Unfair Discipline at Work...What do you Think?

SmilingBluEyes · Apr 21, 2005

If this hospital has a "the customer is always right" attitude, then the DON should bear in mind that the OP was functioning as a CUSTOMER here, not as an employee. Besides the fact that the DON's demand that the OP write a letter of apology being unfair and unreasonable (and what does an apology mean, if its coerced, anyway?), it is also valuing one customer over another. It sounds like the visitor is a real idiot. Who can't tell the difference between a nurse on duty and a sick patient?

BINGO! :)

**canoehead, BSN, RN** · Apr 21, 2005

Probably the mature thing would be to suck it up and cut your losses. That said, you are completely in the right, and if you need to write an apology for what you did then as a patient you deserve an apology for the poor treatment your DON has given you.

What does your immediate supervisor or the supervisor of the ER have to say?

Antikigirl, ASN, RN · Apr 21, 2005

Oh I so would have said "actually can you help hold me up or get a chair I am about to faint, but don't get too close or I may vomit on your shoes".

That would have had her out of your area fast! Or at least a chair!

I find that patients and expecially family of patients do not think of nurses as human beings...so when this happened to me (onset of acute 10/10 abdominal pain and I was trying to get into the bathroom to throw up and I was barely able to walk...and a patients family member, seeing that I couldn't even walk and was hunched over like Kawisemoto (sp?) was asking me questions and demanding I take the patient to the bathroom). I simply said, "Oh no I am going to faint, please get me some help please" and it clued in on that idiot that I was a human being in trouble and I got some help instead. (found out I tore an adhesion from my c-section years ago and it was bleeding something fierce..off to the ER I went...more than likely transfering his loved one!).

As far as the note, no way! I would say that I most certainly did not verbally abuse the woman, and that she is totally incorrect and I am not playing into that or it isn't good. That will set a pattern of that woman crying wolf and using techniques like that to get help on her terms whenever she wants it. Nope, I don't encourage such behavior from family because it is not right to treat a professional with threats!"

and, I would take the consequences and hope for the best. I live with my values, not theirs...and if I get fired...it is still my values I go home with...best to keep them unscathed from the beurocrasy and bs about "the customer always being right"! (yeah if the customer is always right, why do we have nurses or doctors???? It would stand to reason they wouldn't need us anymore huh?).

Good luck!

Marie_LPN, RN, LPN, RN · Apr 21, 2005

If, God forbid, you were hallucinating and took off all your clothes and an around the ER saying you were Jesus Christ, would they discipline you for impersonating a deity? No......well, just because you weren't quite that bad off doesn't mean you have to meet hospital standards.

Probably get a write-up for unprofessional conduct lol.

kitty=^..^=cat · Apr 22, 2005

I think your DON should send a letter that goes something like this --

Dear Whomever,

I appreciate that you took the time to discuss your recent experience in our Emergency Department with me. It is always enlightening to receive perspective from those utilizing our services. Elvis Presley Medical Center strives to continually improve our quality of care, and input from customers like you provides valuable information as we prioritize our improvement needs.

I understand that your interaction with the staff member in question failed to meet your expectations and appreciate your familiarity with our staff. However, thorough follow-up of your issue identified that the staff member in question was present in the Emergency Department for non-work-related reasons and, in consideration of the circumstances, was prohibited from providing the requested assistance due to patient privacy restrictions.

At this time, no further action is indicated.

Once again, thank you for providing me the opportunity to discuss your concern and identify potentials for improvement in the quality of care for ALL patients.

Sincerely,

Jane Hand,

RN

Director of Nursing

EPMC

You can always write one and submit it for her signature, you know?

:idea:

Catch · Apr 22, 2005

More than anything, I think it is ridiculous that management is wasting their time following up on things like this...sure if I had been on duty I would deserve some sort of discipline (like getting fired!), but I wasn't even on the clock! I was wearing sweats and a hospital gown, so it should have been obvious that I was not on duty. I know how distressing it can be to have a sick loved one...maybe this woman didn't even think about that...just recognized my face and that was it!
I wish I had the option of getting health care somewhere else...the nearest hospital is 75 miles away, so I am kind of stuck.
Going to go talk to the DON tomorrow. I may write a letter explaining that I am sorry that I was unable to help the woman, but still explain that I was ill and was not on duty. I guess I can apologize for anything that she felt was rude...

