I shaved off a patient's mustache. Was I wrong? - page 5

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   BowlerRN
    I understand shaving the patient for better hygiene, but I do understand the daughter being upset to some extent, although it sounds like she overreacted.
    If a patient has had a mustache for years, then it is obvious this is something want and should be respected, It seems more like a dignity issue to me. Any nursing home resident has already lost a lot, including their home, ability care for self, privacy, etc. And as an alzheimer's patient he has lost his ability to remember and probably to recognize other people and had a cognitive decline. It may not seem like a big deal, but to someone who has already lost so much, a mustache probably is a big deal.
  2. by   MDSlady
    I personally would be angry too. I have not seen my husband without his moustache since I met him, and however, that I tease him that I would like to see him without it, I would be upset if somebody shaved it off. I know how much it means to him and I know that he would not want anybody to see him other than with his moustache. I would, god forbid this happens, is to have the staff talk with me first and discuss this and make a "group" decision rather that it being the decision of one staff person. If I found out that in the end, it was "best for my husband or loved one", I would agree to it, but however it should not of been done without discussion with family and the resident.
  3. by   following_faith
    I am just wondering something...I thought that you had to have a written, informed consent from the patient before you could shave a beard or mustache. That what my book for school was saying...just curious and trying to gain a little learning.

    Thanks!
  4. by   DusktilDawn
    There was an incident at a facility I worked for over TRIMMING a beard. Apparently it was against custom/religion for men to cut the beard (including trimming) in this situation.

    Other posters have brought up good points in regards to identity and self where beards/mustaches are concerned.

    My suggestion would be error on the side of caution. You can clean the facial hair, but discuss grooming with the patient or family depending on the situaiton. In the case of removing facial hair out of medical necessity, most reasonable people would understand.
  5. by   SharonH, RN
    There have been some excellent points made about patient dignity and identity. However :

    1.3 million people injured each year due to medication errors and
    7000 deaths yearly d/t the same. Between 44000 and 98000 people die from medical errors yearly.


    I don't mean to seem unsympathetic to the "plight" of the family but *shrug* .

    If that is the worst mistake that happens to her father during his hospitalization then she should get down on her knees. In fact, if that is the worst mistake you make during your career then you should get down on your knees.
  6. by   Little Panda RN
    Quote from baby&mommynurse
    I feel a little differently about this situation. Although, I'm sure NebbyLPN was acting in the "best interest" of the patient and he did nod yes when she asked him if it would be okay to shave his mustache off, she should've known about his dimentia. Perhaps she should've checked with the supervisor and the family before doing so. Family members do like to be involved with what goes on in their loved one's care, even if it is just an issue grooming.

    I'm sure the daughter would be more understanding though if she knew the situation about the difficulty of keeping his mustache clean... and maybe next time, she could be involved with that part of the care.
    I know that this does not even pertain to this discussion but baby&mommynurse is that a tiny little foot I see. Was this your pregnancy? All I can say is "AWESOME". I have never seen anything like this before. Who took the picture? Sorry about all the questions, but I was mesmerized
  7. by   TypicalFish
    Quote from SharonH, RN
    There have been some excellent points made about patient dignity and identity. However :

    1.3 million people injured each year due to medication errors and
    7000 deaths yearly d/t the same. Between 44000 and 98000 people die from medical errors yearly.


    I don't mean to seem unsympathetic to the "plight" of the family but *shrug* .

    If that is the worst mistake that happens to her father during his hospitalization then she should get down on her knees. In fact, if that is the worst mistake you make during your career then you should get down on your knees.

    I don't mean to flame you, but I find your "shrug" a bit insensitive. The daughter likely did over-react; but it was more likely a response to everything that was going on-in this case 'a little bit more' of her father had been taken away from her, her control over the situation had been taken away and maybe it was the final straw in her ability to cope that day; seeing her father EVEN MORE changed and decreased was just too much. To wag your finger at her and say "Well. It COULD of been SO much worse" is insensitive and not what the holistic approach that nursing is supposed to be.

    Also, if the daughter was POA, if the father really had dementia issues, then legally she should have been consulted prior to having the beard shaved, unless it was a well-documented emergent situation.
  8. by   Mommy TeleRN
    Did the daughter have durable power of attorney for the medical treatment of the dad? If not, then it seems to me his choice of care is up to HIM. Maybe the food in the mustache was bothering him too?

