Student nurse, What I saw very upset....

barefootlady, ADN, RN · Sep 30, 2005

I am sorry this patient was treated in such a uncaring, unkind manner. I am sorry you were a witness to this incident, but I feel very sure you will be a very vocal patient advocate when you are in the work place. I do not expect your instructor to do much reporting of this incident. The school will not make waves at the facility for fear of placing the program in danger. I think you should consider this your first taste of how patients can be assaulted and abused by physicians in todays healthcare settings and nurses are helpless to stop many abuses from taking place.

Please feel free to report this physicians conduct to the Medical Director of the facility, the Ethics Officer, and the State Board of Physician Licensure. I do not think without a patient complaint much action will be taken but it will be on record somewhere of his abuse. If you do report this it may have a negative effect on your standing at school also. Give careful consideration to your actions. Please seek some stress counselling and support. Even if you students just get together and chat, it will release pressure and form bonds between you students.

I wonder why no one considered this physician needed a consent to suture a tube in place. I was taught if it involved stitches, a consent was needed or it was a crime. Just a thought from my dim past.

I wish you luck and please do not let this stop you from seeing the good in nursing and most physicians really. Have better days.

crb613, BSN, RN · Sep 30, 2005

I just spoke to the director of my program & my instructor had reported this to her. There will be a meeting w/Director of Nsg. at this facility. Not sure who else will be there but I know my instructor & myself will be. They are very upset to put it mildly.........so I will see how it goes. Thank you all for your replies & support, I sure needed it! :icon_hug:

barefootlady, ADN, RN · Sep 30, 2005

I am truly surprised but happy this incident will be investigated and that your school is taking a positive patient advocate stance on this physicians behavior. I am sorry if I sounded judgemental regarding the stance your school and your instructor would take. I wish I had seem more positive patient advocates during my school days but I did not and that has jaded my attitude a bit.

One thing for sure, you will be a better nurse because of this experience. I wish you well. Let us know what happens with this matter.

crb613, BSN, RN · Sep 30, 2005

I am truly surprised but happy this incident will be investigated and that your school is taking a positive patient advocate stance on this physicians behavior. I am sorry if I sounded judgemental regarding the stance your school and your instructor would take. I wish I had seem more positive patient advocates during my school days but I did not and that has jaded my attitude a bit.
One thing for sure, you will be a better nurse because of this experience. I wish you well. Let us know what happens with this matter.

You did not come across as judgmental at all......just stating what you thought would happen. I posted to gain feedback & I appreciated all views. This is not the first time the director at my school has gone head to head w/incidents that were not right. She is very big on pt. rights & advocating for them & she is very protective of "her" students, but will tear your head off in a min. if you get out of line. I am interested to see if she just talks the talk or really walks the walk.I will let ya'll know how it turns out.

KatieBell · Oct 1, 2005

I'll be interested to see how it turns out. Seems to me that the Dr. was waaaay out of line. Using no lidocaine for a very quick stitch is maybe a judgement call, but explaining to the patient what is going on is not a judgement call.

You are definitely getting an education now!!! Congratulations. You are going to be a great patient advocate.

schwalmys8862 · Feb 10, 2006

can a student write up a doc??????????

Kim O'Therapy, BSN, RN · Feb 10, 2006

In some cases, the injected lidocaine may cause unwanted swelling, but they could always use some type of topical instead. This pt was treated horribly and that doc needs his crack cleaned out with a pointy-toed boot.

Exactly. If the physician could/would not numb the area, he/she could still have been kind, explained the procedure, and showed some compassion toward the patient.

crb613, BSN, RN · Feb 11, 2006

Just to update....my director of the nursing program & my clinical instructor did meet w/DON at the facility where this happened. There was quite a stir, the Doc was defended saying this was out of character for him.......which they did believe or accept.It was pointed out that that did not matter it did happen, & was totally unacceptable. The nurses involved were also brought up. I was put on another section of the med surg unit to finish my clinicals. I was told to always remember this & always be a patient advocate.

PJL · Feb 11, 2006

Good for you for speaking up! So often, in any situation, we stand by, afraid to speak up because someone might get "mad". The world would be a better place if more people were as brave as you!

MarySunshine · Feb 11, 2006

I also am really proud of you for speaking up (yay, future nurses!).

I have a little tale to tell. I work in neuro and I had a little demented old alzheimers patient who had a drain in her head. So, I'm in my other patient's room (next door) when I look over on what is the tale end of two doctors who walked into her room, didn't say so much as "how are you?" "kiss my ass" or ANYTHING (I would have heard them speaking) and proceded to pull a drain out of a very frightened lady's head. She was fighting and yelling "I'm sorry! I'm sorry! I didn't mean it!" and fighting with them (but she was very weak, so they just totally ignored that she was in any distress and went about their business).

So, after the commotion I run in there and I witness the one doctor holding down her hands with one arm and using his other arm to put staples in her head with a very large staple gun!!! She was red and screaming and crying and I'm sure those things hurt like crazy. Not once did either of them say a soothing word to her. They just did their thing like she was a crazed animal, not a human.

Sooo, by the time my brain recognized what exactly had just happened (it was like 2 minutes start to finish) I wasn't able to speak right then, I was so shocked. But I happened to have some iv fentanyl in my pocket (from the same pt. earlier) and I stepped in front of the one dr. who hadn't moved yet and shouldered him out of my way and gave her a small dose while trying my best to settle her down and comfort her. The doctors left and I got her calm and comfortable (it took a little while).

