I shaved off a patient's mustache. Was I wrong? - page 3

I was written up yesterday for shaving off a patient's mustache. I don't understand what I did wrong. The man has had a stroke and has trouble feeding himself. He was getting food all over his... Read More

  1. by   ktwlpn
    Quote from NebbyLPN
    I was written up yesterday for shaving off a patient's mustache. I don't understand what I did wrong. The man has had a stroke and has trouble feeding himself. He was getting food all over his mustache and face because of weakness in his right hand and arm. I come in to work the last two days and find all kinds of food particles in the hair and it just looked horrible. I couldn't clean the food particles out. I told two different charge nurses about this. I finally got so disgusted with it that I asked the man if it was OK if we shaved the mustache off. He nodded it was OK. Then, his daughter came in and raised the roof about it. I hadn't seen her visiting him the two previous days. She demanded to talk with the supervisor and told her she was going to sue the hospital! She said her father had this mustache for years--years! and was known among his family for his pride about the mustache. She said he would wax it up into elaborate curls. She told me that I should have called her first before doing this because the man's had dementia for some years. Well, no one told me that. I told the daughter that I had gotten her father's permission to shave the mustache off and he was very cooperative about it. I haven't been able to sleep at all tonight I've been so worried about this. I think I'm in big trouble and scared to go back to work today. What should I do? Should I call a lawyer?
    I don't think shaving off the moustache was a good idea but I don't think you should have been written up....Review your policy and procedures-I think that if this is your first occurence a verbal warning would have been appropriate.If I were you I would speak with the supervisor again.Make a case against the severity of your discipline-no harm was done,non was intended....The family has to be schmoozed majorly (P.R.)but they don't have grounds for any kind of lawsuit...Read the other posts carefully and look at what the moustache symbolizes to the family at this point....I would have carefully trimmed it..Good luck
  2. by   ZASHAGALKA
    I have a list of things you should maybe call and ask the daughter if you can do to her daddy:

    Ask if:

    it's ok to wipe his butt - after all, some of those 'crumbs' might have been there for ' decades' - it might change who he is.

    it's ok to give meds - the xanax might make him a different person.

    it's ok to turn him - if you change the status of potential bedsores, you change who he might be, by his own choice.

    it's ok to feed him peas - he might not like them and so obviously can't speak for himself. Same goes for corn, carrots, meatloaf, pudding, jello, juice, etc. etc.

    it's ok to put a gown on him - after all, that's not how he normally looks.

    I could go on an on. The point is, I EXPECT family members to often be in the anger an denial stages of grief. That's normal.

    You'd think though, that maybe management could figure this out, too. Just because somebody's angry doesn't make that anger justified.

    ~faith,
    Timothy.
  3. by   Marie_LPN, RN
    Quote from ZASHAGALKA
    I have a list of things you should maybe call and ask the daughter if you can do to her daddy:

    Ask if:

    it's ok to wipe his butt - after all, some of those 'crumbs' might have been there for ' decades' - it might change who he is.

    it's ok to give meds - the xanax might make him a different person.

    it's ok to turn him - if you change the status of potential bedsores, you change who he might be, by his own choice.

    it's ok to feed him peas - he might not like them and so obviously can't speak for himself. Same goes for corn, carrots, meatloaf, pudding, jello, juice, etc. etc.

    it's ok to put a gown on him - after all, that's not how he normally looks.

    I could go on an on. The point is, I EXPECT family members to often be in the anger an denial stages of grief. That's normal.

    You'd think though, that maybe management could figure this out, too. Just because somebody's angry doesn't make that anger justified.

    ~faith,
    Timothy.
    Nor does it justify being sarcastic concerning someone's "daddy."

    I completely got your point, but the first sentence of your post with the "daddy" was really condescending.
  4. by   ZASHAGALKA
    Quote from Marie_LPN
    Nor does it justify being sarcastic and condescending concerning someone's "daddy."
    I"m not.

    I don't fault the daughter at all.

    I'm being sarcastic towards management's attitude that all complaints must be the nurse's fault.

    And I'm being sarcastic towards that attitude that the OP should ask the daughter's approval for things the pt already approved.

