away from the volunteer-patient relationship.

Pull up a chair in a corner, grab a book and relax. Do what you are told, nothing more nothing less. You are a volunteer in the most litigious society on earth in the most litigious place on earth. You should be lucky you can even piss in the same toliet as the patients.
 
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Hearing the way nurses have been described in this thread and other places reminds me of my years at the refinery in which I used to work, but in that case it was the Operators.


Empowered by a Union that will protect them at any cost from all discplinary action resulting from carelessness, insubordination, and outright incompetence. "Cover ups" were common and expected. All "company" employees were seen as a threat, a figure that might hold them accountable, someone that might demand that they be diligent, thoughtful, and competent. Education and technical skills were scorned and dismissed. Day to day productivity became bogged down over ego bruising because they can and will make life "miserable" on their units for the technical folks. Generally this attitude was unwarranted because it stemmed from an imaginary idea that the technical people viewed the operations people as inferior. When in fact, the only time that idea took hold was when operations did not do as they were instructed by techical, out of spite, resulting in some form of failure. Now this was not each and every operator, this was however the prevalent "culture" of sorts.
 
Hearing the way nurses have been described in this thread and other places reminds me of my years at the refinery in which I used to work, but in that case it was the Operators.


Empowered by a Union that will protect them at any cost from all discplinary action resulting from carelessness, insubordination, and outright incompetence. "Cover ups" were common and expected. All "company" employees were seen as a threat, a figure that might hold them accountable, someone that might demand that they be diligent, thoughtful, and competent. Education and technical skills were scorned and dismissed. Day to day productivity became bogged down over ego bruising because they can and will make life "miserable" on their units for the technical folks. Generally this attitude was unwarranted because it stemmed from an imaginary idea that the technical people viewed the operations people as inferior. When in fact, the only time that idea took hold was when operations did not do as they were instructed by techical, out of spite, resulting in some form of failure. Now this was not each and every operator, this was however the prevalent "culture" of sorts.


I would say this can kind of be the issue for some, certainly NOT all, or even most. The latter depends on the overall culture of the unit or area and how much leadership turns a blind eye to it, supports it, or stands strong against it. It all depends. I have worked with some great crews of nurses and doctors, where the pts were pretty darn critically ill, and that made the job stressful, BUT people generally worked together. So it all depends.

Places are taking more of a stand against lateral and horizontal violence b/c it can contribute to needless errors. Joint Commission and others have made statements about this kind of thing. Today, if there is bullying, it is usually more covert. That doesn't make things better--just makes things harder to prove. But don't generalize that all nurses or hospitals or units are like this. People can get stressed in healthcare big time. Doesn't justify bad behavior, but it can help in undrestanding it. Most nurses and docs that I have worked with are truly caring people. All people have flaws, issues, or are somehow complicated. Can't throw baby out with the bathwater. So generalizations don't tend to help.

Some nurses hate July, when med students come in and start functioning as PGY1 residents. I always liked July. It depends on your perspective, and some of the nurse negative attitude is exaggerated, b/c there is a structure in clinical medicine, and these people have residents and/or fellows to help or shepard them. Bottom line is people have to work together, period.
 
The only reason to be a tryhard volunteer is if you're going to get a LOR from the place.
That had been the plan, so I was initially more inclined to follow the head nurse's directions.

So you went over her head to her boss and got her in trouble?

Yes, your problems are all solved and you will face no retaliation, whatsoever.
Yeah, exactly. And that's why the more I think about it, the more I think I should just avoid this person for a while. Maybe not forever, but a while.

I really don't like it, but all of you who said it would cause more conflict to do what I'm there to do are probably right. I survived last night, so there are things I could do avoiding half the department. Glad I have 70+ more hours of this nonsense.
 
Yeah, exactly. And that's why the more I think about it, the more I think I should just avoid this person for a while. Maybe not forever, but a while.

I'd just do what she asked, and stop checking in on her patients. I know you mean well, but she actually has responsibility for these people, so you should be polite and follow her orders, even if she wasn't polite about it.

Our volunteers were helpful for stocking and making sure we had appropriate inventories of some things, but since they didn't have any training and weren't allowed to touch a patient, any patient contact they had would likely create more work for the staff. If you ask a patient if they want something to drink, a blanket, or if their pain is under control, you're going to have to come out and bring it to the staff's attention, who then has to deal with it.

It happened a number of times with one of our social workers (an experienced and well-trained employee, not a volunteer): she'd see a patient, and being a very pleasant person, would ask if they wanted all kinds of things to be more comfortable. Sometimes it wasn't appropriate for that patient to be receiving whatever had been offered, and then it fell on the nursing staff to go in and refuse. It occasionally riled up a previously agreeable patient who had been carefully handled to avoid such a situation.

