Dear Colleague
You are fairly new to our Emergency Department, you have done your Emergency Nursing courses and you now have collected a slew of certification initials: ACLS, PALS, TNCC, ENPC. You are confident, and just a little arrogant. Believe it or not, creaking dinosaur I am, I get where you are coming from. You are young, you are working in a job that’s both exciting and has a certain glam cachet, and the world is your oyster. And what I am about to write is not directly a criticism per se of your hard-won nursing skills. I believe, in fact, that in your own way, you are perfectly competent in all the technical skills required of an Emergency Nurse.
This is what is bothering me. I am concerned first, by the casual contempt in which you hold your colleagues, and second, how you transfer contempt to your patients. The two, I think, are not unrelated. When you roll your eyes when a nurse-colleague is giving report, or have your eyes on your Blackberry, and fiddling with something in your purse, or having side-conversations with other nurses passing by, you are clearly signalling what information your nurse-colleague is trying to convey is trivial and unimportant, and consequently, this attitude shows in the patient care you’re about to give. You patronize patients in the way you speak to them, you are dismissive of their valid concerns, and you seem to believe no patient is sick enough to be deserving of your care. Older, more experienced nurses have noticed it, and it has not gone unremarked. Cynicism unrelieved by compassion and empathy is ugly, plain and simple.
Somewhere in you education and socialization as and ED nurse, you have concluded that the best approach and attitude towards patients is disdain and condescension. Whether you’ve been influenced by medical dramas on television (which you surely must recognize as presenting a distorted view of reality as anything else you might name), or by your peers, or have confused for contempt the compassion fatigue in the black humour found in the Emergency Department, I don’t know. But at the end of it, the complete lack of self-awareness and self-reflection, in that you seem incapable of recognizing how any of this adversely affects both you and your patients. I cannot ask you to change, because I am pretty sure you will not see the need. And this might be the worst thing of all.
Yours sincerely
TorontoEmerg
Those Emergency Blues 
#1 by Jenn Jilks on Monday 08 August 2011 - 1155
Well written. It applies in ANY job, with any new employees. I just visited the SE Ontario firing range with an OPP officer, and there is one place where this would not be tolerated. However, I have dealt with many such people over the years. Concerned about number one, or their best friend, who is number two, at the expense of more experienced colleagues. Not as serious as your business, but intensely frustrating and demeaning. My life experiences have taught me much. Theirs might not.
#2 by Anonymous on Monday 08 August 2011 - 1357
Just yesterday I had this exact conversation with a colleague. This woman is a great nurse, compassionate and excellent worker. She worked full time for many years in emergency and loved her job. About 4 years a go she accepted a position with CCAC and went casual in ER.
As soon as a posting came available in ICU she grabbed it. She would occasionally float down to the emerge but found it harder and harder to motivate the nurse generation of nurses. She thought at first she would lead by example, she trained with some awesome ER nurses and thought she would pay it forward. She got attitude to no end, to the point she never wants to float down there again. What a shame that these new nurses didn’t have the brains to learn from her organization skills, knowledge, and certainly her finesse. Oh well emergency’s loss is ICU’s gain.
This conversation came about because I was venting about visiting the ER department with a family member with renal calculi ( as I’m sure everyone knows this can be extremely painful)
We first arrived Friday at noon with the usual crowd not too bad. We were escorted to a room in a fairly timely manor( didn’t ask for special treatment as a staff member, we waited our turn until the pain was too much) All of Friday’s visit was professional and timely, it made me proud to call these nurses my colleagues. After much debate with the doctor and weighing pro and cons we elected to go home for the night to return in the morning for another round of IV antibiotics and ultrasound. The thoughtful doctor stated that she would be on duty the next morning but gave us a note with instructions for the triage nurse on return.
This is the part that angers me and quite frankly embarrassing. I was not present with my family member at the triage who by the way was suffering with pain, but what that nurse said was reportedly rude and unprofessional. This nurse told my family member that they had no business returning at this hour 1030hrs and they will have to wait. So we did.
When I started to notice that patients were being seen in fast track and sub acute and leaving and we were still waiting in the waiting room, I started to get nervous. I was booked to work in a few short hours and thought I needed to start to make arrangements. I left the department looking for my supervisor to find her in the emergency speaking and educating these nurses cardiac pain.
Waiting my turn to talk I noticed that in the acute area out of a possible 20 stretchers or 3 were occupied.
The ER doctor noticed me and asked if we had been there long…………only 3.5 hours I stated.
We were immediately placed in one of the many empty stretchers. The waiting room was full and no were to sit but there new nurses were enjoying their Saturday afternoon catching up on news, gossip and texting their friends, playing on the computer, the list is endless because we spend another 8 hours across from the nursing station. It took them over 1 hour to come and remove the IV and discharge us!!!!!!!!!!!!!!!!!!!!!!
What can we do to show these nurses that they are giving nursing a bad name. Nurses for many years have worked really hard to gain the respect that nurses deserve. Next it will be job cuts or wage cuts especially if administration witnesses what I did.
The sad thing is these nurses have no idea just how much they do not know!!!!!
#3 by Joni Watson on Monday 08 August 2011 - 2033
Thumbs up!
#4 by Heddwch on Thursday 11 August 2011 - 0112
Thank you for your post. I, too, am an “older nurse” who has been doing emergency nursing for 20 years. The flood of new nurses who almost demand to work in the ED is amazing. I think, possibly like you, these new grads have been watching one too many medical drama’s and are hoping to get an adrenalin rush–or something. However, that being said, I seem to notice a general derspect of society with this generation of people. I notice that a lot of my 20-30 yr old patients are every bit as disrespectful as some of these new nurses.
Recently, I went to my nurse manager and spoke about one of these disrespectful new nurses (who used to be an EMT and starts barking out orders -even to M.D.’s!- as soon as they come through the ambulance doors, like the do on the tv drama ER). I even put my worries, concerns and frustrations about her in writing. I was told that the letter would go into her file and that these concerns about her behavour would be brought up at her next employee review. I was also told to try and guide her instead of just complain about her (I wasn’t complaining, just trying to make my manager aware of the nurse’s attitude). But how does one guide someone who thinks that they are God’s gift to ER nursing? I mean, the golden rule, is beneathe her!
I think that respect is something that needs to be taught in nursing school and disrespect not tolerated in medical/nursing practice. The same goes for CNA’s who think that they know more than nurses, as well as disrespect others.
Until then, I will keep preaching the golden rule. Thanks again for your letter. Hopefully she gets a clue.
Peace