Being falsely accused of neglect/abuse

[elthia]

Last night I had a patient who had questions about his vanc piggyback. He was under the impression that the vanc was to run 24 hours. I explained that it didn't work that way, that he was dosed with a certain amount every so many hours. He stated that he felt that it would not fight his infection that way. I stated " it enters the bloodstream and after so many hours of being in circulation it is excreted by the kidneys, which is about the time you get your next dose of vanc. It's like pill abx, you don't take it constantly, just every so many hours based on how long it takes to be excreted" He didn't like that explanation, or any other I gave, so I offered to have another nurse, the nursing supervisor or the resident on call to explain it to him , and he refused, he said he would speak to his attending in the morning. It was a busy night and I did not chart this conversation. Which is turning out to be a big mistake.

At the beginning of the evening shift tonight he had a slight temp 99.9, he's on scheduled motrin, so we said we would recheck the temp later. At 1730 he hits the call light, I'm not his nurse, but I answer the call light. I asked him if he needed something, he said no. I said "are you sure, you did hit the call light' he told me to get out of his room.

An hour later his wife comes up to the nurses station and says she wants his temp rechecked by his nurse, I knew his nurse was in the middle of a "code brown" so I said I would do it. WIfe refused to have me check his temp becuase "he doesn't like you, you explained things on a third grade level last night when he asked you a question, and you never did anything for him when he hit the call light an hour ago." I replied that i went into the room and that he stated he did not need anything.

She's really upset,stating that his care is being compromised, won't allow me in the room, and everyone else is unavailable at the moment, I'm charge nurse but I can't seem to de-escalate the situation, so I call the nursing supervisor up. the first thing the super does ask what's going on. In front of me the wife tells the super that her husband doesn't like me because I said "bad words" to him last night. the super gets angry and asks "what words" the wife then states "she said "I want you to understand", and that is one thing that will drive him crazy." At this point I completely walk away from the wife and the super because I don't want to say or have any facial expression that could get me in trouble.

After a while the nursing super comes over, grabs my arm and pulls me into the break room. The super is insisiting that I go into the room with her and apologize to the patient for my attitude. I tell her, No way, I am not apologizing for wanting a patient to understand the rationale for his med schedule. The super then says this is called service recovery. I tell her I think it is ridiculous to apologize for telling a patient " I want you to understand" when I'm doing patient education. She then threatens me to write me up for verbal patient abuse for the patient education and for neglect for not taking the patients temp when wife requested it. She threatened my nursing license. I tell her to write me up then, because I will fight it all the way up the chain if I have to.

At this point the super launches into a personal attack, criticizing my accent because I sound "stuck up", my "lack of facial expressions" at times when providing patient education, and that I am taking out frustrations from my personal life onto the patients. She kept raising her voice, calling me girl and finally I just went off. I told her I am an adult and a professional nurse, and I expect to be treated like one, do not talk to me like this. She then said I am completely wrong in my handling of the situation, and that this is not the end of this. I am completely upset, and when I get angry/frustated I tend to cry, so then she went off on me about how I am completely unsuited to be a nurse until I can learn to control my emotions.

I did chart some of what when on tonight with the wife's complaints about patient care,yet refusing to allow certain staff in room to provide that care. And I wrote out an internal complaint form that doesn't go into the pt's chart about the super's behavior. But my facility has a zero tolerance policy for alleged patient abuse, and ALLEGED abuse is enough to be suspended.

I honestly don't feel like I did anything wrong other than not charting the patient education on the vanc dosing. Any ideas on what I can do to protect myself in this situation would greatly be appreciated.

[ShayRN]

Can you speak to your nurse manager? I think that your supervisor is the one that needs to be written up for abuse. She grabbed your arm? She was screaming at you? Who the H# is she to lay her hand on you?!? I would talk to my manager and then place a call to risk management. They have a loose cannon running the ship. I am part of the service recovery on my floor, Service recovery does not mean that you must apoligize for every and any perceived slight.

What I would have done in that situation, as a manager/charge nurse is to leave the situation alone for the night. Have another nurse take care of the patient and stay as far away from them as possible. I would then call the patient advocate and leave a message on her machine letting her know what happened and see if she can come up to defuse the situation the next day, after tempers have calmed. Then the next time I was there, I would go into the room and apoligize for anything I may have said that upset him. Notice here, your not saying your sorry for what you said, your saying your sorry it upset him.

Again, your house supervisor needs a reality check. I wouldn't let this drop if I were you.

[Town & Country]

JMO but if I were you I'd start job-hunting ASAP. The customer is always right, you know.....it's the world we live in.

Doesn't matter that you really didn't "do" anything.....one angry, irrational patient (or family member) is all it takes to cost you your job.

:argue:

[caroladybelle, BSN, RN]

I think that your supervisor needs to written up for her inappropriate remarks.

But as a matter of note, to the patient's wife, I usually give the "I regret that you are not satisfied with the care that I provided for your husband." It acknowledges their complaint without validating it. I would then make sure that he has a different nurse, and one backing her/him up to cover the light when s/he is not available. If they ring the call light, and those designated nurses are not available, and the issue is not immediately health threatening, let them know that their nurse will be in presently...and they can wait or accept your help.

