Crisis situation at work last night

[hapeewendy]

I really need some help/input as to a situation I went through at night last night

I work on a very busy med/surg floor currently doing 12 hour night shifts, Five RN's on at night for 35 patients.

we have been working with a nurse for the past year or so who sometimes seemed moody or easily aggravated and had several negative interactions with other satff members, most of which were brought to our unit administrators attention and dealt with and never followed up.

Last night the blank really hit the fan.

we will call her Nurse 1 , well anyway she had been in a bad mood the night before but seemed okay to the other four members on our nursing team.

she came on shift and was not speaking, slammed a door into one of the nurses arms , bumped into me with her medcart and told another RN to shut up.

we were all helping with her patients during the first 2 hours of her 8 hour night shift. I took an admission and then gave her report on it and she ignored me repeatedly, then that same new admission coded on the bathroom floor and this RN was nowhere to be found, another nurse and I initiated the code and started the work etc, I was doing the documentation and RN #1 came up and grabbed the chart and clipboard from me and said "just go away!" I mentioned to my incharge that I was concerned about all these incidents of verbal and even physical abuse by RN #1 , to which the charge nurse agreed, We were contemplating what to do about the situation when RN #1 came to me, threw her charts at me and said that she was leaving her patients and that I was to care for them because she "had to leave before she harmed someone, one of us or one of her patients" I attempted to ask if there was anything I could do but she started to really raise her voice and concern the rest of the team that she could be of harm to our physical safety, one of the nurses was thinking of calling security but by that time nurse #1 had stormed off , leaving her 7 patients without an RN to care for them.

the rest of the members of the team and myself got together, one did the meds for that team, I did the vitals and any patient care, while the third did the ins/outs etc . Our incharge called the unit administrator on call and security, both made reports, our own UA came in early and we all had to fill out detailed reports of what happened etc as this will be a practice issue for the college of nurses.

now on to my problem, this incident has left me shaken, exhausted emotionally and yet still hoping this RN doesnt harm herself or anyone else. Our UA ensured us that she would be in contact with RN #1 but we dont know whats going on and its scary.

also the disgusting state she left her patients in is something i cant get out of my head.

one of the patients had such a soaking underpad that you could ring it out, the other ones head was wedged inbetween the siderails etc.

I havent slept, we left 2 hours late from our shift, our co workers are badgering us for details ,like I said I'm exhausted.

any helpful tips?

thanks

[thisnurse]

i would be shaken too but it WAS better she left before something worse happened.

if someone wants to kill themselves you cant stop them, if they are really intent.

all you can do is try to forget it. from what you said about the state of her patients she didnt much care for her job anyway.

[Paprikat]

Wow, what a horrible situation to be put in. It is nice to see that you still cared about her enough to ask if she was okay and tried to offer support, rather than be angry with her. It sounds like she really needs some help. Maybe things are not good in her life personally, but there really is no excuse for verbal, physical aggression and patient abandonment....I guess that you can't be responsible for other people's actions...

Perhaps I would wait to hear if the UA has contacted her, like she/he said they would...

Take care fo yourself and be proud that you did the right things that night.

[prmenrs, RN]

It would seem like the entire group of nurses on that night need to "de-brief", either together, or better yet, with someone from the hospital who can be supportive (like an Employee Assistance Program counselor or similar), and help you and everyone else in the group deal w/this trauma.

It sounds to me as if whatever was going on w/this nurse had been happening for a long time, had very little to do with you personally and reached the boil-over point. Worse could have happened. If she comes in to the unit without notice, I would contact security. She sounds VERY worrisome.

It sounds to me like the group came together admirably, and took care of the patients in a very professional fashion. That was very good work, hapee!!

Good Luck!

[Mary Dover]

Oh my gosh, hapeewendy. Psychiatric evaluation is definately in order for nurse #1. And I would think that your administrators would want to follow up to ensure that happens - like NOW. Helping nurse#1 is out of your hands now. She obviously has serious trouble. No excuse for patient abandonment, but it's likely a good thing that she left when she did, before worse could happen. Perhaps it's sounds like I am trying to defend her, well in a way maybe I am = but definately NOT her actions. But the fact is, she had likely lost (or is at least beginning to lose) all ability to make rational judgement. So in that sense, yes it is good that she left.

BUT - the really wonderful thing is the way you and your team were able to pick up her slack and go on with caring for your patients as well as hers. I am sure that her patients needed your empathic care, after what they had likely been through as well with nurse #1. God bless you guys!

Take care and please keep us posted about the outcome with nurse#1 as well as about how you are bouncing back.

Mary

[mattsmom81]

Wow. Scarey that there are folks like this out there, isn't it....I worked with a rumored 'agent orange' nurse whose behavior was eerily similar...violent, throwing things, abusive, etc.

The only thing I might add to all the other great comments was consider notifying your BON and let them investigate. I know we hate to do this and potentially harm another nurse's ability to make a living, but she sounds dangerously ill and needs an intervention. The BON will insist she get help and if she won't, they'll take the license.

Hospitals tend to dismiss nurses with behavior problems and drug diversion, etc. and keep things quiet to avoid liability. Often these nurses just move on to another facility to do the same things.....if a conscientious nurse had notified the BON further harm may have been prevented. Sometimes we think "Someone must have reported him/her by now and got her some help" but sadly nobody has.

[oramar]

Boy, I really hope she is seeking help cause she needs it. She is in very big trouble and any one that crosses her path could be in trouble.

[SICU Queen]

Look at it this way. I doubt seriously that you'll be working with her again... She sounds like a lunatic, and hopefully the BON wil force her into some sort of counseling or what not...

Jeez...

[duckie]

This nurse stated she could possibly hurt someone. That should not be taken lightly. There are many reasons one could make a threat like this. Does she have serious home problems, is she using drugs of some sort, does she have mental problems that need addressed? I would certainly hope that no one will allow her to return to caring for patients until the reason for this comment is investigated and acted upon. IF she still has a job there, it should be only after a leave of absence that she could return and after proving she has gotten help for what ever is causing her to behave this way. People snap and I'd hate to see an innocent person harmed because nobody took action to find out why she is behaving in sucha way. Also, by leaving like that, she could loose her license if turned into the nursing board, she left her patients, not caring if anyone took care of them or not and it sounds like even when she was there, she wasn't caring for them. This is a very sad situation and I hope someone gets her some help. Firing her is not a solution, it passes the problem off to someone else. I hope they insist she seek help and then if possible allow her to return to work after all issues have been settled. You were all a great team and pulled together to take care of the patients, you all did great even under the very worst of situations. God Bless and keep us posted.