Dealing with frustrating family and supervisor

[SquishyRN, BSN, RN]

Sorry for the long post, just extremely frustrated. I work on call at a SNF and get called for different shifts and stations, or treatment. I finished being treatment nurse 7-3 this morning and at 8pm get a call from the 3-11 supervisor saying that the family of one of the patients was complaining that I didn't give a breathing tx due at noon. According to the daughter that was there all morning, she didn't see anyone come in to give a breathing treatment all day. They were making a big fuss saying things like we put our mother here bc it's a 5 star facility so we assumed everything is being done... blah blah. First of all, I'm 100% certain I gave that tx. I write all my tx down on sheets of paper for myself and cross them off as I do it. The only reason I would forget to do a tx is if I forgot to write it down, but this particular resident was there and marked off. There's no reason for me to cross someone off if I didn't do it bc it's my personal notes. I kept explaining to the supervisor (and even the complaining family member over the phone) that I remember vividly that I gave the tx b/c I remember seeing the daughter there on her phone when I walked in to start the tx and still being on the phone when I came back 15 min later to turn the tx off. She even stepped aside to let me get to the machine since she was sitting on the bed while her mother was in the w/c. Another reason I remember is bc both patients in that room have noon breathing txs and I remember giving them simultaneously. All the daughter keeps saying is "I don't care about the other patient, but my sister was there and says no one came in to do it." The worst part is the supervisor believes the family. Even though she was telling me "Oh it's probably just miscommunication between them," I felt like she was blowing me off and still throwing me under the bus and telling the family something else. I get that from her personality in general. I'm not worried about getting "in trouble" per se, legally speaking the tx book is signed as given, I'm just worried this is contributing to ruining my reputation as a whole. I'm a new nurse (licensed and working for only 3 months) so one of my biggest challenges right now is building my credibility and reputation as a competent nurse. I ask questions endlessly to the point where I feel like my coworkers are thinking "doesn't she know anything? can't she solve anything on her own?" From my point of view, I'm new, I don't have the experience to reassure that I'm doing something right, so before I do something new, and it seems like there's lots of new things everday, I get reassurance from someone else. For example, one time there was a hole in the G tube of a patient near the Y-adapter. It was a really long g tube so I figured it should be no problem to cut the tube at the hole and put on a new adapter. But before doing so, I went ahead and asked my supervisor if that was okay so she checked it out and said to do it. I feel like I'm being annoying that I do that for every "little thing", but I'd rather not do something first and then find out afterwards it was a major no-no. On top of that I've made mistakes already with this supervisor, like forgetting to chart something and having to come back next shift and do a late entry after the on duty nurse calls me. Or not giving the first dose of an antibiotic bc the pharmacy hadn't delivered it yet and I didn't know the first dose was supposed to come from the e-kit. I only had 2 days of orientation! I didn't even know what an e-kit was, let alone what was in it, before that happened. I feel like I'm being characterized by all the things I do wrong but no one ever notices when I do things right bc everything is going smoothly. I'm not the only one making mistakes -- I've noticed txs and meds having been signed off for days by other nurses even though when it's my turn the package is still unopened. I'm just really frustrated and upset that they don't see me as competent to the point that they're believing the family on this breathing treatment thing. Since I'm on call I'm scared they'll just stop calling me in. Errrrrgh!

[Davey Do]

"I feel your pain." -Bill Clinton

Your situation is a frustrating one, doing your job (and from all indications, a good one) and not being recognized for meeting the responsiblities of your position.

One thing I learned long ago- don't EXPECT to be appreciated for doing a good job- that's what you're paid for. And if you do recieve some praise, merely percieve it as a fringe benefit.

The only person you truly have to please is yourself. We all have to sleep with ourselves. Obviously, SquishyLVN, you have high standards for the quality of care you provide. If you meet your own high-set standards, then you've done not only your job, but a good one at that.

Recently, there was a thread about a woman who tripped and fell into a pool of water at a shopping mall while she was texting. If someone can be so absorbed in texting as to NOT see a large body of water, then someone jabbering on her cell phone will miss noticing a human body.

I feel for you, truly. Just keep up the good work and don't let the bastards get you down.

Sincerely,

Dave

[carolmaccas66, BSN, RN]

The daughter of the first patient and your management have decided to use you as a scapegoat for something. Maybe the daughter is just upset about something else, but has decided to take it out on you. People complain about the stupidest things.

And there's something else I would be confronting the daughter and management with - if, say, you had NOT given this breathing treatment, why didn't the so-called conscientious daugheter and family of this patient come and get someone then? Or was this a new treatment? and why wait till what, 8 hours later to complain about it? If their relative couldn't breathe, they should've gone and go you or someone else.

As to the other things, we have ALL forgotten to chart something. Also if when something happens and you are accused unfairly, you need a supervisor to complete an incident report with your version as well (ie: only had 2 days orientation and didn't know such-and-such), and also document everything in the notes.

And I'll tell you sweetiepie, those other nurses would blab on you in a minute - there is no loyalty in nursing now. MAKE SURE you complain when med packets aren't opened and signed off. Many nurses sign BEFORE giving a medication, then maybe don't bother or forget, get interrupted etc. I've seen this happen many, many times, and it is BAD PRACTICE. Always do your med checks and sign your meds afterwards, even if u do get busy.

