Cursed at a patient-fired

[sle9403RN]

This is very hard to be honest about but I know that I need to in order to move past it and to show that I know that what I did was wrong.

So I'm a relatively new grad (got my RN in Jan 2012). I took my first nursing job at a pediatric dual diagnosis hospital where the patients have both a medical diagnosis and behavioral diagnosis. I worked there for just over a year. In that time I was written up a total of 3 times for cursing, but only 1 of which actually occurred.

The first time, one of my co-workers wrote a letter to the DON stating that I had made a statement at the nurses station about "punching that ******* ***** in the face" and I was brought in and questioned, which I completely denied. The second time is the 1 time it actually did happen, I had a patient call me lazy because I refused to heat up her butter and I stated that I would be damned if anyone is going to call me lazy.

I immediately apologized to the patient and when my supervisor questioned me, due to having been informed by a co-worker, I told her the complete truth. I also used this as a teaching moment for my patients to show them that even adults are not perfect and we all have stuff we have to work on (mine being cursing). The last time never happened.

It started out with a co-worker being upset about the way I treated a patient and the co-worker lied and said I cursed at a another patient. I was working with a patient who had conversion disorder and he would attempt to get the staff to do everything for him. When he was admitted we were given instructions from the doctor and his PT that he was a minimum assist patient. I was trained that if our patients were not up by 8am then they would get cereal on the unit and if they were not up by 9am then the kitchen was closed, the whole time I was there this is how I ran the unit. I had gotten an order from the doctor that this patient be gotten up before 7am, since it took him extra time to get up and out of bed, which ment the night nurse would have to get him up and he would be out of bed when I got there (this never happened).

So that day he was ready to get out of bed when I woke up the other 17 patients. He never said anything about having to go to the bathroom to anyone who went in his room. By the time I went in to get him up, he had gone in the bed. To make a long story short, he didn't get out of bed and to breakfast until after 915. Following the unit rules he wasn't going to get breakfast due not being ready before 9am. The other nurse got rude with me and stated if it were her she would give him the food because he had been awake. She was very upset and I told her that she could give it to him but I felt he should have been up earlier and the rules apply to everyone else.

She went to the DON and complained and told them that I had cursed at another patient saying "stop your ********" which I deny because it didn't happen. I was called in and questioned about the patient's breakfast to which I replied that this was not the first meal he would have missed and I was not the only one who followed the kitchen rules. Also that I had told the Doctor and his Dietitian that he had been missing meals due to not assisting with his activities and such and not one person said anything about not giving him his food.

The DON said we could not do that and we could not deny patients food, I stated then someone, anyone should have said something and that this needs to be told to everyone. They then questioned about the cursing and said that since I have a history that they were letting me go.

I feel like I was targeted. I've tried to find another job but have had no luck and it seems that this issue is why. I have asked interviewers if their are any red flags during my interview and have been told the cursing. I have no idea what to do and how to show people that this was an isolated incident. I mean I worked in customer service for years and never had any issues like this. Any help would be great.

[veggie530]

So you cursed in front of a pediatric patient, and you refused to feed another, regardless of the situation you are supposed to be a patient advocate. I think you are going to have to show some type of change to overcome your "red flag". Just saying this was an isolated incidence isn't going to be enough to employers. You may want to look into anger management or counseling. Something that can be on paper that shows you recognize there is an issue and are addressing it.

This.

If you have done anything that could be perceived as a negative, you need to cite how it was a great learning experience, what anger management book you bought and how many hours of therapy you attended to correct the problem. Show that you were contrite and serious about becoming a new person.

[morte, LPN, LVN]

Dishes...the pat. wasn't denied food, the rules were in place that the patient missed the opp. to eat, by his/her own actions.

sle9403, cursing and witholding food are considered abusive conduct and both behaviours are inconsistent with our professional obligations as nurses. To better recognize abuse and learn abuse prevention practices, suggest you review nursing ethics and abuse prevention guidelines.

[S.G.]

I worked in adolescent psych as a PCT before and during nursing school. We had scheduled mealtimes. We would wake the patients and let them know that breakfast would be arriving and they were to start getting ready. Breakfast was delivered to the dining hall. If they didn't come, we went to their rooms and told them breakfast was here. They could not go without being dressed appropriately in daytime clothes. Breakfast was run for a specific amount of time and then all trays were cleared and removed from the unit. If patients didn't come for breakfast, they didn't get breakfast. We did have a snack time between breakfast and lunch. It was a very strict policy. Without a specific doctor's order, we could not get any extra trays or snacks from the cafeteria other than what was scheduled. As a PCT, I would inform the nurse about patients who were missing meals and he or she would write a note and call the doctor as indicated.

