new nurse, in trouble already

purplemania, BSN, RN · Sep 17, 2004

I would quit the job and get another one, if for no other reason than because you do not feel the staff is supportive. Getting fired, or even going thru peer review, does not automatically mean your licensed will be revoked or suspended. So do not assume the worst. As for finding an attorney, that is an expensive step that may not be required if all that happens is a meeting between you and your supervisors. Law libraries (and attys) have books showing who practices what type of law in each state, so one of them can help you find a lawyer if needed. Right now I would be concerned about my pay. Is a suspension without pay required by the facilities policy? How soon will this be resolved? Will they pay for time missed if you are cleared? I would push for resolution to be quick so you can get on with your life. And I would expect OBJECTIVE evidence to accuse me of being abusive.

dwainlou · Sep 17, 2004

I don't think it is uncommon to be off without pay pending an invetigation of abuse. I'M SORRY THAT IT HAPPENED TO YOU. Most supervisors are not going to risk their licience for you. are you going to risk yours for a cna that an alert pt says abused them? I'm going to check it out very carefully and probably send them home immediatly. NSO provedes coverage inTx also Bill Beatty in dallas covers nurses. Best of luck what ever you decide.If you stay there try to have a witnees when you provide care to this pt.

mattsmom81 · Sep 17, 2004

I am also very sorry to hear this is happening to you and I know from personal experience how you are feeling. If they report you to peer review in preperation for a BON report, there are procedures they must follow. You are entitled to attend the peer review WITH your attorney present to safeguard your rights. You are entitled to make a statement rebuttal to their charges. If there have been any indication they are planning to do this, I would call a nurse attorney STAT. This is your livlihood they are messing with and the $$$ will be worth it IMO. Why would you want to just give your license up without a fight? I know this is a tough profession but you worked so hard for your license...

I doubt this will go away...you will have to deal with this allegation and hopefully your documentation will save the day. Like mentioned, if you don't trust these people, I would consider resigning and finding another job now before they have time to badmouth you in the community. Use people you trust or others uninvolved as references.

Keep your chin up...these situations are very hard, I know, but we do learn and grow from them. Don't automatically assume you will lose this and lose your license...but DO prepare a professional defense. (((HUGS)))

laughingfairy · Sep 17, 2004

Many facilities have a policy of suspension without pay pending investigation.

If you are cleared and even if you do find another job, demand pay for that time. Go to the labor board. They are very supportive of this. As some facilities have been known to do this simply to get rid of people. The accused gets suspended. Days even weeks go by. They find another job but are techinically still suspended, etc. Labor board does not like that kind of thing.

If they have not documented that you were suspended for x, y, and z that have been determined to be true it can not be a true suspension, and there for (in many states) are entitled to your pay, pto, and benefits.

In fact while your waiting contact the labor board.

dazzle256 · Sep 18, 2004

You might also want to think about suing the complaintive for slander.

peaceful · Sep 18, 2004

If your license is threaten what so ever, GET A LAWYER! Also a previous poster had good advice: DOCUMENT, DOCUMENT, DOCUMENT.

Drysolong · Sep 18, 2004

Hi ALL:

I am nursing student changing careers. In my previous job, I did a lot of documentation because of the negative environment I was in. I never had to use my direct documentation, but my quoting exact dates, times, etc. served me well in discussions with upper management.

In reviewing this current discussion, I am wondering do those of you who are nurses document on a regular basis, or only in cases like the one being discussed? Also, how credible are notes in a nurse's personal journal in cases like this when a patient alleges abuse. Is this situation only prevalent in LTC facilities?

Thanks in advance to those of you are experienced caregivers.

jannecdote · Sep 18, 2004

Where I work, we always report these situations ASAP to the supervisor. We are told to document precisely what the patient states to the nurses, etc. This documentation will spare many problems.

