I have had some creepy strange pt's before. Since we get the post cardiothoracic surgery pt's, we see many upstanding citizens, many not so upstanding folks (iv drugs leading to valve replacements), etc. we also get the chest pain needs telemetry pts (b/c to bed placement it doesn't matter that we are post surgery floor, if we have open monitored beds.......but thats another post)
i've cared for prisoners.
i've cared for bipolar manic phase elderly ladies (that was scarier than the prisoner)
i've cared for homeless people
i've cared for mean, hateful, cursing people
i've cared for former convicts
etc etc etc. i've never questioned not taking care of a patient for any reason, even if they gave me the heeby jeebies, b/c htey all need nursing care regardless of who they are or why they are here., they all get my best care.
until this one.
the man who sexually molested me 15 years ago came in as a patient. that was the one i absolutely refused to go into his room. he had a cabg, never knew i work there, and i dont even know if he'd recognize me. i was a child then, he has no idea im a nurse and so on. i do still have the same last name as then.
i was completely over it, not still suffering any from it, i hadn't even thought about it in a long time. but still, i could not take care of him. (lethal dose of K+ anyone?)
I helped out after my shift with a violent man . As the other nurses were putting on wrist restraints, I reached out to hand them a second set for his ankles. Bottom line he got loose, picked up the telephone reciever just before kicking me in the face. I spent the night in the ER with a broken zygoma, and a consult with an oral surgeon.
When I returned the following week to find myself on the schedule as primary care for him, I refused.
NM and director got bent out of shape said " he thought you were trying to kill him. "He didn'" MEAN it,"
I helped out after my shift with a violent man . As the other nurses were putting on wrist restraints, I reached out to hand them a second set for his ankles. Bottom line he got loose, picked up the telephone reciever just before kicking me in the face. I spent the night in the ER with a broken zygoma, and a consult with an oral surgeon.
When I returned the following week to find myself on the schedule as primary care for him, I refused.
NM and director got bent out of shape said " he thought you were trying to kill him. "He didn'" MEAN it,"
How much power do nurses have when it comes to this kind of refusal? Can CNAs refuse to do so too?
MarySunshine: I hear ya on that one. I worked in a Catholic nursing home, where there were several Terri Shiavo-esque patients who were dead but not allowed to die. You didn't see them lifting a finger to help. Imagine you're kept alive with a PEG tube, NPO, mouth caked with layers of dried saliva, nasal passages crusted with mucus, not even a voice to call for water, dried lips, etc. I bet they never did. They might as well have taxidermized their relative and kept him in the living room for all the life that they had.
Why would the patients have layers of dried saliva, nasal passages crusted with mucus, and dried lips? Curious.
Nurses have personalities. Patients have personalities. Sometimes they 'clash'. That should be enough said.
If you know somebody personally and wish not to take care of them; that should be a totally routine request.
If you take care of someone one shift and encounter the above-mentioned 'clash', it should be a routine request not to have to take care of them, again.
Those pts that have personalities that 'clash' with everyone? We call them 'one hit wonders'. They are the ones that everyone must take care of for only one shift, in turn.
Why would the patients have layers of dried saliva, nasal passages crusted with mucus, and dried lips? Curious.
Chronic understaffing and people who are openmouth breathers. I was never instructed to do oral care, but I lubed up thier lips and used those toothette wands when I could. I never saw those glycerin swabs, but I hear that they were banned because they have an overall drying effect.
It goes without explanation, that you had every right to not care for that "thing" . I am so sorry you had to see him again....
I have never personally had to request to not take care of a patient, but if, say, one of my in laws, (that me and my husband are not on speaking terms with), for many reasons, happened to come in, I would absolutely request not to be assigned to them.
HECK YEAH, you should have refused. I refused to take care of my best friend's step-mother. I walked in and realized who she was about the same time she saw me, she said, OH MY GOD, Lisa's friend is taking care of me, I am going to die tonight. (She was on the phone with her daughter) I walked right out of the room and went up to the charge nurse, no problems, just took the next admission.
