Getting fired by a patient/ family member

BSN-to-MSN, ADN, BSN, RN · Apr 30, 2021

I was once told by a manipulative psych patient she does not want me as a nurse because I'm not doing what she wants, and I just said "too bad because you will not get any other nurse". She calmed down after a couple of hours and later apologized. I got over it.

Last week we had an incident when an AOx4 "self" patient requested "a born and raised in America" nurse instead of the young Philippine nurse she had "because she babies me too much (cut up her meat for her) and is very meek". What? It was escalated quickly, and patient signed AMA.

Ioreth, BSN, RN · May 13, 2021

Reasons I've been fired:

Patient fell asleep and dropped his PCA button. It was looped through the rail of the bed for this very reason. I discovered it had fallen when hourly rounding. Patient thought I should check on him more often than hourly and stated, "This has been the worst experience of my life. I thought the first night after surgery would be relaxing." This patient just had spinal surgery.

Patient had baseline dementia and sleeping soundly upon shift change. Patient's daughter was demanding pain medication and ativan to be given together immediately because her sleeping mother was in pain and agitated. When patient woke, I assessed the patient by asking her questions directly (daughter talked over her) and asked her permission to examine her necrotic wounds (daughter refused on her behalf). I used a pain scale for dementia and assessed her pain to be mild and offered Tylenol. Ativan was not indicated by patient's activity and responses. When the physician came in, patient's daughter pointed at me and screamed that I was upsetting her mother.

Patient arrived to floor unarrousable after surgery and required 1on1 supervision, necessitating me giving minimal attention to my other patients. I used non-pharmacological pain control until patient began to mentally clear 2 hours before shift change, and pain was mild. Patient was too nauseated to tolerate oral meds and pain did not indicate IV meds. Fired because I didn't give IV medication for 3/10 pain while patient was dry heaving.

Fired because patient came to floor after being cut off pain medication by anesthesia. Called physician and was told to use non-pharm methods only. Patient would not allow me to assess them until I got them something for pain that wasn't breathing techniques, guided imagery or an ice pack. Patient stated "my friends all told me this wouldn't hurt!" This woman had major GI tract surgery. Her carrying on was likely causing significant flexing of abdominal muscles, which had incisions. I spent 3 hours straight in this room. Husband called me "heartless".

Fired because I dared to turn a quadriplegic q2h. I respected and charted refusals. I was able to turn her when she was sleeping using a bed tilt function a few times. Patient had arrived with several developing pressure ulcers.

Long Term Care Columnist / Guide · May 15, 2021

I never had the dubious distinction of being fired by a patient, but there were sure times when I wished one would. My least favorite was the “Karen” type who came to the hospital at least every 2-3 weeks complaining of diffuse abdominal pain for which no cause could be found and that only responded to the “medicine that starts with a D”. She elevated call-light use to an art form; she refused all offers of showers and demanded twice-daily bed baths; she talked (loudly) on the phone while the nurse tried to assess her. Of course I treated her compassionately like any other patient, and thereafter she requested me by name every time she came in. My co-workers were only too happy to let me deal with her. I would have appreciated it if she’d fired me like she did almost every other nurse, but it was not to be. I wonder sometimes who she let take care of her after I left that job.