I was hired on to an Oncology Unit. A co-worker I had previously worked with told her manager, and after a rather uncomfortable interview, I accepted the position. I had no experience in ONC, with the exception that my mother fought and lost the battle with primary CNS lymphoma. My background was with trauma patients.
My preceptor asked me how long I had been in nursing, which at the time was just under 10 years. Her response to me was that she had been a nurse for three years on this floor and graduated with a BSN. She would then proceed to belittle me every chance she could. They used a different program for charting, so when I didn't pick it up as quickly as she expected me to, it was "well, you've been a nurse for 10 years, you should know this". I had not taken chemo certification class, and so I asked questions when I was unsure of something. Again, her answer was "well, you've been a nurse for 10 years". It was clearly her favorite thing to say to me. Every time I turned around.
She was a Charge Nurse as well. And she would log into my patient load and monitor my charting. If I hung an antibiotic 30 minutes late, she would call and ask why, instead of asking if I needed a hand. Also, parameters are 1 hour before and 1 hour after the scheduled time. It's tricky to hang an IV antibiotic while you are trying to administer Demerol for rigors to a patient with a temp of 104 and a zero ANC. She also had a friend who was a charge nurse as well. Turns out they went to high school together. The same school my kids went to from K-12. This girl was on her phone from the time she clocked in 15min late every shift, until the time she left the unit in the evening. And she was as approachable as a rabid trash panda. Forget asking that one for help. She was something else, and apparently I am not the only nurse or CNA who felt that way.
One day, I was charting in a cubby across the hall from a patient room. One of the CNAs came out and asked if I could assist as Nurse Nancy know-it-all was doing a tube feed in another room. The patient's wife was concerned because her husband appeared to be unresponsive to her. I assessed the patient and noted that his pupils were pinpoint, and his respirations were shallow and 6/min. I spoke to the wife briefly and went to find good ole Nurse Nancy (not her real name, of course). I told her that her patient in room X needed some Narcan. She laughed at me. She proceeded to tell me that she had given the patient MS ER and that Narcan wouldn't do any good. I felt my jaw hit the floor. I explained to her that we may have to give it more than once, and that the wife was concerned as well as myself.
Enter Charge Nurse 2, the iPhone queen. Vitals machine in tow, she exited patient's room and said that his O2 was OK, and that THEY should wait to give the Narcan. I did not feel the same way. I asked Miss smarty pants how long we were supposed to wait because where I come from, not breathing adequately is usually an urgent issue. She informed me that because this is Oncology and patients are suffering with cancer pain, that we just watch them for a little while. I asked her if this particular patient was a DNR. She shrugged her shoulders and said he was on palliative care. She also informed me that they would have to get an order for Narcan, and then wait to be able to pull the drug. The dynamic duo then brushed me off completely. Fine. Clearly they had this handled and I was of no help to them.
Half an hour later, Nancy know-it-all comes rushing up to me in the hall. I will never forget what she said or how.
She was tapping on her watch face and said to me, "you wanted to know how long we wait to give Narcan, well THIS is how long we wait. We need to do this NOW'. Well, all I could think was who are we? Do you have a mouse in your pocket? She grabbed the iPhone queen and about 5 minutes later they approached me with some urgency. "Can you pull Narcan for me?" Her balls were dragging behind her, that's how big they are. "I can." And then the clue bird flew low. "You've never given Narcan, have you?" Of course her answer was no, and she was scared to death. I pulled the drug and gave her the vial. I explained to her how to give it and I told her if she was worried about her patient she didn't have to push it fast.
The patient required Narcan three more times. She had given 15mg initially, to a narcotic naive patient, and it didn't help. She called the MD, who told her to give an additional 30mg. That is where she made her first mistake. I talked with the Nurse Manager regarding how poorly the situation was handled, and she asked me if I charted any of it. Eh? I provided no cares. I can't chart that the dynamic duo chose negligence so that someone else didn't 'steal their thunder'. A couple of weeks later, Nurse Nancy know-it-all asked if she could speak to me in the med room. Sure.
She apologized to me. She said she didn't know what to do because she had never given Narcan before and she was scared. I lit into her. I told her that she should have questioned the order to begin with. Just because the MD is a MD doesn't mean that you don't advocate for patient safety. I told her that I have given Narcan many, many times. That we kept it taped to the PCA machine poles. I told her that her friend the iPhone queen sat and blew smoke up my ass, and that if she thought I was stupid enough to buy what she was selling then she should be ashamed of herself. I told her that I didn't know anything about chemo drugs, and that is why I open my big mouth and ASK. I told her that it was poor nursing judgement and that we should be working as a team to provide patient care, regardless of the assignment. I'm sure I had some other topics to scold her on, but this was the gist. Her friend, the iPhone queen simply scoffed and rolled her eyes at me at every opportunity.
After that incident, neither of them really spoke to me. And one day, I told the Nurse Manger that I wouldn't be returning. She had the sack to try and tell me that it was patient abandonment, to which I replied "what?". Then she tried to tell me that I would never get another job because quitting without notice would look bad on my resume. I wrote a letter to HR citing a hostile work environment and nurse bullying. Turns out a social worker and a case manager left in the same month for the same reasons. I spoke with one of those people and it was the same dynamic duo. It has been a few years and most of the people who I worked with at the time are gone. The dynamic duo are still there. They will likely grow old there, chasing off good competent staff with their nasty antics.
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