Have you ever confronted an ER nurse for being unproffesional?

[read2go]

One of my coworkers recently confronted an ER nurse after he saw here commit a major regional policy violation. What she did was unprofessional and unsafe. All of the other nurses on duty in the ER agreed with what he had to say. He was polite and not aggressive. In the city where I work, ER nurses have earned themselves a reputation for being very nasty to EMS. I understand they are overworked, stressed, tired, have a high number of patients, etc. I am a very patient person, I like to give people the benefit of the doubt, and I respect what ER nurses do.

What I would like is a little advice on how to deal with it when you encounter an ER nurse that is really unprofessional or does something that is unsafe. Thanks in advance for anything you can think of. I would really love to know if anyone else has been in a similar situation and what they did about it, what they said, etc.

 

[NPO]

We generally take the passive approach. "Yes ma'am. Sign here". Short and sweet with those kinds.

Fortunately I've never been confronted with a major violation or patient endangerment situation, just rude nurses.

I have reported non-ER nurses for patient safety violations. Most lf them are SNF nurses and I feel like the complaints fall of deaf ears.

 

[SandpitMedic]

I call nurses out on the daily. I don't care who you are, especially if you're completely and openly endangering patients or putting your own selfish desires ahead of patient care.

Too bad we live in such a politically correct era.

I'm also very blunt, I have issues with tact that I am currently working on.

 

[UnkiEMT]

If it's something that's actively dangerous to a pt, (completely ignoring a massive head lac in favor of the sore ankle, wrong drug/wrong dose/wrong pt, trying to juggle a neonate, etc), you do what you have to do to stop it right there (Usually just saying something to the nurse is enough, if not threaten to/do bring the charge into it.)

If it's something that's unsafe, but unlikely to bring harm to a pt in the next 5 minutes correct the immediate situation (if you can), then go and calmly explain your concerns to the charge nurse. Don't be accusatory, more informational, along the lines of "Hey, I noticed that Nurse Ratched didn't put the side rails up after lowering that stretcher.".

If it's something that's unlikely to bring harm to a patient for the next hour, call your supervisor and get them to call the charge. A) They have a lot more weight to throw around than you do, B) By making the whole conversation twice removed from the situation, the degree of personalities involved in it is lessened and it's easier to handle the whole thing professionally.

If there is a systemic issue that isn't resolved after the above steps have been tried, talk to your Director of Operations about filing a complaint with the facility or, if necessary, nursing board.

 

[SandpitMedic]

I have reported non-ER nurses for patient safety violations. Most lf them are SNF nurses and I feel like the complaints fall of deaf ears.

This...

I am so over thinking "man, if I did that I'd lose my cert immediately!" While these clowns continue to literally do whatever they want with little repercussions.

 

[DrParasite]

I call nurses out on the daily. I don't care who you are, especially if you're completely and openly endangering patients or putting your own selfish desires ahead of patient care.

I love this!!! I wish I could, but if a nurse or doctor is rude to me, is unprofessional, treats me like crap in front of a patient, per my management, I am supposed to take it with a smile, or file written complaint with my admin that will go nowhere.

If I do the same, or call out a nurse for their inappropriate behavior, they will file a complaint with my supervisor, and I can expect disciplinary action to be taken, regardless of if I was inappropriate or not.

Thankfully, I can recall very few nurses who have been rude to me. Not to say that they weren't rude or out of line, but I didn't let it bother me past when I said "sign here" and I was out the door. One from my memory involved an L&D nurse, and a conversation with the ER charge nurse, who brought me to the ER nursing director, who called the L&D nursing director's personal cell phone so I could tell her what happened, and I never had any further issues.

Getting into a screaming match with ER staff usually doesn't solve anything, nor does attempting to correct an RN's inappropriate actions. Usually an informal or formal chat with the charge nurse, head nurse or nursing director can resolve the issue better than an outsider telling a higher trained individual that they are doing something wrong.

 

[SandpitMedic]

I love this!!! I wish I could, but if a nurse or doctor is rude to me, is unprofessional, treats me like crap in front of a patient, per my management, I am supposed to take it with a smile.....resolve the issue better than an outsider telling a higher trained individual that they are doing something wrong.

First, so am I. Take it with a smile... I say, :censored::censored::censored::censored: that.

Second, "higher trained"??? I think not... Ever talk to them about stuff? Those with no EMS experience are generally idiots, who must abide by a doctor's order to even give aspirin.

 

[m1a1h]

i think it is

 

[VFlutter]

Second, "higher trained"??? I think not... Ever talk to them about stuff? Those with no EMS experience are generally idiots, who must abide by a doctor's order to even give aspirin.

 

[MrJones]

...who must abide by a doctor's order to even give aspirin.

As opposed to EMTs/Paramedics who need a standing order in the form of a protocol that's been approved by a doctor in order to even give aspirin?

 

[Carlos Danger]

I call nurses out on the daily

If I ever find myself "calling out" others daily, I hope someone pulls me aside and reminds me of that old saying: "If you think everyone else is an idiot....."

Ever talk to <nurses> about stuff? Those with no EMS experience are generally idiots, who must abide by a doctor's order to even give aspirin.

Glad to see you making progress on your "tact issues".

 

[mycrofft]

If it's something that's actively dangerous to a pt, (completely ignoring a massive head lac in favor of the sore ankle, wrong drug/wrong dose/wrong pt, trying to juggle a neonate, etc), you do what you have to do to stop it right there (Usually just saying something to the nurse is enough, if not threaten to/do bring the charge into it.)

If it's something that's unsafe, but unlikely to bring harm to a pt in the next 5 minutes correct the immediate situation (if you can), then go and calmly explain your concerns to the charge nurse. Don't be accusatory, more informational, along the lines of "Hey, I noticed that Nurse Ratched didn't put the side rails up after lowering that stretcher.".