Or maybe the nurse was just irrational and dumping on you because she's a sub-par human being. Either way, there doesn't seem to be anything to gain from going against her and telling on her. You're there to make things better for everyone, so help those who want your help, and respect the requests of those who are paid and trained to do the job.

As a general rule, try not to go over people's heads unless there's a patient safety or privacy reason.
 
That had been the plan, so I was initially more inclined to follow the head nurse's directions.


Yeah, exactly. And that's why the more I think about it, the more I think I should just avoid this person for a while. Maybe not forever, but a while.

I really don't like it, but all of you who said it would cause more conflict to do what I'm there to do are probably right. I survived last night, so there are things I could do avoiding half the department. Glad I have 70+ more hours of this nonsense.

Dude, get over yourself already. You are there to follow the directions of literally everyone else in the hospital, no matter what the pamphlet they gave you at orientation says. Put the gun back in the holster.
 
I'd probably just stay away from that nurse's patients. It's just not worth it.
 
I'd probably just stay away from that nurse's patients. It's just not worth it.

I'd also adjust your attitude. To be frank, your position does not matter. At best you're reducing a bit of busywork for a tech - you are not vital, the hospital will run without you.

You need to learn to be a bit more humble.

Hospitals are very hierarchical places. Do stuff like this when you're a med student on rotations and you will not be happy with the outcome.

You've got to work with people, not against them, unless you witness something that is truly dangerous that affects patient well-being.
 
I'm having a hard time seeing the bullying scenario. Which, to me is taking ****, both capricious and purposeless, when a power disparity makes rectifying your dignity, improbable to impossible.

You don't work there. You're there for an LOR or to say you were, free to take your leave whenever the cost effectiveness of the endeavor doesn't add up.

The RN is performing an essential function. And has to execute the domain of his/her license. If deemed a hindrance, remove yourself as indicated. If told by their supe to do the opposite then do that. If back and forth like a ping pong ball, then bounce like a mf'er.

I say this hating bullies. Having been bullied by nurses more times than I can remember. Entering a system of training that celebrates the bully. That romanticizes and praises the bully. That does nothing of consequence to prevent it.

You're like....a new inmate asking to speak to the manager....about the dreadful quality of the food in the prison mess hall.

That over there to your right is your own splenic flexure. As you proceed to your left notice the change in blood supply from the inferior mesenteric to superior....
 
You do realize that as a volunteer, you are at the bottom of the org. chart, right?

If the nurse is asking you to leave his/her patients be, then obviously it is causing more trouble that it is worth. If you are truly there seeking to help, then find other ways to help. If someone tells you that something you are doing is not helping, and in fact confusing patients, then stop.

Also, the part about "not wanting her to win" and forcing a confrontation by checking on that particular nurse's patients, simply to prove a point, doesn't exactly scream "team player."

You are a hospital volunteer with a primary motivation of building experience towards getting into medical school. Consider yourself lucky that you are there and don't rock the boat. Seek out staff that are more willing to let you be involved, and avoid staff that are more adversarial. Getting into disagreements and confrontations serves nobody's better interests.
Read this post again, OP, because it's excellent advice. This nurse sounds like a total tool, but keep in mind that nothing you do as an untrained volunteer is necessary for patient care, while her role is essential. Definitely steer very clear unless you're able to befriend her and obtain her support.
 
I worked in an ED for 3 years and confrontations like that happened all the time. An ED is a stressful work environment and tempers flare. Don't take it personally or too seriously, and definitely don't make it into a win/lose game. As others have said, move on and continue to get the most out of your experiences there. :thumbup:
 
As a volunteer there, it's probably not in your best interest/your place to be stirring up trouble. If she doesn't want you doing something, don't. It's her job, you're just a volunteer there. Tattling on her and causing trouble is just a poor choice imo.
 
As a volunteer there, it's probably not in your best interest/your place to be stirring up trouble. If she doesn't want you doing something, don't. It's her job, you're just a volunteer there. Tattling on her and causing trouble is just a poor choice imo.

As a med student, resident, and even attending, it's never a good idea to piss off the nurses without good reason.
 
You are there to follow the directions of literally everyone else in the hospital... Put the gun back in the holster.

:thumbup:

And regarding people who are rude and/or trippin'...

Keep-calm-and-kill-people-in-your-mind-dreamymuffin-31211270-300-342.jpg
 
:thumbup:

And regarding people who are rude and/or trippin'...

