Ever had a patient or family members fire you?

[KeepItRealRN]

Just curious to read a few stories from nurses who have been fired from the bedside. Patients and family members use very different criteria than we do to determine who is and who is not a good nurse. In the interest of full disclosure I have had this happen to me a handful of times in 25 years. The first time I was devistated. Not sure if it was the rejection or my competence being put into question. However since being in charge of an ICU for almost two decades I see this all in a new light.

One time I had the wife of a family member tell me they didn't want their nurse taking care of him. I'm thinking to myself, this nurse is one of my best nurses and if I had a family member in the ICU I would actually request that she take care of him/her.

One thing I learned from dealing with unhappy families is to let them do most of the talking and find out what I can do to make it better. She insisted that she wanted a different nurse. So I said OK fine. When I told the nurse in question that her family didn't want her taking care of the man anymore and that I was going to have to change the assignment, the nurse was devistated. I assured her that I hold her abilities in the highest of esteem and that if I or a family member of mine was in the hospital that I would consider it a priveledge to have her take care of me/him/her. I also told her that in my experience that when a patient or family member fires you it a lot of times has nothing to do with your skills as a nurse. Some people don't like others for a wide variety of reasons. I told her not to dwell on it and not to take it personally.

The nurse I replaced her with was someone who was OK, but not what I would consider the sharpest tool in the shed. The patient and wife loved her and thought she was great. Go figure.

[Poi Dog]

I get fired at least 2x by an ornery lady. Sometimes 4x a shift depending on whether or not she has taken all her meds.

[ICU_RN2]

I had a patient once, 17 years old, in with abdominal pain that ended up having a SBR with an illeostomy created. It was an emergent, middle of the night sort of thing. So the family was extremely worried, I'm sure, which translated into extreme need to control something -- i.e...ME!

I had a ton to do when the patient arrived, as for middle of the night sort of situations, the patient doesn't really spend a lot of time in PACU. So, I had to start a new IV, deal with an epidural that wasn't controlling pain well, set up a PCA, IVF's, all of my admission documentation, deal with my 6 other patients as well, etc. I had only been a nurse for a few months at that time, so all in all it was a lot going on for me at that point.

The family had hundreds of questions - from beginning to end, why this happened, how it happened, illeostomy questions, on and on. I remember asking them to give me a few minutes to reprogram the epidural (something we didn't get a whole lot), then I could continue answering questions. That put them into a frenzy, I was asked not to be their nurse shortly thereafter. By the time they left the hospital, they had a list of 6 nurses that were black listed....

It happens...for whatever reason...some great nurses aren't always that great at basic "people skills"..especially those I've met most recently in my time in the ICU. Great nurses that I want around when stuff starts to go bad...but patients sometimes aren't the most fond of them!

[Esme12, ASN, BSN, RN]

Yes I've been fired by a pt/family. I count that one of the luckiest days of my life:yeah: Every other nurse who cared for the pt envied me my good luck.

I resemble that remark........yup I've been fired and I was dam glad of it!!!

(the family was mad I asked them not to brush her hair anymore with the brush from home because we couldn't use anymore quell on her .....AND....I told them they couldn't come back until treated....Go figure )

[Altra, BSN, RN]

Interesting ... the only place I've heard the term used in this way is here at allnurses. Must be a regional thing.

"Fired" to me means ... my employment has been terminated, not that a patient/family member has requested that I not be their nurse.

This has happened to me twice ... once in the ICU and once in the ER. We did switch patient assignments to accomodate the ICU family member, but they behaved in such a manner that they were escorted out of the ICU by security on a daily basis during the ICU admission. The ER family ... had us switch assignments, but then continued to find such fault with well, everything and everyone, that the house supervisor and security also escorted them to the waiting room, where they remained until their family member went to the OR.

[kessadawn, BSN, RN]

I got fired by a Dad after inadvertantly getting caught in all of the games a divorced couple can play when their beloved child is dying. I could have kissed him I was so grateful to get out of that room! Bothered me some that I was a little blind to what happened between parents until it was too late, but in the end I know what I did for my patient made her happy and comfortable in her last days of life, and I have no regrets.

