Shocked At Nurses Actions Tonight - page 13

I work part time at a local SNF / rehab faciliety. On PM and NOC shift it is staffed with 3 or 4 LPNs and one RN charge nurse (tonight it was me). One of our LPNs is a sweet young girl from a very... Read More

  1. by   Marie_LPN, RN
    If we got to pick and choose the patients that are the best fit, we would call it SHOPPING, not nursing.
    Exactly.
  2. by   leslie :-D
    wow.
    very provocative thread.
    my first thought is the lpn probably doesn't see it as pt abandonment, since she feels she should have been told in report, that her pt was muslim.
    had she known that, she would have refused, thus avoiding abandonment.
    but obviously, why SHOULD it be reported of anyone's race, ethnicity, religion etc.
    so based on a general npa re: moral and professional misconduct, the lpn clearly violated this.
    legally, she did indeed, abandon her patient.

    had i been charge, just to cover my butt, i would have notified the next in command and indicate just that, on my incident report.
    this scenario has some valid and legal implications.

    i too, would have sent her home.
    i'm just not sure about reporting to the bon.
    i'm not even sure about automatic termination.
    i agree with suspension, inservices and employee counselling; then give her a second chance.
    if she still refuses to care for this particular population, God knows what other delusional biases she may have.
    so after all the aforementioned interventions (clearly documented), then i would find it reportable and a terminable offense.
    but in the absence of clear and concrete major violations, i think it prudent to try and educate her.
    chances are, nothing will change her mind.
    but it looks good on paper, that she did indeed, receive cultural-sensitivity training and a refresher course on her duties as a nurse.
    there was not any harm done to the pt.

    the lpn certainly should learn the seriousness of her actions; and why it was pt abandonment.
    but i say suspend her, give her the needed props and if it happens again, terminate and report her.

    leslie
  3. by   PANurseRN1
    The problem is, even if the nurse learns how to parrot appropriate, culturally sensitive language, she clearly demonstrated what was in her heart, and that was hatred. I wouldn't feel like I could trust her again.

    Reporting her to the BON is the appropriate thing to do. If she is incapable of caring for pts. without regard for race/creed/religion, etc., she should find another job where she can avoid such conflicts. She doesn't have a right to be a nurse. Pts. do have the right to receive care free from discrimination, a right that's posted in the entrance of just about every hospital/healthcare facility found in the US.
  4. by   franslagle
    I wish to speak to the issue of the DON being unpleasant and dismissive of her nurse's legitimate concern abour a staff member refusing a patient care assignment. Although retired now, I have been a DON for many years. I always told my staff to call me at any time about anything. I made sure that they had my phone numbers if I was to be away, and with the advent of cell phones I espercially stressed how hey could easily reach me.

    I got very few calls that I felt were not necessary, but the fact that my staff member felt the call to be necessary made me very glad that I had been called. It is hard enough being a charge nurse without having to worry about enraging the DON who is, incidently , enjoying the holiday off duty, unlike her staff.

    Patient care is seriously placed at risk, when staff are afraid to call the DON or other person on call, and attempt to manage situations that really need consultation. By encouraging my staff to call me with any concern, I had the opportunity to offer help early on, and not to have to intervene after the problem had become very grave and much more difficult to resolve.

    There was earlier discussion about the reasons so many nurses leave the profession. I believe that arrogant, insensitive DON's' are a major reason. I remember some of my colleagues and marvel that they could retain any nurses at all! Fran, RN, MSN
  5. by   imenid37
    Quote from franslagle
    ... It is hard enough being a charge nurse without having to worry about enraging the DON who is, incidently , enjoying the holiday off duty, unlike her staff.

    Patient care is seriously placed at risk, when staff are afraid to call the DON or other person on call, and attempt to manage situations that really need consultation. By encouraging my staff to call me with any concern, I had the opportunity to offer help early on, and not to have to intervene after the problem had become very grave and much more difficult to resolve.

    There was earlier discussion about the reasons so many nurses leave the profession. I believe that arrogant, insensitive DON's' are a major reason. I remember some of my colleagues and marvel that they could retain any nurses at all! Fran, RN, MSN
    Fran, you are right on with your thoughts, IMHO.

    I would also say in this day and age, cultural sensitivity is an essential nursing skill. Just because you live in an area w/ a very homogenous population, you can't be fool enough to think you will never encounter people who live a far different lifestyle than your own. Just as nurses should be educated in giving injections, taking vs, etc. Licensed nurses should posess the ability to deal w/ people of different cultures and lifestyles. We all have, if we admit it, our own prejudices and preferences. This has to be worked around or overcome when we deal w/ patients. To us, they are patients first. We need to find out what their individual needs are and address them, even when we don't like or agree w/ those needs. I think the public has the right to expect culturally sensitive care from their nurses. This is why I feel so strongly about this person being dismissed. Hopefully, she will be educated, somewhere and change her attitude. She's apparently in a BSN program. That attitude wouldn't last long in most schools. How do you think a nursing instructor would react if she pulled this stunt at a clinical site? There is more to staffing than supplying a warm bod, esp. when that bod has proven themslves to be acting out inappropriately. I again feel the OP was wise in her decision making, even though I know others feel differently.

