Published Jan 15, 2015
4 members have participated
newnurse34
2 Posts
Ok so im a new nurse just finishing up in my 12 wks of orientation. Im in my final 3 days now. Anyways, the other night my preceptor and I were floated to another floor and given a psych patient along with 3 other patients. We were told in report that this patient had been problematic for 2 days and that they had to remove a roommate of hers due to her behavior and continued disruptive nonsense. The patient was originally fine and causing no issues for us on night shift. After a few hours she because angry and began threatening her new roommate. She wanted her removed she said. Clearly, we had to move one of them before this became a bigger problem so we moved the roommate and then blocked the room as private so that no other patient s wld be subjected to this bullying. As the evening went on things were ok and I went to lunch around 1:45 and returned at 2:30. Upon my return, I was going to hang some NS on a pt that was my new admission, but I cld hear this patients iv pump beeping so I figured I might as well stop in and see whats going on with her pump before walking away. Well this turned out to be a huge mistake! ! The pump was flashing low battery so I explained I was just gonna plug it in for her. She argued and wanted it plugged in across the room and I explained I cldnt do that because its a fall hazard. She said" oh yes u can..now leave it where I said and get out!!!" I said "ok, im just gonna get my preceptor so she can explain again why we cant have cords like that in here" I walked out and told the charge nurse what happened and she just shook her head and said " this patient...ugh" I continued on to hang my saline on my other patient and the next thing I know the charge nurse tells me " we need to talk about the patient in room $#@ " I said "oookk"?? As I exit the room I am told the patient doesnt want u back in there and she said u grabbed her a and almost ripped her iv out!! I was furious at this accusation! I cldnt believe this nonsense!! So the charge nurse called the supervisor and she came and got both sides of the story and then I had to write my statement for my "file" soooo im confused here. My question is why wldnt they have confronted the pt that this was unacceptable behavior and that she has been causing issues since she got here and that this will not be tolerated? I was always taught that with psych pts "never baby them" they need to be held accountable right? I haven't even been able to sleep over this..I did not work for 7 years in school and owe 70,000 in loans for a pt to lie about me like this :-( im so discouraged and scared to even be a nurse now. Plz help me understand
JudyFawce
15 Posts
Sounds like a poorly thought out stance from the charge nurse. The charge should have investigated. Should have pulled you aside discussed it with you. If it was going to be an issue the patient reported then yes call the supervisor. However as charge... She needed to back you up emotionally. Explain the process. Explain to you how to chart to protect yourself. And she could have also offered herself as a witness to this patients behavior in your presence with the supervisor. Basically you feel like she threw you under the bus and by letting you feel this way. She did. A bad reality is.... Not all people have the correct attributes to BE in charge. One day you will feel comfortable pointing those people out and challenging them if needed and that is a great day, trust me. Charges support their staff. Teach them. Mentor them. Protect them. Not all are human enough to do this consistently tho.
Judy
forgivenfaith119
78 Posts
I'm sorry this happened to you. I think the charge nurse could of handled this better. You will encounter other patients and family members in your career. All you can do is do your best and chart the care you gave your patients. :hugs:
MizChelleRN
94 Posts
Especially as the charge nurse earlier that day rolled her eyes and sighed "ohhhh that patient"....and then went on to come at you like that. Plus you said you and your preceptor were floats to that unit that day. Seems they could have come to you, told you what the patient said, and said just don't bother with that patient the rest of the day. I would have removed the nurse from the case JUST so the patient didn't escalate. Then that's that. If you were a floater, you were probably never going to see that pt again anyways. No need to "add it to your file". Hopefully the note added to your file clearly indicates what a PIA and how non-credible this patient was.
FineAgain
372 Posts
So sorry this happened to you...but be kind to yourself. You didn't do anything wrong! I am kinda going against the field on this one, I think the supervisor should have been called. This kind of issue needs handling by higher ups for your protection. I called the supervisor myself once on a patient, then called my charge. The patient said I was diverting her dilaudid because she "couldn't feel the rush". Patients like this have well known and (hopefully) well documented behavior. Reporting what happens not only adds to the documentation, it protects you in the long run. Just my humble opinion.
The outcome by the way of my "diversion"? The supervisor explained to the patient that properly given, dilaudid does not give a "rush". And bought the patient a witness every time narcotics were given.
Libby1987
3,726 Posts
I agree, documenting the incident is a must for possible investigation later.
