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?

[RosesrReder, BSN, MSN, RN]

In my personal opinion I see you meant no harm, the daughter is acting extremely silly and I am willing to bet that the spark of a law-suit just filled the apple of her eye. So sad you are going through this.

It seems like you amputated a limb. The beard will grow back maybe even nicer.

Best wishes to you.

[caroladybelle, BSN, RN]

The patient has dementia!

There are extremely varying degrees of dementia. We are not given the extent of this man's degree of mental impairment. And, no, being in LTC is not definer of severe impairment.

[Cute_CNA, CNA]

The daughter is upset on the grounds that taking away the man's mustache (with his consent) is taking away his dignity. Ironically, I think more of his dignity would have been lost should his consent for a shave been ignored in lieu of getting his daughter's consent. Even if he has dementia. You allow people with dementia to keep as much of their dignity as possible by allowing them as much decision making and self care as possible.

I really do not see how his dignity was taken away...

[PamUK]

I really do not see how his dignity was taken away...

Many men feel great pride in their beards & moustache (dont see it myself though) in the same way many women feel great pride in having great hair.

How would you feel if your hair had been shaved off? Even if you weren't too fussy about your hair, you would be happy would you?

[BowlerRN]

I understand shaving the patient for better hygiene, but I do understand the daughter being upset to some extent, although it sounds like she overreacted.

If a patient has had a mustache for years, then it is obvious this is something want and should be respected, It seems more like a dignity issue to me. Any nursing home resident has already lost a lot, including their home, ability care for self, privacy, etc. And as an alzheimer's patient he has lost his ability to remember and probably to recognize other people and had a cognitive decline. It may not seem like a big deal, but to someone who has already lost so much, a mustache probably is a big deal.

[MDSlady]

I personally would be angry too. I have not seen my husband without his moustache since I met him, and however, that I tease him that I would like to see him without it, I would be upset if somebody shaved it off. I know how much it means to him and I know that he would not want anybody to see him other than with his moustache. I would, god forbid this happens, is to have the staff talk with me first and discuss this and make a "group" decision rather that it being the decision of one staff person. If I found out that in the end, it was "best for my husband or loved one", I would agree to it, but however it should not of been done without discussion with family and the resident.

[following_faith]

I am just wondering something...I thought that you had to have a written, informed consent from the patient before you could shave a beard or mustache. That what my book for school was saying...just curious and trying to gain a little learning.

Thanks!

[DusktilDawn]

There was an incident at a facility I worked for over TRIMMING a beard. Apparently it was against custom/religion for men to cut the beard (including trimming) in this situation.

Other posters have brought up good points in regards to identity and self where beards/mustaches are concerned.

My suggestion would be error on the side of caution. You can clean the facial hair, but discuss grooming with the patient or family depending on the situaiton. In the case of removing facial hair out of medical necessity, most reasonable people would understand.

[SharonH, RN]

There have been some excellent points made about patient dignity and identity. However :

1.3 million people injured each year due to medication errors and

7000 deaths yearly d/t the same. Between 44000 and 98000 people die from medical errors yearly.

I don't mean to seem unsympathetic to the "plight" of the family but *shrug* .

If that is the worst mistake that happens to her father during his hospitalization then she should get down on her knees. In fact, if that is the worst mistake you make during your career then you should get down on your knees.

[Little Panda RN, ASN, RN]

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.

I know that this does not even pertain to this discussion but baby&mommynurse is that a tiny little foot I see. Was this your pregnancy? All I can say is "AWESOME". I have never seen anything like this before. Who took the picture? Sorry about all the questions, but I was mesmerized:cool:

[TypicalFish]

There have been some excellent points made about patient dignity and identity. However :

1.3 million people injured each year due to medication errors and

7000 deaths yearly d/t the same. Between 44000 and 98000 people die from medical errors yearly.

I don't mean to seem unsympathetic to the "plight" of the family but *shrug* .

If that is the worst mistake that happens to her father during his hospitalization then she should get down on her knees. In fact, if that is the worst mistake you make during your career then you should get down on your knees.

I don't mean to flame you, but I find your "shrug" a bit insensitive. The daughter likely did over-react; but it was more likely a response to everything that was going on-in this case 'a little bit more' of her father had been taken away from her, her control over the situation had been taken away and maybe it was the final straw in her ability to cope that day; seeing her father EVEN MORE changed and decreased was just too much. To wag your finger at her and say "Well. It COULD of been SO much worse" is insensitive and not what the holistic approach that nursing is supposed to be.

Also, if the daughter was POA, if the father really had dementia issues, then legally she should have been consulted prior to having the beard shaved, unless it was a well-documented emergent situation.

[Mommy TeleRN, RN]

Did the daughter have durable power of attorney for the medical treatment of the dad? If not, then it seems to me his choice of care is up to HIM. Maybe the food in the mustache was bothering him too?

(with that being said my DH has had a mustache the entire 10 years we've been married and I don't wanna see him without it LOL)