Your worst nightmare scenarios, part 3: Personnel edition

Our feelings about coworkers often fall under the description “love-hate relationship.” Doctors, nurses and support staff who surround us, not the actual work we do, often determine how long we stay with an employer. Here’s some advice for scenarios involving coworkers.

 

 

Your worst nightmare scenarios, part 3: Personnel edition

1. You receive report from an offgoing nurse in trauma ER and immediately get called to the bay for a victim of a multiple-vehicle incident. The patient needs stat X-rays, but the tech is late and no one has heard anything. Ten minutes later you find out that the patient in the trauma bay IS the radiology tech with whom you have worked closely in the past. Despite frantic interventions, the tech does not survive injuries past the golden hour. What should you do?

Reactions to a coworker’s death can vary greatly. You or others may cope better by continuing the shift, and others may become so distracted they endanger further patient care. Immediately following the incident, the charge nurse or manager should briefly assess the staff closely involved with the trauma care, and determine what actions should be taken on a case-by-case basis. All personnel should be given the opportunity to attend debriefing sessions within the next few days.

2. The nursing assistant (NA) staff on your unit is unionized. One NA has a reputation of telling nurses to “go do it yourself” when asked to perform tasks, swearing loudly and threatening to complain of discrimination to the union when told her attire does not meet clinical standards. Your manager seems reluctant to take disciplinary steps beyond talking to this employee. What should you do?

In this situation, strength exists in numbers. All staff who witness abusive or threatening behavior should document incidents independently in official written form, then present them to management, keeping copies of all complaints.

Union procedures for reprimanding/firing can be complicated and time-consuming, but no excuse exists for verbally abusive behavior in a professional work environment. Find out what documentation is required by the union for dismissal and offer to assist your manager in addressing the situation. If the unit manager allows these actions to continue or does not take official action, staff should appeal to the manager’s superior.

3. You get called in at midnight to the PACU to recover a patient from emergency surgery. Per routine, you are the only nurse on the unit at that hour, along with one NA also called in. After delivering the patient safely to the floor around 2 am, you clean up the unit and clock out. When you report for regular shift around 11 am, your coworkers are unusually inquisitive about what had occurred with your patient at midnight. Finally, one coworker states offhand that there was a narcotic discrepancy during the morning count, and pharmacy is now investigating the missing vial. You realize that you are under suspicion. What should you do?

First, don’t panic (and don’t steal drugs). Speak with the charge nurse or manager to find out exactly what is going on and what you need to do. If the pharmacy is unable to resolve the discrepancy, you may be requested to take a drug test. You may want to write down a brief summary of what happened, what medications were used, etc. to trigger your memory if you are asked to give account at a later time. Do not use patient identifying information in your notes.

Remember, you are innocent until proven guilty. No formal charges can be filed with only circumstantial evidence. Unfortunately, some nurses have experienced subtle changes in their workplace because of accusations like this. You may wish to consult a lawyer to gain further advice.

4. You have been a travel nurse in a small ICU for 2 weeks. The charge nurse has vocally stated her dislike of travel staff in your presence. One night she enters your patient’s room while you are performing bathing care, looks at your patient’s monitors and states that you are endangering this patient and will “make this your last shift” if the patient’s numbers do not improve. Before you can even reply, she leaves the room. What should you do?

You have no other witness to this verbal exchange other than the patient. This charge nurse has not only potentially lessened the quality of that patient’s care by failing to help you, but has also created a threatening work environment. To avoid a “he said, she said” situation, document the exchange carefully and have a face to face conversation with the unit manager as soon as possible.

In addition, if you have the guts, have a calm conversation with this nurse in the presence of other coworkers stating that the conduct was unacceptable, and that you will be filing a written statement with her manager.

What’s the worst situation you have ever been in with a coworker? Let us know how it all worked out in the comments!

Check out part 1 and part 2 of this series!