new nurse, in trouble already - page 3

by lorajane 4,086 Views | 28 Comments

I got a call from my DON this morning...said he heard back from the corporate nurse. Said she asked him if he would have done anything different than I did in caring for this patient, and he now says he told her "no" - after... Read More


  1. 0
    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.
  2. 0
    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.
  3. 0
    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.
    Quote from miphillli
    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.
  4. 0
    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!

    Quote from mattsmom81
    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)))
  5. 0
    [DoQUOTE=cyberkat]If the DON is not going to be supportive, I'd get a good nursing lawyer. Fast.[/QUOTE]

    Do you know of any good nursing lawyers?
  6. 0
    Don't give up your career.

    Lots of people have rocky starts.

    I did, and lived to tell about it.

    My advice: get out of LTC and get into a hospital as soon as your family committments allow.

    Good luck.
  7. 0
    I highly doubt they will report anything to the BON.

    If they're like every other LTC facility I've worked at; they have plenty of skeletons in their own closet that they want to stay buried.

    If you know what I mean.
  8. 0
    You are probably VERY right on that one! I gave them my two-weeks' notice last Thursday, so only one weekend to go, but the saga continues.

    Last night, after working my normal weekend-doubles schedule (Sat 6a-10p and Sun 6a-10p), absolutely exhausting, at best, I did not have a nurse to give report to. We were supposed to have two nurses (10-6, MSU, 42 patients), and one had called in. The nurse who did come in "Lisa" was told she would have to take all 42 residents, but when I started giving her report on my two trach patients, she said she had never taken care of a pt with a trach and refused to accept their care...I totally understand, and support her decision especially because one of those pts is pretty sick by NH standards (went into resp distress on me, at shift change, about three weeks ago, sats 76%, turning blue/purple, etc). SO, "Lisa" called the nurse-on-call ("Christine")for the facility, and told her she would not accept care for these residents, and was told she didn't have any choice, the nurse-on-call had called everyone she could and no one was available to come in, and "Christine" was not coming in to help. (!!!!!!!!:angryfire )

    We called the DON (on leave, wife had new baby), the acting DON (also the ADON for the MSU), and the staffing coordinator (a CNA, yes you read that correctly, CNA), and everyone passed the buck! So, I ended up working until 2 am when the M-F 10-6 nurse came in for her 7th night in a row!

    Yes, that means I worked 20 hours! On the hall, responsible for 16 patients (10 medicare, two trachs, most of them alert/disoriented...), giving meds (not many, thank goodness), and breathing treatments!

    THESE PEOPLE HAVE LOST THEIR MINDS!!!!!

    I am still so tired, I can't even decide who to report to first... the BON, the State, the administrator (not holding my breath on that one...), the Labor Board...!

    This is even getting hard to believe! I didn't have these problems at the other facility...and the hospitals "don't hire LVNs". Am I supposed to stop nursing, and let me skills get rusty, or am I going to have to work as an aide, until I finish my RN stuff? Ugh!!!!!!!!


    Quote from SunStreak
    I highly doubt they will report anything to the BON.

    If they're like every other LTC facility I've worked at; they have plenty of skeletons in their own closet that they want to stay buried.

    If you know what I mean.
  9. 0
    Lorajane,

    Why do you have to stop working as an RN? Sorry I think I missed something?

    Quote from lorajane
    You are probably VERY right on that one! I gave them my two-weeks' notice last Thursday, so only one weekend to go, but the saga continues.

    Last night, after working my normal weekend-doubles schedule (Sat 6a-10p and Sun 6a-10p), absolutely exhausting, at best, I did not have a nurse to give report to. We were supposed to have two nurses (10-6, MSU, 42 patients), and one had called in. The nurse who did come in "Lisa" was told she would have to take all 42 residents, but when I started giving her report on my two trach patients, she said she had never taken care of a pt with a trach and refused to accept their care...I totally understand, and support her decision especially because one of those pts is pretty sick by NH standards (went into resp distress on me, at shift change, about three weeks ago, sats 76%, turning blue/purple, etc). SO, "Lisa" called the nurse-on-call ("Christine")for the facility, and told her she would not accept care for these residents, and was told she didn't have any choice, the nurse-on-call had called everyone she could and no one was available to come in, and "Christine" was not coming in to help. (!!!!!!!!:angryfire )

    We called the DON (on leave, wife had new baby), the acting DON (also the ADON for the MSU), and the staffing coordinator (a CNA, yes you read that correctly, CNA), and everyone passed the buck! So, I ended up working until 2 am when the M-F 10-6 nurse came in for her 7th night in a row!

    Yes, that means I worked 20 hours! On the hall, responsible for 16 patients (10 medicare, two trachs, most of them alert/disoriented...), giving meds (not many, thank goodness), and breathing treatments!

    THESE PEOPLE HAVE LOST THEIR MINDS!!!!!

    I am still so tired, I can't even decide who to report to first... the BON, the State, the administrator (not holding my breath on that one...), the Labor Board...!

    This is even getting hard to believe! I didn't have these problems at the other facility...and the hospitals "don't hire LVNs". Am I supposed to stop nursing, and let me skills get rusty, or am I going to have to work as an aide, until I finish my RN stuff? Ugh!!!!!!!!


Top