Help regarding nursing priorities in regards to patient care

Nurses General Nursing

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I had a situation in which I was giving a patient K-ryders for a potassium of 2.8. A seperate patient requested my care specifically to clean her because of a bowel mov't. At the time, I felt unavailable to do both and asked an aide to clean this patient and the patient refused the care due to him being a male staff member. I felt the priority in this situation was to finish giving the medications. A supervisor reprimanded me yesterday stating that patient care was more important than hanging medications and stated specifically "that there are no priorities in nursing" and that the patient who was unclean was more important than giving the medications at that time. This goes against everything I have been taught in school. I just graduated in May of this last year and am looking to find if anyone else thinks I was wrong in this situation. Any advice is appreciated. please help I have never heard of anyone losing their license for a wet bed but I certainly have for medication negligence.

There is another thread going on right now about "what is some of the major problems in nursing" IMHO, part of the problem is this exact thing. The pt. had an aide available to take care of him/her, but that aide wasn't who they wanted, (male vs. female). Our facilities force us to cater to pt. like we are servants, a pt. can say, do or act out any way they want to and know they can get away with it because mngmt. backs them up and knocks us down! I think your priorities are exactly where they should be and had I been in your shoes, would have done the exact same thing. Wouldn't you just love to tell a pt. one time, "if you don't like it here, you can go somewhere else". Guess you can tell I just got off work after kissing family and pt. butt all day long!!!!! (not to mention managements also).

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Almost every point? Well, when you've been on the floor longer than two weeks you'll learn that my every utterance is a glistening pearl of wisdom, to be admired, cherished, and obeyed! :chuckle
Well, now, don't get yourself all worked up....

Our only point in contention is that I would have protected the monitor.....!

:rotfl:

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Specializes in LTC, ER, ICU,.

no comments

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Specializes in Critical Care/ICU.

Only meds I allow other RN's to give for me are prn nausea and pain meds (unless my patient was coding or near coding while I was on break, away from the unit).

I personally don't think it's a good (or safe) practice.

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Specializes in LTC, ER, ICU,.

no comments.

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Specializes in jack of all trades, master of none.

Meds, then poop.... I agree that if this pt was coherent enough to refuse a male's assistance, she 1) wasn't that messy or 2) just a P.I.T.A.

As far as your supervisor goes.. sounds like she has gone to one too many Disney Management Sessions. Nursing is ALL about prioritizing. Uggghghhhgh,this catering to the patients like they are guests in a hotel is reaaaaaallllly getting old.

"Hi, my name is Nurse Genie & I am here to cater to your every wish. Please give me just a moment to grab my magic wand so I can take care of all 8 of my patients at once. Thank you for allowing me to care for you today. Is there anything else I can assist you with at this time, pedicure, manicure, spoon feed you lunch, even though you are up ad lib?" Makes me soooooo glad to be off on medical leave right now. I think I really was needing the break from that B.S.

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Specializes in Community Health Nurse.

dixielee stated in post #7: "you did the right thing. just because someone is a supervisor does not necessarily make them right, or knowledgable. stick to your own good judgement, you sound like you are doing fine."

great advice!!! :) i've had a few "no it alls, but know nothing" supervisors in my days of nursing, and when they say dumb stuff like that, i still will do what i know is best to do first because it's my license and not the supervisor's license on the line. :rolleyes:

that patient should have allowed the male cna to clean her butt. it's no different than when the male docs examine her naked. a man is a man. since she complained about "who" was sent to her room to clean her up, she should have been patient and waited a few more minutes until a female healthcare worker could get to her. it's her right to choose who she wants to clean her, but not her right to complain just because what she wanted didn't happen when she wanted it to. :uhoh3:

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Specializes in Community Health Nurse.
....................................."Hi, my name is Nurse Genie & I am here to cater to your every wish. Please give me just a moment to grab my magic wand so I can take care of all 8 of my patients at once. Thank you for allowing me to care for you today. Is there anything else I can assist you with at this time, pedicure, manicure, spoon feed you lunch, even though you are up ad lib?" Makes me soooooo glad to be off on medical leave right now. I think I really was needing the break from that B.S.

:rotfl: :rotfl: :rotfl: I sooooooooo hear you on this!!!:rotfl:

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I would have done the exact same thing that you did! Waiting 10 extra minutes to be cleaned up will not cause skin breakdown or major trauma...it can wait! Your supervisor has no backbone. Had the patient not complained, you'd have been commended for you prioritizing. It's strange how we're taught to do one thing (by the facilities as well), yet when the patient complains we're always in the wrong regardless of how irrational it is. Nurses need to be like the Shiva with 20 bazillion arms! :rolleyes:

I thought my supervisor was absolutely nut by this. What I neglected to mention in my first post was how the unclean patient's family member came out of the room and threatened physical violence towards me. As it turns out this family threatened not only me but also 2 other staff members on seperate shifts. Apparently, management was aware of all of these incidences but chose not to act on them. The family was fishing for things to complain about in other words. As all this was passed along to my manager it now comes to light if the patient ever returns to our hospital she will not be put on my floor. But do you think I ever got an apology or way to go for following the hospital policies and procedure. The answer to that is no. I knew in my heart and from my knowledge that I did the right thing in this situation, and regardless of what that manager seems to think, if I am ever posed with that situation again I will change none of my actions. Thank you for your agreeance. I just needed to hear it wasn't just me.

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... What I neglected to mention in my first post was how the unclean patient's family member came out of the room and threatened physical violence towards me. As it turns out this family threatened not only me but also 2 other staff members on seperate shifts. Apparently, management was aware of all of these incidences but chose not to act on them.... /QUOTE]

Threatened physical violence? What did they say or do? Was this an adult?

I remember when working in psych, one of the male attendants came to me and said that one of the male patients had threatened him 3 times that day saying he would "break his bones" - I then went to the doctor, a meeting was arranged immediatley with this individual and the staff involved. To explain that his threats were inappropriate and would not be tolerated.

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Specializes in LTC, assisted living, med-surg, psych.

Sometimes I'd love to be able to remind certain types of patients that a hospital is NOT Burger King---you can't have it your way!!

In practice, of course, I always try to accomodate their wants and needs; however, when it's a poopy butt vs. a life-threatening electrolyte imbalance, well.......I don't care if the poopy butt belongs to the Queen of England, the pt. with the K+ of 2.8 wins every time.

If this were a perfect world, we'd be able to be everywhere we're needed at once.....then again, in a perfect world patients who are AA & O wouldn't sh** themselves in bed, refuse CNA care and then whine to the management about not being cleaned up. :angryfire

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I'm still having a good laugh about that one! Obviously, this person did not go to my nursing school! :rolleyes:

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