    Look, I can understand that shaving a mustache can be a 'big deal'. But there are 'big deals' and there are 'BIG DEALS'. This is no big deal.

    ~faith,
    Timothy.
  5. by   grannynurse FNP student
    Quote from ZASHAGALKA
    I have a list of things you should maybe call and ask the daughter if you can do to her daddy:

    Ask if:

    it's ok to wipe his butt - after all, some of those 'crumbs' might have been there for ' decades' - it might change who he is.

    it's ok to give meds - the xanax might make him a different person.

    it's ok to turn him - if you change the status of potential bedsores, you change who he might be, by his own choice.

    it's ok to feed him peas - he might not like them and so obviously can't speak for himself. Same goes for corn, carrots, meatloaf, pudding, jello, juice, etc. etc.

    it's ok to put a gown on him - after all, that's not how he normally looks.

    I could go on an on. The point is, I EXPECT family members to often be in the anger an denial stages of grief. That's normal.

    You'd think though, that maybe management could figure this out, too. Just because somebody's angry doesn't make that anger justified.

    ~faith,
    Timothy.
    The only portion that is possibly correct is the next to the last statement. Timothy, I do not know if you have or have ever had a beard and/or mustache but somehow I get the impression that facial hair is not an important part of your life. For some men and their families, facial hair is an important part of the self. The fact that this gentleman had experience a stroke and had dementia negates the fact that OP shaved off the gentleman's mustache. In a great many facilities this is generally considered a violation of facility policy. I know that it was in several facilities that I have worked at during my career. And it was a violation in the teaching facility that I was an administrative assistant. The other people who failed to clean this gentleman's mustache are in the wrong. And they should be spoken to as it is clear the gentleman is unable to clean it himself.

    Grannynurse
  6. by   TypicalFish
    While I understand what you did, and know that it was for the patient's interest, you needed to think a couple of things out first; you state "She told me that I should have called her first before doing this because the man's had dementia for some years. Well, no one told me that." Didn't you get this in report? Why wouldn't you know that your patient has had dementia 'for years'? I got burned once in report, and now ALWAYS read the pt's H&P, or at least the admission sheet to get the full picture. Also does the daughter have POA? Because if she does, technically, you should of asked her before shaving your patient. And finally, Document, Document, Document! "pt's facial hair has reached length that interferes with feeding patient; food easily tangled into beard; pt's facial hair stays matted and continues to be moist, even with cleaning/grooming q 2 hours and prn; potential for skin breakdown and infection very high; Pt agrees to having mustache shaved, charge nurses notified x2." CYA.
  7. by   Tweety
    ----------------------

    I think the patient's daughter saying she's going to sue is a bit extreme. Why is it that is someone's first reaction?

    I can't really add much to this thread though.

    Good luck.
    Last edit by Tweety on Oct 13, '05
  8. by   ZASHAGALKA
    I shave off mustaches all the time and rarely bother to ask if it's ok.

    But then,

    I work in critical care and sometimes tis necessary to get ETTs to tape and hold in place right.

    I get pts from OR w/ their heads shaved all the time - male and female, regardless of its ability to grow back.

    Look I understand that this is a 'control' issue for a daughter increasing losing control of who her dad is to her. I don't fault her for that. And I don't fault her for being irrationally angry - and let's not mistake this - no matter how 'justified' being upset over a mustache might be, threatening a lawsuit is irrationally over the top.

    It's a stage of grief. Sometimes you have to know where someone is coming from in order to identify with them.

    The woman's actions were 'normal' in their irrationality.

    Management should understand this. I side with the OP. The OP may have made a less than optimal judgment call, but that's it. Management should have stood by her.

    To me, this isn't a patient/family member being upset issue or a patient advocacy issue - it's a management advocacy for staff issue, or in this case, the obvious lack thereof.

    ~faith,
    Timothy.
  9. by   Tweety
    Quote from ZASHAGALKA
    I shave off mustaches all the time and rarely bother to ask if it's ok.

    But then,

    I work in critical care and sometimes tis necessary to get ETTs to tape and hold in place right.

