Criminal or just Bad Judgement?

[Meerkat]

Would like input please...

I work sometimes with a male nurse, who I usually enjoy working with. Tonight I had a new admit, who was also a male, so I called the other nurse to come do the skin assessment with me, which is protocol. My male patient reported a large hematoma inside his thigh. The other nurse told me to leave the room. I told him no, that is my patient and I want to be present for the skin assessment if the patient was agreeable, which he was. So the patient showed us the bruise, which was so high up it was practically perineal. It was a very bad hemtoma, almost black in colour. So, to my shock, the male nurse reaches waaaaaay up to the patients crotch and starts feeling around...without any gloves. It was very uncomfortable and my jaw just about dropped. He paused for a few seconds and then asked me to step out of the room. Again I said the same thing, but this time I stepped out. When the nurse came to the station, he described the bruise as having a knot under it. I explained again that I didn't appreciate being told to leave when my pt said it was fine that I stay. He told me the patient was getting 'embarrassed' that I was there, and he knows this because he is a guy. Anyhow, his 'assessment' seemed very inappropriate to me. Later the patient denied being embarrassed and stated that he would rather i have stayed. When I asked him if he was at all uncomfortable with the other nurse, he deflected the question, 3 times.

The is the second time something like this has happened. The first time I asmin'd an IM injection into the gluteous muscle of a young man, and the male nurse stepped in and started rubbing the guy's butt, I mean massaging it, again bare handed...under the theory of rubbing the injection site for whatever clinical reason. I kept thinking OK he's gonna stop doing that any minute now, but it seemed to last forever, him massaging the guy's butt. I was so uncomfortable that I reported it, but apparently the pt was not uncomfortable and so nothing was done.

This nurse has a mysterious history. Apparently he had some kind of felony years and years ago, something about striking a police officer, and the story goes that having had a felony, he cannot be around kids, legally. All we really know is that he cannot work on the children's unit or be around kids for some reason connected to the policeman incident. Sounds a little off to me, but OK.

Well, what do you think? Am I over reacting?

[all4schwa]

But as an RN my job is to delegate. I didn't appreciate being told by an LPN, to leave MY patient. In this situation though, I do not feel he had any authority whatsoever to instruct me to leave, whether LPN or RN.

since when do we delegate assessment anyway?

[RN BSN 2009]

Definitely inappropriate and shady IMHO.

[ZootRN]

Yep, you're right about that too! Later, the LPN told me there was a 'knot' under the hematoma, so you know he felt around pretty good.

That was another thing I resented. I love our LPN's, they are wonderful. But as an RN my job is to delegate. I didn't appreciate being told by an LPN, to leave MY patient. I have never 'pulled rank', I don't like that kind of stuff. In this situation though, I do not feel he had any authority whatsoever to instruct me to leave, whether LPN or RN.

Initial assessment upon admission should be done by RN. I don't understand why he was doing assessment and you were witnessing it, and even left the room. Should be other way around: you were doing assessment, he was just standing there, witnessing. And how did you chart his assessment findings, just because you watched him doing it? If you charted as you did it, it's legally wrong. If you charted that he did it, when he is LPN and you are RN, this is legally wrong either. I really do not see a point of bringing someone for witnessing, when there really was no witnessing: he told you to leave, and you did just that. Maybe he assaulted a patient, how would you know that? Sorry, I don't mean to sound harsh, but you both did not follow the protocol that was initiated by the facility for the reason.

[Meerkat]

Initial assessment upon admission should be done by RN. I don't understand why he was doing assessment and you were witnessing it, and even left the room. Should be other way around: you were doing assessment, he was just standing there, witnessing. And how did you chart his assessment findings, just because you watched him doing it? If you charted as you did it, it's legally wrong. If you charted that he did it, when he is LPN and you are RN, this is legally wrong either. I really do not see a point of bringing someone for witnessing, when there really was no witnessing: he told you to leave, and you did just that. Maybe he assaulted a patient, how would you know that? Sorry, I don't mean to sound harsh, but you both did not follow the protocol that was initiated by the facility for the reason.

It was a SKIN assessment, not an initial assessment (which I had finished). I charted what I SAW, which was the hematoma and various other scars. He was not called to assess, he was called to witness, and he bullied me out of the room. Literally, pushed me to the threshold of the door. I should not have left, you are right. I was taken by surprise, thinking maybe he knows something I don't, thinking maybe the pt IS embarrassed...

[jill48, ASN, RN]

Initial assessment upon admission should be done by RN. I don't understand why he was doing assessment and you were witnessing it, and even left the room. Should be other way around: you were doing assessment, he was just standing there, witnessing. And how did you chart his assessment findings, just because you watched him doing it? If you charted as you did it, it's legally wrong. If you charted that he did it, when he is LPN and you are RN, this is legally wrong either. I really do not see a point of bringing someone for witnessing, when there really was no witnessing: he told you to leave, and you did just that. Maybe he assaulted a patient, how would you know that? Sorry, I don't mean to sound harsh, but you both did not follow the protocol that was initiated by the facility for the reason.

What are you talking about? As an LPN I have always done my own initial assessments which INCLUDE the skin assessment. This is true not only in long term care, but also when I worked med/surg. Is it true that only an RN should be doing this?:chair:

[all4schwa]

maybe it's another one of those things that varies state to state. here in ohio, in a hospital, an RN must do the initial physical assessment and the care plan. the lpn can do the rest of the admission stuff, and every patient must have an RN for at least one assessment a day (so if an LPN had them on nights, we mark the patients for an RN to take them in the am)

[UMNURSE]

What would you do if the patient was female and 16? We have to protect those who cannot protect themselves. Report him. If your management gives you a bad time about it find a new hospital to work in.

I agree with Tazzi.

UMNURSE

[KR]

I would say, as others have said, trust your gut. It is almost always right. Good for you for reporting your co-workers behavior. Keep us posted if you are able to.

[crissrn27, RN]

I would say, as others have said, trust your gut. It is almost always right. Good for you for reporting your co-workers behavior. Keep us posted if you are able to.

This thread is about a year old, I wonder what happened?

[MrsMommaRN]

:barf02:for the no gloves. wow i'd really be a bit suspicious. document what you told us. discuss it with your nm. let nm how uncomfortable you were in that situation. it reeks.