Keep-calm-and-kill-people-in-your-mind-dreamymuffin-31211270-300-342.jpg


lol Wow. A bit extreme for me. That's giving messed up folks too much power and permission to live in my mind. But I hear you. Sometimes it's like you want to gag certain nasty people and lock em in a closet. See but I don't engage in road rage either. It's giving some problem child too much power. Why make his problem my problem. . .I mean more than I have to. Ain't worth it.
 
Jeez-louise. I suppose it's good to know I'm coming off so terribly to some of you. (Definitely not my intent to be arrogant, for the record: I'm simply frustrated. I haven't volunteered in a hospital before, so the way of doing things is brand spanking new to me. I'm the first volunteer they've had in ages, so there's no one to emulate.)

A couple of friends suggested that I apologize to the nurse. Would this be helpful or harmful?
 
Jeez-louise. I suppose it's good to know I'm coming off so terribly to some of you. (Definitely not my intent to be arrogant, for the record: I'm simply frustrated. I haven't volunteered in a hospital before, so the way of doing things is brand spanking new to me. I'm the first volunteer they've had in ages, so there's no one to emulate.)

A couple of friends suggested that I apologize to the nurse. Would this be helpful or harmful?
You could try. It's might be worth it if you think she was just having a bad day as opposed to being an Axis II personality. But keep in mind that she probably forgot this whole incident about five seconds after she told you to buzz off, while you're still perseverating about it days later. I wouldn't go crazy with apologizing.
 
Jeez-louise. I suppose it's good to know I'm coming off so terribly to some of you. (Definitely not my intent to be arrogant, for the record: I'm simply frustrated. I haven't volunteered in a hospital before, so the way of doing things is brand spanking new to me. I'm the first volunteer they've had in ages, so there's no one to emulate.)

A couple of friends suggested that I apologize to the nurse. Would this be helpful or harmful?

I gotta joke that you should tuck away:

What the difference between a pile of **** and 3rd year medical student?

Nobody goes out of their way to step on a pile of ****. And the pile of **** doesn't say thank you.

So perhaps harshly the attempt was to calibrate your expectations not to denigrate your personhood.

At least you don't pay a 1000$ a week to attain this level of uselessness.

Welcome. The point being...you might get shanked anyway but don't increase your odds.
 
The only reason to be a tryhard volunteer is if you're going to get a LOR from the place. Otherwise, sit back, relax and enjoy your shift/break. You have the rest of your life for real patient contact. Volunteering is just a checkbox you need to tick. Any and all skills you learn in the ER will be worthless when you actually start medical school since the doctor-patient relationship is lightyears away from the volunteer-patient relationship.

Pull up a chair in a corner, grab a book and relax. Do what you are told, nothing more nothing less. You are a volunteer in the most litigious society on earth in the most litigious place on earth. You should be lucky you can even piss in the same toliet as the patients.

As a RN I agree 100%!!
 
This should not be an issue at all. Use your people skills and solve this problem naturally! Don't be afraid of the nurse and don't back down like a scared toddler - instead, knock her over with assertive kindness. Something sort of like this:

"Hey Nurse. When you get a free second, can I talk to you?"
"Um, ok, what do you want, Volunteer?"
"The other day, you told me to not check on your patients....is there anything I did wrong? Is there anything I can change so I can help out with your patients in the future? I'm new at this and I know you're busy and I don't want to ever get in the way - but I would really love it if I could work with you in the future. I value your opinion and I'm amazed at how you are able to balance the workload - I just want to make sure we didn't start off on the wrong foot - what can I do to improve?"
"Um, well volunteer, why don't you wait until just after I do the initial vitals and blood draws but before the doc comes in to see the patients. That oughta work."
"Thank you so much! If I ever get in the way again, I won't take offense if you yell at me to move out the way!"

If she still tells you to go away, well, at least you tried and directly confronted the problem in an assertive, respectful manner rather than running and hiding or going behind her back to her superior in a passive-aggressive move. She'll know that at the very least you aren't a pushover - if she senses fear in you, she just may eat you alive to feed her own power trip. Nurses know when they are being mean, and I've found that directly asking how you can improve and work well with them in the future suprises them and they'll bring their guard down, and who knows, you might end up becoming buddies with the nurse. (As a resident, you might not have the time to play this game and will probably just ignore the problem and hope it goes away on its own.)

Think of this as a test. You WILL get asked in residency interviews and probably medical school interviews about "tell me a situation where you had a conflict with another professional and how did you solve this problem?" You will have the perfect answer for that question now.

Besides, this will only get worse. In med school, the nurse might shoo you away, but if you can't figure out away to see the patient, you'll just get yelled at by the attending/residents for not having the note done - they don't care that the nurse told you to go away.

I guess that's just my 2 cents and how I'd handle the situation.
 
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