    (with that being said my DH has had a mustache the entire 10 years we've been married and I don't wanna see him without it LOL)
  9. by   LEL
    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.
    I agree with your post. I understood it to be sarcastic towards management.
  10. by   GingerSue
    as I read about intentional torts - no harm need be caused for liability to exist

    Battery is the willful touching of a person, or the person's clothing, or something the person is carrying, without consent.

    A requirement for consent is that the client be competent to give consent.

    Determination of consent is not a medical decision - it is made through court hearings.

    Since this patient has dementia - who legally makes decisions for him?

    The moustache will grow back - will it be shaved off again, or will it be cared for? Who is going to decide?
  11. by   NRSKarenRN
    Quote from typicalfish
    the daughter likely did over-react; but it was more likely a response to everything that was going on-in this case 'a little bit more' of her father had been taken away from her, her control over the situation had been taken away and maybe it was the final straw in her ability to cope that day; seeing her father even more changed and decreased was just too much.
    bingo!!

    typical fish more clearly stated issue than i did.

    nurses and assistive personal need to be aware of "flash point" issues that can occur with families who are overly stressed and do what they can to minimize families reaction. learning what to say and how to say it should be part of role playing exercises in nursing school and initial orientation to a facility as first time nurse.

    what we say and the manner in which message delivered can extinguish situation or turn up the flame.


    the following are flash point issues i've come across in 30 years in healthcare:

    1. grooming issues
    a. shaving off beard or mustache, especially elderly without family aware
    b. not shaving female whiskers
    c. hair care: not washing hair or inappropriate hair styling
    (pigtails on a women who was former weekly salon visitor, etc)
    d. not bathing clients/clients who refuse to bathe
    e. dirty clothes/hospital gown or soiled linens
    f. incontinence management: use of adult diapers/foley catheter

    2. nutrition issues
    a. hot food cold, cold food warm
    b. not following diet or food preferences
    c. lack of menu choices, especially in long term care facilities
    d. withholding food terminally ill client
    c. peg tube insertion/feed/withdrawal

    3. lab work
    a. waking clients up at during night for labs
    b. repetitive venipunctures for labs
    c. not knowing critical lab results/failure to followup
    d. failure to obtain written lab orders

    4. waiting to be taken to tests/waiting for test results

    5. iv therapy
    a. multiple restarts
    b. difficult stick
    c. not offering long term access device (picc/port/hickman) sooner
    d. long term iv therapy needed at home but insurance doesn't cover

    6. discharge planning
    a. rn's/docs not realizing planning starts day of admission not 1 hour before discharge orders written
    b. discharge home without needed supplies ordered or prescriptions written
    c. expectation that "visiting nurse will bring syringes/supplies" (so not true with managed care these days)
    d. placement issues: refusing ltc placement, lack of caregiver
    f. caregiver ill prepared to take care of patient once home as no teaching started in hospital: insulin administration/tube feeding/wound care
    g. visiting nurse will come every day and stay several hours


    these are the most common areas i've had to smooth over with families, patients, nurses and doctors over the years. role playing responses ahead of time really helps you to prepare for these situation for they are everyday occurrences.

    worse thing to say is "i don't know why", turn and leave. better comment is "let me look into that, and i will get back to you"

    looking forward to seeing other comments....
  12. by   nicuRN2007
    Well, I might would have some compassion for the daughter if she hadn't threatened to sue. I can't stand hearing people say "I would have sued...you should sue...I'm gonna sue...blah blah blah"...all the time.
  13. by   Tweety
    Quote from ILoveScrubs
    Well, I might would have some compassion for the daughter if she hadn't threatened to sue. I can't stand hearing people say "I would have sued...you should sue...I'm gonna sue...blah blah blah"...all the time.

    ITA. My compassion/empathy quotient for the daughter went close to zero after reading she was going to sue. I get a little weary by this attitude all the time. Like Sharon, I can see getting a lawyer over med errors, etc., but shaving of a mustache, please. Make a scene by all means, go to management, follow up, express you anger, but the old tired line "I'm going to sue" is not appropriate.

    Maybe dad couldn't stand the indigity of having food products on his mustache that he took such pride in. At this point it's not about what the patient wanted and how he feels, it's how the daughter feels and how she presumes the dad to feel (with good reason, she's been his daughter all his life).

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