burn patients - page 2

I recently triaged a patient with 10% burns to her face and neck, mostly 1st degree with a couple spots of 2nd degree. The areas were bathed with cold water in triage and then she went to... Read More

  1. by   graduatemay2004
    You did the right thing. I work on a burn unit, and thank God for you. You never put ice on burns! Thats so frustrating how unfairly you were treated. :angryfire I hope you have been paid an apology by now, and all your workers realize you did the right thing. Thanks for standing up for your patient, and stopping this nurse from applying ice! :hatparty:

    Quote from canoehead
    I recently triaged a patient with 10% burns to her face and neck, mostly 1st degree with a couple spots of 2nd degree. The areas were bathed with cold water in triage and then she went to registration. I met her at the registration desk and brought her into a room, bypassing a waiting room full of people.

    As I walked with her to the room I could hear exclamations of horror from one of the nusres behind the desk saying "OMG she's burned bad, she needs ice and cold compresses, she should have been brought right back." That nurse came in the door of the room as I was coming out and said "she needs ice!" I stopped her saying " I've been told not to put ice on burns." So she turned around and started crabbing to the 2 nurses, secretaries and EMTs at the desk about how the patient needed ice and didn't have it, and "I can't believe she waited, she should have been brought right back" All audible to everyone at the desk and the patient who had landed in a room next to the desk.

    I said "she didn't wait" and got the reply "yes she did, I'm putting ice on her," as the nurse got up again and went to the door. I stopped her and said "what are you doing?" and she explained again about how the pt should have come straight back from triage, gotten ice on her burns, and started to go in the door again. I said "would you let me do it please?" so she walked away and I went in. (with about 8 people watching the whole show, and thanks guys, for helping me out on this one... )

    Once I got in there I realized that I knew ice was not called for and could actually do damage, and that I was going to do this because I wanted to avoid the pressure and embarrassment. So I took a breath and walked back out. She was STILL out there going on about how the poor patient had been neglected. I walked over to the desk and said in a low slow voice "_____Shut up."

    She started to yell, don't tell me to shut up! I've been a nurse for ___ years and I know what needs to be done!" Again, I repeated myself looking her straight in the eye, and she started to yell back. Thankfully one of the EMT's shouted over her, for us to cut it out, go elsewhere, etc. She left the unit, and I stayed.

    When the doc came out I confirmed with her that she didn't want ice on the area and made sure my pt was the next to be seen. The crowd dispersed, and actually the two pts I had were especially nice to me (bless them) and life goes on.

    Except 20 min later and administrator came in and asked me to come with him, not to complete giving pain meds to my burn pt, just come to the office. They took my keys and my badge, escorted me to the timeclock, got my coat and purse for me and escorted me to the door. The head of security was outside the office as we left. I was suspended with pay, pending my manager returning on Monday. I had spent a total of about 45min inside the hospital that shift.

    Of course I was upset and went home and looked up the standard of care from the ENA, and apparently what I did was EXACTLY what they recommend. But no one in the crowd watching backed me up, and in fact one of the M/S nurses got on the phone during this party and asked for STAT unbleached linen for this pt. When I explained the burn was on the pt's face and she wouldn't be needing the linen she rolled her eyes - but why was she getting involved in the first place???

