Nurse who needs to retire!

Nurses General Nursing

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I work rotating days/nights Cardio-Thoracic stepdown and we have a nurse on the night shift who is in her late 60's who regularly mis-treats patients and who is a very toxic and disfunctional personality w/in the staff. First of all, noone likes her b/c she is loud, obnoxious, over-opinionated, argumentative, she talks down to everyone, she accuses everyone of being an alcoholic or drug addict, and she calls out sick ALL the time . I refuse to speak to her /x in report b/c whenever I try to talk to her she argues w/ me or laughs @ me as if I know nothing ( I am a male c/ one year experience, she has been on the unit a little over a year after being a traveler). The difference between working w/ her or not on nights is emmence. When she works everyone is tense and stressed and depressed, and when she doesn't work it's much looser, more fun, more teamwork. We have this one male noc nurse who has the charisma of 10 charasmatic people who is knowledgable beyond beleive and this evil nurse has latched on to him and is sucking the life out of him. He has learned to deal w/ her and deals really well (if I was on speaking terms w/ her, none of the words would be kind ones). She's just simply toxic to the Nth degree.

So I picked up a patient from her this AM who had an emboli to her spine and who can't really move her legs. She also has Breast CA, receiving Chemo and all. She is the sweetest thing you'd ever want to meet. I had had her for a couple of days so evil nurse starts telling me how she used to be an alcoholic and that she can really move her legs fine, she just needs encouragment. I go to see her (the pt) and for the hell of it (I don't usually do this) I asked her what she thought of her nurse during the night. Apparently the pt had asked for the bedpan a couple of times and didn't have to go, so evil nurse tells her that since she had a couple of false alarms she wasn't going to give her the bedpan anymore and she stuck a towel between her legs. So when I went to see her in the morning she was crying and soaking wet w/ urine. Her 2 small stage 2 ulcers on her bottom that I had put dressings on the day before were undressed. So I got her cleaned up, told her to call for the bedpan and not listen to what evil nurse had told her, and I arranged w/ the charge nurse for her to get an actual qualified RN to care for her tonight, otherwise evil nurse would have had her again. I also told her to have her family write a letter to our manager to tell how she was mis-treated by evil nurse. She needs to retire, end of story! This sort of thing is a regular occurance.

Specializes in CV-ICU.

Very nicely put, Renee.

It takes courage to talk with the person you have problems with, and it sounds like there are a number of your co-workers that need to speak up about this to her.

I do talk to my co-workers when I find stuff that upsets me when I come on duty. I try to use non-accusatory phrases ("I found the patient soaked in urine and crying..."; or "I get upset and it slows me down...") rather than attacking ("You always leave..."). Most of the time this allows the other person the chance to tell their side of what happened; and we can work towards better patient care that way.

If that doesn't work, then I involve the nurse manager by requesting a meeting of the 3 of you; if the situation warrants it by causing harm or distress to a patient, I will fill out an incident (or occurance) report and take it to HR.

The thing that bothers me about your post, e-nurse, is the "notes under the manager's door" piece! That hearkens back to playground behavior- the old "he said, she said" routine; not the way for adults to solve work-related problems! Especially when our work involves caring for people at a vulnerable point of their lives! If I was the nurse manager, I would definitely ignore that type of behavior on the part of adults also!

Specializes in ER.

I agree, talk to the nurse, write an occurance, talk with your manager. When you have a pattern of occurance reports built up talk to the Board of Nursing. I witnessed cruelty to a confused patient once and was so startled that I didn't react at the time, I wish I had. Please don't let this nurse think she is getting away with such cruel behavior.

I don't pass notes under the managers door, I have heard that others do. I think that I didn't think to write her up b/c other more senior nurses never do anything. It's pretty well established that M is crazy, ignore what she does and says. I think the other more senior nurses have talked to the manager about her before, but nothing is ever done. The manager actually likes her. I have spoke to the manager once about a co-worker and it was her, and it wasn't about pt mis-treatment, it was about how impossible she is to even talk to. I refuse to try anymore b/c she either laughs @ me like I'm an idiot and know nothing or she argues w/ me. I help bring her pts to the bathroom when they call and she's not around, I alert her to three stars on the tele, I'm not malicious in any way, but I refuse to try to speak w/ her. We had a heart transplant pt a few months ago who was walking, talking, set to go home that AM and she coded. For nurses we had the charge nurse(whose pt it was), M, myself (6 months experience @ the time), and another nurse who was new to the floor. Charge called the code while myself and the other new nurse did what we could (which wasn't much) until the code team got there, and then we continued to help charge until they revived her after 45 mins. When the code first started all M was doing was walking up and down the hall saying "It's useless, she's not going to make it..ect", she wasn't even trying to help. She's really unbelievable, and it's unbelievable that nothing is ever done about her.

Everytime I read about some crabby old nurse who everyone wishes would retire, I am reminded of how really terrible most hospital pension plans are. Maybe the old gal can't afford to retire. I know so many people who worked for a single hospital forever, only to find out, at 60 something, that the pension wouldn't keep them in cat food, let alone support them.

Many others with risky professions (law enforcement, firefighters, FBI, etc) get generous pensions and have early retirement provisions. As physical as nursing is, we should fight for pension rights. Then maybe the sour old ladies could leave with grace!

she is getting all the permits signed, checking the paperwork in the charts, (care plans, directives, DNR's, etc.), calling the m.d.'s, transferring patients in and out, entering all the census stuff in the computer, making sure all the pre-op stuff is done, getting lab and radiology results off of the computer and putting them in the charts for dr.'s morning rounds ,checking blood, answering all the new nurses and agency nurses questions, and taking care of staffing for the next shift.

