The phrases junior nurses and most staff do not care to hear from senior nurses…

…or the negativity they can spew….

“You wouldn’t know what to look for in that type of patient assessment anyways…”

How do you know I don’t know what to assess for? Are you the textbook I read from? The online periodicals I continue to educate myself with? Are you every patient I have assessed in the last 8 years? Did you teach me? Were you my preceptor in some nightmare? Well since you are none of the previous and you’re not a bound textbook (despite how wound up you are all the time) please do not assume that since I have less experience than you, I won’t know how to assess a patient with XYZ diagnosis. Perhaps just ask if I know what the presenting signs and symptoms may be and any associated complications to monitor for, what the normal would be, etc… and take a supportive and educative approach if you are concerned about my assessment skills without any condescending tone or implied disregard for my apparent limited knowledge.

I recently had a patient with a skull fracture, (the head injury happened a day earlier), and the senior nurse asked if the patient had battle’s sign, (bruising behind the ears), which they did not, I informed her, to which she rudely replied with, “you wouldn’t know what battle’s sign looks like anyways…”. Between being 0645 in the morning after a long night shift and the only words coming out of my mouth would have been immature and highly offensive, I felt it right to walk away from the conversation.

As per this blog post, I’m clearly still stewing.

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  1. #1 by Lynda M O on Tuesday 05 June 2012 - 0025

    Love that you know when to walk away and when to just say nothing. You have inspired me more than once to think… then walk.

    • #2 by jeanhill on Tuesday 05 June 2012 - 0959

      Learning to walk away may have been the best thing for myself I’ve learned in the ER. Be it with angry, inappropriate patients or families or argumentative colleagues. I don’t suggest backing down and being walked all over but at times recognizing who you’re engaged with and is it really worth it?

    • #3 by toronto botox on Tuesday 19 June 2012 - 0712

      Yes lynda you are right because walk away from any situation is not the solution of problems so think first of the situation. I glad to read your post thank you toronto botox

  2. #4 by torontoemerg on Tuesday 05 June 2012 - 0844

    Love the informal hierarchy that separates “senior” from “junior” nurses… and isn’t it funny how some nurses are never considered “senior” even though they have 20+ years… ?

    Anyhow, my job as a (cough, cough) a senior nurse (read: older then dirt) is to coach and mentor my younger and less experienced colleagues. Not to dismiss or belittle. And by the way, catching all the subtle signs and symptoms is often the product of experience, not intelligence.

    In short, a nurse with both book-smarts and street smarts is about as awesome as can be.

    • #5 by jeanhill on Tuesday 05 June 2012 - 1007

      I agree how some nurses never garner that “senior nurse title” despite their years of experience. Maybe it’s because they don’t feel it necessary to tell everyone all the time how many years they’ve been working like its a protective barrier against any potential negative thoughts regarding their judgment or practice.
      Some of the best nurses and mentors I know take joy in just teaching and passing down their knowledge without flaunting their years of service because they feel it will ultimately contribute to good patient care and a great novice nurse!

  3. #6 by Kevin Ross (@innovativenurse) on Tuesday 05 June 2012 - 0859

    I’m stewing with you. I don’t know why I’m always surprised each time when I hear a story like this about our colleagues tearing each other down. I suppose it’s because I don’t want to “just get used to it”, or have it just be “part of the job.”

  4. #7 by suki on Tuesday 05 June 2012 - 1244

    I always say: it is not always what one says but more important how they say it. To automatically interject that the person didn’t know what it looked like is plain arrogant. We are all constantly learning each and everyday out there in healthcare. Those that attempt to portray the “image” that they know it all are only harming themselves. I have learned from even my nursing students. When I feel I have stopped learning, I need to retire from nursing. It is the wise nurse that can utilize her vast nursing experiences with the ever changing world today. But the wise nurse is far more valuable if she can also share her nursing exposure and knowledge with those newer to the field. That nurse is worth her/his weight in gold. Personally this old nurse wants to share. I pray I never come across as arrogant to the younger nurses.

    • #8 by jeanhill on Tuesday 05 June 2012 - 1252

      What an incredible comment! You’ve left me neat speechless! I admire and respect everything you just wrote. I especially agree with the fact that no one can know it all and the day one thinks they do they need to leave the profession. I adopted the notion of no one can know it all the day I started nursing. Somewhat as an idea to lean on in times of feeling inadequate due to lack of experience but now I see it as a goal. To always be learning and seek information. I can’t know it all but I can learn as much as possible!
      Thank you for your inspiring post Suki!

      • #9 by toronto botox on Tuesday 19 June 2012 - 0717

        jeanhill you are commenting so nicely and i inspire from you for your new thing learning habit. thank you botox toronto

  5. #10 by Mandyem on Saturday 30 June 2012 - 2032

    As an RPN in a GTA ER I can all too well understand that comment. I have heard worse “You’re not a real nurse” as a matter of fact. Hm…I wonder what I have been doing for 19+ years or so??? I congratulate you on being able to just walk away. I do not know if I could have or not.

    I have stood up to physicians who have wanted to send patients home without looking at the entire picture and was after praised for ensuring he actually lived. The man ended up with a spleen injury after a fall off of a tall ladder and was going to be sent home when he complained about his painful belly. After much insistance the Physician returned to see him and he was prepared for the OR.

    I have take courses. I keep myself up to date and pay the same college dues as an RN. Experience and education do count for something.

    It has been difficult for all involved with so much change in the Nursing field and it will always continue to be so I believe. Be well and stay strong. We are there for our patients (or at least I have always thought that to be so)

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