We had a pt. who called his physician a F****** B**** when she was making rounds. She turned over the care to another physician. The nurses would plead with the supervisor to give them extra patients if it meant not having to deal with this guy. This went on for weeks. The man was alert and oriented.

It all came to a head when he cursed out a nurse--once more--and she got the supervisor. He called the supervisor a f****** b****. The supervisor was so mad she got everybody on the shift who witnessed the event to document it and then the problem was discussed in a case management meeting. The man was out within a week. Funny, huh?

I bet if the higher ups where you work had to take care of this guy for a few days the whole situation would be a heck of a lot different.

miphillli · Sep 19, 2004

Lorajane..........I am not sure what to make of this, if this pt. has a history of abusive behavior to staff,verbal and/or physical your facility should be seeking a mental health exam,pt may benifit from a behavior modification program as well,they also need to consult with his medical doctor. I don't know about Texas but in many states the facility can suggest to the pt and pt's family that it is obvious that he is not satisfied with his care and that another facility may be able to meet his needs to his satisfaction,this,of course,is after meeting with family and pt and working on a solution that would benifit the pt and be workable for the staff. This said...did you abuse the pt?It sounds like from your posting that you may have forgotten to document your difficulty with him? Every nurse,if she stays in nursing any length of time,will have a complaint made against her,it hurts to the core,( you would not be in nursing if you did not care about mankind)but you will learn from it as well.

It sounds like you have alot on your plate right now,good luck with your new children and please don't loose any sleep or over react to your situation...it will pass.

Nurseboi · Sep 19, 2004

When I worked in Emergency I had an abusive patient. He was a bit of a, well I guess you guy's from the US would call him a BUM, we call em Beggers.

Anyway, he carried on like a pork chop, swearing and abusing staff and other patients. Unfortunatly due to it being Emergency everything he said could be heard by the other patients because it was a very open enviroment.

It when on and on till it got to the point where he said "I am so F....... sick of F...... waiting I have forgotten what I came in for" He also said he wanted a smoke, I said he coudn't till the doctor saw him, then I said do you have smokes? he said he didn't but he would bot one. I said no way are you going to the waiting room to ask other patients for smokes, then he said he would get a butt from the gutter. I said you can do that when your discharged, but you aint gunna get out in the gutter get hit by a car and then get me taken to court!!

Anyway, on and on it went till I had enough. I eventully said" GET OUT, you told me you can't remember while your here so, GET OUT" It was very liberating and the other patients begain to clap and cheer HAHAHA He woudn't go though so I had to call my boss. He was very understanding and on the same wave lengh as me so he asked him to leave and with that and the help of security he left!

Then it was about documentation of everything that happened and if I remember my boss even got one of the other patients to document something to.

I think documentation is KEY. If any nurse ever goes to court for anything to do with a patient, documentation is certainly one thing that will be looked at!

It's pushed here in Australia, Cover yourself - Document, Document, Document - It's the three D's.

lorajane · Sep 19, 2004

The patient had a long history of "behavior issues", at the hospital, in the jail where he was before he went to the hospital, and at our facility. He had had many psych evals, but nobody was willing to treat his psych issues because of his liver disease, encephalitis and high blood ammonia levels - our facility psych doctor said he didn't want the patient to die because of psych meds.