    I am so angry at how I was treated, my job is in jeopardy, and NOONE helped me, I can't believe it. I loved where I worked until this incident, what now???
  2. by   Northernlights
    I'm curious--will you need to work with this nurse again? Often? Was this an isolated incident or has she been "on your case?"
    You obviously gave good nursing care and met standards of practice. You can be proud that you stood up for your patient's best interests in the face of your co-workers' rantings.
    I would guess that she was alleging that your anger was out of control and that is why admin reacted the way they did. Did she feel threatened? Or was it a manipulation to get you into hot water? Either way, what's done is done and I would be concerned about how to move forward if you need to relate to her in the work setting in the future.
    By the way, the suggestion to agree to counselling, etc was good; but she should also need to receive some education about burn treatment. I've been a nurse for years like her; but unlike her, I realize that things I learned 5, 10, 20 years ago are no longer the accepted best practice.
    Best of luck to you in this difficult situation. Let us know how it goes.
    Northern Lights
  3. by   tonchitoRN
    in no way should you take this lying down. i suggest getting your documentation to justify your nursing care. you should also demand a written apology from the nurse you confronted, the supervisor who ordered you off the unit and security. and you should fill out greivance papers for harrassment. believe it or not you have rights not to be humilated or harassed on the job. of course the lawyer is the next step (if needed). if you accept this treatment it can happen again. if you want respect sometimes you have to demand it. good luck.
  4. by   canoehead
    I just looked at the ads at the bottom of this thread and did you know that you can buy a New or Used Burn on Ebay right now!! I gotta look into that!

    Meeting with the NM tomorrow, I will let you know what happens.
  5. by   steelcityrn
    for whatever reason, i think you are treated very poorly there by the staff. i would look for another job and save yourself the stress of possibly getting back in there, and you know ppl, you will never be able to clear your name there. been around these types before, they are the type of people that give nursing a bad name ...good luck
    Quote from canoehead
    there is no assigned triage rn, we rotate as registration calls that someone needs to be triaged. by taking the pt into the room i was her nurse, and another nurse was interfering with the care of my pt. there is no charge nurse either...as usually we only have two rns on duty and an md. in fact the nurse that i am speaking of was officially "off" at the time this happened, and was just finishing up, i was her relief.

    i agree "shut up" was not one of my more articulate moments... i think "we all heard you the first four times " would more express how i felt.... if i had left the unit i know that someone would have gone in there with ice and although it wouldn't have caused the world to end i was determined at that point that my patient would get the right care, not be left to a bunch of mouth breathing, ignorant, clodhoppers (but there, i'm being inappropriate again :0


    ok i'm better now. thank you karen for all the great resources.
  6. by   Brotherbob
    Quote from canoehead
    What do I say to the people who sat/stood at the desk and assumed that I was completely wrong, and didn't tell the other nurse to back down. What about the MS nurse who got in the middle of it even though it wasn't her unit, wasn't her patient, wasn't any of her business in the first place? These are my coworkers...and they hung me out to dry. )
    Dont say anything if they dont ask, you know that you were right and in time they will know too.
  7. by   truthtutor
    you have my support as a nurse--it's sad when we can't work as a team to assist the patients instead question each other's nursing judgement-in a humilating way at that, but it's best to always consider care of patient first just as you did and to piggyback on karen-diffusion of the situation with help of supervisors can stop the unprofessional ranting of a coworker as you experienced. sorry you are going thru this. hope things work out for you-you sound like you really enjoy your job but, if there is no dignity in your workplace(facility) and if management will not consider that patient care could possibly be compromised by other coworkers not following policy/procedures or just not using good nursing judgement then you might want to consider if this facility is the place that you are willing to risk continued humilation /or loss of licensure :smiley_abcare plans should never contain a duel between nurses. protect yourself
  8. by   jojotoo
    OK, so I know this thread is over two years old, but canoehead, what was the final outcome for you?
  9. by   canoehead
    I'm still working at the same hospital. I met with the director of patient care and had the written standards of care from the ENA in front of me and went through the wh9le situation with her step by step. I was vindicated, pretty much, but there was no apology from anyone. I did keep my job and got 3 days pay for the time I was suspended.

    Since then I think I've proven myself as knowledgeable and always having standards to back up what I do. I did approach the nurse I had a problem with about a month afterwards and said my choice of words was poor, I shouldn't have said shut up. She said "yeah, you were really rude." No return apology, so I guess I know where I stand with her. What I didn't know at the time was that a year earlier she had been the ER manager, so she had extra drag with TPTB, and I had just started at that hospital a few months prior.

    I would have been soo horribly alone if it wasn't for my allnurses support team. I have to thank each and every one of you. I really questioned myself and my judgement and you all backed me up. Thank you.