Given that the patient had been incontinent and need to be cleaned up, causing the missed meal, I would have called the doctor to get an order and would have written a note if the request was denied, if I were the nurse.

[S.G.]

As far as cursing in front of patients, one time is reason for dismissal let alone being reported 3 times (I realize the OP said she only actually did it once). It is never appropriate and I would be irate if any of my child's caregivers were swearing at them or in their presence. I don't talk like that around my kids and I would expect hospital staff to act more professionally.

[Anna Flaxis, BSN, RN]

I worked in adolescent psych as a PCT before and during nursing school. We had scheduled mealtimes. We would wake the patients and let them know that breakfast would be arriving and they were to start getting ready. Breakfast was delivered to the dining hall. If they didn't come, we went to their rooms and told them breakfast was here. They could not go without being dressed appropriately in daytime clothes. Breakfast was run for a specific amount of time and then all trays were cleared and removed from the unit. If patients didn't come for breakfast, they didn't get breakfast. We did have a snack time between breakfast and lunch. It was a very strict policy. Without a specific doctor's order, we could not get any extra trays or snacks from the cafeteria other than what was scheduled. As a PCT, I would inform the nurse about patients who were missing meals and he or she would write a note and call the doctor as indicated.

This is what I had imagined the scenario to be like.

Also, couldn't the child have been incontinent because of the conversion disorder?

[mlbluvr]

You're lucky they fired you, and that you weren't charged with assault ('to do something to make someone fear being injured'). You got off easy. If you had been charged with assault, the people judging you would surely agree that a nurse cussing at a minor patient could cause that child to fear being injured, and then you could forget working as a nurse again. Keep a tight rubber band around your wrist, and snap it 'hard' every time you think of, hear, say, or see a cuss word. You'll condition yourself real fast not to cuss!

[dirtyhippiegirl, BSN, RN]

You're lucky they fired you, and that you weren't charged with assault ('to do something to make someone fear being injured'). You got off easy. If you had been charged with assault, the people judging you would surely agree that a nurse cussing at a minor patient could cause that child to fear being injured, and then you could forget working as a nurse again. Keep a tight rubber band around your wrist, and snap it 'hard' every time you think of, hear, say, or see a cuss word. You'll condition yourself real fast not to cuss!

Because you never, ever cursed yourself or heard someone else curse before you were eighteen.

[janeybirdRN]

I swear a lot. I know most of it is private conversations at the nurse's station with people I am comfortable with but I think it's with patients too. I mean I remember one time a patient pooped everywhere and we were kind of chuckling about it- the patient and I were in the bathroom together- he started the chuckling. Anyway, I said something like "**** happens". He was laughing even harder then. I think sometimes it makes people realize you are human. Now it's not appropriate with certain populations but when the patient talks like that and as long as you aren't swearing AT them, I think you just have to use judgement. I don't think I drop the F bomb too much at work. This is an interesting discussion though because at what point is it unprofessional? I can see how some managers might have a no tolerance policy but I don't think everything is black and white like that.

[mlbluvr]

Because you never, ever cursed yourself or heard someone else curse before you were eighteen.

I never cussed until I learned HOW to in 3rd grade, Catholic school. I was hooked right away. Ever since, I've never stopped. Unless it could cost me a job, say- or a nursing license?

[Quit Floating Me, BSN, RN]

The DON said we could not do that and we could not deny patients food, I stated then someone, anyone should have said something and that this needs to be told to everyone.

Uhhhmmm - you cannot deny a client food unless ordered by a doctor for medical purposes (NPO) or other situations in non-medical facilities (i.e. mental health client asking for snack right after eating 100% of a meal - even then I'd probably still give a snack)!!!!!!! That is common sense.

[J-Swish]

Sounds like my colleague, who has anger and cussing issues but learned to manage them by replacing them with words or letters and gradually weaned off of saying them out of habit. Sounds silly, but it works...

Instead of holy ****, say holy smokes.

Instead of ****, say duck or similar.

Instead of *****, say ditch or similar.

Those are some of the most common swear words in the US. If only we can say "bloody hell" like the Brits (Yes, that is a swear word, and it doesn't sound as bad).

[LANDKRNmommy]

In the beginning you started by attempting to claim responsibility for your actions, but with every comment you responded to you were defensive and made excuses for your actions. If this is how you acted in the work place, it may be the reason you say you were singled out for things like cursing. As a nurse, it is our job to be advocate for good practice and critical thinking should lead you toward with holding food being inappropriate.