If it's something that's unlikely to bring harm to a patient for the next hour, call your supervisor and get them to call the charge. A) They have a lot more weight to throw around than you do, B) By making the whole conversation twice removed from the situation, the degree of personalities involved in it is lessened and it's easier to handle the whole thing professionally.

If there is a systemic issue that isn't resolved after the above steps have been tried, talk to your Director of Operations about filing a complaint with the facility or, if necessary, nursing board.

With you entirely.

Getting into a worker bee-to-worker bee dustup on the nurse's home turf may not be tactically advisable in most places (know your turf), and would be equivalent to the nurse taking you aside and chewing you out.

PS: an old nursing trick: play Jeoprdy and make your observation into a question, such as "Why does Mr Johnson in bay 4 keep gasping for air?" when his O2 hasn't been turned on, etc etc.

edit: Some people will welcome backstopping (I do except when I'm teaching), some won't. Where they don't, you might have a scenario where backSTABBING is a cottage industry amongst the staff.

And for many, not all, "regional expert" techs rolling in hot off the street with yet another dyspneic or drunk patient might remember that the "regional policy" applied to street techs might not be in force regarding in-house professional staff. They MAY be within their operating instructions for that "house" (hospital).

 

[SandpitMedic]

As opposed to EMTs/Paramedics who need a standing order in the form of a protocol that's been approved by a doctor in order to even give aspirin?

Protocol deviation whaaat... At least we have standing orders, much like doctors have guidelines to follow. And then there is this example:

ACLS to RN= "Doctor can I give epi?

ACLS to us= "lets push a round of Epi."


Halothane:

Thanks. Baby steps, baby steps. Nice jab.
Amongst friends, banter over tact.

 

[SandpitMedic]

Getting into a worker bee-to-worker bee dustup on the nurse's home turf may not be tactically advisable in most places (know your turf), and would be equivalent to the nurse taking you aside and chewing you out.

PS: an old nursing trick: play Jeoprdy and make your observation into a question, such as "Why does Mr Johnson in bay 4 keep gasping for air?" when his O2 hasn't been turned on, etc etc.

I like this.

 

[mycrofft]

Protocol deviation whaaat... At least we have standing orders, much like doctors have guidelines to follow. And then there is this example:

ACLS to RN= "Doctor can I give epi?

ACLS to us= "lets push a round of Epi."


Halothane:

Thanks. Baby steps, baby steps. Nice jab.
Amongst friends, banter over tact.

With adequate standardized procedures, RNs can do much more than go ask a doctor for an order. At one point I could start 10 day courses of oral Bactrim or PCN, give glucagon, start IVs, issue sulfa eyedrops, and even continue for three days outside Rxs in the pt's property. etcetera, etcetera, etcetera.

But they had better be trained and documented in doing those procedures. Most places place the training and documentation bit on the nurse's shoulders and therefore hire nurses with extra letters after their names.

 

[mycrofft]

I like this.

Thank you, I appreciate that.

 

[VFlutter]

Protocol deviation whaaat... At least we have standing orders, much like doctors have guidelines to follow. And then there is this example:

ACLS to RN= "Doctor can I give epi?

ACLS to us= "lets push a round of Epi."

Ah so much ignorance. I have never in my career asked a Physican to give an ACLS drug. I have these mystical things called "protocols" and "standing orders" too! I better go ask the Doctor what to do with them.

 

[Summit]

Ah so much ignorance. I have never in my career asked a Physican to give an ACLS drug. I have these mystical things called "protocols" and "standing orders" too! I better go ask the Doctor what to do with them.

Now if only we can get someone in here repeating that tired BS about RNs have to ask the doctors permission to give O2 :rofl:

 

[mgr22]

One of my coworkers recently confronted an ER nurse after he saw here commit a major regional policy violation. What she did was unprofessional and unsafe. All of the other nurses on duty in the ER agreed with what he had to say. He was polite and not aggressive. In the city where I work, ER nurses have earned themselves a reputation for being very nasty to EMS. I understand they are overworked, stressed, tired, have a high number of patients, etc. I am a very patient person, I like to give people the benefit of the doubt, and I respect what ER nurses do.

What I would like is a little advice on how to deal with it when you encounter an ER nurse that is really unprofessional or does something that is unsafe. Thanks in advance for anything you can think of. I would really love to know if anyone else has been in a similar situation and what they did about it, what they said, etc.

What if the roles were reversed? How would you want nurses to respond if they saw an EMS provider do something they considered unprofessional or unsafe?

If I were the EMS provider, first I'd hope the nurses hadn't already drawn conclusions about me based on rumors, or even the reputation of EMS providers as a whole.

Next I'd want the nurses to approach me privately, unless they felt they needed to intercede in a clearly dangerous situation.

If the nurses still felt I was unprofessional or unsafe after discussing those concerns with me, I guess I'd expect them to go to my boss. I'd probably be angry if I thought they over-reacted, but at least I wouldn't be blind-sided by whatever came next.

 

[Ridryder911]

I use the same methodology on all professions; albeit physician, nurse, medic, janitor, cook... etc.

I pull them aside after things have calmed down, somewhere private and inform them on the problem I had seen. Let them at least give an explanation; (you might be surprised) and if they even are aware of the problem.

I have learned to never attempt to berate, belittle or attempt to embarrass anyone in front of peers or others. Even if you are correct/right; it will be you that will appear to be in the wrong. Confrontation never is a good thing, especially in the patient area. It is better to bite one's tongue and deal with it appropriately.

If the party does not respond actively or it involves action(s) that are dangerous to patient care, then I have a duty to report to their superiors.

Use common courtesy, professionalism and appropriate tone.

R/r 911