making enemies

[loridoo]

I worked third shift last night and received complaints about the nurses who cared for my patients on day shift. I passed these complaints on to the supervisor on day shift this morning. She told the RN from days that she wanted to speak to her about some patient complaints at some point today and the RN pressed her to talk immediately. The supervisor went on to tell her the complaints (while I was sitting next to her). As I was walking down the hall to clock out both the RN and her tech approached me and told me from now on to come to them first before going to the supervisor.

The complaints were from a pt who stated that a dose of her phenergan IVP was slammed into her IV site and from a pt (and her family members) who complained she had been left in the chair for entire first shift - she is "bed bound" at home.

I thought I handled the issue properly - these patients would have talked to the head nurse today themselves I am sure - I was just giving her a heads up. I like to think I take the patient advocate part of my job very seriously.

Any thoughts?????

[Altra, BSN, RN]

The most important that needs to happen is that the family and patient need to understand why the patient was gotten oob instead of looking for wrongdoer or someone to balme because that just gives credence to the patients complaint and makes them think they are right. the poor day shift nurse probably just got reported for doing her job, and we wonder why nurses burn out.

Agree.

As a nurse, yes, you are a patient advocate. You are also a team member. You & your coworkers don't have to all be best friends, but you have to be able to work as a cohesive group.

[nurselaur]

wow - you already got a lot of responses and I just wanted to give you a supervisors opinion. You did exactly the right thing. It's your supervisor that did not. She should never have been bullied into talking about that in front of you and NEVER should have admitted that she heard these complaints from you. THat puts you in the awkward position of being the "snitch". You were advocating for your patients regardless of if their complaints were valid or not. It is the supervisor's job to find out the details and help explain to the patients whether the nurse was doing the bes tthing to help or was being inappropriate. I don't know what else to say that will help because the damamge was already done - but keep doing what you are doing and give the best care to your patients that you can.

[clemmm78, RN]

wow - you already got a lot of responses and I just wanted to give you a supervisors opinion. You did exactly the right thing. It's your supervisor that did not. She should never have been bullied into talking about that in front of you and NEVER should have admitted that she heard these complaints from you. THat puts you in the awkward position of being the "snitch". You were advocating for your patients regardless of if their complaints were valid or not. It is the supervisor's job to find out the details and help explain to the patients whether the nurse was doing the bes tthing to help or was being inappropriate. I don't know what else to say that will help because the damamge was already done - but keep doing what you are doing and give the best care to your patients that you can.

See, and I was a supervisor at one time, and my response would have been, "did you ask Jane about this?" if it was a first time thing. Now, if "Jane" had a lot of complaints or a history of some sort, then yes, it's best to go straight to the supervisor, but if they are complaints such as being left out of bed too long, I would prefer that the staff try to handle this or else it becomes "go to the supervisor for anything."

By the way, I was considered a good supervisor by my staff and they were truly sorry to see me go. I was fair to all, but I also expected a lot from my staff, and that included problem solving like this.

[GardenDove]

I would have handled this much differently. I would never report a complaint like this, because many times they are groundless. Some pts like to play one shift off of another. Maybe the day nurse was super busy or doesn't have the best bedside manner. I will listen to the pt's complaint, but it's up to them to go higher up. If they are super upset, we have a care and service report form that we can give them. They can also use these forms to lavish praise on their caregivers.

Yes, reporting complaints of this sort will make enemies. It can start a shift war, where the different shifts write one another up.

[nurse4theplanet, RN]

I agree with the general census here...should have approached the nurse first. Don't ignore your pt's complaints, but don't take them for the gospel either. After getting both sides of the story, then you could determine whether any serious incident occurred that was worth bringing in the supervisor. At the very least, the nurse should have had the opportunity to address the complaints first hand and clarify or make ammends for anything that happened. You didn't even give her that chance...is there a reason for this besides you feeling that you had to be the 'patient advocate'?

[loridoo]

The nurse in question does get into a bit of trouble on her own. I guess I will try to handle these situations differently from here on out. I will try to approach the day nurse, but I don't know if she will listen.

I was overtired this morning, going on next to no sleep, 12 patients including one that wouldn't stay in bed, and my 4th shift in a row - maybe I wasn't thinking as clearly as I could have been at 0615.

I think I would have got the same attitude from the nurse and her tech even if I went to them first - that's probably why my first instinct was to go to the supervisor.

[Mulan]

If the day nurse had 12 patients too, maybe that had something to do with the complaints.

People don't like it when you do what you did, reporting them without telling them.

[pagandeva2000, LPN]

I echo what others are saying...take the issue up with the nurse before you go carting over to the head nurse or supervisor. These things, unfortunately can begin to rear into an ugly head. Advocating also calls for diplomacy and knowing when to say what to who. I know that you did not mean any harm at all...you're new. But, watch around, above and below you and try not to make total enemies out of your co-workers; you may need them.

[dorselm]

Lori

Being a patient advocate does not mean every time a pt comes to you with a complaint you go to the supervisor about it. Like it was said before, there are two sides to every story and before you go advocating you should get both sides. If anything, you should have given a heads up to the nurse that the pt had a complaint and then maybe you would have had a chance to hear the nurses side. Its nice to know that you care for your patients which I think is why you'll do well as a nurse but girl, you gotta work with your co-workers and you never know, one day it may be you being complained about for something that you may not have done intentionally.

[CHATSDALE]

some pts really like to be the 'favorite' pt and when a nurse is busy and can't sit and talk or give special attention they get their feelings hurt

the pt that was left sitting up 'all day' this could range from neglect to the family considering two hours all day..even if you decided that the case warrented going to supervisor you should have asked what time she was placed in chair, when a return to bed was requested, dx anything pertinent so that the supervisor would have information to make a judgement

as for 'slamming med into iv' this would be very difficult to judge by patient or by a nurse that wasn't a witness some meds like k+ are very uncomfortable but proper dilution will help

talking with the nurse would not only be a courtesy to fellow worker but it would put a nurse with sloppy habits on alert to clean up their act

i hope that you continue to give good care and standing up for pts

[chadash]

I think I would have spoken to the nurses directly involved to give them a chance to remedy the circumstances, or clarify what really happened. It is important to comfort and help the patients, as well as help restore their confidence in the nurses involved. Think of yourself as a mediator of good will...

Of course, if there is evidence of real neglect or harm, or the nurses are not responsive to patient concerns, go to the supervisor. Additionally, sometimes I have approached my charge nurse to give her a heads up that the patient is not very happy, especially if I was the one who blew it. Let's face it, we all will displease someone one time or another, and I hope someone will give me the benefit of the doubt.

If the patient was left sitting up all day, you really have a problem there. But this might not be an individual nurse problem. Sounds like understaffing. That would be neglect.

[wildmountainchild]

I had a pt complain about me b/c I kept turning them.

"She was always in here flipping me from one side to the other. I just wanted to be on my back. I could never get to sleep!"

She had a stage four pressure ulcer on her coccyx!

She was paralyzed from the waist down and a bit wonky but imagine if a passing student took her complaint seriously and sent it up the ladder before checking w/ me first?

But I think you get the point.

Good luck.