I should have said something...

  1. Recently I admitted a patient in 5 point restraints going through ETOH withdrawal who needed Ativan IVP. A coworker and friend was helping to secure one of his wrists and when the patient wiggled, she slapped him on the hand and said "NO." Right then, at that moment, I wanted to say something, but I bit my tongue. This isn't the first time I've felt guilty about not saying something. A couple months ago, a coworker was verbally demeaning an elderly and demented patient of mine by mocking her to her face, which really ticked me off and I really almost said something to her as well.

    I guess I just dont have the guts at the moment to say something. I guess I feel like since I'm one of the newest RNs there, that I will get crap for speaking out or criticizing something a more experienced nurse does. Also, the nurse I first mentioned is very very defensive and if I would have said something at that moment, I am quite positive she would have reacted in a 'dramatic way.' However, I am still feeling guilty. I guess I just needed to get it off my chest and hear what advice I could get from you guys.

    Thanks in advance to all who reply...
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  2. 33 Comments

  3. by   cc902
    when i was a relatively new nurse and on the night shift, there was a patient who was uncooperative. a med student came in to draw blood on her and i was there to assist, i was shocked when i saw the med student hit the patient, and the patient started crying telling her to stop hitting her. i am a very quiet person, but i was outraged and immediately called the supervisor. the med students story was that the patient was about to bite me, but i was watching her and i know that was a lie. the following morning i had to meet with the vice president of nursing as well as the chief of medicine. not suprisingly, the med student was barely reprimanded and i was made to feel as if i was in the wrong for reporting it. I have never been as proud of myself as i did that night for standing up for that patient. i cant tell you what to do, but in your heart you know if what the co worker did was wrong. good luck
  4. by   nurseangel47
    OK. You're as guilty as she for a) not calling her on it and b) not reporting it.
    The first example is a case of patient abuse, verbal abuse.
    The second example is out and out assault, physical assault.
    Not to be tolerated. Neither of them. Grow a touch outer coating around your feelings, girl. Don't worry about how she'll feel towards YOU. We're not nurses because it's a popularity contest! You shouldn't worry about what so and so at work thinks of you for reporting these actions or what they think of you as a person...period. You're there to do a good, thorough, safe job for the PATIENT! NOT to protect the friendships/feelings of coworkers!
    GeeeZ! Get a tougher skin, will ya? Sorry...don't mean to sound mean.
    It's just a cut and dry case of patient care, right and wrong. Nothing gray about it!
  5. by   MsPiggy
    Oh Gee, were you alone with the other nurse at the time? Any nurse knows this is clearly wrong, if she reacts defensively I am sure it is out of guilt.

    Why don't you go to your DON and report it confidentially for now? In the future don't be afraid to speak up right then & there, bet anything she backs off & apologizes for her behavior. I think she assumes because your the new kid on the block you'll be to scared to do or say anything.

    Shame on her for setting a bad example-now prove her wrong and be your patients advocate. You probably will get a little crap from her and maybe others that feel this treatment is ok, but you know it's not so don't be afraid to stand your ground.

    If your really uncomfortable with confrontation write it up, but I encourage you to get comfortable with confrontation at times because your going to run into these situations throughout your career/life. It''s not always the patients that have behavior issues.

    Don't worry, as time goes on you will get more comfortable in your own skin & standing up to people like this. In the mean time, just put your patients safety & care first and go to your DON with these issues.

    Yes, you are going to have to toughen up a bit, as my Momma says (also a nurse) "Stop taking that crap & be the b**** I raised you to be!" Good ol' Mom..

    Hugs,
    -Ms.P
    Last edit by MsPiggy on Dec 19, '06 : Reason: adding a comment
  6. by   Jesskanurse
    I totally understand... I should have been more tough. I guess I was just wrapped up in the whole situation, there were at least 2 other nurses in the room, as well as security, a sitter, and I know the Nursing Supervisor, and Clinical Nurse Consultant was either right outside the room or just in the hallway. I dont know who did and who didn't see what I saw though. I think I was trying to prioritize in my head what I needed to do (since everyone had hyped me up for this patient) and since I'm fairly new, it's hard for me to balance everything at once. I will definitely work on that in the future though. Do you think it's too late to say something? This happened at least 2 weeks ago.
  7. by   nursejess
    I understand. I'm a relatively new nurse also. And it is uncomfortable confronting a more experienced nurse about their treatment of patients, but I think you would feel better if you did say something. I personally would confront the nurse, and tell him or her that the situation has been bothering you and you think the action was inappropriate. If you don't want to speak with him or her directly, you can always go to your manager. You don't want other patients to be abused by this nurse in the future.
  8. by   Jesskanurse
    Quote from nurseangel47
    OK. You're as guilty as she for a) not calling her on it and b) not reporting it.
    The first example is a case of patient abuse, verbal abuse.
    The second example is out and out assault, physical assault.
    Not to be tolerated. Neither of them. Grow a touch outer coating around your feelings, girl. Don't worry about how she'll feel towards YOU. We're not nurses because it's a popularity contest! You shouldn't worry about what so and so at work thinks of you for reporting these actions or what they think of you as a person...period. You're there to do a good, thorough, safe job for the PATIENT! NOT to protect the friendships/feelings of coworkers!
    GeeeZ! Get a tougher skin, will ya? Sorry...don't mean to sound mean.
    It's just a cut and dry case of patient care, right and wrong. Nothing gray about it!
    Wow... I am just as guilty? That makes me really nervous. I mean, I did realize that it was wrong, I just don't have the 'coating' to bring it up right then and there to her face in front of everyone. I absolutely do not think nursing is a popularity contest. I dont know if anyone can understand how overwhelming it is sometimes for a newer nurse to be in that type of situation. I was trying to process everything within like 30 seconds of what I could say, what the potential things she'd say back to me, etc. and in the meantime I'm still getting things shouted to me from the hall from the nurse who had him on the floor who told me she'd finish up her report once he got up to ICU.

