Nurse with very strange behavior.

Nurses General Nursing

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We have an RN who is a pet of management because she is a good nurse who is good with the patients. On top of that, she is in graduate school to be a nurse practitioner so they really think she is highly intelligent and all that and a bag of chips, too. She actually is a very nice person, but has a little problem dealing with confrontation and stress, though. When she feels overwhelmed she kind of acts nutty. Today, an employee was arguing with her about how she scheduled them to work and she went in the DON's office, threw a pen on the floor, stomped her feet, turned red, then started ranting about how she hates her shoes and she kicked them off and threw them in the break room and was running around in her socks...:confused: She has had tantrums before when frustrated with something in management and always apologizes afterward, but, what gives? What can be done with her? She also sits out in the smoking area puffing on cigars and laughing to herself. Sometimes, she has laughing spells in the middle of inservice and will have to get up and leave the room because she can't stop...weird.

Sounds like she has a mental health problem. Be on the lookout for behavior that jeopardizes patient safety and be prepared to report it. If management fails to act upon reports of behavior that is detrimental to patient safety, then be prepared to report it to the Board.

She reminds me of someone I know and respect. The person I know though don't have "laughing spells" and don't smoke. She is very intelligent and is very good in patient care and management. She actually holds a very high position at the facility. But she have same problems, when she is stressed or is facing confrontations, she acts weird. But I have no problems with her. It is just the fact that no one can have everything... One maybe good in patient care and management, very nice and intelligent, but is not good in facing and dealing with stress and confrontations. It is just a fact that nobody is perfect.

I consider laughing spells as somewhat "within normal behavior"... Maybe while she is smoking or during inservice, she reminisce a very happy memory which makes her elated.

I believe she is a good nurse, an almost perfect one if not because of her ability to deal with stress. I won't judge her as having any mental or psychotic breakdown just because of her "laughing spells" and tantrums. I know many person that are like that and they are great nurses... They are just happy and sees life the happy way. :D When I was still at nursing school, me and my group-mate had a "laughing spell" during one lecture for we remember a very funny experience. We can't stop laughing and had to leave the classroom for awhile.

We have an RN who is a pet of management because she is a good nurse who is good with the patients. On top of that, she is in graduate school to be a nurse practitioner so they really think she is highly intelligent and all that and a bag of chips, too. She actually is a very nice person, but has a little problem dealing with confrontation and stress, though. When she feels overwhelmed she kind of acts nutty. Today, an employee was arguing with her about how she scheduled them to work and she went in the DON's office, threw a pen on the floor, stomped her feet, turned red, then started ranting about how she hates her shoes and she kicked them off and threw them in the break room and was running around in her socks...:confused: She has had tantrums before when frustrated with something in management and always apologizes afterward, but, what gives? What can be done with her? She also sits out in the smoking area puffing on cigars and laughing to herself. Sometimes, she has laughing spells in the middle of inservice and will have to get up and leave the room because she can't stop...weird.

It seems like the tantrums and laughing are coping methods for feelings of anxiety. Did the employee confront her in front of other people? Do a lot of employees attend the inservice? Notice, in the situations you described, she removes herself when her behavior changes. Maybe she has panic/anxiety disorder and certain social environments trigger the symptoms. Thank goodness she was able to get to a safe place and not get paralyzed by her moods and forced to ride them out in front of an audience.

The next time you see her as you described, try a little patience and empathy. Try offering her the same courtesy you are suppose to give your patients. You stated yourself that she is a good nurse, educated, and good w/ the patients. It seems obvious that she can't help it when these episodes surface. You think it's weird, imagine how it must torment her. You can use your knowledge and experience in healthcare w/ coworkers too. Be kind.

Specializes in LTC.

It does sound like the laughing spells and tandrums are her own way of coping with stress. I admit I laugh also when I have high anxiety.

Sounds like she has a mental health problem. Be on the lookout for behavior that jeopardizes patient safety and be prepared to report it. If management fails to act upon reports of behavior that is detrimental to patient safety, then be prepared to report it to the Board.

I thought the original post read that this nurse is good w/ the patients and educated. Seems like her job holds a lot of responsibility and stress. She probably takes it very personally when her team is unhappy. Just because she is educated, a manager, and a nurse, doesn't mean she can't vent when things get rough. She's still a human being.