    I get pts from OR w/ their heads shaved all the time - male and female, regardless of its ability to grow back.

    Look I understand that this is a 'control' issue for a daughter increasing losing control of who her dad is to her. I don't fault her for that. And I don't fault her for being irrationally angry - and let's not mistake this - no matter how 'justified' being upset over a mustache might be, threatening a lawsuit is irrationally over the top.

    It's a stage of grief. Sometimes you have to know where someone is coming from in order to identify with them.

    The woman's actions were 'normal' in their irrationality.

    Management should understand this. I side with the OP. The OP may have made a less than optimal judgment call, but that's it. Management should have stood by her.

    To me, this isn't a patient/family member being upset issue or a patient advocacy issue - it's a management advocacy for staff issue, or in this case, the obvious lack thereof.

    ~faith,
    Timothy.
    There's a difference between a medically necessary shave and what this nurse did in my opinion.

    But I agree, management should have been more supportive.
  10. by   caroladybelle
    The patient approved so I do not see where the daughter could sue.

    I get aggravated with the complaints when we do not shave the patient, but then when we do, it is "Oh, the side burns are too short, the goatee is wrong", yada, yada.

    Facial hair is to men what hairstyles are to women...very intensely personal and frequently a defining feature to many. Children of an elderly lady might be ticked if she agreed to cut her hair and the nurse did so. Yet, I have had elderly patients ask me to do so, or chemo patients losing their hair ask me to trim it short for comfort.

    If a patient has had a specific style for most of their life, the change can be scary to those around them. Many women of my kin do not ever do more than trim their hair lightly during much of their lives. If someone cut a loved ones hair short, someone in the family would probably raise Cain, whether the patient requested or not.

    I personally cannot abide kissing men with abundant facial hair, unless it is very soft......I get serious whisker burn. And I have had men that absolutely adored me, but I could not be close to them without developing a rash from their facial hair. Yet, some could not stand the thought of shaving their moustaches off, thus the relationship ended. I know women that will cut/grow/ dye their hair for a man but men that will not shave their moustaches for them.
  11. by   menolly_33
    I completely got your point, but the first sentence of your post with the "daddy" was really condescending.[/QUOTE]

    Why do you automatically assume the wordy daddy was used in a condecending way. I was raised in the south and have never called by father anything else. I see the poster is in TX so he may not have meant it that way. I found the post to be very funny. Your da**ed if you do, and da**ed if you don"t
  12. by   Corvette Guy
    Quote from ZASHAGALKA
    I"m not.

    I don't fault the daughter at all.

    I'm being sarcastic towards management's attitude that all complaints must be the nurse's fault.

    And I'm being sarcastic towards that attitude that the OP should ask the daughter's approval for things the pt already approved.

    Look, I can understand that shaving a mustache can be a 'big deal'. But there are 'big deals' and there are 'BIG DEALS'. This is no big deal.

    ~faith,
    Timothy.
    The patient has dementia!
  13. by   Corvette Guy
    Quote from caroladybelle
    The patient approved so I do not see where the daughter could sue.

    I get aggravated with the complaints when we do not shave the patient, but then when we do, it is "Oh, the side burns are too short, the goatee is wrong", yada, yada.

    Facial hair is to men what hairstyles are to women...very intensely personal and frequently a defining feature to many. Children of an elderly lady might be ticked if she agreed to cut her hair and the nurse did so. Yet, I have had elderly patients ask me to do so, or chemo patients losing their hair ask me to trim it short for comfort.

    If a patient has had a specific style for most of their life, the change can be scary to those around them. Many women of my kin do not ever do more than trim their hair lightly during much of their lives. If someone cut a loved ones hair short, someone in the family would probably raise Cain, whether the patient requested or not.

    I personally cannot abide kissing men with abundant facial hair, unless it is very soft......I get serious whisker burn. And I have had men that absolutely adored me, but I could not be close to them without developing a rash from their facial hair. Yet, some could not stand the thought of shaving their moustaches off, thus the relationship ended. I know women that will cut/grow/ dye their hair for a man but men that will not shave their moustaches for them.
    The patient has dementia! Yet, I seriously doubt any grounds to sue are legitmate here.

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