I had a guy kick me in the face and I told the charge nurse I would not go back into his room for the rest of my shift and that she could reassign him or take him. (I wish I had filed some sort of complaint, but I didn't know what to do.)
When I asked the charge nurse what to do about this guy who looked at me, aimed, and then kicked me, thus knew what he was doing, she said, "I'll go in there if he needs anything, I grew up with a lot of brothers."
Uh, yeah, so did I, but they didn't hit me!!! I never took him back, and he died not long after.
This is an interesting thread to read as I get ready for work. We have this very sick (no duh!) pt with a very demanding wife/family who for some reason loves me, and has fought with many other nurses, so no one wants to take care of this guy. Whenever I work I'm asked to take care of him, and the wife often requests me. Although I get along with his wife and him, he's still a very emotionally and physically challenging pt to care for.
Of course, I have to work tonight, and I know I'll be asked to care for him again. And I'm just tired. (Although, I did say I could only care for him as a 1:1 because whenever I have another pt paired with him I end up not being able to adequately care for pt#2.)
Specializes in Med/Surge, Psych, LTC, Home Health.
I'm just getting ready for work too, ICURN! =) Actually, I don't know whether to smile or frown... I worked last night and have had a total of about three hours sleep today.
Anyway... I believe it should be within every nurse's right to refuse care to any patient, regardless of reason. I mean, the situation should always be discussed with a charge nurse or supervisor of course, but if a nurse isn't comfortable taking care of a patient for any reason, then they shouldn't care for that patient.
That's not to say that nurse's aren't going to abuse that right. =) There used to be this day shift nurse at my hospital who, EVERY DAY, had a patient that she would simply say "Oh, I'm not taking care of this guy again today", and then the board would have to be rearranged and the patients split up just so that miss thing didn't have to take this patient or that patient.
That's also not to say that a nurse who constantly abuses that right shouldn't receive a rather poor evaluation.... or at least a good talking-to.
I am curious after reading this thread...is it not abandonment because you say it at the outset that you won't care for a patient? I am going to be a graduate nurse in a matter of weeks and I want to be sure I understand what is allowable and what is abandonment.
I am so glad to hear your replies. I to have cared for all types, criminals and what not....but we all need to know our limitations. If you let someone push you out of nursing because of that one situation that you have to say no to, then you can not help those many many people you have said yes to....sorry about the grammar.
If I were caring for a patient, and I dropped that patient without them being reassigned to another equally capable person, that would be abandonment. If a patient is in my care, I am obligated to make sure that provisions are made for their care.
If I approach the patients case manager, for instance, and come to a resolution and someone else is assigned to this person, my obligation ends.
I had a situation like this, and my case manager released me from the patient, but later I was pressured to return from a manager. Then, I thought it was resolved again, and the manager just wouldn't let go of the situation, so I left. I never at anytime neglected to care for this patient when I was assigned to do so, at considerable distress, and gave the very best care I could. My situation was so similar to the OP, that it actually made me wonder....
Oh, and the vitamin K remark, funny but I understand. I would give this man the best of care, and the manager would say when I came back to the office"He just LOOVES you!" She would just creep me out with this one. I only showed him kindness, as I would any patient, and then cry all the way home in the car. Oh, the vit K thingey, I had this impulse to slap him, never did, never would, but that was why I asked to be released....
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Uh, yeah, so did I, but they didn't hit me!!! I never took him back, and he died not long after.
Miss Ludie
79 Posts
I helped out after my shift with a violent man . As the other nurses were putting on wrist restraints, I reached out to hand them a second set for his ankles. Bottom line he got loose, picked up the telephone reciever just before kicking me in the face. I spent the night in the ER with a broken zygoma, and a consult with an oral surgeon.
When I returned the following week to find myself on the schedule as primary care for him, I refused.
NM and director got bent out of shape said " he thought you were trying to kill him. "He didn'" MEAN it,"