Monday, January 28, 2013

Tell me Everything

One of the nurses I work with is crazier than most of the patients.  And selfish.  She shows up late and then starts yelling at me for not doing her work, regardless of what I am doing or who else is present.

"You are so selfish.  All you care about is getting your assignment under way.  What about mine?  Did you ever even stop to think for a minute that you are part of a team and the team needs help?"

By "team" she means herself.  And no, I don't care more about her assignment than she does.

One day this past week, one of the other nurses who is not too bright but doesn't advertise her selfishness, gloated, "I am not here to fight, so I don't let her bother me."

"How do you achieve that?" I asked.

"Just do whatever she tells you to do," she replied.

"I can't accomplish all of the ridiculous and unnecessary tasks she hurls at me, designed to make sure that I don't get my actual assignments done."  She'll walk into the middle of wound care and start screaming, "You were supposed to make lists of what the patients want for lunch.  You didn't do this.  I tell you to do something and you ignore me, like you are better than everybody else, like you have more important things to do.  You are a member of a team, but you go off on your own."

(Actually, I could use help with the wound care, but you all refused.  You won't even do the wound care when I am not there, so if the "team" could clean and dress some of these wounds on my off days, that would really help out.  But it's not going to happen.)  I don't say this.

Dense nurse tells me something enlightening:  "Tell her everything.  She likes to know every little detail about everything."

My first thought:  Who wants to know every little detail?
My second thought:  She does complain a lot that "Nobody told me this."  I was thinking to myself that if you were not late and you stayed on the ward and got off your cell phone, you would pick up on more of these details.  Also, the flow of information is a two-way street and I have never been clued-in or tipped-off by her about anything.

When the unenlightened "team player" wandered back to the ward, she started on another rant:  "You went behind my back and ordered supplements for a patient.  You conspired with the doctor and the two of you got together when I wasn't here and put her on supplements.  Does this make any sense to you?  No, of course not, because it's ridiculous.  If you had asked me, which you never do, I would have told both of you not to do it.  Now administration is going to ask me why this patient is on supplements, and I have no idea because you won't tell me anything."

I countered with my usual:  Weight loss over the last two weeks over 10% of her body weight.  Poor intake at meals.  Anemia.  Low serum protein.

She countered:  You didn't tell me any of this.

Me:  You were not here for those two weeks.  It is documented in the chart.

She wouldn't give in- I was wrong and she was right.  Never mind that I had two doctors and a dietitian supporting my position in the chart.

So I tried this new strategy:  "Speaking of this patient, we have pending orders for her to have a podiatry consult and special shoe fitting because of her bunions.  We are just waiting for a return phonecall with the appointment time."

Almost magically, nasty nurse calmed down, like I was feeding her some sedating nectar.

So I continued.  Whatever popped into my head about any patient, no matter how irrelevant or outdated it may have been, I told her.  It was so bizarre.  She got a kind of smile on her face, but with a far-away look in her eyes.  She became calmer.  I was afraid that she was going to start arguing about how this or that was wrong, so I kept it simple and factual.  "Mr Smith visited his son yesterday.  We served cake and orange soda on the unit for Ms Miller's birthday, courtesy of the recreation department.  Yesterday's lunch was well-received by everyone."

This is an interesting exercise in human interactions and personality, but this is too much to take anymore.  I not only have to quell psychotic patients, I have to placate psychotic staff members, but without medication.

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