    I came from a very prejudiced family, but I feel I am pretty open-minded. It came from within though. It was by going to school as a young child and meeting kids of different races, even though the message I got at home was that these people were bad. I knew, even as a little kid, that they weren't because I knew them personally. I wish this young LPN luck. If she still thinks like this as an adult. I think the older you get, the harder it is to change. If she is really going to change, I think personal experience w/ people of different races, backgrounds is more valuable than just a canned education.
  6. by   PANurseRN1
    Honestly, that's one of the reasons I think she should be reported; she's in a BSN program. Get her out of the profession before she has a chance to inflict even more damage.

    Zero tolerance for racists and bigots.
  7. by   Tweety
    Quote from stevielynn
    Maybe that is the real point here . . . knowing your DON. My DON would also want to be alerted to this and pronto.

    I'm basing my judgment on that fact and on the fact that if I was the DON I would also want the info asap.

    steph


    That's how I feel. Fortunately we have house supers all the time and it's easy for us. However, as house sup. I've had to call administration on call for situations just so they are in the know. I work for an organization that likes to be in the know. Not that they micromanage or can even do anything about, but I know who I work for.

    If I worked for a DON that relinquished total authority and wouldn't come in and say "why did you do such and such, and why wasn't I aware" then I would in turn supervise that way.

    Sometimes as I said before, your danged if you do and danged if you don't.
  8. by   Gennaver
    Quote from PMFB-RN
    I work part time at a local SNF / rehab faciliety. On PM and NOC shift it is staffed with 3 or 4 LPNs and one RN charge nurse (tonight it was me). One of our LPNs is a sweet young girl from a very small town near by. She is in a BSN program to become an RN as well. She was late to work and I assinged her to care for a new admit who is recovering from a serious MVA. She took report and went to meet her patient. She came back out of the room about 5 min later very upset. She demanded to know why I hadn't told her the patient was a muslim in report. I asked her why it mattered. She said that "those people are all trying to kill us!" and she couldn't understand why the patient was even admited or even given medical care in America! She flatly refused to provide care for this person. Nothing I said to her had any affect on her. She actually got angry at me for trying to explain why this person needs and deserves nurses care.
    ...
    Oh my goodness,

    What a distressful situation to have to deal with and one that totally surprises me.

    Where there extenuating triggers for this young lady? I mean, did she just lose a loved one fighting in the war possibly?

    I don't understand...

    For what its worth I am waiting to sign my contract and take my oath to assess into the Active Duty Army Nurse Corps and if deployed am sworn to care for all, (regardless of which side of the shooting they were on,). So, her actions are not even those endorsed by Military Nurses.

    It seems that your only course would've been to send her home, lest the institution get in big BIG trouble or accused of supporting her extremist attitude.

    Pity that someone so young has such "extremeist fundamentalist" type of attitudes. Scarey too.
    Gen
  9. by   P_RN
    Please don't take this as a hijack...but the OP said she is a part-timer at the LTC. I assume the LPN was a full staff member? Maybe not as she is a student. I have been a part-time and also a full time RN.

    I've been floated every way from Sunday, but I can only remember one patient I really "refused" (or rather asked to trade) and that was a patient who had kicked me in the face, broke my cheekbone, gave me a concussion and sent me to the ER. Turned out he was in DTs and lied about etoh consumption.

    Anyway that was bad enough, but when I returned to work I found he was telling everyone how funny it had been. Actually I really wanted to take a 2x4 to him, but asked to be reassigned. In 32 + years that's the only one I can recall.

    I would have called the DON that night on this young LPN. But I would have left the rest (BON etc) to her discretion. What I am afraid of is that the full-time employee might hold some sway over the DON if it is left to Monday morning quarterbacking.

    Now back to our regularly scheduled thread.........
  10. by   nursejohio
    Quote from TrudyRN
    I am Jewish. I have cared for many a pt with shaven blonde head and swastika tattoos all over the place. I make absolutely certain to give them the absolutely best possible care. At some point during my interactions with them, I have made it known that I know they apparently admire Hitler and his teachings and I make it known that I am Jewish. Every one of these patients has been totally caught off guard by my revelation because, as they, each and every one, have said to me, "But you were so nice to me. You are such a good nurse, such a sweet person." And I just smile and say, "Yes, and you were very nice to me, too. Now if we can get along so well in here, maybe we can get along outside the hospital, too." And I have left them with that thought. I have never had any negative repercussions and I'd like to think that they have gone away just a little more informed, a little less angry at Jews, and a little more open to the suggestion that we all try to live in peace.

