So we recently admitted a male patient who identifies himself as female. We don't get many patients like her. A nurse in particular let's his political views get in the way of work and has been calling this patient "it".
Now, let's fast forward to the dilemma. During medication pass, he addressed the patient as "it" out loud and other staff and patients started laughing; next thing you know, we had a behavioral emergency on our hands.
I filled out an incident report because several other nurses and I have spoken to this nurse prior to the event happening. One nurse even brought it up the chain of command. Not only is it unprofessional but it's endangering the safety of others - clearly, it's one of her triggers. Has anyone ever dealt with this type of conduct?
People confuse free speech with the right to say whatever they want whenever they want without any repercussions. Free speech only refers to the government limiting what you say and even that has limits. The common example of limitations on free speech is you don't have the right to scream fire in a crowded movie theater.
Employers can and do limit your speech. They are free to require employees to say "Welcome to Walmart" or "Thank you for shopping at" or even "We want you to have exceptional care."
The OP posted about a nurse on an inpatient Psych unit who addressed the patient to their face as It. This caused a behavioral emergency.
This wasn't an accident. It was intentional. You could argue it was an accident if the nurse called the patient he instead of she. No one ever calls a person IT without intent.
This was a Psych unit where nurses are trained in effective communication, and in fact a large part of their treatment orificenal is therapeutic communication.
This nurse caused harm to the patient by creating a behavioral emergency.
This nurse created a situation in which patients and staff could have been harmed during the behavioral emergency.
This nurse has taught the other patients who witnessed this that the nurse can't be trusted to treat all patients with respect. It has probably caused some patients to distrust other nurses and healthcare providers. More than any other area of medicine, Psych depends on the trust relationship between patient and provider to effectively treat the patient.
Normally I agree that employees should be counseled and given an opportunity to improve. In this case I think termination is appropriate.
There are some actions every adult knows will get them fired on the spot. Those include stealing from the employer and sleeping on the job. I'd include calling a person of color the "n word", calling a mentally challenged person a "re-tard", calling a gay man a "f__", or any customer any perjorative. Calling a patient "IT" falls in the category.
The hospital will be lucky if the patient/family doesn't file a complaint with the state or CMS or file a lawsuit.
So people's right to hold their opinion is only valid when you agree with it?
And the other side isn't trying to impose anything on their opponents at all, right?
Sure, anyone can hold any opinion about anything. It doesn't mean that your opinion should affect my daily life. Civil Rights laws protect minorities, the disabled, women and LGBT for that very reason(because bigoted opinions and actions shouldn't be tolerated).
People go in psychiatric units for relief of their pain, not to have more inflicted upon them.
I would approach this patient and say I want you to know that I and my colleagues and this hospital do not condone or purport the behavior of this individual nurse, and behalf of all of us, I apologize.
And then be prepared for what may likely follow...
Maybe better to just stay out of it, and let the "offending" nurse deal with it on his own.
@Overland1: not a psych nurse here, but I don't agree. It seems to me that staff's recognition that the behavior was abusive would be more therapeutic than not. An apology even more so.
I'm curious to know the likely fallout that you think would outweigh that.
@Overland1: not a psych nurse here, but I don't agree. It seems to me that staff's recognition that the behavior was abusive would be more therapeutic than not. An apology even more so.
I'm curious to know the likely fallout that you think would outweigh that.
Can I respond to your question?
Woudn't acknowledgement and validation of abuse by another employee have an impact on liability? "Even your own staff said I was abused," would be admitting abuse?
Not that I disagree, I don't know why that nurse and those that laughed along are still employed, but I would consider my job at risk for admitting wrong doing to the patient. We don't typically do that at work, admit to a patient that they received bad care (insert correct adjective) and leave it to our managers, right?
Woudn't acknowledgement and validation of abuse by another employee have an impact on liability? "Even your own staff said I was abused," would be admitting abuse?
Not that I disagree, I don't know why that nurse and those that laughed along are still employed, but I would consider my job at risk for admitting wrong doing to the patient. We don't typically do that at work, admit to a patient that they received bad care (insert correct adjective) and leave it to our managers, right?
If fear of litigation prevents a person from doing the decent thing and admitting wrongdoing and apologize sincerely for treating someone very poorly and likely causing them distress, something in society has gone awry..
