I shaved off a patient's mustache. Was I wrong?

[NebbyLPN]

I was written up yesterday for shaving off a patient's mustache. I don't understand what I did wrong. The man has had a stroke and has trouble feeding himself. He was getting food all over his mustache and face because of weakness in his right hand and arm. I come in to work the last two days and find all kinds of food particles in the hair and it just looked horrible. I couldn't clean the food particles out. I told two different charge nurses about this. I finally got so disgusted with it that I asked the man if it was OK if we shaved the mustache off. He nodded it was OK. Then, his daughter came in and raised the roof about it. I hadn't seen her visiting him the two previous days. She demanded to talk with the supervisor and told her she was going to sue the hospital! She said her father had this mustache for years--years! and was known among his family for his pride about the mustache. She said he would wax it up into elaborate curls. She told me that I should have called her first before doing this because the man's had dementia for some years. Well, no one told me that. I told the daughter that I had gotten her father's permission to shave the mustache off and he was very cooperative about it. I haven't been able to sleep at all tonight I've been so worried about this. I think I'm in big trouble and scared to go back to work today. What should I do? Should I call a lawyer?

[snowfreeze, BSN, RN]

You acted in what you perceived as "patients best interest". Daughter needs to understand that the mustach will grow back. Get your social worker involved Right Now.

[Cute_CNA, CNA]

I think this woman is overreacting "just a little bit."

Come on, now. You didn't amputate a limb. Moustaches can grow back. I don't think this woman will be taken seriously. I think she's just being a female dog.

I think you were acting in the patients' best interest. If you were not able to keep his moustache clean, wouldn't it be neglect to have food on his face?

You were probably written up just so the hospital can say they disciplined you, even though it was something that stupid.

Was it permanent? No. Did it cause him harm? No.

I'd like to see this woman try to get a lawyer for this. I know you can find a lawyer for just about anything these days, but I think that even THEY have their limits.

I think people who try to take stuff like this to court should be FINED for wasting peoples' time, not just have their cases thrown out.

However, I am surprised that you weren't able to keep to keep the moustache clean?

[baby&mommynurse]

I feel a little differently about this situation. Although, I'm sure NebbyLPN was acting in the "best interest" of the patient and he did nod yes when she asked him if it would be okay to shave his mustache off, she should've known about his dimentia. Perhaps she should've checked with the supervisor and the family before doing so. Family members do like to be involved with what goes on in their loved one's care, even if it is just an issue grooming.

I'm sure the daughter would be more understanding though if she knew the situation about the difficulty of keeping his mustache clean... and maybe next time, she could be involved with that part of the care.

[TiffyRN, BSN, PhD]

A few years ago I saw a similar situation. A 50ish man in a coma who had one of those large bushy mustaches. A very good nurse on another shift decided to get very meticulous about his hygiene and shaved off that "messy" mustache. He was NPO and DNR, not expected to survive his illness. The nurse might have considered that and asked the family's permission. He passed away about a day after the shaving. The family was very nice but quite upset. None of his family and friends had ever seen him without a mustache and now he was going to be viewed at his funeral clean-shaven. Not good. The nurse in this situation was counseled but that was all, probably because his family was so forgiving. I know this is extreme and not exactly like your situation (you felt you had consent) but something to think about.

[NRSKarenRN, BSN, RN]

Twenty years ago that was my UNCLE doing the yelling after the SNF aide shaved grandfather's mustache for same reason!

Alot of the angust is that the mustache was part of his identity---who he was and that identity changed rapidly due to stroke. The very altered facial appearance was like a "slap in the face" to daughter/my uncle that this beloved family member will never be the same functional parent.

Please respect and think of that fact.

What needs to to be done is acknowledge daughter's concern and allow her to vent. Have charge nurse reinforce that you acted in patients best interest due to hygiene issues and staff will allow the mustache to grow back. Social service involvement might help. Facial hair just as important as how one styles head of hair. When hair on head shaved due to trauma/surgery/chemo similar reactions envoked. Kudos to you for seeking patient's permission--hope you documented that fact.

The uproar in my family resolved after about 10 days and most likely will here too.

