Is this nurse in the wrong?
- 0Dec 22, '12 by NovoMy brother was admitted into a psych unit this week and when I visited him today I walked in on him arguing with the nurse. He was asking why he was there - which he has done since the first day he arrived We tell him because he's not well but the nurse today told him EXACTLY why. She basically read of the chart to him and said it was because he was delusional, schizo, may cause harm to others and mentally unstable. At this point I could see my brother clenching his fists and as shocked as I was to hear her say this to him I kept my composure for his sake. She also noticed his agitated state and I saw her reach down and try to press the security call button. I told her we were going for a walk and escorted him away from the front desk. Moments later she followed us with meds and insisted that he take them. After he swallowed them - he started going off again on how he wasn't crazy and AGAIN she started arguing with him and this time even louder and more condescending than the first time. Again I walked him away from her and we came back 15mins later when he calmed down for him to do some paper work.
I'm only a student by why on earth would you argue with a psych patient. I mean I've tried to convince him that his delusions arent real but he just gets agitated and very defensive - whatever he's seeing must be real to him so I just let it be. But I felt this nurse today was agitating him on purpose. When he aks any other nurse they either nod and tell him you;re not feeling well. Furthermore, she was speaking to him like he was in some kind of prison in such a condescending tone - not therapeutic.
I didn't react to her attitude because I knew that my brother would feed off of it and it would cause him to have freak out. What can I do now though? Can I have her taken off my brothers case or even file a complaint against her? I'm pretty sure she was the charge nurse. Did she do anything wrong - again not sure If I'm over reacting since I have a personal stake in this.Last edit by Novo on Dec 22, '12
- 0Dec 22, '12 by eatmysoxRNMaybe she was having a bad day? However, that's no reason for her to be disrespectful toward a patient, delusional or whatever. You could call and speak with the nurse or another person in management to express your concerns. Best wishes for your brother. Many people don't take mental health issues seriously enough.
- 2Dec 22, '12 by liveyourlife747She shouldn't have fought with him. I agree that the pt has the right to know why they are in the hospital, but this should be done in private (not at the nurses station or hallway) in a non threatening way. Psych is a hard area, but nurses need to remember that the Pts feelings/delusions are real for the pt and it should not be argued over.
- 2Dec 22, '12 by lovingtheunlovedIt's crazy to try to argue with a crazy person. I think psych nurses can get to a point where everything is just routine to them, they see this stuff all the time, and forget that to the patient, this is all very real, and usually very painful and distressing. I think the nurse that was caring for your brother needs a career change. Shame on her for treating a patient that way.
- 6Dec 22, '12 by marydcYes, I would have told him why he was there. Honesty is important and it is his right to know. As others have said it needs to be done in an empathetic, respectful and tactful way.
It's also important when teaching the patient about their diagnosis to look at where they are in their treatment. Start with simple facts and build on that. More specific and clinical terms should wait until they have progressed to where the symptoms are better controlled.Last edit by marydc on Dec 22, '12 : Reason: wanted to add
- 1Dec 22, '12 by MrChicagoRNIt's hard to tell without knowing the full context of the conversation. Sometimes patients ask the same question many times, and denying the answer each time. Maybe this was the end point of that. However, loud and condescending is not appropriate. It is perfectly appropriate to ask to speak to the manager or administrator for the unit to discuss your concerns. But be aware that confidentiality is very strict, and while the manager may investigate, the response that you receive may be somewhat non-specific.
- 0Dec 22, '12 by olddraggerThis nurse needs some education in how to react to an agitated patient and how to not confort a psychiatric patient in a non therapeutic way. Confrontation can be therapeutic but it has to be done within the proper context and environment--for example in a therapeutic group meeting.
She was wrong plain and simple. You are fortunate that you have the opportunity to learn from this event.
I would bring my concerns to the Nursing Director concerning this nurse in a constructive way. The Nurse simply may not know how to handle a situation such as the one you described.
Kudos to you for you support of your brother. He is lucky to have a brother that cares for him.
- 5Dec 23, '12 by Meriwhen, ASN, BSN, RN Senior ModeratorShe was correct in being honest with him, as he does have the legal right to know why he is in the facility. Mind you, exactly how she tells him should always be tweaked to the immediate situation...but no matter what his condition is, he has the legal right to know. However, her attitude and tone, as well as trying to foist medications on him when he didn't want them, was not appropriate.
Since all we know is your side of the story, it's possible that things were out of taken out of context. However, you can (and definitely should) file a complaint if you feel that the nurse was acting inappropriately. Be as neutral as possible when stating the facts, because I'll be honest with you: in psych we find that for a variety of reasons, the family is often far more difficult to deal with than the patient. So I'm trying to help you here when I say that staying calm and sticking to the facts when filing the complaint will go a lot further towards advocating for your brother than shrieking like a banshee and throwing out the "student nurse" card.
However as others have said, because of patient confidentiality don't expect to be kept abreast of every single development in the complaint process. And the request for a change of nurse would be taken more seriously if he makes it, since ultimately it's he and not you who is the patient.
I hope everything works out.Last edit by Meriwhen on Dec 23, '12