I totally agree with all the posts stating that being asked to write the letter is wrong, unfair and inappropriate. On the other hand, you have the DON to consider, and how much are you willing to risk getting on her bad side? Whatever you say or do about this, she will remember forever, even if she doesn't fire you. Somebody posted "this is not a hill to die on." I was in a situation where a family member went crazy and blew up in my face and ranted and raved and accused me of all kinds of rediculous things. The nursing supervisor for the weekend asked me to apologize and I refused to do that. I never regretted that decision. (the supervisor was not the DON, either, and she never carried the issue to the regular management). Whatever you decided to do you will pay, one way or the other, so. . .you just have to figure out what makes the most sense to you.

UnchainedFever · May 7, 2005

Agree --
Have you considered talking to your facility's compliance officer? You might just approach it from an inquisitive angle -- "With everything we've been told about HIPAA and protecting patient information and who is appropriate to access certain information, please explain this expectation that off-the-clock employees become involved in patient-related issues if they're here as a patient?"
He or she should be able to help you out with this. If you're pressed to write the letter, write it -- it's not "a hill to die on".
CMS requires that all patient complaints be resolved. As the CNO of my facility, it's the responsibility of either myself or our Director of Quality and Risk Management to write follow-up/apology letters to assure that they're appropriate and don't contain language that creates liability for us.
Good luck!

I'm glad that nurses like you are there for me with that attitude. You obviously have had a sound background.

**SKM-NURSIEPOOH, BSN, RN** · May 7, 2005

sorry, pickles, but i agree with everyone else. filing a complaint about another patient (which is exactly what this is, no more, no less) generally brings about a concerned shrug from management. management will tell the complainer that they don't control patients, and would point out that the other person was a patient and not feeling well. somehow, you expect cotjockey, who was a human being long before becoming a nurse, to behave to a standard higher than anyone else.

long a problem in nursing. we must be caring and understanding where our patients are concerned. we must be compassionate in the face of ugly, and even rude, behavior, because the patient isn't feeling well, or the patient is in pain, and it is the illness or pain that is causing the patient's behavior. i remember hearing things like this from day one in nursing school. do you?

however, let the patient be a nurse, then all expectations change. headache? ignore it and be nice to the customer. ready to throw up? better hold it in long enough to give good customer service. off duty and ill? wrong, you are never off duty, whether we are paying you or not. why do you hold nurses to different standards of behavior when sick than the rest of the human race? that attitude is incomprehensible to me, and just one of the reasons that i would never have stayed in nursing, were it not for the availability of advanced practice degrees.

tweety hit the nail on the head. personally, there are too many nursing jobs out there for me to want to compromise my self respect to write a letter of apology for things i did not do. also, there is the distinct possibility that this could come back at a later date to bite the op, as we all know that everything stays in a nurses file forever and ever, amen. (i personally believe that nursing "disciplinary files" have a longer half life than plutonium.)

another manager could be hired to cotjockey's unit, and the manager's first impression of her would be her employee file. "good lord, this woman was rude to a little old lady? rude enough to have to write a letter of apology?" such an impression could forever taint that relationship. nope, wouldn't do it.

personally, i'd ask for a meeting with the don. i'd stay professional and respectful, and point out the following facts:

1. i was not on duty. i was there as a patient, and whether the grandmother recognized me or not, i had (and have) a right to be treated at that time as a patient, not an employee.

2. in that vein, i believe that it is unfair for the hospital don to require me to write a letter based on behavior that supposedly occurred when i was off the clock.

3. i was ill. not just "i don't feel good" ill, but ill enough to make myself seek medical attention. sorry, but when i am that ill, i won't be rude, but frankly my own well being is going to take priority.

