Butt kissing management

[jessiern]

This makes me so mad! Yesterday I was (yet again) charge nurse. We had a peds patient that was supposed to discharge. The doctor hadn't round, and the LPN providing care asked me if I thought she should hang her AM levaquin. I said "of course"-since the child was still running a temp(doc admits the child should have stayed, but mother insisted he leave-she "had things to do"). Well, doc rounds a few minutes after it was hung. I was at the desk charting, and the mother comes storming up screaming "if ya'll think I am going to stay around for that bag to go in, your crazy. I ain't got all day". I explained to her that the antibiotic, which had started 15 minutes earlier, would be finished in 45 minutes. It would take most of that time for the discharge paperwork to be ready, and for the nurse to be in to do teaching. She again startes screaming about us trying to keep her there to charge he insurnace more. I patiently explain to her that I, nor her nurse, cares how much her insurance is charge, seeing as how our pay doesn't change-and that neither one of us even knows enough about the rules regarding insurance payment to even dream up such a diablic plan. I send her back to her room, mad, but I could care less. Well, my sec that witnessed the whole thing called our DON to tell her about it.

Our butt kissing DON comes up, and goes to the room. When she comes out, I asked her what that was all about. She says, "oh u/s says she was upset about having to wait, so I wanted to smooth things over" She is notorious for giving gift cards to mad family, whether or not we did anything room, so I asked if she did. She said she did. I asked her if she felt my and the LPN did anything wrong, and she said no she didn't, we did what she would have.

So, I voiced to her how upset that mad me. To me, giving the gift card when the staff has done no wrong gives the appearance that we did something we shouldn't have. She replies that the patient's perceptions sometimes are wrong, and we have to be careful of that. So, explain the situation to the patient. Try to change their misconception! Don't kiss their butt so they go to the grocery store and tell others to go to the hospitla and complain "because they give you money if you do" (heard that with my own ear, more than once).

[Lucy4]

I have never heard of giving out gift cards to families - these places must have a big budget!!!

[aeauooo]

Had a wonderful female patient that faked seizures. Of course it happened with everyone in the room. So I leave to call the doc who says that he knows she fakes seizures and he's not ordering any benzos. So when I get back to the room, the first thing the girl asks me is "can i get some ativan"..I said "no and the doctor said your seizures aren't real". She didn't mess with me the rest of the night although later in the morning she put on a wonderful performance by pretending she had stridor. I told her to knock it off, stridor cleared right up.

Some of the other nurses didn't agree with my methods or me telling her that she was faking it but I had other patients to care for and I certainly wasn't going to cater to her antics.

Yeah, stridor during a 'seizure' is a dead give-away. Pseudoseizures tend to be very dramatic. Malingerers need to read the books to realize that generalized seizures are usually quiet.

I've seen some very bizarre seizures, and I've been fooled too.

With this girl the clinical picture just didn't fit the history I was given. I was ready to pack her up for a trip to CT.

Feeling her muscle tone, which I wasn't looking for in the first place, was an 'Ah ha!' moment - that piece of the puzzle that makes sense of it.

[Medic04]

I have never heard of giving out gift cards to families - these places must have a big budget!!!

Ummmmmmmmmm no we don't have a huge budget, they made cuts in other places(Staffing and so on) to make sure these things are/were given out. Plus of course the CEO and board did not take a cut.

Yes, worked in retail where"The customer" is always right is a total different CONCEPT then in a hospital.

Now we award bad behavior or families, pt and their friends. Pts and those folks know it too and it is a damn shame, then the staff is held responsible as"you could have apeased them more" For what doing my job?

This whole thing is a sad development of what we have become as a industry in whole:down:.

[rph3664]

Our department's Director handed out goody bags to patients one day, when we were holding admissions for up to 24 hours....

Perhaps we could instead use money to acquire more nursing staff.

It appears that condoning and encouraging bad behavior is the new norm.....

When someone acts out in triage and let's their emotions escalate, they are generally rewarded with special treatment.

And thus, the cycle goes on..... show some bad behavior, attract the attention of management, and have your behavior reinforced by getting what you want, getting a gift, or getting your proverbial bum kissed by the director.

And this is all so we can have good survey scores??

I have never heard of things like this going on at the hospital where I work, but then again I'm cooped up in the basement and not in the trenches like you folks.

When I worked at the grocery store pharmacy, an Osco opened up across the street, and a man came in and behaved in a matter so erratic, they had to call the police. He complained to HQ about this, and they sent him a big package of discount coupons TO OSCO without even contacting that store to find out what really happened.

That store closed barely a year later, not because of this but because of traffic patterns. Osco saw a bare patch of earth across from Walgreens and constructed a store without taking into account all those one-way streets. No wonder that company got bought out by CVS (and don't get us started on that!)

[RN1982]

Yeah, stridor during a 'seizure' is a dead give-away. Pseudoseizures tend to be very dramatic. Malingerers need to read the books to realize that generalized seizures are usually quiet.

I've seen some very bizarre seizures, and I've been fooled too.

With this girl the clinical picture just didn't fit the history I was given. I was ready to pack her up for a trip to CT.

Feeling her muscle tone, which I wasn't looking for in the first place, was an 'Ah ha!' moment - that piece of the puzzle that makes sense of it.

No the stridor came after the seizure. The girl came in for "respiratory distress". She got two hour long breathing treatments and was having "stridor" when she came to me, we did abgs and they were perfectly normal. Everyone left the room after that. She tried to get me to lift her to the commode and I said no. The sad part is, is that her mother and sister bought into her act.

[aeauooo]

No the stridor came after the seizure...The sad part is, is that her mother and sister bought into her act.

Got it.

People pull these acts to get attention - in the case of your patient, it sounds like it worked on her family.

After the dust had settled with the girl I mentioned, I told the nursing supervisor that I wanted to trade her for another patient because I had the sneaking suspecision that I was about to be accused of sexual abuse. As it was, the only time I was with her was when the room was full of people, but I didn't want to be left alone with her. Maybe I was just paranoid, but I didn't want to find out the hard way.

One time I had a patient with 'bizarre' seizures. The docs were just as perplexed as I was. When I came back to work the next day I asked if the had considered tetorifice. They said, "Don't give her any ideas!" then pointed to a chart eight inches thick from all of her psych admissions.

[RN1982]

Got it.

People pull these acts to get attention - in the case of your patient, it sounds like it worked on her family.

After the dust had settled with the girl I mentioned, I told the nursing supervisor that I wanted to trade her for another patient because I had the sneaking suspecision that I was about to be accused of sexual abuse. As it was, the only time I was with her was when the room was full of people, but I didn't want to be left alone with her. Maybe I was just paranoid, but I didn't want to find out the hard way.

One time I had a patient with 'bizarre' seizures. The docs were just as perplexed as I was. When I came back to work the next day I asked if the had considered tetorifice. They said, "Don't give her any ideas!" then pointed to a chart eight inches thick from all of her psych admissions.

Yikes.

[GallopinGal48]

If you do something right, do YOU get a gift card???

Aw, I already know the answer to that one...