Well. I was shaking I was so mad. My temper was flaring and I was one inch away from screaming obscenities. But I thought better of it. I walked over to the main culprit and I said "In the future, please do not do a procedure like that without a nurse present. That was unnecessarily upsetting and painful for this woman. I don't think you would have done that if she was a family member of yours." All in a calm voice with full eye contact (or trying, he wouldn't make eye contact with me). I was so proud!

He said he used it, partially, as a "neuro assessment tool." HA! I said, "Well, I think that's very extreme." He ended up apologizing and saying he wouldn't do that again without a nurse (after multiple excuses that I shot down). To my knowledge he hasn't. Maybe I should have pushed it with the chain of command and all that, but neurosurgury = gods, so I was skeptical of that route. If he does anything like this again, I will push as hard as I can to stop him.

In retrospect I should have written down date, time and details for my own personal use (in case of another incident) and I should have discussed it throughly with my nurse manager (I was a brand new nurse). All the same, I'm glad I stood up to him. And really glad that I think it was effective. Most physicians are NOT so cruel. Good luck to you in your career -- unfortunately you'll probably see something similar again during it. Now you know what to do.

AtlantaRN, RN · Feb 11, 2006

THAT is just so WRONG!!!!!!

I'm so sorry that you had to witness such a brutal act, and I am so SORRY for that poor patient!!!!!!!!!!

Can it be reporting to the medical board? anonymously?

linda

SummerLPN · Feb 11, 2006

PLEASE choose your battles wisely. Speaking up can sometimes get you in a lot of trouble. You may have the instructor(s) on your side in private but you know things can and will do turn around sometimes. The schools and instructors have contracts with the facilities where clinicals are held. The schools officials will do whatever it takes to preserve those contracts. My last 3 months of nursing school were miserable for speaking up. On top of that, one of my instuctors was a close friend of the person who accused me of belittling the facility and the staff in the ER.

This is basically what happened. The night prior to my rotation to the ER, one of my kids arrived there at 8 pm with asthma trouble and a temp of 105. There were a few pt's who trickled in and I wondered why my child wasn't being seen. At 2:45, I told the registrar that I was leaving because I had been there 6 hours and had not been triaged yet; she could see the anger on my face. My child was seen at 3:30 am. They sent 6 staff members and some quality assurance people down to apologize. I refused to file a complaint. I made it home at 4:30am, took a brief nap, got up at 5:10, got my other kids ready to be dropped off at my parents' house and made the 35 minute drive (which took 25 this morning) back to clinicals at this hopsital. One of the male nurses recognized me and I told him I had just left about 2 hrs ago. Hours later, some friends met me in the ER to check on me and go to lunch. They asked me what happened in the confines of a room in the ER, a ladycalled me a "liar" and that no one has ever had a bad experience in HER ER ( I didn't know she was the ER director and wife of one of this facilities "A list doctors"). I told her that as a student nurse we cannot continue this discussion without things getting out of hand because she was one of my superiors. She asked me my name and my child. I told her. She left the room. I didn't know she looked up the information and called male nurse in. She found out the experience was true and the male nurse, who happened to still be there working a double, told the truth. He got fired. She was embarrassed and called one of my instructors, who just happened to be a close person friend of hers, unbeknownst to me of course. They shut down clinicals early. SHe went immediately to the dean of the school and I was told that she acted a fool! I was banned from clinicals and class for a week. They called me in supposedly for a meeting and asked me to write a letter of apology. FOr what? The school said for their sake I should do so to show her that I didn't mean to upset her, like she was some kind of toddler with a temper tantrum. (keep in mind I never said anything bad about the facility and what I DID say was only in the presence of the ER staff) I said I would write a letter but not of apology, which I did. I asked if they were going to kick me out of school or keep punishing me for telling the truth to questions that were being asked. They couldn't say anything. My other instructor replied, "I have gotten to know Summer quite well over the past year. She is honest even if would cost her everything she has worked hard for. If you keep on with this charade, I may as well quit." She also commented on how there were students in face-to-face confrontations with the other instuctors and nurses at the facility prior to this particular incident and no has ever gotten reprimanded in any way and that she wouldn't also allow ME to be anyone's scapegoat. Needless to say, I finished school, passed boards on the first try, and I'm gainfully employed. Of the 6 "pets" (you know those certain chosen few that one instructor has that she shows favoritism to), only ONE (1) has passed boards so far. We graduated at the beginning of May 2005! It is Feb 2006. She was forced to resign in September 2005. Isn't that KARMA!?

GO TO SCHOOL, DO WHAT IS REQUESTED OF YOU. NEVER GIVE YOUR PERSONAL OPINION BECAUSE YOU NEVER KNOW WHEN THINGS CAN TURN AROUND ON YOU. IF YOU HAVE TO GIVE YOUR OPINION, MAKE IT AS OBJECTIVE AS POSSIBLE *IF* POSSIBLE. NEVER, EVER DISCUSS YOUR VIEWS ON THE WAY YOU THINK THINGS SHOULD BE DONE WITH THE NURSES AT THE CLINICAL SITE. AND IF YOU ABSOLUTELY HAVE TO TO "GET AN UNDERSTANDING", PLEASE SAY IT IN THE FORM OF A QUESTION. THERE ARE NO DUMB QUESTIONS. Many of you may not agree with these things but this is what I was advised to do so you do not step on anyone's toes. And they got me out of last little bit of school.

P.S. The nurse who got fired did get his job back.