Very Unprofessional....

Nurses Relations

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So, last night I get report from a patient in the Unit who was in ETOH protocol. This was the patient's 3rd day withdrawing!!! When I got report from this XY Nurse, she told me that the patient was scoring pretty high. I was surprised because we usually send them to the unit when they score over 12. Anyhow, she tells me a little bit about the patient and says to me "ugh he fell at home due to a seizure and that's why you will see all that nasty stuff on his face". I was like, excuse me? and she was like " well yeah, all that dried blood on his face." I just stayed quiet and continue on with report. When I received the patient, he looked like a total hot mess. Yes, I know he is an alcoholic, but we are not here to judge. I offered a bedbath , ( since he was on seizures precautions/ and on bedrest). We cleaned all the blood off his face. Patients need to have dignity, like every human deserves to have! I do not mean to be so sensitive, BUT WE NURSES , came into the profession to help and be compassionate, or at least be professional in the way we communicate about our patients with other colleagues. Anyways, It felt good, I just love being a Nurse!

Perhaps the patient was too combative prior to this to get him cleaned up? Or too combative and when finally not, the nurse had a few other patients acting a hot mess and wasn't able to get in there?

When I come into a mess, I clean it up, assume other matters were more pressing for the nurse I'm following, and move on. I don't spend time judging the person I'm following because I know that I've left the occasional mess that would make me look bad when it was really just a time/situation/whatever issue.

Specializes in NICU.
Perhaps the patient was too combative prior to this to get him cleaned up? Or too combative and when finally not, the nurse had a few other patients acting a hot mess and wasn't able to get in there?

When I come into a mess, I clean it up, assume other matters were more pressing for the nurse I'm following, and move on. I don't spend time judging the person I'm following because I know that I've left the occasional mess that would make me look bad when it was really just a time/situation/whatever issue.

I think it's because it was his third day there. Nobody found time?

Like I said, combative for a couple shifts, let him sleep for one, didn't have time for one. You can easily get to day 3. Perhaps he refused at some point (as patients have a right to do.)

Maybe it's crazy, but I don't automatically jump to assuming my coworkers all suck (or are "unprofessional").

Specializes in LTC Rehab Med/Surg.

It would have been beneficial if the OP had asked WHY the patient still had dried blood after three days.

I would have asked. There might or might not have been a reason.

I might even have asked the patient.

Since nobody asked, we get to just assume the nurse was wrong.

I used to just take report and not question the questionable.

Now when something doesn't make sense I ask why.

Once again, I think it was more of the wording she used referring to the patient as " Nastyness" on his face. Of course I understand that we can get really busy, leave things undone and just move on. It is part of the profession. However, It was real unprofessional and unethical to refer to the patient as such. She gave me report on the phone and used those terms to describe the patient, for all she knows, I can be the director of nursing or such. I never told anyone what she said or what ever. I just moved and and carried on. I am sure it wont the he first or the last. It was a good reflection though , at least for myself as a Professional nurse.

Specializes in Peds/outpatient FP,derm,allergy/private duty.

Thank you so much for doing that. As I've shared here before, my severely alcoholic dad died under similar circumstances. Several days later I was able to talk to a nurse who was working that night. Her patience and tone of voice made me realize that someone else on this planet saw something other than a broken and bleeding bum, and at the time had no idea if he had a family or not. I will never forget that act of kindness.

When I was a second year nursing student - young and green, I admitted a a patient that was in a car accident. I was working nights and the patient was just brought in. As he was being helped getting settled into bed, I got all the admission paperwork and immediately started the admitting process. I did not notice the blood on the patient's arm. Yeah I know...

While I was continuing with the very lengthy admission, one of my instructors (yes she was there at night - in those years the 80's our professors would just pop up any shift any time where we students were and just observe us without any notice! Talk about pressure!

Well, this night I was so busy with the admission as it was almost time for day shift and she came up behind me so silently and after a while came to stand in front of me looking VERY ANGRY and said in a soft, angry tone : "Student nurse why are you doing the admission paperwork when your patient is covered in blood?" Then she proceeded to hold up the patient's arm with now dried blood.

She demanded I put down my pen and give the patient a bath to clean him up. I was red in the face.She told me the patient comes first. It is something I have ALWAYS remembered these 20 + years in the profession! You can imagine how embarrassed I was when I had to face her in lecture a few days later!!

Because dried blood means there was bleeding somewhere that is difficult to see. It is akin to leaving an incontinent patient covered with urine and feces because there's no time, it is not deemed important--

A good head to toe assessment always. Document what you see. Skin integrity is huge.

And I agree OP that a nurse describing anything as "nastiness" and choosing to not do something about that is not good practice. That you found a 3 day old lac under all the dried blood troublesome.

Yes, I get that the patient COULD have been combative. Yes, I get that the patient COULD have refused to be cleaned up. But then means there needs to be some sort of conversation about this--chances are with a seizure there could have been incontinence--lots of things--and skin breakdown, which is sorta hard to explain to the powers that be when the least ethical of which the hospital is dinged for skin breakdown acquired at a hospital. But most importantly to your patient and/or the patient's family on why one thinks it is less than important to leave a patient covered in their own blood.

OP, you did the right thing. Anyone who has a relative, friend, or significant other who struggles with ETOH will tell you we thank you for your compassion in your practice.

Once again, I think it was more of the wording she used referring to the patient as " Nastyness" on his face. Of course I understand that we can get really busy, leave things undone and just move on. It is part of the profession. However, It was real unprofessional and unethical to refer to the patient as such. She gave me report on the phone and used those terms to describe the patient, for all she knows, I can be the director of nursing or such. I never told anyone what she said or what ever. I just moved and and carried on. I am sure it wont the he first or the last. It was a good reflection though , at least for myself as a Professional nurse.

She did not refer to the patient as "nastiness", your OP states she referred to "nasty stuff" on the patient's face. Very different.

I think you are using this situation to puff yourself up - the wonderful "professional" nurse against the slacker from the previous shift/s. As you gain experience, you will realise the many factors that make up a shift and might be prepared to be a little more compassionate towards your colleague. They are people too.

Nurse Medicine Woman, your post made me a little nostalgic. Charting is becoming such a big part of our nursing life, more so now that charting is linked to reimbursement and compliance. Your instructor saw what really mattered.

If he was combative during the 3 shifts that he was there and that's the reason why she didn't clean his face, wouldn't she mention that in report? Like "he has nasty stuff on his face. He's been combative so we haven't had a chance to clean him up" then maybe I would give her a pass. But for her to make the comment and move on? Makes me think no one even tried with him.

I definitely assessed the patient , cared for him . Monitored his withdrawal and medicated as ordered . I just wanted to also point out that there is much more to just saving a life . My point is the dignity of the patient . That counts too . Good point about the skin assessment . It was pretty hard to take all that dried blood from his face , mouth , and teeth . I did see a laceration from the fall I'm assuming underneath all that dry blood . I had a pretty tough district last night , I mean what medical Medsurg floor isn't ? Lol --- it just made me realized how little things we do out of our way can make a difference. In this case keeping the patient's dignity . I also realized based on the other nurse'a response that not everyone takes that into consideration. It was just a reflection I had of my night last night . I thank you all for the positive responses !!!!

We all agree. Nurses are the heart and soul of anyone's recovery. Our behavior and attitudes affects the paitent more than realized. Helping others is why i wanted to be a nurse in the first place. I don't think its a little issue because he has been covered in blood for three days. How many nurses cared for him before you??!. They should all be ashamed at themselves. Patients are human and care for them like if your loved one was in their situation...

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