She can vent any way she chooses and act as weird as she wants to. Nobody said she has to act just like everyone else. But nothing gives her the right to harm patients. Should her behavior take a bent toward mistreatment of the patients, the OP has an obligation to do something about it. That is the only responsibility the OP or anyone else in that facility has toward the behavior of this nurse. Though, I would wonder what reaction a patient would have toward witnessing her tantrums and shoe hurling episodes. If I were sick enough, I might not want someone exhibiting strange behavior around me. It would be difficult to rest with one eye open for flying shoes.

Specializes in LTC, Acute Care.

http://en.wikipedia.org/wiki/Labile_affect

I found this little tidbit interesting, because I also have always had an issue with laughing inappropriately, sometimes uncontrollably. (I have ADHD that was recently diagnosed.) However, this shows other causes for odd laughing like that.

Wow, how quick, we are to diagnose. Is it any wonder then?

Specializes in Cardiology, Oncology, Medsurge.

See, this is exactly what nursing will do if you do it for very long, turn you into a cigar smoking tantrum totting nut case!

On a serious note, management should not tolerate such behavior and have her take anger management courses or take a mental health day now and then. sheesh.

Specializes in Peds/outpatient FP,derm,allergy/private duty.
We have an RN who is a pet of management because she is a good nurse who is good with the patients. On top of that, she is in graduate school to be a nurse practitioner so they really think she is highly intelligent and all that and a bag of chips, too. She actually is a very nice person, but has a little problem dealing with confrontation and stress, though. When she feels overwhelmed she kind of acts nutty. Today, an employee was arguing with her about how she scheduled them to work and she went in the DON's office, threw a pen on the floor, stomped her feet, turned red, then started ranting about how she hates her shoes and she kicked them off and threw them in the break room and was running around in her socks...:confused: She has had tantrums before when frustrated with something in management and always apologizes afterward, but, what gives? What can be done with her? She also sits out in the smoking area puffing on cigars and laughing to herself. Sometimes, she has laughing spells in the middle of inservice and will have to get up and leave the room because she can't stop...weird.

On the plus side. She's a good nurse. She's good with the patients. She's advancing her education through graduate school while working at a job with sufficient authority to make out schedules. She's a nice person. The people who actually could fire her if they wanted to are supportive of her. Minus side, inappropriate affect away from patient care.

What was the DON's reaction when the two of you were in the DON's office watching the spectacle onfold? That would probably tell you a lot about how she is perceived by the manager. Lots of people have tantrums to varying degrees. Was she verbally abusive to you? If not, there probably isn't anything for you to do with her. It would seem the management has already decided what can be done with her. That mental image of smoking a cigar :smokin: and talking to herself is pretty entertaining anyway. :)

Specializes in acute rehab, med surg, LTC, peds, home c.
It seems like the tantrums and laughing are coping methods for feelings of anxiety. Did the employee confront her in front of other people? Do a lot of employees attend the inservice? Notice, in the situations you described, she removes herself when her behavior changes. Maybe she has panic/anxiety disorder and certain social environments trigger the symptoms. Thank goodness she was able to get to a safe place and not get paralyzed by her moods and forced to ride them out in front of an audience.

The next time you see her as you described, try a little patience and empathy. Try offering her the same courtesy you are suppose to give your patients. You stated yourself that she is a good nurse, educated, and good w/ the patients. It seems obvious that she can't help it when these episodes surface. You think it's weird, imagine how it must torment her. You can use your knowledge and experience in healthcare w/ coworkers too. Be kind.

The OP said this person is going to be a nurse practitioner. Someone in this position needs to be evaluated, not just allowed to let the bizzare behavior can continue. She is going to be managing other peoples health care. The managers should recommend a mandatory visit to OC health. If her own mental/medical problems are impairing her, something needs to be done.

I had a similar situation with a nurse I worked with. She had all the managers thinking she walked on water but the rest of us new the "real her". The irrational behavior, manic outbursts of innapropriate emotions, lying about doing pt care. She definitely had issues. Then one day she showed up for work barely coherent from some type of substance abuse. Thats when it hit the fan. Luckily no one was hurt.

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