Actually, the only thing that saved me was my documentation. I was in his room every 20 minutes, addressing his issues (the meds and his behavior), and counseling him that his behavior was not acceptable. He threatened to throw himself on the floor (as he had done before), paraplegic and all, and he spiraled out of control after that. {The last time he threatened that with me, I told him it would be considered an attempt at self-injury and he would be transported to the psych ER - he said that was fine - and when I asked him what his purpose was in that, he replied "because you're a b****" -and out he went, where he denied having any behavior or psych issues and was returned with no treatments or med changes, of course, right at shift change.} In retrospect, I should have handled him the same way again, except it didn't seem to have accomplished anything, and I figured I had just wasted a bunch of people's time and money, so in the midst of dealing with my other 12 patients, I just dealt with it best I could. Anyway, he did put himself on the floor this time, and everytime I went to check on him (every 20-30 minutes), he yelled and cussed, etc. I told him to let us know when he was ready to be taken care of, but that I was not going to subject myself and my CNA to his behavior. I asked him if he wanted a pillow under his head (his reply was a curse), I made sure his call light was in reach (actually I tried to clip it to his gown, but he tried to hit me) and I closed the door so his yelling would not disturb the other residents. I did this every 20-30 minutes for 2 hours, and every time I went in, he acted a fool. Finally, when he did decide to settle down, I told him I was going to call for a porter to clean up the sticky floor and dishes that he had thrown, so we could use the hoyer to lift him, and he replied "you already have a Porter, that's what started this whole mess" (his last name is Porter), and I documented that, as well, in quotes. I don't believe I have ever seen anyone has manipulative, and hateful, as him. And the real problem came because he was NOT always like that - he had certain people he "liked", and certain people he didn't, and I happened to be one he didn't.

Sorry to vent - it still just shocks me! And then my DON says "sometimes we have to be the better person" when handling patients like this, and grrrr! It's just almost unbelievable! I don't think I abused him - I think I protected myself and my aide. He always had a call light, until he pulled both of them out of the wall and started banging on the closed door with them; I offered him assistance, and a pillow; I assessed for respiratory distress, m/s injuries, and skin issues - there were none, although I could have done more complete documentation on these; I really don't know what else I could have done, except send him out again, which was completely ineffective the last time (and that was completely documented). So, if I missed anything, and anyone has some advice (besides "be the better person..."), I'm open. Right now I'm glad he's gone (d/c home with home health), and I've still got a job, and more importantly, my license. Thanks again for your input.

Lorajane..........I am not sure what to make of this, if this pt. has a history of abusive behavior to staff,verbal and/or physical your facility should be seeking a mental health exam,pt may benifit from a behavior modification program as well,they also need to consult with his medical doctor. I don't know about Texas but in many states the facility can suggest to the pt and pt's family that it is obvious that he is not satisfied with his care and that another facility may be able to meet his needs to his satisfaction,this,of course,is after meeting with family and pt and working on a solution that would benifit the pt and be workable for the staff. This said...did you abuse the pt?It sounds like from your posting that you may have forgotten to document your difficulty with him? Every nurse,if she stays in nursing any length of time,will have a complaint made against her,it hurts to the core,( you would not be in nursing if you did not care about mankind)but you will learn from it as well.
It sounds like you have alot on your plate right now,good luck with your new children and please don't loose any sleep or over react to your situation...it will pass.

lorajane · Sep 19, 2004

Thank you for sharing. I have another question now: if the allegation is cleared by the facility, can it/will it be reported to the BON, or does it just get dropped? I thought it might be better to just give up the license rather than risk a fight - but you're right, I worked very hard, with three kids in tow, and I think I'm as good a nurse as I can be with a whopping 10 months of experience. So, how can I know if they're planning to report this to the BON?

Thanks, again!

I am also very sorry to hear this is happening to you and I know from personal experience how you are feeling. If they report you to peer review in preperation for a BON report, there are procedures they must follow. You are entitled to attend the peer review WITH your attorney present to safeguard your rights. You are entitled to make a statement rebuttal to their charges. If there have been any indication they are planning to do this, I would call a nurse attorney STAT. This is your livlihood they are messing with and the $$$ will be worth it IMO. Why would you want to just give your license up without a fight? I know this is a tough profession but you worked so hard for your license...
I doubt this will go away...you will have to deal with this allegation and hopefully your documentation will save the day. Like mentioned, if you don't trust these people, I would consider resigning and finding another job now before they have time to badmouth you in the community. Use people you trust or others uninvolved as references.
Keep your chin up...these situations are very hard, I know, but we do learn and grow from them. Don't automatically assume you will lose this and lose your license...but DO prepare a professional defense. (((HUGS)))