What are the nurse's rights regarding difficult family members? - page 3
Well this post will be half advice seeking and half venting, I suppose I need both. I was a fortunate new grad, and started my first job as a LTC/Rehab nurse the end of August, less than a month... Read More
Dec 2, '12I am not a nurse or even a student yet (I am a potential career changer) but I would have a very difficult time caving in to someone who is not only disrespectful, but verbally and physically threatening. You are there to provide care, not be abused. I do not know the protocols in your work environment or nursing in general but in my current job (dept of social service) clients that are hostile or threatening in any manner are not serviced, period. In some instances those client are escorted by security/peace officers and are not allowed back into the center until the next day (at which point they are much calmer, compliant, etc.). Again I am far from being a nurse but it sounds like you are doing all in your power to deal with the situation, why should you be penalized? I don't know. I would love to be a nurse one day but I know me. I WOULD NOT let anyone just disrespect or threaten me/co workers and not do something (call security/police, etc.).
Dec 2, '12I would have had this woman removed from the facility after the first warning failed- she would get no warning for physical assault. You can't cure stupid, but we sure shouldn't enable it!
By the way, you did the right thing walking away. Everyone knows to walk away before it escalates.
Also, like a previous poster stated, this patient should have been refused without a written understanding with the family or POV.
Now I also join the others in saying Document everything. I know your workload is overwhelming- but it is imperative if you stay. You have done great, don't let an idiot discourage one of our good nurses. That's how we win, if your standing after the storm, you won.
That said, that would have been my last discussion with this aDON, and I would have handed her my Nametag. She is creating the oven that will burn you out; I'd rather lose my job, than lose my career.
I understand you not wanting to go up the chain-of-command, the aDON could make it hell on you. You have done the right thing, and it sounds like you will make a good decision. We don't have to live with the decision- you do. Just make sure it's what you want, and what you can live with.
This type of Mngt. Is dangerous. Now you know what to expect when you may really need them!
Good Luck!!!!!!Last edit by BostonTerrierLoverRN on Dec 2, '12
Dec 3, '12Op, Please before you do anything, speak with an attorney. A lot of the other advice given by the other posters is good advice if you were dealing with a reasonable person. But if the way you describe this person is accurate, then I'm not sure she would qualify as reasonable. I just don't want you to have a well meaning conversation with this woman, and have it taken in the wrong way by her (or even if it isn't taken the wrong way, she may just use it as something else to make a scene over), leading to an incident which, whether fair or not leads to your termination.
You have already stated that after speaking to management about the woman, your job was threatened. This means that they will not only not be there for you if things go bad, but they will work against you in the name of protecting the facility and its income. They've made it clear that YOU are expendable (not that this is right, but it's how they feel...), and they choose this woman's satisfaction and ego over your personal rights. Now that you know this, act accordingly. Like one of the previous posters suggested, do not tell your co-workers that you plan on speaking to an atty! Maybe you think they all like you, and maybe they all do. But I am pretty sure that none of them will speak out for you for fear of losing their own jobs, as since they've been there a while they understand even better than you how management feels in the "Nurse Vs PT/PT family" issue.
Dec 3, '12Do NOT do 1:1 with these type of family members....always have another staff member around. could be come a he said- she said thing.
I second the going up the chain of command...maybe this ADON is brushing this under the rug?
Dec 3, '12Learn this now - you are nobody punching bag. A person has no more right to assault you than they do a bank teller or a butcher. Yes, there are times we deal with confused patients and may get injured - that is one thing - but an alert and oriented, albeit angry person whether it's a patient, family member or whomever has no right to put their hands on you. It wouldn't be tolerated in any other industry and we need to stop tolerating it in ours.
Dec 3, '12Is the patient supposed to be discharged home with this family member? Some possible red flags are: threatening speech, becoming vocally beligerent when aggravated, acting out physically against staff, making unreasonable demands, invading another's personal space, throwing, hitting or pushing objects in the environment. Abuse by family caregivers can and does happen- it would be a tragedy for a patient to be discharged home into the hands of an abuser.
Who Are the Abusers?
Dec 10, '12Quote from country momExcellent point! Report dtr as an abuser of her mother! That might solve the whole mess. I love it, sorry I didn't think of it. Do NOT tell ANYONE, ANYONE, ANYWHERE, ANYWHERE that you reported, if you do report.Is the patient supposed to be discharged home with this family member? Some possible red flags are: threatening speech, becoming vocally beligerent when aggravated, acting out physically against staff, making unreasonable demands, invading another's personal space, throwing, hitting or pushing objects in the environment. Abuse by family caregivers can and does happen- it would be a tragedy for a patient to be discharged home into the hands of an abuser.
Who Are the Abusers?Last edit by Kooky Korky on Dec 10, '12
Dec 11, '12There needs to be an adminstrative meeting with all disciplines to create some sort of plan to deal with this family member and her behavior. Then it is up to the administrators to direct you all on specific ways to deal with her, and a safety plan put in place. If this family member is not a POA, and Mom can speak for herself, then she is a guest in your facility, and can be placed on a no tresspass order. Which is exactly what needs to happen should the family member not adhere to the rules of the facility. Social work needs to speak with her, to come up with a plan everyone can deal with. Weekly family meetings,in addition to a plan for family member to write everything down and charge will meet with her ONCE daily to address any issues. Set perimeters on when she can come and see her mother, and otherwise, when she can call to speak directly to her. And she needs to be told that in fact should she be verbally or physically agressive with staff that she will deal with the police. I am not sure why adminstration is dealing with this, however, should your direct supervisors not be amendable to a plan for safety and effective communication, then I would most certainly bring this higher in the chain of command, right to the corporate aspect of the facility. In most nursing homes, there's an omsbudsmun, and state agencies--I would certainly make use of them as well. There's difficult family members, then there's people who are members of a resident's family who are threatening and dangerous. I am curious if Elder Services is involved in this case, as if a daughter is that out of control, I would fear for the resident's safety should this be a short term stay. Additionally, I would speak with your case manager and social work regarding reporting to elder services should the resident go home, as perhaps this resident needs a court appointed guardian if the daughter is incapacitated to the point of physical agression in trying to make a point. You have a resident to protect and ethically and appropriately deal with via your nursing license. I would not put it on the line for a dangerous individual who has no business taking care of her mother in any aspect until she can get herself under control--if that is even possible.
Dec 11, '12Oh, and report to OSHA. Do that TODAY. There needs to be an alternate level of supervision if your current administration will tolerate assault of staff. And if your facility accepts state or federal insurance (Medicare) I would call the compliance hotline. And your parent corporation probably has a complaince hotline as well. Look it up. If you lose your job over this, then I would contact an attorney. Otherwise, this will put some plans in place outside of the facility itself to keep you all safe. Another thought I had is that most local police departments have officers specific to elders. You need to start a paper trail with this officer. I use all of this "drastic" measure interventions, as you are charge in the facility when some of this stuff happens, so you are responsible. If another family member of another resident has seen all this behavior, you never know who has already made reports to agencies and the police. CYA.