4. to fulfill this woman's wishes, i would have to have violated hippa. it would seem to me to be a no win situation. point out to the woman i am off duty, and get in trouble for that, or violate hippa and get in trouble for that. from the perspective of the don, there is apparently no route i can take to resolve the situation without getting myself in trouble. especially since this woman is going to lie about my behavior anyway.

5. the woman claims i was obscene and made rude gestures. i say i didn't. in fact, i know i didn't. i will not apologize to someone else for things they made up.

6. from the don's perspective, it probably would not have taken much for me to find an on-duty employee to help the woman. however, from my perspective, staying conscious and not throwing up on the floor was occupying all of my attention at that moment. if you would not ask a patient at that time to do something other than attend to their own needs, then it is unfair to expect me to do so.

7. if you have a little extra money, it might not be a bad idea to consult a lawyer before your meeting with the don. (and yes, i think this is that important.) if the meeting is not going well, you can simply respond "that's not what my lawyer advised me." (however, save this for the last resort, as it will be sure to earn you the don's undying anger.)

bottom line? i'd have another job lined up, and if the meeting with the don did not go exactly as i wanted, i would be a new employee elsewhere. and i'd let my lawyer deal with the don and the hospital. end of story.

you did nothing wrong, cotjockey. stick to your guns.

kevin mchugh

:angryfire cotjockey, i'd even go so far as to support you even if you *were* rude & told the old woman to *f* off!!! she had no right invading your personal space & insisting that you help her while you were obviously in an incapacitated state! this person probably is a *frequent* flyer as you've said she comes in often enough for you to *know* just where to retrieve her medical records. as such...ten-to-one...either you've pissed this woman off sometime in the past, or someone else did & she took this opportunity to use this situation for pay-back. or may be you did piss her off with whatever (or more than likely...however) you'd said to her...regardless...she should've taken the clue that you weren't *able* to help her & simply moved onto someone else who could.

my problem is...why didn't she register a complaint about the other staff (or the lack thereof) working that day? why did she point you-out as being *the problem* of a situation you obviously had no control of? furthermore, why is your don making you apologize for words obviously said in haste as you were in pain & feeling ill? you were already registered as a patient, in a patient gown, & on your way to the bathroom with a specimen cup in hand & your don thinks this person was in her rights to violate your personal space/time? not only would i not write that letter of apology...but i'd demand that the don write you (the patient & staff nsg) a letter of apology for one...allowing another patient's family (because this person wasn't even a patient that day) to invade your space while being a patient yourself...& two...for the shear nerve of asking you to take responsibility for said person's actions in invading your space! you would've been in the wrong if you've had of told her the location of her granddaughter. i think you'd appropriately told her where she could find said info out (but she should've already known that as being a *frequent flyer* that she is she probably is also aware of the hippa regulations too....that's probably why she *thought* she could come-up to you....hoping to by pass/circumvent the clerk at the desk. this person more than likely isn't the poa for her granddaughter & as such....she knows she doesn't have the right or privy to her where abouts. this person's lucky that security wasn't involved because if it would've happened to *me* & she insisted on invading *my*space, i'd would've call them back & she would've have to wait in the sitting area until her daughter/son (or whoever is the poa) called up front...requesting that she'd be allowed back to the room.

i'd wouldn't write a damn thing! let your don just try to discipline you....then go through the grievance hearing. tell them in said hearing (where they'll have their legal staff i'm sure) why you didn't get involve as kevin so eloquently pointed out. tell them that the state, sbon, & jcaho would be very interested in your institution's policies & procedures regarding hippa regulations & how they're being conducted there. meanwhile...do have that *other* job all line-up! there's a nsg shortage & you'll have no problems finding work elsewhere.

it's a damn shame that you're being force to make such choices though...especially if you really enjoy your current position. one thing's for sure...should you get from out of this without having to have to write that letter and you're able to keep your current position in the ed...i'd make damn sure i'd insist on someone else being this patient's nsg in the future. my professional relationship with her would cease with these accusations. i think she went too far in reporting you & if she feels that strongly against you...then she's effectively stating she doesn't require your services either.

anyroad...good luck!