    I do have a lot of respect for the nurses who would be able to speak up like that.

    I am going to bring it up with my manager the next time I go to work.
  9. by   canoehead
    In the first situation slapping the patient was stupid and demeaning, but saying "no!" seems appropriate to me. If the patient is moving while you are treating them verbally telling them to stay still is necessary. A little volume for a drunk and uncooperative patient- absolutely.

    I agree with the other posters that you should report abuse, but you may find yourself reporting 2-3 times a day. Find someone experienced that you can trust and run it by them before the formal report. If you find reportable abuse more than once a week (and that is a LOT) you may need to pick your battles on this unit. Resigning from such a disgusting instution would be on my options list as well.
  10. by   sanctuary
    Yes, your instinct is correct, and your insecurity as a newbie got in the way. Well, it never gets easier. I've been called on the carpet, called names by my peers, and "reduced in rank" for criticising the wrongs I've seen around me. But I promised myself a loooong time ago that I would rather be fired for doing a job right than to keep a job and lose self respect. Repeated that a couple of times when I was being 'counseled' about my attitude. and it shut them up. That being said, look for another position and keep on speaking up. Our patients need you, and your heart.
  11. by   EMTSNA
    A lot of folks seem to advocate going straight to your superviser in order to avoid confrontation. While this is always an option, the first step should always be to address the issue with the nurse personally. I hate when people won't speak directly when they have a problem with something. It shows a lack of respect and creates an atmosphere of distrust between coworkers. Granted the nurses actions where totally inappropriate. If you had done something wrong would you prefer to have another nurse speak to you personally or would you rather speak to your manager. The nurse screwed up, but going behind someones back shouldn't be your first choice.
  12. by   outcomesfirst
    I have been in this situation. The nurse was male and physically intimidating and an aggressive person. I was charge at the time. The incident happened about 1 am in an ICU - he struck a patient in DTs who kept getting out of bed. I changed his assignment, with support from another nurse, no drama, but he knew what was going on. I documented the incident, and waited for the NM to come in in the morning. We discussed what happened. She had been waiting for written documents on his behavior. She asked if I would confront him, I said no I felt afraid. She understood this. The NM worked with admin and the nurse was fired that day. No further discussion. A tough, necessary call. We all knew what happened, but there was no discussion/gossip. I felt bad he lost his job. I wish we had discussed it as group. Today, maybe counseling or something would happen. As mentioned, his behavior had been a noted problem - and nothing was done until it was written down. I now know the difficulties of NMs - she knew I would take it further if action was not taken, and it would cost her license, but she needed proof - not gossip. It was sad.

    Your situation is too late - time has passed. Will discussion with the nurse or the manager change the behavior? or cause drama? Chalk it up to a learning experience, and next time, be there and do the right thing.
  13. by   gitterbug
    Interesting and informative posts from all posters.
  14. by   Jesskanurse
    [QUOTE=canoehead;1979118]A little volume for a drunk and uncooperative patient- absolutely.[QUOTE]


    Ok, I don't feel comfortable with this comment. To me this seems a little insensitive. A lot of people suffer from chemical dependencies and I dont feel comfortable calling someone who I am taking care of a "drunk." I try to use empathy, and to me that doesn't seem empathetic. He was going through a lot. I can't imagine how hard it must be for someone experiencing ETOH withdrawal, but I would assume it's not easy. I think too many people are quick to get angry at patients when they see ETOH on ther list rather than going that extra step to try to treat the patient fairly. It isn't our job to judge their habits, just take care of them. Right?
    Last edit by Jesskanurse on Dec 20, '06 : Reason: typo

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