    Wow! What a powerful, thoughtful and kind way to handle what had the potential to be very ugly. You could have gone screaming to the nurses station, saying you refuse to give comfort to the enemy because once a drunken group of aryans beat up your little brother or something equally *justified*... but you didn't. You held your composure and gave "the enemy" a nugget to take home and think about. Great work!
  11. by   rach_nc_03
    I think it's clear that the LPN is guilty of patient abandonment. Got report, accepted assignment, then refused to care for the patient. Abandonment. During my brief stint in LTC, I was required, as supervisor, to report any CNA who abandoned a patient (sadly, we had a handful who did that) to the state department of facility services (who handled certification of nursing assistants). It was a requirement. Don't know the rules surrounding patient abandonment in the OP's state, but I'm guessing that someone at the facility (probably DON) will have to report the LPN.

    What blows me away is that the LPN was so culturally ignorant as to actually think that this patient was somehow her *enemy*. I admit, I've always rolled my eyes a bit when I hear 'diversity training' and 'cultural sensitivity'. I always thought it was just common sense for one to understand that someone with a different religion/skin tone/sexual identity/nationality may have different views, beliefs, dietary preferences, intimate relationships, etc. than their own. *THEN* I attended nursing school in an itty bitty town. I was stunned how many people had never been anywhere besides that particular county (which happened to be very segregated). So we talked about such things in school- everyone had their own misconceptions about other groups- some minor, some major.

    One of my classmates approached me on the first day of clinicals, when we were doing bed baths, and said, 'how do you wash a black person's hair??'Um....what about shampoo? I told her to ask the patient what she wanted (she may have brought shampoo from home), but I think she was fairly flustered. She ended up asking one of our classmates, who was black, what to do- who was highly amused by it all- and the two of them became very good friends.

    So....isn't this part of nursing school curricula everywhere? (Both classroom teaching/discussions and teaching opportunities during clinicals, I mean.) How'd she graduate from her LPN program in the first place if she's happy to spout this nonsense in front of all her peers (and supervisor!) at work? That's the part I really don't understand. She would've been out on her tail if she'd been a student at my school- which was, as I said, in an itty bitty town.

    I just can't believe how she's gotten as far as she has without (a) showing her posterior, which is what she did, and (b) someone calling her on it.
    Last edit by rach_nc_03 on Nov 25, '06 : Reason: posted when i meant to edit- oops!
  12. by   DutchgirlRN
    Quote from phriedomRN
    Wow! What a powerful, thoughtful and kind way to handle what had the potential to be very ugly. You could have gone screaming to the nurses station, saying you refuse to give comfort to the enemy because once a drunken group of aryans beat up your little brother or something equally *justified*... but you didn't. You held your composure and gave "the enemy" a nugget to take home and think about. Great work!
    I think what she is doing is wrong and also dangerous. In a rosey world where all is right this might be a kind and wonderful way to handle people with extreme views. We don't live in a rosey world where all is right. We live in a world where we have to be careful how we speak to people we don't know and especially those who have extreme views.

    Quote from TrudyRN
    I am Jewish. I have made it known that I know they apparently admire Hitler and his teachings and I make it know that I am Jewish.
    You can never assume that a person with swastika tattoos admired Hitler and his teachings. They are ignorant, caught up in a way of thinking, and forming opinions about something they know absolutely squat about. They are to be pitied. You can't honestly believe that a few minutes with them would really change their minds. If you run into a patient with swastikas who is really extreme you may find yourself in trouble on your way out to your car after work. It's just not worth it.

    I am also of Jewish heritage, my parents both lived through WWII as Jews in the Netherlands. I know of what I speak.

    BTW I would never refuse to care for a pt with swastika tatoos. I wouldn't treat them any differently.

    They weren't even alive, nor were their parents, when my relatives were exterminated as they called it, it was more like their children were ripped away from them, all their possessions taken away, then their clothes, their gold teeth yanked from their mouths and then they were gased to death. Many were not dead when they were thrown into a large oven and burned into ashes.

    As I said these punks know squat about Hitler and WWII in Europe. Pity them, be wary of them, treat them well while in your care.
    Last edit by DutchgirlRN on Nov 25, '06
  13. by   SharonH, RN
    Quote from DutchgirlRN

    You can never assume that a person with swastika tattoos admired Hitler and his teachings.
    Why not? I think you CAN safely assume that a person with tattoos admired Hitler, I think that by wearing swastikas, that is exactly what they intend to convey.


    But I do agree with you about confronting those people, you never know how dangerous they are and it is unlikely that you will have changed their minds or opinions with such limited contact.

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