moe

stevierae · May 7, 2005

I have only read the first pages of replies you received but it appears I am going to disagree with most here.
While I don't believe you had any reason to obtain information for this woman I have to admit I fully disagree with your presentation. I'd feel a lot better if you were paraphrasing your words but instead you use quotation marks and that tells me you used those words or that attitude at the very least.
You had a few options;
1) Find out the information for her,
2) Flag down someone that could point her in the right direction,
3) Claim total ignorance because afterall there is no reason she should have had any clue where you work,
4) Point her in the direction that she can find someone on her own.
Honestly, if I was the DON there and I was faced with an employee that said what you claim you said - your days would be numbered. As a DON I would have no problems with any of the above four suggestions. But since the woman does know you are an employee and you told her you have no need to know her information and to leave you alone... that's going too far. We don't like it when we are treated that way by our patients or their family, our patient's and their family members don't like it when we treat them that way either.
Think about it, shrugging your shoulders and telling her you had no idea and gestering to where staff were available... that takes less effort than going through the drama of telling her how sick you are and why you won't get her information and how bad you feel.
If you were wearing even the bottoms of your scrubs then you are still representing the hospital to some degree.
Bottom line, it would have taken less time to be nice, and if you really weren't wearing your scrubs she should have had no reason to approach you to begin with.

Bottom line is, she was representing NO ONE except herSELF---she was a PATIENT of that particular health plan, there to get treatment. What if she had had a ruptured appendix? Or a perforated colon? Or a ruptured AAA?

Let's take it a step further: what if she was in there as a patient of that health plan, to have a baby? During labor, was ambulating down the hall, concentrating on her own breathing? Or in the pediatric ward with a sick child? Or in the ER with a family member who had been the victim of a horrible car accident (as I have been, when my daughter was very young?) Do you STILL feel that, first and foremost, if someone recognizes her as a staff member or, God forbid, she has hospital scrub pants on (possibly having body fluids or tissue, either her own, or a family member's, on her original outfit, rendering it unfit for wear) she must STILL maintain decorum and remember her "responsibility" as a hospital spokesperson? To remember that she is "representing the hospital" in some way?

Is she first and foremost a nurse, representing that hospital and its health plan? NO. She is not even on DUTY--is there as a paying MEMBER of that health plan--a sick member at that, with her OWN needs, which must be her priority.

I don't think you get it. Excuse me, but after my 8 (or 10, or 12) hours is done, I am done--and the same goes for any other hospital employee, including cotjockey, except for perhaps management, like yourself---that's why you get paid the big bucks to carry a beeper and supposedly be "on call" while never really having to show up (and never intending to show up, even if you WERE called--hey, you have NURSES to function as lackeys.)

Trust me; I truly don't mean this as an attack on you--please don't take it that way. I just can't understand why management has such unrealistic and unreasonable demands of nurses who aren't even on duty in an attempt to meet some marketing executive's ideas of how to achieve "patient satisfaction."

caroladybelle, BSN, RN · May 7, 2005

Do not apoligize for anything that you did not do as that can be used against you later as evidence of guilt.

The DON can write whatever letter that she pleases.

You were off duty when this person (a visitor) approached you (a patient), you should not have been "harassed" by the visitor and her doing so could be construed as a violation of YOUR patient rights and YOUR privacy. She had no legal right whatsoever entitling her to be there, nor to approach you. She was also not entitled to any reason for you being there and no explanation other than "you need to speak to the on duty nurse". And you most certainly could not violate HIPAA to obtain that info.

Please remind your DON, of that little legality and feel free to mention that you will be happy to consult an attorney, and have them speak to risk management about the obvious breach of your care. That this interfered with your rights to confidential care and that they need to manage visitors in the ER better.

caroladybelle, BSN, RN · May 7, 2005

Honestly, if I was the DON there and I was faced with an employee that said what you claim you said - your days would be numbered. As a DON I would have no problems with any of the above four suggestions. But since the woman does know you are an employee and you told her you have no need to know her information and to leave you alone... that's going too far. We don't like it when we are treated that way by our patients or their family, our patient's and their family members don't like it when we treat them that way either.