Our jobs are difficult enough without this bulldust going on.

No one can "have your license" for a mere polite disagreement and a dislike of facial expressions. And if a facility were to threaten me with that, they would be seeing a notice from my lawyer.

I also think it ironic that with all the emphasis on "cultural competence" in nursing, in regards to patient care, that we are less tolerant of those cultural issues in staff. i personally think that bringing up your private life issues and accent/lack of facial expression reeks of discrimination and harassment. That should be very clearly discussed with someone, up the chain of command from the super.

And I would also probably look for a different job, one that treats their employees with a bit more respect.

[nursemary9, BSN, RN]

Hi

No matter what, I would NOT allow ANYONE to touch me!!

If anyone even so much as touched me, much less grabbed me, I think I would be on the phone to the police. No one is allowed to touch or grab without your permission. I don't care if she is your supervisor.

I would be talking to someone as soon as possible this morning to get some of this cleared away--especially the stuff with the Supervisor. As some one else said, this is a loose cannon.

Yes, service recovery is all about patient satisfaction & the patient is always right, but that doesn't mean you need to be abused.

Let us know what happens.

I do think I'd start looking around tho for another job.

Mary Ann

[JAHJF]

Last year we had a Cardiologist yell at and grab the nurse manager for his groups office b/c he was upset w/her for letting one of "his" nurses go. He was arrested and charged w/assault, all over the news and everything.

[dawngloves, BSN, RN]

She chides you for your lack of facial expression in one breath and then tells you you are unsuited to be a nurse because you can't control you emotions in another?? (Which is BS in itself. We are humans. Being a nurse does not mean I am a Vulcan)

[fledgling]

Please, while everything is fresh in your mind, WRITE DOWN EVERYTHING THAT TRANSPIRED. Do it in Word if possible so that as you remember more details, you can add to it. Document everything you remember.

I am not a nurse yet but I did work as in customer service for AT&T for many years and served as a Union steward, representing employees with grievances against management. The other nurses are right; this NS was the one in the wrong. In fact, her behavior is so outrageously inappropriate and in violation of any state's labor laws that it is *she* who should be upset and afraid for her job/license, not you.

Her response to the pt and his wife should have been to apologize that they did not feel satisfied with your assistance and to not have you interact with them in the future. Period. Did it not occur to her that she is dealing with someone who is medicated and that he may not be responding normally to you?

Her behavior -- the disturbing personal insults, threatening your license and grabbing your arm are all so incredibly irresponsible and inexcusable: they expose both her and the hospital to a lawsuit. I have seen successful ones for less. She doesn't have any business supervising anyone.

The best defense in this case may be to file your own complaint against her as soon as possible. It will make you feel better to fight this and clear your name.

Remember this: YOU DID NOTHING WRONG. Although maybe you should look around for another job, don't leave without resolving this to your own satisfaction. That way, you can leave with your head held high.

Sorry this is so long. My very best wishes to you,

Michelle

[chadash]

I found it interesting that the wife said her husband was triggered by your using the words "I want you to understand>>" Does this guy have any psychiatric diagnosis?

Also, your manager did exactly the opposite of what she needed to do to defuse the situation. She sounds goofy.

[Tweety, BSN, RN]

Excellent responses here.

I've seen too many good nurses loose when butting heads with supers. I would ask for a meeting between your manager, the supervisor and a mediator from human resources so that you all can talk it out profressionally without the grabbing of the arms and the tears and anger. Be prepared ahead of time, writing down all your concerns.

I hate being misunderstood and would have to have a meeting to explain myself. Or at the very least put it in writing and send it to several people, asking for a meeting.

Good luck and keep in touch.

[tencat]

I'm not a nurse yet, but I've had issues with a bad supervisor. I think it's important to mention that if you have to interact with this supervisor, make DARN sure that you and the super are never alone. If she drags you into an unoccupied room and away from others, tell her that you'd be happy to meet with her to discuss concerns, but you will not meet with her without a union rep, or her supervisor, or whoever deals with employee issues present. I'm not sure how nursing works, but in teaching we had the right to meet with a supervisor and anyone else we wanted to bring to a meeting (another teacher, a union rep. etc.). Others already mentioned documenting everything with time and date on it, and telling the patient and his wife (with someone else present, but NOT just with the supervisor) that you are sorry he felt offended. I'd be dusting off my resume and looking for a better job, too!

Just a rant :angryfire : It burns my biscuits that you are the professional who has been trained, and this bozo thinks he has the authority and knowledge to tell you that his abx is being given to him 'wrong'.

[Mulan]

I found it interesting that the wife said her husband was triggered by your using the words "I want you to understand>>"

I thought the same thing, like we are supposed to know this about a patient????

Sounds like the patient has a problem, no one else, except maybe the wife for going along with him, and of course the supervisor.

Complaining about being spoken to on a third grade level, what is his education and occupation?

I would write it up and give a copy to more than just the nurse manager in case she sides with the supervisor, though I'm not sure who would be the appropriate people to send a copy to.

Let us know what happens and good luck!