I was in charge last night. Received a phone call from the computer room to check one of the patient's charts to stamp a report as "permanent record." So I was standing outside of the patient's room and the nurse was in the room, not knowing I was right outside the door flipping through the chart.
Patient had pulled off his bipap machine, apparently. I hear the nurse say "Look what you've done. You're an As*h***. I'm through playing your f****** games." I'm aghast. I go to the doorway and say "I know he's a difficult patient but that's not appropriate!" She just starts saying "Look at his bipap! He broke it! Isn't this broken?!" Doesn't address my comment at all. I go in, fix the bipap mask and help her reapply it. And that's that.
I then walk out and write down verbatim what happened. We've had problems with her before. Give it to my manager in the morning and am called into the office with this nurse. She flat-out denies saying it. She was not angry, just seemed very apologetic with statements like "I'm sorry, I don't know HOW you heard that; I never said anything like that. I don't remember you saying anything to me."
I did do the right thing, didn't I?! (Manager believes me, by the way. But can she act on anything, if the nurse flat-out denies it happening? There were no other witnesses. Pt's mental state is uncertain.)
If you were in charge, I think you should have dealt with the issue WHEN IT HAPPENED. I would have told her, or got the right administrator on the phone (even at 3am) and got permission to - send her home immediately.
See, by allowing her to finish, it became her word against yours, and even if yours TRUMPS, it's now removed from the situation and action against her is doubtful.
It was SUCH an issue that it should have been an issue, then. I would have sent her home, and, if necessary, taken her patients, doled them out, got more help, asked for adminstrative help, etc.
No, the charge nurse was the OP. But even so, my charge nurse speaks to a pt like that, and my manager will be on the phone talking to me - even at 3 am. The house supr would be there, the thing would be investigated on the spot. I would make a stink commensurate with the dropping of the f-bomb on a patient.
had the charge nurse get mean with my elderly mom when she was hospitalized, and when it happened, our mouths just sort of dropped open, and mom was very kind to her in response. When she left the room, we just discussed what kind of stress she must be under, and stuff happens. The rest of the night, they sent in another nurse, so I think she knew she was out of line. We never complained, alls well that ends well. The other nurses were just great.
I agree that I should have pushed harder when it happened. I was just shocked; I'd never witnessed nor heard this behavior before. In retrospect, I should have been more forceful in my denunciation of the behavior with that nurse at that time. As "charge nurse" for the night, however, I also have no "authority" over my fellow nurses; it's more of a coordinator position than an authoritative position.
I have also since learned that this is at least her second, if not third, offense of this kind. I'm just hoping my lack of immediate and decisive action -- thereby allowing her to just deny it to my manager -- doesn't prevent the corrective action that needs to be taken.
If you in fact ever witness it again though, i would definately step in the room,, tell her you heard everything she said to the patient, go directly to the nearest computer and type up a verbatem senerio including what you did and what she did and said in exact order, then call her in and have her sign it.
By the way,, what matters what the patients mental status is,, we should be wondering about the nurses mental status that treats any patient like that. Can you imagine how if she has children they must be verbally abused?
There are very few things that I would consider reporting if it wasn't out and out jeopardizing a patient's health or safety.. but let me tell you that THIS is something I would have no qualms about reporting whatsoever. :angryfire
You wouldn't call your customer at McDonald's an A**H*** would you? You think you'd be canned on the spot? You bet!
Surely the same expectations apply here?
Off with her head.
Raus.
I don't know, I once called my customer at Arby's an a**h*** because he was making lewd comments about my rear end and saying what he wanted to do to it. Then he asked me out, if you could call it that, and when I politely declined, he called me a b**** and threw his food in my face!
I think he was embarrassed because I turned him down in front of his friends.
I didn't get fired either and my manager was standing right there!
I agree that I should have pushed harder when it happened. I was just shocked; I'd never witnessed nor heard this behavior before. In retrospect, I should have been more forceful in my denunciation of the behavior with that nurse at that time. As "charge nurse" for the night, however, I also have no "authority" over my fellow nurses; it's more of a coordinator position than an authoritative position.
I have also since learned that this is at least her second, if not third, offense of this kind. I'm just hoping my lack of immediate and decisive action -- thereby allowing her to just deny it to my manager -- doesn't prevent the corrective action that needs to be taken.
Thanks for your replies!
I understand what you mean about 'charge nurse' being more of an 'honorary' title than an authoritative one: but - you are the point person to marshall those authority figures to bear. And you should have done so AT THE TIME. Even in the middle of the night.
I'm not giving you grief. Just analyzing a situation and offering an opinion on how to deal with it should it happen again.
We all do things and second guess our actions. I would suppose that is why you posted about it. The point of second guessing is to work through the scenario to determine how to act if presented with a similar situation in the future.
Your actions weren't wrong. I think you could have acted better, but that's monday morning QBing on my part. The real question is: how will you act NEXT TIME. And I think you have lots of food for thought on that.
