by am4182

I am a male nurse working on a med-surg unit . My shift is nights. I am wondering how or if it is even possible to protect yourself from complaints by female patients for "touching them inappropriately." I have had this happen twice. One was a 74 year old lady , pysch history. When I woke her up to take her 0600 meds she acted very very scared. Much more fear than out of the ordinary. Of course I apologized for startling her, gave the meds and left. A few days later the hospital was investigating a complaint she made stating I touched her inappropriately. I had floated to this floor one time only, seen this pt one time only. However her complaint was that one day I was a nurse, one day a lab person, one day dressed as a doctor and even a black man one day. One would think that this complaint might cause you to suspect that she has some issues. The hospital investigated, found no basis for the complaint. The end I thought. Approx. 3 days later I was called down to the nursing office and was left with two detectives from the local police department who questioned me for 3 hours about the incident. It seems the husband was not happy with the hospitals findings so he went to the police. Again nothing came of this.
The second complaint just recently was another lady late 60's in on an overdose. She was unhappy because the pain med ordered by her MD did not meet her criteria. I explained to her over and over that I could not give meds not ordered, or increase frequency without an MD's order. She had a hep locked IV in her hand and I had to give her an antibiotic. This was done with no problem. The next day I was assigned te same patient and before I actually saw how ever the charge nurse came to me and said that the patient did not want me to take care of her. I was not sorry about this and gladly accepted a switch in patients. However I learned that she has no complained that she did not like the way I touched her hand when flushing the hep locked IV, The charge nurse asked if I was not gentle, was I rude etc. She responded that she just did not like it. Over the weekend I got a telephone message from my nursing supervisor stating this lady had made a complaint about me. Her message was "I know you did nothing wrong, but in the light of what happened last year we need to talk." I called back she is on vacation for a week. Leaving me to worry about this.
I am so frustrated with this. The other nurses I work with when I have talked to them about this first reaction is "YOU?????" Of all people I am more careful re: touching any patient in a way to make them uncomfortable. I am much, much more careful than any of the other RNs when it comes to not exposing patients. I always ask for permission, and explain what I am doing. Every complaint has been with a older female, most with pysch issues. I have had many female patients and their families request I take care of them or their family member.

It seems that all it takes is one angry, vindicative patient to ruin your career. I have had two thoughts regarding this. One is to leave nursing entirely. The other is to make it very clear to the hospital and patients that complain that I will take legal action against the patient for slander or defamation. Really I doubt this would ever get me anything, most of these patients have no money, etc. The fact is I don't want their money, I want them to be made to be responsible for what they say.

Despite all this I really do love being a RN caring for so many fine people. I live every day at my job in fear that someone will say something. Of course you are guilty until proven innocent, and even when proven innocent a cloud of suspicion follows you.

As for suggestions we have a patient ratio at night o 1:10, with 1 or 2 CNA's for30 patients so it s not always possible to get a female nurse, CNA to join you when working with a female patient.

Re: protecting yourself against complaints

First off, I think you need to make it abundantly clear that "in light of what happened last year," is that you were falsely accused by a confused patient. I gather your manager is aware of that, but it wouldn't hurt to remind her.
I don't think suing your patients for slander is likely to be a useful solution, but it might not be amiss to consult an attorney regarding your relationship with your facility, and get copies of everything that occurs. I find it hard to imagine they would dismiss you, since you haven't done anything wrong. In fact, it seems arguable that you could put the burden on them for allowing what may amount to a hostile work environment, i.e., the hospital may have an obligation to protect you from conditions such as these, perhaps by assuring that a chaperone is available. I dunno. I'm not a lawyer, but I did stay in a Holiday Inn Express, once...
I'm sorry you've had these problems. From your post, it's clear you are doing everything you can to preserve the patient's modesty. It may be that more consideration of the patient's Hx needs to be given in making assignments. "Psych history" is pretty broad. I don't think a major depressive disorder would be nearly as problemmatic as, say, a histrionic personality disorder, or even bipolar. Is there dementia? At my facility, we pretty routinely try to avoid given the 600lb patient to the 90lb nurse, or the pt with active shingles to the pregnant nurse.
I have been given pts with a Hx of sexual abuse and, so far, I've been lucky, but patient assignments shouldn't just be drawn out of a hat. To the extent that situations such as you describe can be foreseen, they ought to be avoided. Your charge nurses should be considering that, and maybe you need to, as well. Maybe checking the chart before starting your shift would be a way to spot high-risk patients before you accept them. Just a thought--and, no, I don't know where in the heck I would find time to do all that, either.
A lot of the nurses I get report from are very good about pointing out relevant history in report, so a lot of times I don't have to look it up or guess. That isn't foolproof, but it's an area we could probably be more proactive in protecting each other. If a male patient of mine is inappropriate toward a female aide, I'm sure going to pass that along to the female nurse who follows me. If a male or female patient is confused, I expect to know that from the report I receive and give it in the report I give. I have, occassionally, learned from the patient that she had a psych history, but I've never had to learn from the patient that she had been a rape victim.
Sorry I don't have any really solid answers for you. What I think I'm taking away from your unfortunate experiences is that in an acute care setting, we need to be assessing all of a patient's systems, including psychosocial. (I'm not critiquing your practice, here, but my own. I typically don't ask my 68y.o. stroke patient about his sex life, but maybe I should.)

