Having an issue with a nurse manager who is now getting other staff members upset and I am unsure what to do.
A nurse brought a concern to me about a patient being severely fatigued during the day on an ongoing basis and was concerned it was their medications. After looking at their history and finding this was unlikely the issue, I observed the patient having a 10 second apnea episode while napping and decided to order a sleep study to rule out sleep apnea as the issue making him fatigued during the day.
The nurse manager questioned the respiratory therapist about why this was ordered, who would be paying for it and made a comment to the effect of me not knowing anything and we have the same degree and clearly I did not learn anything during my degree program (nurse manager has an MSN….in administration, so not clinical).
The sleep study ended up getting done which showed severe sleep apnea and their fatigue was greatly improved on the CPAP. Nurse manager wanted the RT to not show me the results of the test and instead show someone else instead because again, I don't know anything. The RT told her even if she showed the pulmonologist, the results would be the same. The nurse manager said all of this stuff at the nursing station in front of a whole bunch of staff.
Last week as I was getting on the elevator, she went up one side of me and down another for changing someone's diabetes meds "when the patient has been stable for so long." I am a certified diabetes educator and board certified in advanced diabetes management, so I definitely know more than a little about diabetes management and wanted to get the patient down on insulin as much as possible (patient was only on insulin and nothing else with great renal function which made no sense where they have T2DM). She accused me in front of other staff in the elevator and at the nursing station of not knowing what I am doing and not knowing how to manage diabetes and I had to painstakingly explain the labs I checked to show they're still making endogenous insulin and we should try sensitizing them to insulin to lower their weight and insulin requirements and the patient was fully on board with this and wanted it.
I am unsure what to do at this point. Other staff have reported her to the Director of Nursing, I told my practice medical director today and he was very supportive and said the manager has had lots of personal conflicts in the past and doesn't get along with anyone really. I've never run into this problem and every other manager and DON I work with I have a great relationship with. She is constantly second-guessing my clinical decision making and if those sleep study results had been hidden from me and tucked away, it would have affected the patient's care. She also doesn't want us ordering vaccines for patients who need them "because they're all going to die soon anyway." I don't want her to undermine my clinical decision making or make nurses not trust my clinical judgment but I am not a confrontational person unless I absolutely have to be. Was hoping to get some advice/guidance here how to approach this.
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