Disresepectful hospice nurse

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Specializes in LTC/Rehab, Med Surg, Home Care.

About a week ago, I noticed that the HHA that comes in to our LTC to work with the hospice pts. didn't appear to be doing much with them during her time with them, and was caught on her cell phone more than once by our CNAs who later told me, prompting my conversation. Because she works for a different agency and is not a direct employee, I talked to the hospice nurse supervisor when she came in. I asked her to clarify hospice's expectations of the HHA role, and how much direction the wanted us to be providing within our LTC. I received very positive feedback and was glad I spoke up and advocated for our pts.

A few days later, a different hospice nurse came in and asked us how things were going, so I told her the conversation I'd had with the previous nurse and she pulled out a notebook and asked for specifics. I made it clear that we needed the HHA to step it up, and really just wanted to know how much direction they were comfortable with us giving the HHA, and that I'd already talked to another hospice nurse. She asked what specific things we wanted the HHA to be doing.

So we went through each pt, and I gave her ideas...this pt. scratches himself easily, please make sure nails are short...family is particular about appearance on these two, help with their meals, help with their bathes, etc, etc, etc....I thought it was a very positive interaction "wow, look what happens when we communicate well and work hard for our residents!" was my thought.

This morning I found a printed copy of an e-mail she sent (not to our LTC) with a comment in it that said

"Then the 'complaints' from these dumb jocks ensue..." with bullet points about the things we'd went over!!!

I was aghast! Why would she say that? I don't know how she could have twisted what I said! The HHA was actually here again and did a fabulous job. She was obviously spoken to, and took the feedback to heart. She did a great job. Our hospice pts. got the extra TLC they needed, got their extra showers, no one had to wait to be fed, etc.

Later in the day I found the copy she intended for us to see, without typos, errors, or any derogatory comments toward our staff. I gave it to one of our nurse managers, they were shocked too...this is not the end of it.

But I'm left with a bad taste in my mouth.

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Specializes in telemetry, med-surg, home health, psych.

I don't really think that it was your place to talk to the Hospice Supervisor...I used to work in LTC and several of our pts. had their own hospice nurse that would come in...granted, they all did not seem to be "on the job" 24/7 but they filled a vital role and were certainly a great help to us just by being there..Now if the supervisor asked for your input that is one thing but to "tattle" is another..

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Specializes in LTC/Rehab, Med Surg, Home Care.

Does that justify her response?

The problem was, is the "vital role" you speak of was not being fullfilled.

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sunny, you were 100% justified in sharing your concerns.

honestly though, i am thinking i would have likely gone directly to the hha...

recognizing that the 'correct' route to take, would have been to talk to someone from the hospice agcy, such as you did.

regardless, the nurse's veiled response was shabby and most unprofessional.

the DON from your facility needs to speak w/a mgr from their facility, to ensure seamless continuity of care and ongoing collaboration.

it would leave a bad taste in my mouth as well.

continue on the higher road.

you'll never go wrong.

leslie

eta: i reread aloe's response.

while the 'extra' help is appreciated, if hospice isn't made aware of employee concerns, one day they'll be wondering why they are losing contracts with facilities.

diplomatic communication is a must, in order for any business to survive and even thrive.

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Specializes in LTC/Rehab, Med Surg, Home Care.

Thanks, Leslie, I think that's why I needed to vent somewhat anonymously, so I can try and take the higher road the next time she's in. These are my residents, I want them taken care of...I didn't go to the aid directly because I think I'm still a little uncomfortable with my authority. I certainly don't want to abuse it, or step on the Hospice nurse's territory with her HHAs. I knew my pts were safe, but they were NOT getting what they should have been from hospice services.

But I didn't want to just start telling her what to do without clarifying it with the hospice nurse first. The hospice nurses are typically only at the facility once a week for a few hours total, ask us, the regular nurses how the pts. are doing, if they've had any significant changes (we would have called them if that was the case), and then they see them, do an assessment, and move on. They pts. get two hours a week from the HHA each. With the number of hospice pts. our facility has, that means the HHA spends 7-8 hours a day twice a week with our facility.

Oh how I WISH I had an hour to spend with each pt! One of our facility nurses also has to sign their paperwork, and I asked my DON today if we should be sending them to her for signatures. She said no, but we SHOULD be questioning them and asking them what they did for each resident.

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Specializes in Neuro ICU and Med Surg.

Sunny,

I don't blame you for being upset. I think Leslie gave some great advice.

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Specializes in telemetry, med-surg, home health, psych.

But one must remember, there are two sides to every story....

"Give so much time to the improvement of yoursef that you have no time to criticize others"

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Specializes in telemetry, med-surg, home health, psych.

I re-read the OP and the only thing that was stated is that she got second hand info from the CNA that the Hospice nurse was on the phone...

come on....that is not neglecting her pt. in the least....the CNA may have not liked her to begin with...we all know how vicious rumors get started...that is no reason to complain about her to her supervisor...the perverbial "can of worms" was opened...

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I re-read the OP and the only thing that was stated is that she got second hand info from the CNA that the Hospice nurse was on the phone...

come on....that is not neglecting her pt. in the least....the CNA may have not liked her to begin with...we all know how vicious rumors get started...that is no reason to complain about her to her supervisor...the perverbial "can of worms" was opened...

the only 2nd hand info, was about the hha being on the phone.

op had made direct observations herself, as well.

in this case, it is the hospice pt who was allegedly being denied top notch care.

esp with a dying pt, now is not the time to be looking the other way.

but i agree with you aloe, that i would not have complained had it been based only on 2nd hand info.

leslie

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Specializes in LTC/Rehab, Med Surg, Home Care.
I re-read the OP and the only thing that was stated is that she got second hand info from the CNA that the Hospice nurse was on the phone...

come on....that is not neglecting her pt. in the least....the CNA may have not liked her to begin with...we all know how vicious rumors get started...that is no reason to complain about her to her supervisor...the perverbial "can of worms" was opened...

Our CNA was there also and stated she too, had seen this. Again, I'd like to point out that it's obvious the HHA has been talked to about expectations and the things that she can do. The HHA did a great job today.

There was a second nurse who talked to the hospice nurse too.

So how does this justify stating we had 'complaints' (She put it in quotes as if to trivialize the concerns we had), and calling us "dumb jocks".

I should have added in my OP that there were other LTC staff who came forward, and the hospice nurse began asking us questions, seeking out additional information. But, I tend to write books anyway and was trying to avoid doing so.

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Specializes in LTC/Rehab, Med Surg, Home Care.
But one must remember, there are two sides to every story....

"Give so much time to the improvement of yoursef that you have no time to criticize others"

What do you suppose the other side would be? AGAIN, THE HHA WAS SPOKEN TO ABOUT HER PERFORMANCE AND IT HAS DRAMATICALLY IMPROVED. HOW DOES THAT JUSTIFY NAMING CALLING?

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Sunny,

I don't blame you for being upset. I think Leslie gave some great advice.

Agreed on both counts. And the most important thing is the patient is now getting the care they need and deserve. Good job.

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