Talk about blaming the victim?????????????

DONs that behave in this manner will soon find that they will be working the floors themselves without any staff. Jobs are way too easy to get.

medsurgnurse, RN · May 7, 2005

Sorry, Pickles, but I agree with everyone else. Filing a complaint about another patient (which is exactly what this is, no more, no less) generally brings about a concerned shrug from management. Management will tell the complainer that they don't control patients, and would point out that the other person WAS a patient and not feeling well. Somehow, you expect Cotjockey, who was a human being long before becoming a nurse, to behave to a standard higher than anyone else.
Long a problem in nursing. We must be caring and understanding where our patients are concerned. We must be compassionate in the face of ugly, and even rude, behavior, because the patient isn't feeling well, or the patient is in pain, and it is the illness or pain that is causing the patient's behavior. I remember hearing things like this from day one in nursing school. Do you?
However, let the patient be a nurse, then all expectations change. Headache? Ignore it and be nice to the customer. Ready to throw up? Better hold it in long enough to give good customer service. Off duty and ill? Wrong, you are never off duty, whether we are paying you or not. Why do you hold nurses to different standards of behavior when sick than the rest of the human race? That attitude is incomprehensible to me, and just one of the reasons that I would never have stayed in nursing, were it not for the availability of advanced practice degrees.
Tweety hit the nail on the head. Personally, there are too many nursing jobs out there for me to want to compromise my self respect to write a letter of apology for things I did not do. Also, there is the distinct possibility that this could come back at a later date to bite the OP, as we all know that everything stays in a nurses file forever and ever, amen. (I personally believe that nursing "disciplinary files" have a longer half life than plutonium.)
Another manager could be hired to Cotjockey's unit, and the manager's first impression of her would be her employee file. "Good lord, this woman was rude to a little old lady? Rude enough to have to write a letter of apology?" Such an impression could forever taint that relationship. Nope, wouldn't do it.
Personally, I'd ask for a meeting with the DON. I'd stay professional and respectful, and point out the following facts:
1. I was NOT on duty. I was there as a patient, and whether the grandmother recognized me or not, I had (and have) a right to be treated at that time as a patient, not an employee.
2. In that vein, I believe that it is unfair for the hospital DON to require me to write a letter based on behavior that supposedly occurred when I was off the clock.
3. I was ill. Not just "I don't feel good" ill, but ill enough to make myself seek medical attention. Sorry, but when I am that ill, I won't be rude, but frankly my own well being is going to take priority.
4. To fulfill this woman's wishes, I would have to have violated HIPPA. It would seem to me to be a no win situation. Point out to the woman I am off duty, and get in trouble for that, or violate HIPPA and get in trouble for that. From the perspective of the DON, there is apparently no route I can take to resolve the situation without getting myself in trouble. Especially since this woman is going to lie about my behavior anyway.
5. The woman claims I was obscene and made rude gestures. I say I didn't. In fact, I know I didn't. I will not apologize to someone else for things they made up.
6. From the DON's perspective, it probably would not have taken much for me to find an on-duty employee to help the woman. However, from my perspective, staying conscious and not throwing up on the floor was occupying all of my attention at that moment. If you would not ask a patient at that time to do something other than attend to their own needs, then it is unfair to expect me to do so.
7. If you have a little extra money, it might not be a bad idea to consult a lawyer before your meeting with the DON. (And yes, I think this is that important.) If the meeting is not going well, you can simply respond "that's not what my lawyer advised me." (However, save this for the last resort, as it will be sure to earn you the DON's undying anger.)
Bottom line? I'd have another job lined up, and if the meeting with the DON did not go exactly as I wanted, I would be a new employee elsewhere. And I'd let my lawyer deal with the DON and the hospital. End of story.
You did nothing wrong, Cotjockey. Stick to your guns.
Kevin McHugh

So beautifully stated kmchugh! I absolutely agree with the points you made. I think the OP would do well to consider some of the things you said. I want you on my side when I have a problem.