Charge nurse has an attitude...

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I work nights. My patient was 94yo male. On a first step mattress, stage two to his buttocks, incontinent of BM, copious amounts of diarrhea, and a GI bleed on top of that.

To prevent further skin breakdown, I got an order for a flexi-seal (rectal tube). At the end of my shift, I repositioned him, on his side, butt in the air, xenaderm on the sores, with the kin-air pad under him.

This evening when I came on shift, the day charge nurse says to me that I need to make sure this patient is turned every 2 hours, make sure there is no diaper on him, and make sure that he has the appropriate pad under him. Apparently, someone put a diaper on him and a regular linen saver under him (thus trapping heat and making his stage twos worse). I asked her who did that and she just LOOKED at me. She said that they found the patient that way this morning.

She was such a COW about the whole thing. I know she is doing her job, but don't come at me and insinuate that I don't know how to take care of my patients. I spent HOURS in that room with my patient, painstakenly wiping his raw butt off, cleaning him up, turning him, etc....and she has the audacity to insinuate that I allowed someone to put a diaper on him and the wrong kind of chuck under him? Give me a break!!!!!

Ok, I feel better now. :)

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Specializes in Oncology, Palliative care.

Sorry you had a bad day :(

As a manager she certainly could have handled that situation, sounds to me like she perhaps need to brush up on her communication and interpersonal skills! I would have also asked her what her rationale was for her order.

Hope you feel better.... ;)

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Specializes in med/surg, telemetry, IV therapy, mgmt.

You should have just shook your head unbelievably and gone about what you had to do. By asking "who did that?" you were wanting to point blame at someone. What good would that do? That doesn't promote teamwork.

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I guess when I asked her who had done it, I wasnt trying to place blame....it was my way of letting her know that it didnt happen on my shift. It was the fact that she insinuated that I was the one that allowed it to happen. I am meticulous when it comes to caring for patients skin, especially when there is pre-existing breakdown. If one of my CNA's tried to put a diaper on a patient that shouldnt have one, I would definately teach them what not to do. To me, the point really isnt *who* did it......Im more concerned about *why*. Im sure that the person who did it didnt have bad intentions....they probably just didnt realize that it was doing more harm than good.

I know this charge nurse. I have worked with her on days. She has a horrible temper...I have seen her throw a med book across the counter in a fit of rage. When she came at me, she said she was furious about the whole thing. Now don't get me wrong, I am all about advocating for the patient....however, I know that as a charge nurse (or as any nurse for that matter), it is better to respond rather than react.

I shouldnt let it get under my skin....it just aggravates me. I take it very, VERY personally when someone insinuates that I dont take care of my patients.

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I know this charge nurse. I have worked with her on days. She has a horrible temper...I have seen her throw a med book across the counter in a fit of rage. When she came at me, she said she was furious about the whole thing. Now don't get me wrong, I am all about advocating for the patient....however, I know that as a charge nurse (or as any nurse for that matter), it is better to respond rather than react.

I shouldnt let it get under my skin....it just aggravates me. I take it very, VERY personally when someone insinuates that I dont take care of my patients.

Throwing books isn't acceptable behavior.

Of course you take the insinuation personally, you sound like you care about the patients. Just move on and know you're worth your weight in GOLD.

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Specializes in IM/Critical Care/Cardiology.

I don't know about your documentation policy, but if you documented, she can read can't she? Let it slide, if she sees you upset from her side it just makes her power go up a notch. Like a previous poster said, shake your head and walk away or ask her to read your documentation. Hope today is better for you!

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When I have patients that need special stuff - like no diapers - I make a sign and post it. Put down what is not acceptable and what is the acceptable treatment. That way, when someone comes in to do whatever, they know what my plan is. I've had people help out and never tell me, but they didn't know that my plan for the patient did not include a certain item. And I can't tell you how many nurses cannot understand that you do not use plastic chux or diapers on pts with air beds/mattresses. Right off the bat it is easier to make a quick sign to put on the wall, the bed, the bathroom, wherever they will see it, so that everyone is on the same page.

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Specializes in Jack of all trades, and still learning.
You should have just shook your head unbelievably and gone about what you had to do. By asking "who did that?" you were wanting to point blame at someone. What good would that do? That doesn't promote teamwork.

No, by asking "who did that" the charge should have understood that the OP didn't do that. The charge shouldn't have assumed. Maybe by confronting her you made her feel uncomfortable. Sometimes it is good to document these things in your patients notes when there is conflict about patient care...

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Specializes in Med/Surge, Psych, LTC, Home Health.

As a side note... so do rectal tubes REALLY work? Do they tend to work primarily on patients who have really runny/watery stools? I admit I haven't used rectal tubes much at all; in fact I only remember taking care of one patient a long time ago with a rectal tube. Seems like all it did was make a big mess, but the patient's stool wasn't especially watery; it was soft and loose. Maybe it just wasn't being used right (I don't even think I was an RN at the time, still an aide).

Sorry to hijack the thread... I agree that your charge nurse shouldn't have insinuated that it was you that put the diaper and the pad on the bed. I also agree though that it would have been good to inform the CNA's right away not to put a diaper on the patient or a pad on the bed. Those two things seem to be "automatics" in the minds of a lot of people, when caring for an incontinent patient.

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Specializes in ER, ICU, L&D, OR.
I work nights. My patient was 94yo male. On a first step mattress, stage two to his buttocks, incontinent of BM, copious amounts of diarrhea, and a GI bleed on top of that.

To prevent further skin breakdown, I got an order for a flexi-seal (rectal tube). At the end of my shift, I repositioned him, on his side, butt in the air, xenaderm on the sores, with the kin-air pad under him.

This evening when I came on shift, the day charge nurse says to me that I need to make sure this patient is turned every 2 hours, make sure there is no diaper on him, and make sure that he has the appropriate pad under him. Apparently, someone put a diaper on him and a regular linen saver under him (thus trapping heat and making his stage twos worse). I asked her who did that and she just LOOKED at me. She said that they found the patient that way this morning.

She was such a COW about the whole thing. I know she is doing her job, but don't come at me and insinuate that I don't know how to take care of my patients. I spent HOURS in that room with my patient, painstakenly wiping his raw butt off, cleaning him up, turning him, etc....and she has the audacity to insinuate that I allowed someone to put a diaper on him and the wrong kind of chuck under him? Give me a break!!!!!

Ok, I feel better now. :)

Glad I aint a floor nurse

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