I just need to VENT and get some INPUT...

Have any of you ever worked with someone who seems to NEED chaos? Have you ever worked with someone who absolutely MUST have some sort of crisis on a daily basis? If so, how do you keep it from driving you insane? Let me give you a little history on the situation...

I hope you have a few minutes...

I accepted a new position with a sub-acute facility as a charge nurse on a rehabilitation unit back in December. On this unit, we have anything from spinal and brain injuries to foot reconstruction and everything in between. It was the perfect opportunity for me! I love being on my toes! I love helping people and I LOVE new experiences, as they bring new skills! As a new hire, I was trained on each individual hallway for a week and then set free on MY UNIT. As I mentioned before. I love being on my toes. I love busy work and this offered me BUSY WORK in a critical care environment. I am also a relatively new nurse and I LOVE IT! I began working on my unit alongside a decent, easy going nurse who just didn't have the assessment skills to make it on a rehab unit, so he got transferred out to longterm care and another nurse was brought in to take his place because she is a "seasoned nurse".

Here comes the fun... Are you ready for it? The nurse that was brought it was actually working on the longterm care unit. She was hired about 2 months before I was and had been a nurse for a number of years, working in a doctors office. We shall call her Chaotica so as not to breech any privacy rules and regs. Chaotica has the same number of patients as I and their level of care ranges along the same gamut as mine. We were informed by our unit manager that no one would be coming to work on the middle cart until 7pm, so we have to take over that cart as well as ours and pass those pills too. We both take over at 3pm and I grab my med cart and head off down the hall. I pass my share on the middle cart and then tackle my own carts pill load. She sits at the desk complaining about how unfair it is to have to work half of the middle cart. She complains to the unit manager SO much that the unit manager gets pissed and tells her to go complain to the Director Of Nursing, which she proceeds to do.

The DON (who has been in the building since 6:45am) comes to the unit and makes a beeline to the middle cart and starts pulling pills for two residents. I asked her why she was doing it and she states that the way things were going, the residents wouldn't get their pills until midnight because Chaotica was just too damn slow. Around 4pm, I am mostly done with my med pass and Chaotica decides to start hers. On a normal day, we have phone calls, aides requesting our help, new orders, urgent situations, pharmacy calls, labs to be drawn, and patient requests to anticipate so we try to work around it without falling behind. Chaotica passes a few pills and then comes to the nurses station to ask me to help her with a catheter. I stop what I am doing and go help. Chaotica passes a few more pills and comes to ask me to draw up a blood sample for her so it can be sent out for a BMP and a CBC. I do it because, Hey! I'm actually ahead!

Chaotica starts to panic because it is about 6pm and her 3pm, 4pm, and 5pm medications are still not passed on EITHER CART so Chaotica starts complaining that her aides aren't doing what they should be doing and she is having to take up their slack and THAT is the "real" reason she is falling behind. (Did I mention Chaotica claims that each of the aides working with her are belligerent, lazy, and practice insubordination on a regular basis?) A call light goes off and a resident requests that Chaotica perform a quick in/out catheterizing on him because he is having trouble going to the bathroom due to prostate swelling. Chaotica informs resident that he will have to wait until after dinner (another hour). Now, the catheter that Chaotica requested me to help her with was actually to be used to perform a Urinalysis and a Culture and Sensitivity to determine if the resident has a bladder infection so I write up her lab sheets and call the courier FOR HER. Chaotica gets a call from one of her aides stating that the resident who was requesting to be catheterized has now fallen and hit his head because he was trying to go to the bathroom without assistance. Rather than rush to the residents room, Chaotica stands in the hallway arguing with the aide, accusing the aide of negligence. The aide yells back stating that she doesn't appreciate the way Chaotica IS and HAS BEEN speaking to her and that she only has two hands and two eyes. (To be perfectly honest, it is Chaoticas fault because her resident requested to be catheterized and she put it off too long) OK, that was just an excerpt of today...

Friday, I was a the nurses station and one of the aides came running up the hall stating that one of the residents had stopped breathing (which we knew was going to happen soon because she just wasn't doing well). The resident in one of Chaoticas assigned patients so I grab a vitals machine and a stethoscope and start running. I yell at Chaotica that there is a code blue on one of her patients. She says OK, I'm coming. I get to the patients room and start running vitals while sending an aide to call family because there is a change in the patients status and they need to be here. The vitals are dropping and the patient is trying to drag some air in but she is just too weak. I get an aide to run get an O2 tank to put on the patient to try to get her sats up but it isn't enough and her O2 sats are dropping while her heart is slowing and her BP is dropping. I step into the hallway to see if her nurse is coming but I don't see her. I send and aide for her, who found her in the dining room, requesting some Ensure for her residents to drink... WHAT???? ARE YOU FOR REAL???? OK, did she not hear me say CODE BLUE!!!??? Finally, she arrives and I hand over care of her patient whose heart eventually stops when her daughter walks through the door. She was holding on for her daughter, how terribly sad!

Tuesday, its me, Chaotica, and a former classmate of mine on the three carts. Chaotica is down the hall, ordering her dinner from the dining room or something. An aide calls out for a nurse and states that she thinks a resident is having a stroke. Again, we grab the vitals machine and run but Chaotica is not in sight so my former classmate/Mr. Nurse starts paging her "Nurse Chaotica, you are needed in room ### STAT!!!". Stat is code for STOP WHATEVER IT IS THAT YOU ARE DOING AND GET YOUR ASS IN HERE RIGHT NOW!!! While running vitals on our poor resident, we notice that his left side is starting to droop and he begins to slouch in that direction and stops responding to our questions. A call is made to the ON-CALL Doctor because it is after hours and he must give the OK for any hospital admits. We wait... Chaotica shows up just before the call comes back and takes the call. She knows nothing of her patients condition and needs to ask me and Mr. Nurse what happened. We fill her in and she passes the phone to me to give the details to the doctor. The doctor gives the green light to send the patient out to the ER. Chaotica has the nerve to sit there and complain because the man who is stroking is now causing her to fall behind in her work. (Gee lady, I'm sorry I'm having a stroke right now!! Should I have waited until you finished ordering your dinner? Or maybe until you finish with everything else?)

OK... So, obviously I think Chaotica is incompetent and I inform the Unit Manager as well as the DON that I think she is a hazard to her patients. Now, I wonder what will happen next... I never want someone to lose their job! I do, however, think that these patients deserve the best nurses and the best care in order to regain their strength. I expect fellow nurses to do what they have been license to do. NURSE! I am here, doing what I do, because it is what my heart says I was put here for.

Is it all just a paycheck for Chaotica? If so, she needs to let it go and go back to the calm, stress-free doctors office job she came from because in rehab, they need nurses who are on their toes and ready to jump in and get the job done!!!