First write up as an RN

[Leesha]

I work in a sub-acute unit at a physical rehabilitation center. It's my first job as an RN and I have been there for 7 months. I recently had 2 patients complain to me about how they were treated by a particular nurse on the weekend. I have never had a patient complain before for so I asked the DON what to do and was told to fill out a form. I filled out the form and turned it in as I was told to do. The next day I was called in to the office and was written up. I was accused of talking about another nurse on night shift to my patients which never happened!!! I find it very convenient that this happens to me after I report a nurse that has been there for 7 years. I thought we were supposed to advocate for our patients??? How am I wrong for following a policy that they put in place?

As frustrating as this is I will have to start looking for another job. They called the write up a class 3 so it is my first and final warning. Any insight on this would be appreciated.

Thanks,

Leesha

[Leesha]

Don't get petulant, of course patient advocacy is something we must do. However, you were asked some good questions and given advice based on only what you told us on the first post. Try to go back and read what people answered more carefully; they all mean well. And try not to assume that just because everyone didn't jump up to agree with you on first blush that it's time to go out back and eat worms. :)

I got the point of what's expected from my job loud and clear. I have also thanked everyone on here for their input and advice...perhaps you should go back and read my responses more carefully. And I'm not looking for people to agree with me, I'm simply looking for an objective opinion from someone with more experience that can do it in a non-condescending way.

Thank you :)

[Leesha]

I disagree. It is not my job to play investigator and ask a nurse about his/her relationship with a patient. If I were the OP and a patient complained I would find out what the policy says and take it from there. I would not get caught up in "she said he said" stuff. If the policy is for the nurse to whom it was reported to to fill out a form of complaint then so be it. If a patient was to complain about me, I would rather for a formal investigation to be started so that facts would come out. I agree that we don't have enough info. to speculate but if the OP did follow policy and kept the convo objective, then she/he should not have been given a first and final. I don't agree with reporting any and everything to the DON unless it constitutes resident abuse. [/quote']

The purpose of going to the DON was to ask what the policy was...not to report anyone to her. I thought I was doing the right thing for my patient.

Thank you :)

[nnancy627]

I got the point of what's expected from my job loud and clear. I have also thanked everyone on here for their input and advice...perhaps you should go back and read my responses more carefully. And I'm not looking for people to agree with me, I'm simply looking for an objective opinion from someone with more experience that can do it in a non-condescending way.

Thank you :)

Welcome to the American nursing home world. It's a big gooey pot of 'lose/lose' situations, daily. Same menu every day, just different spices. (Hot 'n' nasty being the preferred).

[BrandonLPN, LPN]

I disagree. It is not my job to play investigator and ask a nurse about his/her relationship with a patient. If I were the OP and a patient complained, I would find out what the policy says and take it from there. I would not get caught up in "she said he said" stuff. If the policy is for the nurse to whom it was reported to to fill out a form of complaint then so be it. If a patient was to complain about me, I would rather for a formal investigation to be started so that facts would come out. I agree that we don't have enough info. to speculate but if the OP did follow policy and kept the convo objective, then she/he should not have been given a first and final. I don't agree with reporting any and everything to the DON unless it constitutes resident abuse.

Well, isn't reporting someone based on what someone else said pretty much the definition of "he said, she said"?

I guess a lot of this hinges on what exactly these pts told the OP. From what she (the OP) said, I glean that these pts were c/o something more along the line of perceived "meaness". Very different from a legit abuse allegation. It goes without saying that suspected abuse needs to be brought to the higher-ups' attention. But general complaints about another nurse's performance?

I'm sorry, but if what we're talking about here is rooms 207 and 210 complaining that the night nurse is rude and mean, you better have something more concrete before you go to the DON or fill out some official report. These types of complaints might be part of your case when "turning in" a bad nurse. But if that's all you got..... sorry it's not enough on it's own.

Do you know how many times I hear Little Old Lady #1 tell me "Nurse Suzy didn't do my dressing!" only to discover it's a qod dressing change and today's not the day? Or Little Old Lady #2 tell me "CNA BettyLou threw me around" only to find out for firsthand that this LOL considers being log rolled in bed tantamount to assault and battery?

Even if a facility's policy in these situations is to fill out some form, it's prudent to adress it with the nurse in question first. Isn't that just a professional courtesy?