Ditto all of the above. You most certainly DID do the right thing. Now...document...document...document... you know the drill!
I might add... document, document, document. In otherwords, this nurse has a serious problem and the only thing to do is document a history of her behavior. Too bad this nurse is in denial.
If you were in charge, I think you should have dealt with the issue WHEN IT HAPPENED. I would have told her, or got the right administrator on the phone (even at 3am) and got permission to - send her home immediately.
See, by allowing her to finish, it became her word against yours, and even if yours TRUMPS, it's now removed from the situation and action against her is doubtful.
It was SUCH an issue that it should have been an issue, then. I would have sent her home, and, if necessary, taken her patients, doled them out, got more help, asked for adminstrative help, etc.
I could not imagine allowing somebody that uses the F bomb on a patient the opportunity to interact even one more minute with anybody else on my watch. To me, this is on par to discovering somebody is drunk at work: that behavior forbids the ability to continue for one more minute. Goodbye, punch out, go home. HR will be calling you. . .
You did the right thing; but you didn't go far enough.
That's my take.
~faith,
Timothy.
Zee_RN; "Patient had pulled off his bipap machine, apparently. I hear the nurse say "Look what you've done. You're an As*h***. I'm through playing your f****** games." I'm aghast. I go to the doorway and say "I know he's a difficult patient but that's not appropriate!" She just starts saying "Look at his bipap! He broke it! Isn't this broken?!" Doesn't address my comment at all. I go in, fix the bipap mask and help her reapply it. And that's that.
I then walk out and write down verbatim what happened. We've had problems with her before. Give it to my manager in the morning and am called into the office with this nurse. She flat-out denies saying it. She was not angry, just seemed very apologetic with statements like "I'm sorry, I don't know HOW you heard that; I never said anything like that. I don't remember you saying anything to me."
I did do the right thing, didn't I?! (Manager believes me, by the way. But can she act on anything, if the nurse flat-out denies it happening? There were no other witnesses. Pt's mental state is uncertain.)
Timothy, the OP handled the situation appropriately regards to she made the required adjustment to the Bipap, then asked the primary nurse to reapply the Bipap mask. Then, she documented the event soon afterwards so as to not forget any details. Now, I will say the OP could have not said anything to the nurse in front of the patient. After the patient's mask had been reapplied successfully and all other immediate care accomplished with the patient the OP could have had a stern counsel session in private.
Regards to sending the nurse home early is a thought, yet a tough call, IMHO. The OP was undoubtedly taken back by the nurses verbal abuse towards the patient. I would offer that patient should have been taken away from the nurses assignment for the remainder of the shift. Possibly a one for one switch could have been done with another nurse.
The long term problem arises with this nurses denial of her frustration with this patient, and more importantly her lack of professionalism with the situation. Thus, at least the documentation took place, and the Bipap was reapplied promptly.
I understand what you mean about 'charge nurse' being more of an 'honorary' title than an authoritative one: but - you are the point person to marshall those authority figures to bear. And you should have done so AT THE TIME. Even in the middle of the night.
I'm not giving you grief. Just analyzing a situation and offering an opinion on how to deal with it should it happen again.
We all do things and second guess our actions. I would suppose that is why you posted about it. The point of second guessing is to work through the scenario to determine how to act if presented with a similar situation in the future.
Your actions weren't wrong. I think you could have acted better, but that's monday morning QBing on my part. The real question is: how will you act NEXT TIME. And I think you have lots of food for thought on that.
Good luck to you,
~faith,
Timothy.
Excellent points; the OP posted to get feedback & will most likely do a little different next time in a similar situation.
I don't know, I once called my customer at Arby's an a**h*** because he was making lewd comments about my rear end and saying what he wanted to do to it. Then he asked me out, if you could call it that, and when I politely declined, he called me a b**** and threw his food in my face!
I think he was embarrassed because I turned him down in front of his friends.
I didn't get fired either and my manager was standing right there!
Fired? IMHO, you should have called the police! At the least, the manager should have ordered the customer to leave immediately.
Nonetheless, your situation, although a shame, does not relate to the OP's Thread... does it? Your were rude to your customer d/t his rude & assaultive behavior. The OP posted about this nurse that was verbally abusive to a patient, which the patient had not been rude to her.
Fired? IMHO, you should have called the police! At the least, the manager should have ordered the customer to leave immediately.
Nonetheless, your situation, although a shame, does not relate to the OP's Thread... does it? Your were rude to your customer d/t his rude & assaultive behavior. The OP posted about this nurse that was verbally abusive to a patient, which the patient had not been rude to her.
:yeahthat:
and frankly even if the patient had been rude to her, there are other ways to handle a situation like that. I remember reading something when my son was very small that went something like "Just because your child is having a temper tantrum doesn't mean you have to". I'm learning how to apply that concept to all the parts of my life.
SuesquatchRN, BSN, RN
10,263 Posts
Well, it was the charge nurse who did it.