The incident described by OP deals with nursing ethics and how we should act towards our patients, but it really boils down to everyday human-to-human interaction. How do we treat/address our fellow wo/man? What kind of a world do we wish to live in?
If fear of litigation prevents a person from doing the decent thing and admitting wrongdoing and apologize sincerely for treating someone very poorly and likely causing them distress, something in society has gone awry..
I know you're not American, so you may not realize that this exact thing has been awry for decades. Fear of liability is a cancer that infects nearly every interaction in this country.
To specifically relate it to healthcare, the reason our cesarean rate is obscenely high, the reason tiny old folks and those riddled with fatal cancer end up tortured in ICUs for weeks, the reason people and businesses who've done nothing wrong pay settlement money, is all fear of liability.
If fear of litigation prevents a person from doing the decent thing and admitting wrongdoing and apologize sincerely for treating someone very poorly and likely causing them distress, something in society has gone awry..
The incident described by OP deals with nursing ethics and how we should act towards our patients, but it really boils down to everyday human-to-human interaction. How do we treat/address our fellow wo/man? What kind of a world do we wish to live in?
I'm not sure if you realize what question I was responding to but I in no way support wrong doing or avoiding doing the decent thing.
Sadly, our litigious society is a result of people doing the wrong thing. Big manufacturer pollutes lakes and rivers, rash of children born with defects and surging cancer rates. The victims have to sue to obtain justice.
A transgendered person who is in a psychiatric facility, who may have a very poor self image and self worth and maybe even a fragile grasp on reality, needs someone in her corner. I don't want her to be afraid that it might happen again. That is my priority, not shielding a hospital from being reported to CMS or being sued.
I would want this whole appalling incident to be exposed, and for the med nurse to be terminated. I would put the truth in a written statement because I do not want people like that working in the same hospital as me.
If the patient sues, they are going to write a check to make her go away. I am okay with that. I am not okay with patients being mistreated by rude and crude employees. Even if it makes me very unpopular or even unsafe at work. Even if the entire staff that was present lies and says "I didn't hear anything," and they will.
Every day is a series of moral (personal) and ethical (actions and duty) decisions.
Woudn't acknowledgement and validation of abuse by another employee have an impact on liability? "Even your own staff said I was abused," would be admitting abuse?
Not that I disagree, I don't know why that nurse and those that laughed along are still employed, but I would consider my job at risk for admitting wrong doing to the patient. We don't typically do that at work, admit to a patient that they received bad care (insert correct adjective) and leave it to our managers, right?
Bingo! Admitting alleged wrongdoing by another person is, at the very least, bad form. Beyond that, while apologizing for the alleged action of another may feel good, it can potentially put the person who apologizes in the third person in a bad legal position.
Libby1987, is correct... leaving this to management to handle is likely the best course of action.
Anonymous865
483 Posts
People confuse free speech with the right to say whatever they want whenever they want without any repercussions. Free speech only refers to the government limiting what you say and even that has limits. The common example of limitations on free speech is you don't have the right to scream fire in a crowded movie theater.
Employers can and do limit your speech. They are free to require employees to say "Welcome to Walmart" or "Thank you for shopping at" or even "We want you to have exceptional care."
The OP posted about a nurse on an inpatient Psych unit who addressed the patient to their face as It. This caused a behavioral emergency.
This wasn't an accident. It was intentional. You could argue it was an accident if the nurse called the patient he instead of she. No one ever calls a person IT without intent.
This was a Psych unit where nurses are trained in effective communication, and in fact a large part of their treatment orificenal is therapeutic communication.
This nurse caused harm to the patient by creating a behavioral emergency.
This nurse created a situation in which patients and staff could have been harmed during the behavioral emergency.
This nurse has taught the other patients who witnessed this that the nurse can't be trusted to treat all patients with respect. It has probably caused some patients to distrust other nurses and healthcare providers. More than any other area of medicine, Psych depends on the trust relationship between patient and provider to effectively treat the patient.
Normally I agree that employees should be counseled and given an opportunity to improve. In this case I think termination is appropriate.
There are some actions every adult knows will get them fired on the spot. Those include stealing from the employer and sleeping on the job. I'd include calling a person of color the "n word", calling a mentally challenged person a "re-tard", calling a gay man a "f__", or any customer any perjorative. Calling a patient "IT" falls in the category.
The hospital will be lucky if the patient/family doesn't file a complaint with the state or CMS or file a lawsuit.