A similar thing has happened to me when an extremely abusive and nasty patient complained re stuff I didn't even do and I was told not to go back to one hospital (I wasn't planning to go back after that nightmare shift), and the complaint wasn't even investigated. They will stab you in the back every time.

But do always make sure you document everything in the patent's notes to cover yourself.

[SquishyRN, BSN, RN]

Thanks to both of you for your advice. How would I go about documenting this particular situation? The treatment was a routine tx so I did no additional documentation other than signing the tx book as given. And since I'm only on call I have no idea the next time I would be in. But for sure I'll be calling the DON as soon as she gets in tomorrow morning so she has a heads up on the situation and my side of the story before the family approaches her to complain.

[Davey Do]

Carolmaccas66 makes a viable point: Why did the Family wait so long to complain?

However, Administrators often do not confront family because they see themselves as the PR Person or Buffer Zone between the Upper Class and the Proletariat.

I've been in similar situations and I document EVERYTHING. If away from the workplace, I type up a Report using Patient numbers or some way that the Individual could never be identified outside of the Facility. I document exactly what took place and if called on it, submit the Report as my Rebuttal to any Charges. I ask that my Report be kept in my file, especially with any Documented Charges.

If you want to discuss any fine point, feel free to send me a PM.

Dave

[SquishyRN, BSN, RN]

If I were to speculate, I assume they waited that long to complain bc that is probably when the 2nd daughter arrived and asked her sister what happened during the day. I doubt the first sister outright stated that no breathing tx was given but when asked by the 2nd if one was given she replied that she did not see it done. How could someone not notice their mother had a mask on her face for 15 min when she's sitting right next to her??? And the machine is so loud I'm sure it must have affected her phone conversation. Especially since I had 2 of them going on in that room at the same time.

[Davey Do]

How could someone not notice their mother had a mask on her face for 15 min when she's sitting right next to her??? And the machine is so loud I'm sure it must have affected her phone conversation. Especially since I had 2 of them going on in that room at the same time.

Hmm... maybe they're just out to get you.

Still, I advocate writing up a Report from Your Perspective. Which is probably Closer to Reality.

Dave

[carolmaccas66, BSN, RN]

Schedule a meeting with your DON/NUM and the daughter and thrash it out - if they are serious re this complaint, I think u have to confront them TBH.

Type up your version, make sure the DON/NUM gets a copy and I would still want to confront the daughter and family. They can't just get away with making complaints and making your life hard.

Confronting people is uncomfortable, you will probably sweat and feel very nervous BUT if you confront them, they will probably back down. Actually, if you ask for a meeting they will probably not even want the meeting and may back down.

I'll think more about it cos it's getting late and I'm getting too tired to think.

Let us know if you go see the DON or not.

You'll be OK matey, just stand up for yourself! :)

[OldNurseEducator]

The daughter of the first patient and your management have decided to use you as a scapegoat for something. Maybe the daughter is just upset about something else, but has decided to take it out on you. People complain about the stupidest things.

And there's something else I would be confronting the daughter and management with - if, say, you had NOT given this breathing treatment, why didn't the so-called conscientious daugheter and family of this patient come and get someone then? Or was this a new treatment? and why wait till what, 8 hours later to complain about it? If their relative couldn't breathe, they should've gone and go you or someone else.

You sound burned out. Why do you use the word "confront"? Sounds like you may have similar problems.

[happy2learn]

Was she on her cell phone? We don't allow cell phone use in patient's rooms. Hospital policy. Even if it's not a cell phone, it's kinda rude of her to be chatting on the phone in her mom's room. Poor mom. Why doesn't she step out to do that? I hate sitting next to people while they are chatting on the phone.

Clearly she cannot pay attention to a single thing when she is on the phone. Hope she doesn't talk on the phone while she drives!

I don't necessarily agree with "confronting" her. She thinks she is right, and you have already told your side and she doesn't believe you. So telling your side to her face to face isn't going to help the situation, it will only make it worse.

However, the next time you have to do this treatment, I would make it very noticeable that you are doing it even if that means saying what you are doing REALLY loud. lol. Try to get her off the dang phone too somehow.

[OldNurseEducator]

Was she on her cell phone? We don't allow cell phone use in patient's rooms. Hospital policy. Even if it's not a cell phone, it's kinda rude of her to be chatting on the phone in her mom's room. Poor mom. Why doesn't she step out to do that? I hate sitting next to people while they are chatting on the phone.

Clearly she cannot pay attention to a single thing when she is on the phone. Hope she doesn't talk on the phone while she drives!

I don't necessarily agree with "confronting" her. She thinks she is right, and you have already told your side and she doesn't believe you. So telling your side to her face to face isn't going to help the situation, it will only make it worse.

However, the next time you have to do this treatment, I would make it very noticeable that you are doing it even if that means saying what you are doing REALLY loud. lol. Try to get her off the dang phone too somehow.

I don't think most people in our world think that talking on the phone in front of others is rude. But, it is!! Just sayin'.

[noahsmama]

However, the next time you have to do this treatment, I would make it very noticeable that you are doing it even if that means saying what you are doing REALLY loud. lol. Try to get her off the dang phone too somehow.

Easy. Just go up to her and say "Excuse me, but I just wanted to warn you that I'm about to start your mother's breathing treatment, and the machine will be loud. You may want to step outside to finish your phone call."

Then, whether she actually does step outside or not, you've gotten her attention and she's more likely to remember that the treatment actually happened.