Re: protecting yourself against complaints

I don't have a direct suggestion for this, but I suggest that you pick up private malpractice immediately. Should the hospital decide to take the patient's side on one of these complaints you'll see how high you bounce when your butt hits the pavement.

www.nso.com

I had a demented LOL accuse me of kissing her in a way that "women don't kiss like that!" Um, okay. But it was LTC and she didn't even remember ME in the morning.

Re: protecting yourself against complaints

It can be tough....older adults can be tough to deal with. The husband probably isn't thinking clearly, and went to police because he believed his wife of x years. Men in nursing are not widely accepting by some older people.
I wouldn't worry...as far as the IV thing goes, I would say that I usually try not to touch the hand as I flush,give, flush. I ask them to raise it slightly if able, screw on the syringes, and give as i have to. Usually only touching the cath tip....helps to protect myself on that score.
Of course for caths, personal things, etc....I always have a female in room with me helping as a witness. going to bathroom, or bedbaths, etc...I always ask my patients if they would like me to help them or if they want the female cna...because some won't ask me, but they'll ask me for the aide...so you do what you can.

Re: protecting yourself against complaints

Don't let the patients get you down! And don't let them slander your name or keep you from helping others by staying in the nursing field.

Inform your supervisor that "yes, we do need to talk" and do some research to bring with you when you go talk to her. It is her responsiblity(the hospitals) to protect you if you are accused and to protect you FROM being accused. I know you are short on staff and these things are going to happen but you should not have to talk to detectives and be investigated like you are a criminal. You need to take steps (and the hospital needs to as well) to protect yourself.

If you look bad= hospital looks bad so the administration at your hospital should be informed immediately. If your supervisor is not protecting you then you need to go up the chain of command.

I'm sure it will all work out please update us as to what happens!

Re: protecting yourself against complaints

I'm grateful for never being accused of anything like this in my 15 year career. It doesn't sound like to me that with these 2 nutbag accusers you could have done anything differently.

The best protection for you as a man when working with female patients is to have a witness. If it's busy and hard to find somebody, wait a few minutes until you can. I NEVER do certain things without a female coworker in the room with me (usually a tech/CNA).

The 3 most common tasks that I won't perform without a witness on a female patient are:

1)urinary catherization
2)physical skin assessment that involves the perineal area or breasts
3)cream/ointment/medications applied to peri area or breasts.

Re: protecting yourself against complaints

I actually do not do caths, or any other treatments that involve the peri or breast area on female pts that are teens or older. My female coworkers do it. And in return I do a lot of work on their male pts. In the end we are all a lot more at ease. I actually spend most of my time on pedi, but I work med/surg and nursery during the summer.
When making rounds in the nursery I make rounds on some babies that are rooming in with mom. I often have to deal with the breast feeding mother. Sometimes I have to deal with the mother who is scared to even talk about breastfeeding with a guy, others want you to watch to see if they are doing it right.
I never avoid discussing any topic with a woman. But I always use a female nurse for any "hands-on" training or observation. If a mother starts to breastfeed while I am in the room, I just ignore it and avoid eye contact.
When dealing with children, I ask the parent to stay, unless it is something that scares them-then I will have another nurse assist me. This usually involves starting IVs and thing like that.
Common sense and a professional attitude go a long way.
But I also carry a million dollar personal insurance policy!

Re: protecting yourself against complaints

It makes for a lousy environment when our managers don’t/won’t support us as staff members. Conversely, it is encouraging and reassuring when they prove they will back us; it depends on the caliber of the manager.

One thing that continues to perplex me is this notion that we are supposed to act like someone other than a nurse while doing pt cares. We are in a hospital setting; the nature of the job requires us to get into people’s personal space. I do believe it is prudent to explain what you are about to do and ask if “it is ok”, just as you would any procedure, thereby gaining verbal consent. Chart it. I do not believe we should excuse ourselves from being professionals performing in a professional manner. However, CYA is always prudent as well. Having another staff member you trust (male or female) to corroborate you in charting would pretty much cover it.

It seems there may be an issue /c the way that facility/management projects how you as a professional are to be viewed.

It is unfortunate that this has come your way. Stand your ground. You are a licensed professional, and if that organization is going to leave you hangin’ the problem is not you, it is in their operation.

I have to question the professionalism and integrity of managerial personnel not willing to support their staff. Is this the position from the CNO, or specific to your department? If the former, then it might be time to move on, it can be liberating. If the latter, then I agree with jewishhatmaker, talk it through /c your mgr; from a position of performing professionally, not apologetically.

Good luck.

Re: protecting yourself against complaints

You pick up malpractice yet?

Re: protecting yourself against complaints

Support tort reform.

We need to sue, incarcerate and severely punish people who make false allegations.