Originally posted by NicuGal

Notes under the manager's door...that is not really effective I would think...you need to write it up, make copies..one to her, one to the DON and one to your personnel department. And you need people to back you up....not just SAY they are going to. Good Luck!

I agree with this message and will add one more place to turn if no response from a DON or administration and that is Social Service. When this happen at a former position, these situations were taken to Social Service deparment. Patients can be considered vulnerable adult and can reported as such to the county and then you will see the nursing department reply when they have a vulnerable adult situation handed to them. However, we saw social service handled the situation in a prompt manner unlike nursing supervisors. This one situation would be enough for a vulnerable adult case to be investigated.

Originally posted by Enright

Everytime I read about some crabby old nurse who everyone wishes would retire, I am reminded of how really terrible most hospital pension plans are. Maybe the old gal can't afford to retire. I know so many people who worked for a single hospital forever, only to find out, at 60 something, that the pension wouldn't keep them in cat food, let alone support them.

Many others with risky professions (law enforcement, firefighters, FBI, etc) get generous pensions and have early retirement provisions. As physical as nursing is, we should fight for pension rights. Then maybe the sour old ladies could leave with grace!

People don't change with age and she most likely was a crabby nurses in her younger years. Not many professions today have pensions plans that you could plan to live entirely off when you retire and this is why most need to look to save while they are younger. I don't catagorize nursing in the same high level of risk as law enforcement or a firefighter. In addition, in many rural areas, firefighters are volunteer and work mainly for a well deserve pension.

Honestly, I haven't seen many sixty year old nurses still working full-time, but on call.

If

I'm with you Chuckie. A towel dosen't cut it for me either! We had a CNA tell a resident to "go in your diaper" when he asked to be put on the commode and she was out of there the next day! The resident c/o the incident to the unit manager himself. :D

When you have had more experience, you will learn that a patient can be scrupulously clean at 6 a.m. and soiled/soaked in urine at 6:30 a.m. I have cleaned many a patient 4-5 times a night and think I was leaving them clean to have them pee a gallon an hour before shift change. And , guess what?? Last night , I had a diaper on a patient and two towels in the diaper !!!! It is not that uncommon to have a towel between the legs of a female, many request one, (many wear pads all day at home for urine leaks), and many aides/assistants place towels on /under females. I do not see anything wrong with saying to a female, who has asked for the bedpan twice, but did not pee, "I will just leave this towel here in case you do go while I am gone"...(it wouldn't feel so hot to sit on the bedpan 1/2 the night til the actual voiding occurs, however, a towel or two is not uncomfortable......as far as the dressings on the decubiti, , hello?,, bedridden patient...turning to put off and on bedpan, etc. all night....yes, they do come off.... I repeat, you did a hateful thing, very unprofessional, manipulative, (elicited the ""correct"" response you wanted from the patient,.)...I would write you up in a New York minute. You are IMHO, a control-freak and a major trouble-maker in the making. You were not behaving as a patient-advocate. Nor were you behaving as a professional or as an advocate for nursing. You instigated and elicited the complaint. [/b]

I've worked nine years in long term care where I've changed many many incontinent products too numerous to count. I've never had to place a towel with or without incontinent products with a resident or patients since we checked incontinent products every two hours or more if they are having loose stools etc. If there was a leakage from the incontinent products, we change the linen and cleansed the resident. This is the same policy I've at my present position in the hospital. It is not a common practice to place towels as additional protection for incontinence and not necessary if you are are checking them every two hours or more. Incontinent products today are made so well they really can absorb a moderate amount of urine and it pulls the urine away from the skin to keep it dry vs. a towel would not do this. A good enviroment for an ulcer would be a towel wet from urine against skin. Most women who request a pad want a pad not a towel.

If I found a towel placed between the legs from a previous shift I would question the nurse. Dressings do fall off, but I take a check of them during my last rounds to ensure they are clean and intact which is part of my responsiblity. They just don't come off that easy unless perhaps a confuse patient removes it themself. If you are asking about responsiblity of a nursing assistant, the professional nurses is ultimately responsible for their actions or should ensure that her/his assigned patients or resident are being keep dry and clean of incontinence. When a patient is unable to go on a bedpan, if possible, I will try to get them up to a commode or walk them to the bathroom. I would not tell them will place a towel there just in case I can't get there in time.

I didn't read where this patient was on bedrest?

I agree you could clean and place a new incontinent product on a patient to find it soil within a short period of time, but this isn't the case in this situation. Who knows how long this patient sat with a wet towel between her legs.

I'm not a young inexperienced nurse like the nurse in the orginal message and reading your message leads me to believe you are not giving quality care. I probably handle the situation differently then e nurse, but I would without a doubt want a nurse like this new nurse who isn't perfect vs one like yourself caring for me. No thank to the towel offer would had been my first response if I was unable to void on the bedpan.

Originally posted by Chuckie

If I had a family member in a hospital and it received even a small decube I would sue the hospital there should not be an excuse for it no matter how bad the care is. A towel between the legs does not hack it in my world.

I agree and will add you will see a low or no incidences of decubitus ulcers with proactive nursing. Bad care can result in an ulcer. A towel doesn't hack it my world either.

Originally posted by night owl

I'm with you Chuckie. A towel dosen't cut it for me either! We had a CNA tell a resident to "go in your diaper" when he asked to be put on the commode and she was out of there the next day! The resident c/o the incident to the unit manager himself. :D

I was clear with the CNA and made it known this was not part of the facility policies to tell residents to go in their incontinent products. Telling a patient I'll place a towel just in case I can't return is close to "go in your towel." I was not big on using the words like diapers since that is what I placed on my children at that time so I would call incontinent products "pads." Something about telling an adult that they need a diaper change seems not right with the dignity issue?

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