Anyone ever gotten mad at a caregiver?

[nurseby07]

So for weeks I have had a rather young patient in a foster home. It was a bad fit from the start, she and the caregiver do not get along. I have had MSW in there to help and done what I could do. 4 weeks ago it was impossible not to notice that she had yet to be bathed, ever. I did a bed bath, peri-care (truly one of the most horrifying sights yet) and taught the CG about how important bathes were. I called my manager, reported it to her, documented and went on. Next visit, still unclean, more "teaching". This last visit I went out and as soon as I opened the door I was overwhelmed with the stench of urine. My young-ish pt complains to me, now crying about how she doesn't get decent care and when she does it is after an argument. I find the CG, ask her to get off the internet and come talk to us. She was filled with excuses "But I did" and "I have a bad back" So, without yelling, but obviously angry I went off on her and said that if my pt wasn't bathed by the next day I would report them. I then went off further and said that they wouldn't treat their mother this way and they even treat their dog better than this pt. (yes I know, not appropriate to say, at least I didn't say **&*&% dog)

I left, shaking, called manager and reported everything.

MSW went out, of course he "didn't smell urine and the pt was clean" Well duh, they cleaned her up before he could get there!

Today I get called in and CG has filed a complaint against me. Manager says I need to watch my boundaries, watch my back & license, and I should call and apologize. I said I wouldn't do it, but I know I will if I have too.

The pt is being transferred to another care home (thank God)

My husband (a nurse) says I got the job done but that I should apologize for harmony at work's sake. I really don't care but I feel sick over this whole thing. I feel sick that a)people are treated that way b)no real back up from manager c) said caregiver can threaten me and cause harm to my livelihood for not only doing what is right, but doing what any normal person SHOULD do.

I think I need a break. I do so many good things at work and don't expect nor do I receive a "great job on that call" but this comes to bite me in the backside, and it smarts too!

So seasoned nurses, what's your opinion?

[HmarieD]

I have lost count of the cg's that have infuriated and sickened me over the years. Just remember that you must maintain your professionalism even in the face of gross neglect and abuse. You may have crossed the line in your dressing down of this cg.

In Illinois (where I practice) nurses are mandated reporters and as such are required to report situations of abuse and/or neglect to the appropriate authorities or investigating agencies. I have found that when you warn a cg that you intend to report them, without fail they will clean up the problem temporarily so as to pass muster, and then the situation returns to the status quo. A surprise inspection is much more likely to produce an accurate picture.

It is unfortunate that your manager has not been more supportive of you. Perhaps you can find a compromise and apologize for the way in which you spoke to this person while still emphasizing that your evaluation of the care provided has not changed, and your professional requirement (if it exists in your state) to report these situations.

Oh - and Document, Document, Document. Good luck and please don't let this discourage you from providing the best care and oversight that your patients deserve.

[caliotter3]

I can't count the number of times my employers have failed to back me up no matter what manner my conduct. You were wrong in that you went overboard. If anything you can apologize for that. But if it were me, I would not apologize for doing your job and advocating for the patient. It is so easy to see how this family has taken their abuse of their mother and made it into your problem with a trumped up complaint. Your employer fell for it, hook, line and sinker. You gave them the grist for their "complaint" with your harsh words. I would certainly ask to be removed from this case. In your written request you can insinuate that you do not care to be involved in the family's continued abuse of their mother. If there is evidence that this is the stance that your agency will take with complaints, you might want to start to shift your efforts toward a second employer, which can become your only employer, if need be. I have found that over the years, this type of lack of support from the employer will undermine my job satisfaction to the point that I will eventually find myself looking for a better workplace. I'm not necessarily talking about a place where my efforts are appreciated, but more so a place where everything I do is not undermined by my supervisors. JMO

[TazziRN, RN]

I would have done exactly what you did, and reported the facility as well. This would be a legit referral to APS.