[vashtee, RN]

I had a difficult patient "fire" me before... her doctor asked me how I did it so he could do it, too.

[MrChicagoRN, RN]

I've had a number of occasions where a patient doesn't want a particular staff member.

I'd then go on to discuss it with the patient & listen to their concerns. Sometimes the issue really has nothing to do with the individual, but with something else altogether. No sense changing the staff around if the same core problem is going to rear its ugly head again in a day or two.

I will gladly change assignments if it will make the patient and/or clinician happy, but I don't do it automatically.

[danh3190]

I've been "fired" twice. Once the family was entirely unreasonable so it doesn't bother me at all.

The second time I was fired after I'd gone into my patient's room the first time. Family or pt told the UD that they'd had me a previous admission and didn't want me again. No idea why. That kind of bothers me since I try to do my best for the patients and wonder what I did to bother this one.

It also bothers me since I'm concerned it'll come up to bite me at a performance review and there's no way I can discuss it intelligently since I don't know what happened.

[ZippyGBR, BSN, RN]

Yes I've been fired by a pt/family. I count that one of the luckiest days of my life:yeah: Every other nurse who cared for the pt envied me my good luck.

indeed, it is good luck to be 'fired' by a problem patient ...

[shoegalRN, RN]

I had a pt fire me last week because I didnt have air freshner for his room.

He was in the ER, and the only one in the room.

He also fired me again, after I told him there is not another nurse who can care for him at the moment, because there are two emergent situations going on (traumas). He then told me I was gonna pay for his cab ride home and when I told him I will not, he said "well, I'm gonna call my lawyer". I then said, "with all due respect, you can afford a lawyer, but not a cab ride home?"

He then asked to speak with my supervisor. I told him she is tied up in a life threatening situation right now and is not able to speak with him at the moment. He then said, "I'm gonna report you for being rude to me, what's your last name?" I told him I am not required to give my last name for security reasons.

The attending doc was outside in the nursing station laughing his head off. This pt had been a complete jerk and a-hole to the staff his entire 4 hour stay.

Needless to say, he left the ER with only a bus pass. Gave me the side eye as I directed him to the waiting room.

[TonyaM73, ASN, RN]

Had a pt and his wife that wanted to dictate the dose of medications (sometimes a little more than prescribed and sometimes a little less.) I repeatedly told them that I could only give what was prescribed by the md and that it was out of my scope of practice to change it. Finally, they said that they wanted another nurse. I had a timed medication that needed to be given, so I asked them if they wanted me to give it or did they want to wait for the other nurse, but that it might be a while for her it get to them. They said yes for me to give the med and I asked them why they wanted another nurse.

They told me that they wanted another nurse to give them the medications the way they wanted it. I tried not to laugh when I told them that ANY good RN is not going to change the dose given without a doctor's order. They then told me "Oh in that case we'll stick with you". GEE THANKS!!

[mskate]

I have been fired from a handful or two of rooms. I consider it a wonderful thing! I don't have to deal with you, even better! :)

One time I was coming on shift with 2 patients. Separate rooms, you couldn't see one patient from the other room. Patient A was a new admit from the OR that the other nurse had just settled in and barely started on propofol. Patient B was actively desaturating.

I started my shift off in Patient B's room. Patient's A's daughter (who was a nurse, supposedly) was IRATE that Patient A was restrained. I wasn't about to go in and d/c restraints on an intubated patient, who I haven't assessed, who JUST started on the propofol. No way. And I also was not going to pay attention to Patient A's daughter when Patient B was having an emergency. The daughter was standing there yelling that she wanted me to print out the policy immediately. I explained (between runs to the supply room for the other patient) that at this point, it was my judgement call and I would remove the restraints when I able to determine it was safe.

Patient A's wife fired me from the room for not unrestraining her mother when I felt it was unsafe to do so.

..... Patient A extubated herself a few hours later when the new nurse removed the restraints per the daughters request and have to be emergently reintubated.

.... That being said - the new hospital I work with does not allow nurses to be "fired" from rooms unless there is a serious, major, major issue. The rationale is that the family does not get to determine ICU staffing. The charge nurse decides who has the best skill set for each patient and that is that.