Again, if one were to just fill out a report every time a pt complains, it would make for a truly miserable, drama-filled career. I don't know where you work, but where I work pts complaining about one shift to another is a daily thing. You gotta take it with a grain of salt.

[BrandonLPN, LPN]

I didn't know who the nurse was that the patient was complaining about since she didn't wear a name tag and the patient didn't know her. I asked the DON what the proper procedure was....I didn't "go running" to get someone in trouble. I guess being an advocate for patients is something they teach in school but not really what we're supposed to do in our practice. I got the point loud and clear.

Thanks for your input :)

I can support the idea of a new nurse wanting to find out what the proper policies and procedures are.

But after you found this information out you obviously reported what those patients said about this nurse, be it verbally or in a official report.

Isn't it kinda passive aggressive to now say "but I was only inquiring what proper policy was"?

I stand by the advice that you should be more careful in the future.

[NurseDirtyBird]

"Advocating for our patients" does not necessarily mean reporting and recording every complaint made by the patients. People in sub acute/long term care, are very rarely happy to be there. There's always plenty to complain about, and out of the several nurses caring for them, there's bound to be one or two they just don't like. That's life. As long as the complaint was not about poor care or abuse, you go to the nurse in question and tell them "so and so said you were mean to him last night, what happened?" You might hear something like, "He called me a racial slur and cursed at me, so I said as little as possible and got out of there as fast as I could."

You have advocated for your patient by finding out both sides of the story, and can decide whether the complaint warrants being sent through official channels.

Your DON likely did not have any idea what was going on and told you the policy, just like you asked. When it came across her desk, she may have seen that the official paperwork was unwarranted, you misjudged the situation, and you got into trouble. Not saying it's fair, just what may have happened.

[BrandonLPN, LPN]

And Leesha, yes you were being somewhat petulant.

When you thank everyone for their advice and then, in the same breath, question our commitment to patient advocacy it decreases the sincerity somewhat. Don't get me wrong though, I always appreciate a healthy dose of sarcasm.

If you disagree with how people responded then, by all means, defend your position. Present your arguments. Join in the fray. Maybe you have some insight I haven't thought of. But I grow weary of threads where the OP says "I came hear for advice and all I got was condescending/mean comments." What you're really saying is "Why isn't everyone agreeing with me?"

[leslie :-D]

i agree, something sounds *off* about a first and final warning.

being a new nurse, i can and do understand your reaction of going to the DON.

but pt advocacy needs to be appreciated in the grand scheme of it all.

depending on the severity of complaints, it is preferable and more courteous to go to the recipient of complaints, and give him/her a heads up.

"mary, i just thought you'd want to know that a couple of pts are complaining that you were rude to them".

"mary,.... "want to know that a couple of pts are complaining that you are being too rough during personal care".

relatively benign stuff should be relayed to the accusee.

more serious stuff, e.g., abuses, negligence, withholding meds...should be brought up the chain of command.

or, as your p&p dictates (for serious accusations).

choose your battles wisely, they say.

and that's very true.

unless we are missing some pertinent info, it does sound as if you are being unfairly dealt with.

and sadly, that isn't anything new either.

you have a deep learning curve ahead of you in your nsg career, leesha.

i would suggest you read and reread the posts and focus on the message...

and not the messenger.

wishing you the very best,

leslie

[Racer15, BSN, RN]

When a patient complains to me about another nurse or doctor, I encourage them to either make that complaint clear in their customer satisfaction survey, or give them the number of our director, who handles such complaints. I don't like to play middle man.

[drowningdaily]

Patient advocacy does NOT mean getting involved in patient reindeer games. With the ever annoying motif of the customer is always right, most facilities have clearly identified ways to communicate concerns to management. Unless it was abuse or neglect, let it go. Throwing fellow nurses under the bus for meanness is not appropriate.

[chrisrn24]

At my work we have concern forms. In that case, I would write a form saying patient X told me this and patient Y said this about nurse Z. Our social work department will decide to investigate or not, but at least you know that you reported it.

[tyvin, BSN, RN]

It's not a good idea, no...it's never a good idea to write up a he said she said. It invites speculation and gossip and there you go. Next time give them a number to call or refer them to the hospital survey that will be coming post stay. Believe me, there will be a next time.

My goodness; how did you find the time to do all that! That's a lot of energy wasted. Remember; phone number, patient survey.