And I will bet, given this being your first patient complaint so early into your new career, that you are probably more sensitive than you might be a hundred years down the road when a beligerent patient who's already demonstrated acting out makes a claim against you. Have you really done anything over the last 12 weeks to make your supervising staff, or any other coworkers, suspect you of patient violence? I'm sure not. Let this one roll off.
Not sure the connection of the poll.
Thank you all so much for your response. I have been so upset about this and tonight is my first night back since the incident. I know ive done nothing wrong and im confident in that. I never even had a complaint such as this when I was a nurses aide! Its unfortunate that I havent even been a nurse for more than a few months and im already defending myself?! Its exhausting :-( libby, the poll was just a random question. .I had to fill it jn or it wldnt post so I just picked a random question that I was curious about :-)
Pangea Reunited, ASN, RN
1,547 Posts
One patient wrote a letter about me saying that I got angry, grabbed her NG tube, and ripped it right out of her face. I was shocked when I had to meet with administration to provide an "official" response. After all, the patient was a known liar and trouble-maker. She made similar outrageous claims about almost everyone she encountered while hospitalized.
The report may have had more to do with documentation than you being "in trouble". It seems like the supervisor could have said a bit more to put you at ease if that's the case.
PS: I am eligible for rehire at that hospital:)
Meriwhen, ASN, BSN, MSN, RN
4 Articles; 7,907 Posts
I was always taught that with psych pts "never baby them" they need to be held accountable right? I haven't even been able to sleep over this..I did not work for 7 years in school and owe 70,000 in loans for a pt to lie about me like this :-(
Yes, psych patients do need to be held accountable for their behavior.
That being said, any accusation made by a psych patient MUST be taken as seriously as one made by a non-psych patient, and the accusation will be investigated. Just because they are a psych patient doesn't mean that their concerns may be invalid or will be disregarded because she's "crazy." That is why you had to write a statement even though the accusation seemed outrageous to you.
That is also why that you should--if you don't do it already--get into the habit of meticulously documenting your care in order to CYA. And that is why if you know a patient has a history of problematic behavior, making accusations, or will be troublesome, you should always bring a witness with you.
As far as nursing managment confronting her on her behavior, that's not necessarily going to happen in front of you.
You will get through this. Learn from it.
Emergent, RN
4,278 Posts
I hope that you did very thorough charting at the time. Whenever you have any questionable incident of this type, the most important thing you can do is chart accurately the behaviors leading up to it and your responses.
You are still learning. I know you didn't do anything 'wrong', this pt is obviously a problem child. But, there may have been something you could have done better in order to avoid her going off on you. Next time you interact with a psyche pt, maybe try a different approach and see if it works better.
As far as you being investigated, you're likely being over-sensitive since you are new, but they should have been more reassuring to you, as they know the pt has behavior issues.
Gooselady, BSN, RN
601 Posts
Complaints of physical battery by patients are taken VERY seriously -- in this case, as a matter of paperwork and covering the hospitals (and your) butts.
You were in the wrong place at the wrong time, with the wrong patient lol. I'm sure everyone knows that. But hospitals are REQUIRED to take these situations very seriously, at least to APPEAR to. Being so new to nursing I'm sure this feels awful! But it ISN'T awful, if that makes sense :) This is CYA all the way and within a week, everyone will have forgotten and this patient will be plaguing another hospital or doctor's office while her psych case manager tries to hunt her down lol.
This isn't about YOU, that's the good news :) No one thinks you hit this patient. And your management is trying to handle this in a state and federally approved way, which will be clumsy and confusing to you.
We had a very opiate addicted patient on our floor (for what felt like YEARS) for long term MRSA abx. One evening, he accused the day shift charge of NOT giving him the IV Dilaudid she said she did because 'he didn't feel anything afterward'. He made such a stink that he demanded the nurse be drug tested, called the patient advocate, and so on. Our response was to double RN check/witness every molecule of opioid we gave him IN FRONT OF HIM. He had to sign as witness that two RNs checked each other. I'll leave off how THAT went over . No nurse was on the hot seat, we were just CYAing in case this fool caught the attention of the state or worse.
We learned a great lesson. Make sure the patient knows you are giving the med, make eye contact and wave the syringe under their nose while you hook it up to the port. Especially the patients who are very focused on their narcotics. A person with high tolerance won't 'feel' the drug sometimes.
Anyway, welcome to nursing lol! It's not you, and these sorts of things will not bother you so much after a while.