Toxic work environment

Well, I guess it was my turn. I got to have my day with the toxic coworker.

It came out of nowhere to be honest. I was LITERALLY just sitting there working on the inpatient list and behind me I hear:

“F*ucking lazy nurses” and “nurses never get off their lazy @ssess” and my personal fave, “they are delaying patient care!”

Now, this is coming from one of the supervisors. I am fuming! However, instead of leadership stopping this behavior from continuing I was told to keep calm and just ignore it.

Now if at this point you are glaring at your screen like, “WTF?”, I am pretty sure I had the same look at that moment.

I decided to go up my chain of command and apparently it went up their chain as well. I mean, did this person really think I was going to let them say such disrespectful things and not say anything? Apparently, they did.

So now there is this toxic work environment once the shift changes. The awkwardness is palpable. Communication between the nurses and the technologists changes. There is still hostility that can be felt. Unfortunately, a lot of the vibe change is spurred on by the supervisor that started all this . I have been told that this person rolls their eyes when I am walking away. They avoid speaking to me. They refuse eye contact. In a sense, they avoid me at all costs.

Honestly, I don’t understand why we are dragging this on. Toxicity benefits no one. It leads to an “us vs them” type of feeling. I am hoping as time goes by the toxic feeling will begin to leave our department. It is hard to work in a truly toxic work environment. A department can’t function like that for very long. We can either rise above or get sucked in and weighed down. I think there are enough of us there that will fight to rise above it… at least I hope so.

Speak up when it doesn’t feel right

You are your patient’s last line of defense.  Whether it’s meds, bedside procedures, trips off the unit, or just care in general, you are the person that can potentially save a patient.

I know, medical shows would have you believe that doctors are the saviors. Doctors are the last hope. Doctors save the world! Yeah, most of the doctors I know can’t start an IV sooo…

You are the one at the bedside for 12 hours. You are the one that has had them for three shifts straight and don’t even need report anymore. You are the one that knows that patient. You are the one that may notice something wrong.

Perhaps you come in for your shift and notice that Mr. B, who is typically trying to crawl out of the low bed and get back to his “bus”, it far too chill. His vitals have been great all day. The team doesn’t order labs for him daily anymore but the ones from two days ago look fine. In your gut you know something isn’t right. You talk to the doc, who isn’t impressed. You give it all you got and at least convince the doc to order a set of labs for now. You get those labs and anxiously wait to see if they can help you figure out why Mr. B hasn’t tried to kick you in the face tonight.

And then the lab results come back AND THEY ARE A SHIT SHOW! His WBC’s are almost 30. His H&H has dropped by 3. His BUN and creatinine are climbing. All of his electrolytes are out of wack. But once again, his vitals have been good all day.

You just saved your patient. You knew something wasn’t right, even if you couldn’t pinpoint it. By being a patient advocate you may be the reason he’s alive.

Maybe it’s less dramatic than that. Maybe they have ordered a medication for your patient that seems like it just might be contraindicated at this point. His platelets are low. His INR is going up, not down. One of the teams wants you to give heparin. You aren’t comfortable with that, especially since the primary team (or doc) purposefully stopped it because of his labs. You try and talk to the ordering provider and rather than listen he yells “just do it!“.  Do NOT just do it. Healthcare was not designed by Nike and that rarely works out. You can take another step. You can talk to the primary team or doc about a consulting team or doc restarting what they’ve stopped. So you do just that. Primary agrees with your hesitation and they talk to the consult to let them know heparin has been discontinued and why. Turns out, consult didn’t actually look at any labs before ordering it.

Looks at you walking around saving the day, like you have an “S” on your chest! You know what you are doing. You know when something isn’t quite right. You know your patient. Trust yourself and speak up when you feel like it is necessary.