? Incompetent Nurse..(part vent)..long

Nurses General Nursing

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Hi all, this is in part an opportunity for me to vent, in part a request for other nurses to comment on whether they are seeing the same in their institutions. I care about my place of employment a lot, and would have a hard time going to work anywhere else, in part because the closest hospital is approx. 70 miles from here.

I work in a small critical access hospital that employs approximately 10 full time RN's, all of which are good nurses, that are very consciencious and take good care of our patients (we all have our better or worse days), except one nurse.

This has been an ongoing problem over a few years, this nurse continuously makes med errors, is rude to patients, families and co-workers alike and is not at all open to new policies or procedures. (A common comment I hear from her is "This is not my job, i am not going to do this). She never volunteers for anything, holds grudges for ever, conveniently disappears when there is a patient in ER or is being admitted. And if you ask her at the end of the day, she had to do it all by herself. She will not ask for help and would rather stick a patient 10 times attempting to start an IV than to ask a co-worker.

In the last few weeks she has had several episodes of crying, she feels as she is being treated unfairly. These crying jags apparently do not alarm anyone in administration to the fact that there may be a problem with her coping and her ability to handle stress.

There have been many complaints made to our DON and the Hospital Administrator (I know, because I made some of them myself), but they make excuses for her such as "You know this is a bad time of the year for her", or " you have to understand maybe her med levels need to be checked"

(she is on medication for bipolar disorder). There has been an investigation by the Board of Nursing, which cleared her of any wrongdoing.

What do you think, is it me that has a problem?

Specializes in Peds.

I have a friend who is a physician and is scizoaffective. When the illness was under control she was awesome as a physician but unfortunately, she could not stay stable. Needless to say, she no longer practices medicine and fortunately she never harmed a patient. It seems though that even with the ADA, they could only protect this nurse so much.... Her med errors alone could kill someone.

Specializes in Certified Wound Care Nurse.

** Disclaimer: My two cent's worth. **

I hope for her sake (not to mention everyone else's) someone brings this to the forefront - without knowing all the particulars and having my biases, I wonder what led her to this point? Is it truly Bipolar? Is it caregiver role strain? Is she an older nurse that's finding she's slowly being phased out bit by bit (subtly) based on her age? Is it that nursing has changed over the years from one of absolute direction from physicians to one that requires a level of confidence/competence she may be afraid to possess? No matter what the issue(s), and I am sure the issues are compounded, I wonder what can be done to help her in the workplace, given that she *may* have a dx of Bipolar disorder?

If she has a disability, keeping in mind the work environment and the concern for patients - maybe contacting the Job Accommodation Network would be a place to start. As far as new policies and procedures, she could be fearing the unknown... Hearing that she's so insistent upon sticking a patient 10 times w/o asking for help indicates to me that she's afraid of being perceived as incompetent - I know this b/c I am stubborn in different situations and have set personal boundaries with myself on how and when to ask for help at work - no matter what.

If she's been there for years, she has to be privy to certain aspects of that hospital's hx and environment and probably has stories to tell. I don't know how many new nurse orientees you get, but perhaps she could have more of a teaching role since she has many years of service there. That way, she gets a break, patients are safe until she "recharges" and gets back on track, and she is maintains her dignity and self respect as a nurse.

My heart goes out to her and to you and the hospital where you both work. No one chooses to be Bipolar, BPD or any other mental illness for that matter, and those around them indirectly suffer the pain of mental illness as well. The "rub" is the presentation of the illness - there are no *visible* wounds, no quantifying way of assessing the "size" of the wounds or the disease process itself... there are no blood levels or labs to check to determine the presence of diseases like this, no x-rays or CT's for dx - making stigma easy for me, in particular, to embrace with alacrity. I forget sometimes, how many people are on antidepressants, walk with wounds that are invisible to the naked eye and how quick I am to judge and to tell people with depression to just "shake it off" or "pull it together". It's not that easy.

Reading about her crying jags at work made me think of an experience I encountered several years before I decided to become a nurse. I was at a party where there were two off duty nurses. One talked about having meds available to him at all times and "indulging" while on the job, the other drank herself silly, saying that she had a "wee bit" of trouble with alcohol. During the conversation she said she managed to take a sip or two while at work (I wonder when she found time?). I'd almost prefer a nurse having a discharge/melt down instead...

I hope everything works out for the patients, the hospital, and for you for the best possible outcome.

Shawna

Have you spoken with her about the situation? in a non-combative way of course. Asking her if she needs some help, a hand with dealing with things, a pointer in the right direction. I hope she doesn't end up killing someone and then have to face the guilt and pain of that for the rest of her life. Could you imagine having to live with that?

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