Let this be a teaching lesson to all nurses and students: notify next of kin first to decrease the shock in non-urgent situations.

[RainbowSkye]

I certainly understand what you did, and I hope the family will come to understand as well.

However, your supervisor really should have made you aware of this patient's dementia as that is a crucial part of of his care.

Also, I odn't think anyone would shave the hair off someone's head or their eyebrows because they were hard to keep clean. Just a thought.

I also want to thank you for sharing this, it's hard to do when there might be some negative comments. It helps us all.

Thanks.

[SmilingBluEyes]

Twenty years ago that was my UNCLE doing the yelling after the SNF aide shaved grandfather's mustache for same reason!

Alot of the angust is that the mustache was part of his identity---who he was and that identity changed rapidly due to stroke. The very altered facial appearance was like a "slap in the face" to daughter/my uncle that this beloved family member will never be the same functional parent.

Please respect and think of that fact.

What needs to to be done is acknowledge daughter's concern and allow her to vent. Have charge nurse reinforce that you acted in patients best interest due to hygiene issues and staff will allow the mustache to grow back. Social service involvement might help. Facial hair just as important as how one styles head of hair. When hair on head shaved due to trauma/surgery/chemo similar reactions envoked. Kudos to you for seeking patient's permission--hope you documented that fact.

The uproar in my family resolved after about 10 days and most likely will here too.

Let this be a teaching lesson to all nurses and students: notify next of kin first to decrease the shock in non-urgent situations.

I agree. I would be upset if someone cut my hair off, "for my wellbeing" as well. It is part of who I am. JMO.

[Lisa CCU RN, RN]

I am a CNA and I have never been told not to shave anyone except for diabetic patients. We learned how to shave patients in CNA classes and I have always thought of shaving as routine hygiene. I have had family get mad because I DID NOT shave their father( and sometimes their mother in some cases). I think some people are just vey silly and like other posters have said, it's not like you did something permanent, it WILL grow back. I hope I never act this silly if someone in my family is in the hospital. This is exactly why I work night, so I can AVOID families like this who don't appreciate the fact that you are taking care of their loved ones when they cannot. I swear, there needs to be a class for people of loved ones who have family in hospital care and LTC so they can learn the skill of not over reacting. I love my patients, it's the families I could do without. Yes, they are stressed about the fact that someone is sick, but it's no excuse to act the way they do sometimes. If you didn't know he was dememted in the past, why wouldn't you assume that it was ok to shave him with his permission? Also, why do families act as if their elderly parents suddenly cannot make their own decisions anymore and treat them like children? Maybe he was tired of the mustache and didn't care if you shaved it off. He said yes after all. Good Luck to you.

[llg, PhD, RN]

An additional fact to consider: Some religions REQUIRE that the men not be clean-shaven. We can not assume that "no harm will be done" if we shave someone without their persmission.

llg

[ZASHAGALKA, RN]

your supervisor should have stuck up for you.

yet another nurse bites the dust to appease pt/family satisfaction surveys.

I don't think that you don't need a lawyer - the standard of negligence requires that the plaintiff prove that 1. you had a duty and failed to uphold it - in fact, you were attempting to uphold your duty to this pt. and 2. plaintiff must prove 'harm' as a result of your action/inaction regarding your duty to your patient.. I doubt, given your understanding of expressed consent on the part of the patient, that a family member could prove 'harm'. In addition, there is a discconect between duty and harm in this case - it would be very difficult to prove that your actions breached your professional duty.

And again, your boss should have taken your side. Your management team let you down. But it's altogether common for management to summarily decide all complaints against nursing these days.

Good luck. I wouldn't apologize for your actions, if anything, just express regret that the daughter doesn't 'agree' with you.

~faith,

Timothy.

[Lisa CCU RN, RN]

An additional fact to consider: Some religions REQUIRE that the men not be clean-shaven. We can not assume that "no harm will be done" if we shave someone without their persmission.

llg

This may be true, but if it were that serious or if a family had such strong reasons for not having something done, it should be in the chart or in a care plan in their closet or above the bed or something. There is no way she could have known not to do this. And she didn't assume, she asked him.