Last night I had a patient who had questions about his vanc piggyback. He was under the impression that the vanc was to run 24 hours. I explained that it didn't work that way, that he was dosed with a certain amount every so many hours. He stated that he felt that it would not fight his infection that way. I stated " it enters the bloodstream and after so many hours of being in circulation it is excreted by the kidneys, which is about the time you get your next dose of vanc. It's like pill abx, you don't take it constantly, just every so many hours based on how long it takes to be excreted" He didn't like that explanation, or any other I gave, so I offered to have another nurse, the nursing supervisor or the resident on call to explain it to him , and he refused, he said he would speak to his attending in the morning. It was a busy night and I did not chart this conversation. Which is turning out to be a big mistake.
At the beginning of the evening shift tonight he had a slight temp 99.9, he's on scheduled motrin, so we said we would recheck the temp later. At 1730 he hits the call light, I'm not his nurse, but I answer the call light. I asked him if he needed something, he said no. I said "are you sure, you did hit the call light' he told me to get out of his room.
An hour later his wife comes up to the nurses station and says she wants his temp rechecked by his nurse, I knew his nurse was in the middle of a "code brown" so I said I would do it. WIfe refused to have me check his temp becuase "he doesn't like you, you explained things on a third grade level last night when he asked you a question, and you never did anything for him when he hit the call light an hour ago." I replied that i went into the room and that he stated he did not need anything.
She's really upset,stating that his care is being compromised, won't allow me in the room, and everyone else is unavailable at the moment, I'm charge nurse but I can't seem to de-escalate the situation, so I call the nursing supervisor up. the first thing the super does ask what's going on. In front of me the wife tells the super that her husband doesn't like me because I said "bad words" to him last night. the super gets angry and asks "what words" the wife then states "she said "I want you to understand", and that is one thing that will drive him crazy." At this point I completely walk away from the wife and the super because I don't want to say or have any facial expression that could get me in trouble.
After a while the nursing super comes over, grabs my arm and pulls me into the break room. The super is insisiting that I go into the room with her and apologize to the patient for my attitude. I tell her, No way, I am not apologizing for wanting a patient to understand the rationale for his med schedule. The super then says this is called service recovery. I tell her I think it is ridiculous to apologize for telling a patient " I want you to understand" when I'm doing patient education. She then threatens me to write me up for verbal patient abuse for the patient education and for neglect for not taking the patients temp when wife requested it. She threatened my nursing license. I tell her to write me up then, because I will fight it all the way up the chain if I have to.
At this point the super launches into a personal attack, criticizing my accent because I sound "stuck up", my "lack of facial expressions" at times when providing patient education, and that I am taking out frustrations from my personal life onto the patients. She kept raising her voice, calling me girl and finally I just went off. I told her I am an adult and a professional nurse, and I expect to be treated like one, do not talk to me like this. She then said I am completely wrong in my handling of the situation, and that this is not the end of this. I am completely upset, and when I get angry/frustated I tend to cry, so then she went off on me about how I am completely unsuited to be a nurse until I can learn to control my emotions.
I did chart some of what when on tonight with the wife's complaints about patient care,yet refusing to allow certain staff in room to provide that care. And I wrote out an internal complaint form that doesn't go into the pt's chart about the super's behavior. But my facility has a zero tolerance policy for alleged patient abuse, and ALLEGED abuse is enough to be suspended.
I honestly don't feel like I did anything wrong other than not charting the patient education on the vanc dosing. Any ideas on what I can do to protect myself in this situation would greatly be appreciated.
